Considerations in building a curriculum using entrustable professional activities

Competency-based education of health professionals has been gaining momentum across the globe for the past two decades. The central tenet is to start with the outcomes that are required of a trainee to meet the health care needs of the public. These outcomes lead to the elaboration of requisite competencies, which in turn drive the curriculum and assessment programs. Educators have encountered many challenges in the development and implementation of curricula and assessment systems that effectively teach and measure performance of the requisite competencies. Entrustable professional activities (EPAs) offer an excellent framework for addressing many of those challenges.

In this chapter, we offer the unique potential of an EPA framework in promoting a competency-based curriculum. We review some of the curricular structural implications of using EPAs, including the role of sequencing of EPAs in the curriculum, describe how an EPA-based curriculum adds agency to the trainee’s journey, and explore the notion of time-variability in competency-based education and training based on success stories using an EPA framework. We conclude that a well-designed curriculum and assessment system using EPAs provides an excellent foundation for ensuring health professionals’ readiness to provide safe and effective care within the scope of their discipline and at the appropriate level of supervision.