Implementation of Entrustable Professional Activities (EPAs) in Residency Training

EPAs (Entrustable Professional Activities/ Anvertraubare Professionalle Aktivitäten/ Activités Professionnelles Confiables) serve as a teaching and assessment tool for competency based medical training (CBME), a newly introduced framework in postgraduate medical training in Switzerland. You can find further information on EPAs and CBME here.

The current studies

Currently, we investigate the implementation and use of EPAs in the setting of cardiology training and at pilot centres volunteering to use EPAs across specialties.

Five cardiology training centres across Switzerland have already been using EPAs since 2022, in 2024, all other cardiology training centres started following. The first study in the cardiology setting focuses on the implementation process at the five pilot centres from the organisers’ point of view. The second study in the cardiology setting aims to learn from trainees and supervisors of all cardiology training centres in Switzerland. They are inquired via an online survey, before and after the implementation of EPAs, on implementation, use and impact of EPAs especially on learning climate and feedback culture. The first survey was conducted in spring 2024, the second survey is planned for spring 2025.

Starting in 2024, several centres volunteered to use EPAs in different specialities within their institution. These centres cover different medical specialties and represent small and large hospitals in different regions of Switzerland. They are working in close collaboration with the SIWF/ISFM EPA Commission . To get started with EPAs, these centres use so-called "common EPAs", which are formulated to work across different specialities. Similar to the cardiology centres, we collect qualitative data in interviews with organisers and quantitative data in surveys of trainees and supervisors.

How the results of these studies are used

We try to implement EPAs as effective and helpful as possible. The cardiology centres and common EPA pilot centres are playing a pioneering role in the use of EPAs. The results from these centres will be used to improve the use of EPAs directly at their sites, as well as inform the process for other medical specialties and settings that will follow with the use of EPAs.