Developing a Framework of Entrustable Professional Activities for Residency Training in Hematology

Area of Science:

• Medical Education
• Hematology Training
• Competency-Based Assessment

Background:

• Entrustable Professional Activities (EPAs) are crucial for assessing trainee readiness for independent patient care.
• Existing EPA models require adaptation to specific national training systems and clinical contexts.

Purpose of the Study:

• To develop a context-specific EPA framework for hematology residency training in China.
• To establish a validated tool for competency-based assessment in Chinese hematology programs.

Main Methods:

• A modified Delphi method involving 35 experts from 8 academic hospitals.
• Systematic literature review integrating international EPA models with China's Standardized Training System for Residents (STSR).
• Structural validation using the EQual rubric and two-round Delphi consultations to assess EPA importance, observability, and feasibility.

Main Results:

• A 12-item EPA framework was finalized after expert review and consensus.
• EPAs achieved unanimous EQual compliance (≥4.07) and strong Delphi consensus (Kendall's W: Round 2 = 0.529, p<0.001).
• Clinical entrustment-supervision levels were stratified by training phase and expected competency.

Conclusions:

• China's first hematology-specific EPA framework was established, integrating local clinical demands and international best practices.
• The framework provides a validated tool for competency-based assessment in hematology residency.
• Future work includes digital implementation and nationwide validation of the EPA framework.