Development of an Interprofessional Teamwork Entrustable Professional Activity for Addiction Medicine and Addiction Psychiatry Fellows

BACKGROUND: Substance-use disorders (SUD) require collaborative, multi-specialty care. While graduate medical education (GME) fellowships in addiction medicine (AM) and addiction psychiatry (AP) prepare trainees for interprofessional collaborative care, standard Accreditation Council for Graduate Medical Education milestones lack a mechanism to directly observe and assess competence in providing interprofessional team-based care. OBJECTIVE: To develop and pilot an entrustable professional activity (EPA) focused on interprofessional team-based care applicable to both AM and AP fellowships. METHODS: Using a systematic 3-step consensus process, a multidisciplinary faculty team mapped overlapping AM and AP milestones across 6 Accreditation Council for Graduate Medical Education core domains to identify those related to interprofessional work. Key functions and a scoring instrument to measure them were developed by an iterative consensus process. The team then drafted an Interprofessional EPA listing foundational milestones and related functions alongside descriptions of expected behaviors at 3 developmental levels. RESULTS: The EPA was piloted with faculty and fellows. Initial implementation faced barriers regarding faculty uptake due to competing demands. Based on faculty feedback, the EPA was transitioned from a summative scale to a formative tool utilizing narrative summaries to enhance real-time feedback and support milestone reporting. CONCLUSIONS: This EPA provides a structured approach to assess essential, observable interprofessional clinical skills. By shifting to a formative framework, the tool facilitates low-stakes feedback and fosters cross-disciplinary learning. As there is a national push to incorporate EPAs into trainee assessments, this process can inform other residency and fellowship training programs nationally in implementing similar frameworks.