EPAs

Entrustable Professional Activity (EPA)

An EPA refers to a clinical task that can be safely delegated to a trainee after competence has been demonstrated. EPAs are considered a "unit" of training in a CBME assessment system but there are other factors considered for progress and promotion. For more detailed information, see the Competence Committee (CC) page.

Expectations

As of July 2021, all residents are expected to attempt at least three EPAs per week except during MCT, Research, Vacation and CanMEDS blocks.

Data.med Context reporting video 

Did you know you can quickly figure out which contexts for a given EPA are still outstanding using the DATA.med platform?  Watch the Program EPA Tracker video to see how you tell which contexts have been completed with the required number of "I didn't need to be there" EPA observations.  (Please note that these totals in DATA.med are based purely on the numeric scores entered in the EPA record, and that the Competence Committee may adjust counts based on the EPA comments or other factors.)

Promotions

Promotion between stages of CBME is primarily based on demonstrated competency in the form of achieved Entrustable Professional Activities (EPA's), achievement of all milestones in current stage of training, no significant concerns based on ITER review and competence in all other assessments (OSCE, Orals, etc). 

Here is an example of a likely EPA for the Foundations (i.e. junior resident) level of training:

Assessing, diagnosing, and initiating management for patients with common acute medical presentations in acute care settings

• Performs complete and appropriate assessments of patients with common acute medical presentations

• Generates differential diagnoses along with appropriate diagnostic strategies

• Implements initial management plans

• Presentations include but are not limited to chest pain, gastrointestinal bleeding, shortness of breath, acute kidney injury, weakness, nausea and vomiting, fever, altered mental status, toxidromes, delirium, overdose, pain.