Implementing entrustable professional activities in a pre-certification medicine program: the Macquarie University approach

Purpose The incorporation of Entrustable Professional Activities (EPAs) into pre-certification medical education programs remains a subject of debate. The Macquarie Doctor of Medicine (Macquarie MD), a four-year program culminating in graduates becoming eligible to commence an internship in Australia, was designed with a programmatic assessment framework that integrates EPAs within a comprehensive capability development design that includes the aggregation of multiple low-stakes assessment data into an assessment portfolio. The purpose of this project was to evaluate the effectiveness of EPA integration within the Macquarie MD program. Design/methodology/approach A mixed-methods design was used. Detailed reporting is provided on the decision-making processes underlying EPA implementation within the assessment framework. Quantitative data were obtained from student assessment outcomes across multiple cohorts. Qualitative insights were gleaned through surveys of students and clinical supervisors. Findings Analysis of outcome data from four graduating cohorts (n = 224) demonstrated that 95% of students achieved the standards necessary for internship eligibility in Australia, receiving either an “Available” or “React” supervision rating for all Stage 2 EPAs. Feedback from clinical staff and students indicated that both the overall assessment scheme and the inclusion of EPAs were positively received. Practical implications EPAs can be effectively implemented in a pre-certification medical education program. Inclusion of EPAs in the assessment framework is rated positively by students and clinicians. Graduates can meet the required EPA supervision levels for practice as an Intern in Australia. Originality/value The implementation of EPAs in a pre-certification medical program provided focused attention on core clinical tasks, fostering student confidence and supporting the development of trust with clinical supervisors in preparation for future clinical responsibilities.