Entrustable Professional Activities in Dutch General Surgical Training: Perspectives of Surgeons and Trainees

In 2009 a competency based curriculum was implemented in the Netherlands with a focus on competency-based medical education. This program utilized entrustable acts (i.e., Entrustable Professional Activities, EPAs) to provide a framework for teaching and assessing competencies.

To investigate the use of EPAs in the Dutch general surgical training program, interviews were conducted with both surgeons and trainees across the Netherlands. Inductive thematic analysis was used to analyze interviews.

8 surgeons and 8 trainees were interviewed across the Netherlands. Four major themes were identified: (1) Perceived ease of use (A "seamless system", and strong user engagement), (2) Perceived usefulness (An accurate reflection of skill, that can lead to entrustment and progressive autonomy), (3) Attitude towards use (Both surgeons and trainees praise EPAs,) and (4) Actual use (Realtime assessment and feedback that is both surgeon and trainee initiated).

In Dutch surgical training, EPAs are valued for creating a shared learning model, assessment of competency, and progressing trainee autonomy. Whilst non-operative competencies remain difficult to supervise, EPAs provide a reliable way of linking a trainee's day-to-day performance with competencies, thus supporting a competency-based surgical training program.