Entrustable Professional Activities (EPAs) in General Surgery-From Inception to Implementation: A Scoping Review

Area of Science:

• Medical Education
• Surgical Training
• Competency-Based Education

Background:

• Entrustable Professional Activities (EPAs) represent a shift towards competency-based medical education.
• EPAs aim to define specific clinical tasks that trainees can perform under supervision.

Purpose of the Study:

• To review the conceptualization, development, implementation, and evaluation of EPAs in general surgery training.
• To identify gaps in the existing literature regarding EPAs in surgical education.

Main Methods:

• Systematic scoping review following PRISMA-S guidelines.
• Searched PubMed, Scopus, Embase, and Web of Science from inception to November 2025.
• Included original research, observational studies, commentaries, and letters on general surgery EPAs.

Main Results:

• 82 studies were included, showing EPA progression from concept to national implementation.
• High completion rates (80.8%) and practice-ready rates (99.6%) were observed.
• Correlations between EPA scores and Accreditation Council for Graduate Medical Education (ACGME) milestones exist, but heterogeneity in definitions and perception gaps persist.

Conclusions:

• EPAs are widely implemented in general surgery but require standardized definitions and validation.
• Gaps remain in bias mitigation and linking EPAs to surgical outcomes.
• Future research should focus on theory-driven validity frameworks and outcome-linked evaluations.