Entrustable Professional Activities in Postgraduate General Surgery Training: A Scoping Review.

Area of Science:

• Medical Education
• Surgical Training
• Competency-Based Assessment

Background:

• Entrustable Professional Activities (EPAs) link clinical competencies to trainee readiness for practice.
• The adoption of EPAs in postgraduate general surgery training is growing globally.
• Significant variations in EPA implementation necessitate a comprehensive overview.

Purpose of the Study:

• To provide an international overview of current Entrustable Professional Activity (EPA) utilization in general surgery training.
• To identify common EPAs and variations in their application across different training contexts.
• To explore barriers and facilitators associated with EPA integration in surgical curricula.

Main Methods:

• A scoping review was conducted using Arksey and O'Malley's 5-stage approach.
• The review incorporated PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols extension for scoping reviews) guidelines.
• Twenty-nine sources from published and grey literature were analyzed.

Main Results:

• EPAs are used in general surgery training across 11 international contexts (North America, South America, Europe, Asia, Africa, Australia).
• Substantial differences were observed in EPA scope, number, assessment tools, and sequencing.
• Eight distinct EPAs were common to over 80% of the reviewed contexts, with identified barriers and facilitators to integration.

Conclusions:

• The findings offer guidance for implementing and refining EPA-based assessment and curriculum design in surgical training.
• This review aids certification bodies, program directors, and institutions in optimizing EPA strategies.
• Data can inform the refinement of existing EPA programs and support new implementations globally.