Entrustable professional activities for family and community medicine residency in the Brazilian context

ABSTRACT Introduction: Entrustable professional activities (EPAs) describe units of professional practice of a specialty and, therefore, fundamental to be offered as training by residency programs. EPAs for residency in Family and Community Medicine (FCM) have already been described in other countries. In Brazil there is still no description of these EPAs for the specialty. Objectives: Develop EPAs for FCM in the Brazilian context and validate them using the Delphi technique. Method: FCM experts and teachers with expertise in medical education analyzed the national competency matrices for FCM residency and the EPAs previously described in other countries for the specialty. This core group formulated EPAs considering the population’s health needs, the legislation of the Brazilian Unified Health System (SUS) and the specificities of FCM training in the country. FCM specialists with experience working in medical residency were invited to form a Delphi panel to evaluate the proposed EPAs. A Content Validation Index of 80% was considered for consensus. Results: 14 EPAs were defined by the core group. The Delphi panel consisted of a group of 24 preceptors and program supervisors, with an average length of experience as educators in FCM residency of eleven years. It took two rounds to establish the consensus and all 14 EPAs were approved. Discussion: Brazil has specificities related to its population and the health system organization that differentiate it from countries where EPAs for FCM have been described. There is a uniqueness in FCM training in the country, with the need to develop local EPAs. This was demonstrated by the need to formulate EPAs considering operations in health care networks, addressing vulnerabilities and health care considering the operation territory. Conclusion: This study describes a proposal for the development and validation of EPAs for the Family and Community Medicine residency in Brazil. The specification of these activities has the potential to support the orientation of residency programs in the specialty and reduce differences in FCM training in the country.