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Defining Practice Ready: Ensuring Training and Certification Are Designed to Meet Patient Needs.
Ariel S Winn1, Meghan O'Connor2, Megan Aylor3
1Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts.
Pediatrics
|May 21, 2026
Summary
Pediatric trainees must demonstrate competence in essential activities (EPAs) for certification. A "practice ready" pediatrician provides safe, effective care in a collaborative setting, not necessarily independent practice.
Area of Science:
- Medical Education
- Pediatrics
- Professional Competency
Background:
- Graduate medical education ensures trainees are "practice ready" to meet patient needs.
- The American Board of Pediatrics (ABP) will require attestation of Entrustable Professional Activities (EPAs) for certification starting in 2028.
- Defining "practice ready" requires clarity on performance standards for EPAs in real-world settings.
Purpose of the Study:
- To clarify the definition of a "practice ready" trainee.
- To operationalize the ABP's commitment to public safety in pediatric certification.
- To establish performance benchmarks for essential pediatric activities.
Main Methods:
- Defining "practice ready" as providing safe and effective care without assigned supervision in a collaborative practice.
- Introducing and applying a supervision scale to case examples.
- Analyzing the nuances of help-seeking and collaboration versus independence.
Main Results:
- A "practice ready" pediatrician can deliver safe, effective care within a collaborative practice environment.
- The concept of "practice ready" emphasizes appropriate help-seeking and collaboration.
- A supervision scale provides a framework for assessing trainee performance.
Conclusions:
- Clear performance standards are crucial for pediatric graduate medical education and certification.
- The ABP's implementation of EPAs requires a nuanced understanding of "practice ready" competence.
- Future efforts should focus on ensuring new pediatricians meet patient needs effectively in practice.
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