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This study aimed to develop specific Entrustable Professional Activities (EPAs) for undergraduate Oral and Maxillofacial Surgery (OMFS) training and assess their quality and reliability.

April 26, 2026BMC Medical Education0 citationsOpen Access

Bridging competency gaps: developing entrustable professional activities for undergraduate oral and maxillofacial surgery training

DSDr Saima SiddiquiHamdard University SHSonia Ijaz HaiderDow University of Health Sciences RJRafey Ahmad Jameel

Key Points

This study aimed to develop specific Entrustable Professional Activities (EPAs) for undergraduate Oral and Maxillofacial Surgery (OMFS) training and assess their quality and reliability.
Developed a set of 10 EPAs using a consensus-generating mixed-methods design with a purposive expert panel of 10.
Employed the Nominal Group Technique for EPA generation and structured rating on a 5-point Likert scale.
Evaluated EPA quality using the 14-item EQual rubric and analyzed data with descriptive statistics and inter-rater reliability measures.
Achieved a consensus of 9/10 for history-taking, diagnostic testing, informed consent, and non-surgical care; lower consensus for others like preventive care (3/10).
Eight out of ten EPAs were deemed satisfactory, while orofacial pain management and preventive/follow-up care EPAs required further refinement based on expert feedback.
Overall mean EQual scores were between 4.26 and 4.41, indicating high reliability (Cronbach's alpha = 0.89) and excellent dependability (phi = 0.987 for specialists).

Abstract

Entrustable Professional Activities (EPAs) translate competency domains into observable clinical tasks and support workplace-based assessment in undergraduate Oral and Maxillofacial Surgery (OMFS). This study aimed to develop a context-specific set of OMFS EPAs for final-year BDS students and evaluate their quality and reliability using the Queen’s EQual rubric. A consensus-generating mixed-methods design was employed using a purposive expert panel (n = 10). The Nominal Group Technique was used to generate and prioritise EPAs, followed by structured rating on a 5-point Likert scale and iterative refinement. EPA quality was evaluated using the 14-item EQual rubric. Analyses included descriptive statistics, Cronbach’s alpha, generalizability theory (phi coefficient), and intraclass correlation coefficients (ICC). Ten experts (60% male; five specialists, four general dentists, and one medical educationist) completed all study phases. Ten EPAs were developed. The highest consensus (9/10) was achieved for history-taking, diagnostic testing and imaging, informed consent, and non-surgical care, whereas lower consensus was observed for preventive and follow-up care (3/10) and orofacial pain and anxiety management (4/10). Most EPAs (8/10) were judged by a majority as not requiring revision; however, the EPAs addressing orofacial pain and anxiety management and preventive and follow-up care were most frequently identified for refinement (n ≥ 6; mean ratings 3.60 and 3.40, respectively). All EPAs exceeded the predefined EQual cut score (4.07), with overall mean scores ranging from 4.26 to 4.41 (SD 0.16–0.23) and high internal consistency (Cronbach’s alpha = 0.89). Reliability evidence indicated excellent dependability (phi = 0.987 for specialists; 0.888 for general dentists) and strong inter-rater agreement (ICC = 0.969 95% CI 0.914–0.996 for specialists; 0.964 0.900–0.996 for general dentists; p < 0.001). A 10-item EPA framework for undergraduate OMFS demonstrated acceptable structural quality and strong reliability. Refinement priorities were identified for EPAs related to preventive and follow-up care and orofacial pain and anxiety management. This framework provides a structured basis for workplace-based assessment and curriculum alignment in undergraduate OMFS training.

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