Entrustable Professional Activities for Emergency Medicine Specialists

Abstract Background Various countries have developed competency frameworks for postgraduate training programs. Identifying Entrustable Professional Activities (EPAs) that are core clinical activities could bridge the gap between competencies and clinical practice. We aim to define essential EPAs required for safe independent practice as an Emergency Medicine (EM) Specialist, aligned with curricular outcomes from the International Federation for Emergency Medicine (IFEM) model curriculum for undergraduate, postgraduate and continuing professional training. Methods A nominal group of six members used consensus methodology to generate and rate essential EPAs for safe, independent practice as an EM specialist. Using existing literature on EPAs and IFEM curricular documents, the nominal group generated and clarified ideas for potential EPAs. Feedback was obtained from the IFEM Core Curriculum and Education committee, which comprises representatives from countries across all six IFEM regions, and integrated with iterative revisions. The EQual: Queen’s EPA Quality Rubric were used to rate how essential each EPA was for safe practice and the quality of each EPA. This approach is more rigorous as it allows for examination of the quality of EPAs generated and how well they align with the key domains of the EPA construct. Results A total of five EPAs were selected and refined from twenty-nine proposed EPAs. The five EPAs were: EPA 1 (Patient resuscitation), EPA 2 (Adult and/or paediatric non-resuscitative emergency care), EPA 3 (Managing multiple emergency patients), EPA 4 (Maintaining quality emergency care), and EPA 5 (Teaching emergency staff). All EPAs were directly mapped to the IFEM model curriculum to ensure relevancy and reliability. They were then rated using the EQual rubrics, with all five EPAs faring excellently and achieving overall median scores of more than four. Conclusion Five EPAs were identified and evaluated to show their importance as essential EPAs required for safe, independent practice as an EM specialist. These EPAs represent a promising framework of EPAs which will serve as a guide for individual countries to develop individual EPAs for training.