title: The case for use of entrustable professional activities in undergraduate medical education.
abstract: Many graduate medical education (GME) programs have started to consider and adopt entrustable professional activities (EPAs) in their competency frameworks. Do EPAs also have a place in undergraduate medical education (UME)? In this Perspective article, the authors discuss arguments in favor of the use of EPAs in UME. A competency framework that aligns UME and GME outcome expectations would allow for better integration across the educational continuum. The EPA approach would be consistent with what is known about progressive skill development. The key principles underlying EPAs, workplace learning and trust, are generalizable and would also be applicable to UME learners. Lastly, EPAs could increase transparency in the workplace regarding student abilities and help ensure safe and quality patient care. The authors also outline what UME EPAs might look like, suggesting core, specialty-specific, and elective EPAs related to core clinical residency entry expectations and learner interest. UME EPAs would be defined as essential health care activities with which one would expect to entrust a resident at the beginning of residency to perform without direct supervision. Finally, the authors recommend a refinement and expansion of the entrustment and supervision scale previously developed for GME to better incorporate the supervision expectations for UME learners. They suggest that EPAs could be operationalized for UME if UME-specific EPAs were developed and the entrustment scale were expanded.
authors.affiliation: Dr. Chen is professor of clinical pediatrics, Department of Pediatrics, University of California, San Francisco, School of Medicine, San Francisco, California. Dr. van den Broek is a PhD candidate in medical education, University Medical Center Utrecht, Utrecht, the Netherlands. Dr. ten Cate is professor of medical education and director, Center for Research and Development of Education, University Medical Center Utrecht, Utrecht, the Netherlands, and adjunct professor of medicine, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California.
authors.forename: H Carrie
authors.initials: HC
authors.lastname: Chen
authors.forename: W E Sjoukje
authors.initials: WE
authors.lastname: van den Broek
authors.forename: Olle
authors.initials: O
authors.lastname: ten Cate
mesh_terms: D004503:Education, Medical, Graduate; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D007396:Internship and Residency; D007858:Learning; D011361:Professional Competence; D011785:Quality Assurance, Health Care; D014481:United States