Entrustable Professional Activities for Emergency Medicine specialists

Various countries have developed competency frameworks for postgraduate training programs. Identifying Entrustable Professional Activities (EPAs) that are core clinical activities could bridge the gap between competencies and clinical practice. We aim to define core EPAs required for safe independent practice as an Emergency Medicine (EM) Specialist, aligned with curricular outcomes from the International Federation for Emergency Medicine (IFEM) model curriculum for postgraduate training and existing EPAs from IFEM member countries to demonstrate the value such core documents bring to training and practice. A nominal group of six members used consensus methodology to generate and rate essential EPAs for safe, independent practice as an EM specialist. Using existing literature on EPAs and IFEM curricular documents, the nominal group generated and clarified ideas for potential EPAs. Feedback was obtained from the IFEM Core Curriculum and Education committee, which comprises representatives from countries across all seven international regions, and integrated with iterative revisions. The EQual: Queen’s EPA Quality Rubric were used to rate how essential each EPA was for safe practice and the quality of each EPA. This approach is more rigorous as it allows for examination of the quality of EPAs generated and how well they align with the key domains of the EPA construct. A total of five core EPAs were selected and refined from seventeen proposed EPAs. The five EPAs were: EPA 1 (Patient resuscitation), EPA 2 (Adult and/or paediatric non-resuscitative emergency care), EPA 3 (Managing multiple emergency patients), EPA 4 (Maintaining quality emergency care), and EPA 5 (Teaching emergency staff). All core EPAs were directly mapped to the IFEM model curriculum to ensure relevancy and reliability. Rating with the EQual rubrics showed all five EPAs faring excellently, achieving overall median scores of more than four. Five EPAs were identified and evaluated to show their importance as core EPAs required for safe, independent practice as an EM specialist. These EPAs can serve as a guide for individual countries to develop EPAs for training.