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Reframing entrustment through humanistic values: Entrustable Professional Activity-based assessment in the context of
Shih-Chun Lin1,2, Malcolm Koo3,4, Yi-Kung Lee5,6
1Department of Nursing, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.
Abstract:
Entrustable Professional Activities (EPAs) are widely used to operationalize competency-based education through workplace-based assessment. Although EPAs emphasize authentic clinical tasks, entrustment decisions are not value-neutral and inevitably reflect assumptions about professional competence and trust. This conceptual argument study examines the EPA-based assessment through the lens of Tzu Chi nursing education, a value-explicit healthcare context in which compassion, attentiveness to suffering, and moral responsibility are central to professional identity. We argue that entrustment decisions function not only as judgments of task readiness but also as sites where institutional humanistic values are enacted in everyday assessment practice. This article contributes by conceptualizing value-explicit healthcare systems as a distinct context for assessment design, translating humanistic values into entrustment decision-making practices, and proposing implementable narrative-based faculty language that preserves professional judgment without introducing additional scoring instruments. By focusing on entrustment decision-making rather than additional measurement tools, we propose how narrative justification and shared faculty language can support both assessment coherence and humanistic professional identity formation.
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