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Perspectives on Medical Education
Published in: Perspectives on Medical Education 4/2021

Open Access 01-08-2021 | Original Article

Benefits of EPAs at risk? The influence of the workplace environment on the uptake of EPAs in EPA-based curricula

Authors: Karsten Arthur van Loon, Linda Helena Anna Bonnie, Nynke van Dijk, Fedde Scheele

Published in: Perspectives on Medical Education | Issue 4/2021

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Abstract

Introduction

Entrustable Professional Activities (EPAs) have been applied differently in many postgraduate medical education (PGME) programmes, but the reasons for and the consequences of this variation are not well known. Our objective was to investigate how the uptake of EPAs is influenced by the workplace environment and to what extent the benefits of working with EPAs are at risk when the uptake of EPAs is influenced. This knowledge can be used by curriculum developers who intend to apply EPAs in their curricula.

Method

For this qualitative study, we selected four PGME programmes: General Practice, Clinical Geriatrics, Obstetrics & Gynaecology, and Radiology & Nuclear Medicine. A document analysis was performed on the national training plans, supported by the AMEE Guide for developing EPA-based curricula and relevant EPA-based literature. Interviews were undertaken with medical specialists who had specific involvement in the development of the curricula. Content analysis was employed and illuminated the possible reasons for variation in the uptake of EPAs.

Results

An important part of the variation in the uptake of EPAs can be explained by environmental factors, such as patient population, the role of the physician in the health-care system, and the setup of local medical care institutions where the training programme takes place. The variation in uptake of EPAs is specifically reflected in the number and breadth of the EPAs, and in the way the entrustment decision is executed within the PGME programme.

Discussion

Due to variation in uptake of EPAs, the opportunities for trainees to work independently during the training programme might be challenging. EPAs can be implemented in the curriculum of PGME programmes in a meaningful way, but only if the quality of an EPA is assessed, future users are involved in the development, and the key feature of EPAs (the entrustment decision) is retained.
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Metadata
Title
Benefits of EPAs at risk? The influence of the workplace environment on the uptake of EPAs in EPA-based curricula
Authors
Karsten Arthur van Loon
Linda Helena Anna Bonnie
Nynke van Dijk
Fedde Scheele
Publication date
01-08-2021
Publisher
Bohn Stafleu van Loghum
Published in
Perspectives on Medical Education / Issue 4/2021
Print ISSN: 2212-2761
Electronic ISSN: 2212-277X
DOI
https://doi.org/10.1007/s40037-021-00658-9

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