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Entrustable Professional Activities for Newly Graduated Physician Associates: Validation Through a Modified Delphi

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A validated framework of 12 Entrustable Professional Activities (EPAs) was developed for physician associate (PA) graduates. This framework supports competency-based medical education (CBME) and readiness-to-practice assessments.

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Area of Science:

  • Medical Education
  • Physician Associate Studies
  • Competency-Based Medical Education (CBME)

Background:

  • Entrustable Professional Activities (EPAs) define observable tasks for medical trainees.
  • Existing EPA frameworks exist for physicians, but not specifically for physician associates (PAs).
  • A validated EPA framework is needed for newly graduated PAs to ensure readiness-to-practice.

Purpose of the Study:

  • To develop and validate a profession-specific EPA framework for physician associate (PA) graduates.
  • To align EPAs with national PA competencies and accreditation standards.
  • To establish a structured approach for assessing PA graduate readiness.

Main Methods:

  • A modified Delphi study involving 35 experts in PA education and practice.
  • Development of 21 initial EPAs based on existing frameworks and 2020 PA Competencies.
  • Iterative survey rounds using Qualtrics, retaining EPAs with ≥75% expert consensus and refining language based on qualitative feedback.

Main Results:

  • Twelve EPAs achieved expert consensus, all reaching "Strongly Agree" levels.
  • The 12 EPAs were organized into 5 domains: Core Clinical Skills, Critical Thinking/Reflective Practice, Interconnected Clinical Skills, Proactive Patient Care, and Communication/Cultural Awareness.
  • Participants in the study represented diverse roles, specialties, and geographic regions.

Conclusions:

  • A validated, profession-specific EPA framework for PA graduates has been established.
  • The 12 EPAs support Competency-Based Medical Education (CBME), accreditation standards, and national PA competencies.
  • This framework can guide readiness-to-practice assessments, curriculum development, and faculty training for PAs.