The Association of Faculties of Medicine of Canada (AFMC) has developed 12 Entrustable Professional Activities (EPAs) for Undergraduate Learners.
The goal of EPAs is to define regular clinical activities — such as taking a history and performing a physical examination, or formulating and implementing a management plan — that a student would be expected to exhibit competence in prior to graduation and the start of residency training, and to assess and give feedback to learners based on these activities.
The 12 EPAs are to be implemented by all Canadian medical schools to ensure a common frame of reference outlining what residency program directors can expect of an incoming Canadian medical graduate.
What is an EPA?
Entrustable Professional Activities (EPAs) are responsibilities that learners can be entrusted to do without direct supervision by the time they enter residency.
An EPA:
- is a discrete, time-limited task a learner can be observed performing.
- is designed to be directly observed by faculty who document the encounter and provide corrective coaching in the moment.
- does not represent a pass/fail decision, but is a simple record of what was observed in the moment.
When faculty are observing a learner performing an EPA, they are asked to capture their observations through the UGME EPA app. Many such observations will be put together to form an overview of the learner's performance.
EPA App
- easy to use
- offers voice-to-text to transcribe narrative feedback
Please contact your departmental administration for app login information (USask NSID login required).
Information for Learners
Implementing EPAs
The USask College of Medicine will be assessing all of EPAs 1-12 in all core clerkship and elective rotations, alongside current assessment procedures, as well as in Clinical Skills Advanced Communication sessions in years 1 and 2.
- EPA 1 - Obtain history and perform a physical examination adapted to patient's clinical situation.
- EPA 2 - Formulate and justify a prioritized differential diagnosis.
- EPA 3 - Formulate an initial investigative plan based on the diagnostic hypothesis.
- EPA 4 - Interpret and communicate results of common diagnostic and screening tests.
- EPA 5 - Formulate, communicate and implement management plans.
- EPA 6 - Present oral and written reports that document a clinical encounter.
- EPA 7 – Provide and receive the handover in transitions of care
- EPA 8 – Recognize a patient requiring urgent or emergent care, provide initial management & seek help
- EPA 9 – Communicate in difficult situations
- EPA 10 - Contribute to a culture of safety and improvement
- EPA 11 – Perform general procedures of a physician
- EPA 12 – Educate patients on disease management, health promotion and preventive medicine
Specific requirements are outlined in the relevant course or rotation syllabus
Information for Faculty
Faculty and residents are asked to observe students performing EPAs and document their observations as they happen, or "in the moment." Observations should be specific and should provide actionable feedback, such as what was done well, and what can be improved upon. Specific milestones for each EPA also provide a useful structure for this feedback.
These observations can be captured via the custom developed UGME EPA app. Please contact your departmental administration for app login information (USask NSID login required).
Training
Additional EPA training and development is available for an overview or specific elements. Please contact Dr. Susanna Martin for more information.