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Entrustable Professional Activities (EPAs) can support or hinder self-regulated learning in clinical training. Trainees adapt their use of EPAs over time, with discussions with supervisors being key to effective learning.

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Area of Science:

  • Medical Education
  • Professional Development
  • Self-Regulated Learning

Background:

  • Entrustable Professional Activities (EPAs) are proposed to enhance clinical learning.
  • Concerns exist regarding potential negative impacts, such as 'checkbox behavior'.
  • The interplay between EPAs and self-regulated learning (SRL) in clinical settings requires further investigation.

Purpose of the Study:

  • To explore how general practice (GP) trainees utilize EPAs within their clinical environment.
  • To understand whether EPAs facilitate or impede trainee learning through the framework of SRL theory.

Main Methods:

  • Constructivist grounded theory methodology was employed.
  • A purposive and theoretical sample of GP trainees participated in interviews.
  • Constant comparative analysis guided data collection and analysis.

Main Results:

  • Trainees' use of EPAs evolved through three stages: adaptation, taking control, and "checking the boxes."
  • EPAs were most beneficial during the "taking control" phase.
  • EPAs hindered SRL in later stages due to perceived bureaucracy and misaligned learning goals, though supervisor discussions proved beneficial.

Conclusions:

  • EPAs present a dual potential to both aid and obstruct SRL in clinical training.
  • The effectiveness of EPAs is dynamic and changes as trainees progress.
  • Supervisors play a crucial role in helping trainees navigate and optimize the use of EPAs for learning.