From Competency to Entrustment: An Innovative Curricular Model for Physical Therapist Education

The transition to competency-based education (CBE) and entrustable professional activities (EPAs) reflects a growing emphasis on learner outcomes and clinical readiness. Despite this paradigm shift, few physical therapist education programs have operationalized these frameworks. This method/model presentation describes the development of a Competency- and Entrustment-Based Education (CEBE) model in a hybrid Doctor of Physical Therapy program designed to prepare workforce-ready graduates.

Thirteen faculty members collaboratively designed the CEBE curriculum, using backward design and 8 guiding educational principles, including case-based learning, academic coaching, integrated content delivery, and flipped classrooms. Through iterative peer review, they defined 7 Domains of Competence (DOCs), related competencies, and 10 EPAs. Distinct scales were developed to assess both competence and entrustment levels.

Faculty and 52 external clinicians provided feedback through a Likert-style survey to validate the framework. Most DOCs and EPAs received strong agreement ratings, reflecting strong perceived relevance to entry-level practice. External feedback led to minor revisions, especially within the Practice Management and Stewards of Societal Health domains. Based on stakeholder feedback, 3 EPAs were removed, 1 added, and 1 reinstated.

This CEBE model offers a feasible, learner-centered framework for developing and assessing progressive competence and entrustment. Its innovative design promotes learner autonomy, aligns with current clinical standards, and responds to broader health system needs. Lessons from this implementation may guide broader adoption of CBE and EPA frameworks across the profession. Future work will focus on longitudinal implementation outcomes and interinstitutional collaboration to refine CEBE in physical therapist education.