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Related Concept Videos

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Nursing Implementation

Implementation is the execution of the nursing care plan developed during the planning phase.
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Purposive Learning01:22

Purposive Learning

E. C. Tolman emphasized the purposiveness of behavior — the idea that much of our behavior is goal-directed. For instance, employees who aim for a promotion work diligently to meet their targets. Tolman argued that when classical conditioning and operant conditioning occur, the organism acquires certain expectations. In classical conditioning, a child might fear a dog because they expect it to bite. In operant conditioning, a person might consistently work overtime because they expect a bonus...
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Role-Based Identity01:21

Role-Based Identity

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Nursing Process for Patient and Caregiver Teaching I: Assessment and Diagnosis

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  3. Understanding Curriculum Implementation With Entrustable Professional Activities Through The Lens Of Normalization Process Theory.
  1. Home
  3. Understanding Curriculum Implementation With Entrustable Professional Activities Through The Lens Of Normalization Process Theory.

Related Experiment Videos

Understanding Curriculum Implementation with Entrustable Professional Activities Through the Lens of Normalization

Marije P Hennus1, Roberta I Ladenheim2, H Carrie Chen3

  • 1Department of Pediatric Intensive Care, University Medical Center Utrecht, Utrecht, The Netherlands.

Perspectives on Medical Education
|June 15, 2026

View abstract on PubMed

Summary
This summary is machine-generated.

Competency-based medical education (CBME) implementation faces challenges. Entrustable Professional Activities (EPAs) show varied adoption, but Normalization Process Theory (NPT) explains how to integrate them effectively into practice.

Related Experiment Videos

Area of Science:

  • Medical Education Research
  • Implementation Science

Background:

  • Competency-based medical education (CBME) adoption is widespread but faces practical implementation hurdles.
  • Entrustable Professional Activities (EPAs) are key to operationalizing CBME, yet their implementation varies significantly across different educational contexts.

Purpose of the Study:

  • To analyze the uptake, enactment, and sustainability of EPA-based curriculum reforms using Normalization Process Theory (NPT).
  • To understand the mechanisms driving variation in EPA implementation across diverse international settings.

Main Methods:

  • A comparative, theory-informed analysis of implementation experiences from five global regions.
  • Data collected via pre-symposium surveys, presentations, plenary discussions, and follow-up reflections from an international EPA symposium.

Main Results:

  • Implementation challenges included conceptual ambiguity, variable stakeholder engagement, workflow pressures, and misalignment with existing practices.
  • Enabling factors for successful EPA implementation comprised clear communication, phased strategies, faculty development, leadership support, and context-specific adaptations.

Conclusions:

  • Normalization Process Theory (NPT) provides a valuable framework for analyzing and understanding the complexities of implementing EPA-based CBME reforms.
  • Focusing on implementation mechanisms, rather than solely outcomes, offers a transferable approach to guide, evaluate, and refine curriculum innovations in medical education.