Rethinking Informed Consent as an EPA in Surgery.

Area of Science:

• Medical Education
• Surgical Training
• Competency-Based Education

Background:

• Entrustable Professional Activities (EPAs) are key in competency-based medical education.
• Informed consent is explored as a specific EPA in surgical residency.
• Cultural context is crucial for understanding trust and entrustment.

Purpose of the Study:

• To examine informed consent as an EPA in surgical residency.
• To reevaluate trust and entrustment decisions within a cultural framework.
• To compare EPA frameworks with traditional training methods like role modeling.

Main Methods:

• Commentary and conceptual analysis.
• Exploration of cultural influences on medical training.
• Discussion of faculty role modeling and professional identity formation.

Main Results:

• Formal EPA frameworks may not always be superior to role modeling and professional identity formation.
• Cultural context significantly impacts the effectiveness of EPAs.
• Transferring entrustment concepts from undergraduate to graduate medical education requires caution.

Conclusions:

• EPAs are most effective when tailored to the local culture of a specific specialty and program.
• Faculty should leverage role modeling and professional identity formation alongside or instead of formal EPAs.
• A nuanced approach is needed when implementing entrustment principles in graduate medical education.