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Entrustable professional activities (EPAs) for regulation of a new profession in the UK

Oral Presentation
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Oral Presentation

10:00 am

28 February 2024

M209

EPAs

Presentation Description

Thomas Gale1
Richard Hankins2, Leigh Wilson2 and Manda Gillard2
1 Peninsula Medical School
2 General Medical Council, UK




Background
EPAs guide learners and clinical educators in establishing a graded increase in autonomy and responsibility towards performing key tasks of the profession.(1) Although EPAs have been implemented widely across the healthcare professions there is limited use within the context of regulation or licensing assessments despite them being promoted for bridging the capability – competency chasm which exists between the skills that graduates possess and those required by employers.(2) Since July 2019 the General Medical Council has developed plans for the regulation of Anaesthesia Associates (AAs) in the UK. The Anaesthesia Associate Registration Assessment (AARA) has been designed to include the use of EPAs for summative assessment of job activities required of newly qualified AAs. 


Summary of work
A development group of key stakeholders involved with training, supervision and setting standards for Anaesthesia Associates used iterative processes, including 2 national surveys, to gain national consensus for the new AA curriculum, content map and method of assessment for registration. 


Results
164 participants responded to the surveys, representing AAs, anaesthetists, physician associates, students, education providers, medical schools, postgraduate medical institutions, NHS organisations and arms-length bodies. 

Capabilities from the content map were mapped to the AARA which comprises: 
  •  an applied knowledge test,
  • an assessment of key professional activities involving five EPAs (pre-operative assessment, general anaesthesia, procedural sedation, peripheral regional anaesthesia, spinal anaesthesia). 


Discussion and conclusions
Student AAs spend the majority of their training time in the workplace as an apprenticeship, with extensive clinical exposure and access to patients. We have established consensus on defined entrustment levels for five EPAs required to qualify as an AA which are achievable across multiple higher education providers in the UK. Using EPAs provides greater authenticity than a simulated OSCE for a national registration assessment but future research is required to establish validity compared to other assessments. 




References (maximum three) 

  1. ten Cate, O. (2005). Entrustability of professional activities and competency-based training. Medical Education, 39(12), 1176–1177 

  2. Ma, T., ten Cate, O. (2023) Entrustable professional activities: a model for job activity competency framework with microcredentials. The International Journal of Information and Learning Technology DOI 10.1108/IJILT-05-2022-0108 

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