Enhancing dermatology education: entrustable professional activities for undergraduate clerkships

Skin conditions affect about two billion people worldwide. Nondermatologist physicians often struggle to diagnose and manage these conditions effectively. Medical students perceive inadequate dermatology training that hinders competent care delivery. In resource-limited settings such as Pakistan, structured dermatology clerkships are scarce, emphasizing the need to equip physicians with essential skin pathology management skills. This study aimed to develop entrustable professional activities (EPAs) for final-year Bachelor of Medicine, Bachelor of Surgery students completing dermatology clerkships. Competencies, supervision levels and assessment strategies associated with these EPAs were also identified.

To establish consensus on EPAs for undergraduate dermatology clerkships, including competencies (knowledge, skills and attitudes), assessment strategies and supervision levels.

A modified Delphi method with three iterative rounds was used. Expert opinions were gathered through online questionnaires distributed to 42 dermatology consultants across Pakistan. Consensus was achieved by excluding items not meeting the predefined criteria. Response stability was assessed in the final round.

After three rounds, consensus was reached on 6 EPAs, encompassing 42 competencies and assessment strategies. Five EPAs aimed at 'level 3a' supervision, addressing key aspects of dermatology practice. The clerkship duration of 4 weeks received the majority agreement and overall stability was high for EPAs and competencies.

This study establishes a comprehensive competency-based framework for undergraduate dermatology education, contributing to a competency-based approach for training and assessment. The identified EPAs can align with existing clerkship objectives, enhancing dermatology curriculum effectiveness.