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    Entrustable Professional Activities (EPAs) in surgical residency require careful consideration of program culture. Faculty role modeling and professional identity formation may be more effective than formal EPAs for teaching values-based skills.

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    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.