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Residents' Experiences of Learning, Working, and Developing in Entrustable Professional Activity-Based Training.

Maaike P Smit1, Janiëlle A E M van der Velden2, Reinoud J B J Gemke3

  • 1Erasmus MC-Sophia Children's Hospital, Department of Neonatal & Pediatric Intensive Care, Division of Pediatric Intensive Care, University Medical Center Rotterdam, The Netherlands.

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Paediatric residents gain confidence and autonomy in Entrustable Professional Activity (EPA) programs, though some find Clinical Competence Committee evaluations challenging. Making Self-Regulated Learning principles explicit can enhance training.

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Area of Science:

  • Medical Education
  • Pediatric Residency Training
  • Competency-Based Medical Education

Background:

  • Entrustable Professional Activity (EPA)-based programs aim to structure residency training with flexibility and increasing autonomy.
  • Understanding residents' lived experiences within EPA frameworks is crucial for optimizing learning and development.

Purpose of the Study:

  • To explore paediatric residents' experiences of learning, working, and professional development within an EPA-based training program.
  • To identify factors influencing resident learning and autonomy in EPA-structured curricula.

Main Methods:

  • Qualitative study employing semi-structured interviews with 11 paediatric residents.
  • Data analyzed using template analysis to identify key themes in resident experiences.

Main Results:

  • Residents reported increased confidence and competence, linking it to EPA structure (goal setting, feedback) or clinical experience.
  • The entrustment process, including Clinical Competence Committee feedback, was reassuring but sometimes uncomfortable.
  • Post-entrustment, residents experienced varied supervision and some felt empowered for individualized learning.

Conclusions:

  • Explicitly integrating Self-Regulated Learning principles into EPA programs can enhance resident learning and preparedness for independent practice.
  • Addressing resident discomfort with group evaluation and standardizing supervision practices are important considerations for EPA-based training.