A multi-method approach to drafting candidate entrustable professional activities for a general internal medicine...

Area of Science:

• Medical Education
• Competency-Based Medical Education
• Internal Medicine Training

Background:

• Entrustable Professional Activities (EPAs) are key components of modern postgraduate medical training, representing daily clinical tasks trainees must master.
• Developing a comprehensive EPA framework for a national training program requires a robust methodology and deep understanding of the concept.
• General Internal Medicine (GIM) training programs internationally are increasingly adopting EPAs.

Purpose of the Study:

• To describe the methodology and results of a multi-step process for creating a list of candidate EPAs for Switzerland's GIM postgraduate training.
• To establish a validated list of EPAs suitable for GIM residency programs.

Main Methods:

• A systematic literature review was conducted to identify existing EPAs.
• Four national focus groups engaged stakeholders to gather input.
• A national consensus process using the RAND appropriateness method and EQual criteria was employed for validation.

Main Results:

• A list of 247 candidate EPAs for GIM was generated and submitted for consensus.
• Following two rounds of expert rating, 225 EPAs were deemed appropriate for GIM postgraduate training.
• Only 22 EPAs were deemed inappropriate, with persistent disagreement on just two.

Conclusions:

• This study presents a validated, comprehensive list of EPAs for GIM postgraduate training in Switzerland.
• The detailed methodology offers a transferable model for developing or revising EPA lists in other medical specialties or countries.
• The findings support the integration of EPAs into competency-based medical education frameworks for enhanced physician training.