Entrustable Professional Activity (EPA)

EPAs are authentic tasks of a discipline. A supervisor can delegate a task to a resident and observe their performance in the workplace. Overtime, frequent observations of a trainee’s performance of an EPA, will provide a comprehensive image of their competence and inform promotion decisions.

Royal College EPAs are related to each stage of training (transition to discipline, foundations of discipline, core of discipline, transition to practice). EPAs are designed to be developmental — they go from smaller tasks to bigger tasks as trainees progress through stages of training. Each EPA integrates a number of milestones from different CanMEDS roles; a bigger task may include more milestones and/or more complex milestones.

The process of defining a series of EPAs at each stage provides residents with a clear understanding of the expectations at that stage. EPAs focus the supervisor on stage appropriate expectations, which helps supervisors pinpoint a learner’s achievements and areas for improvement. EPAs are also part of competence committee discussions about resident performance.

Trainees must collect the specified number of assessments for each EPA in each stage. You may need to collect more than the specified number of assessments to achieve the required the number of successful assessments. It is the trainee's responsibility to initiate and collect these assessments. It is the trainee's responsibility to be familiar with their EPAs.

There are a total of 25 EPAs within the 4 stages. You will need a total of 112 assessments successfully completed within your 2 year training program.

All assessments are reviewed by the Competency Committee, who makes decisions about promotion of trainees to the next stage of training. Failure to collect the required assessments will hinder trainees from being promoted.

Some of the assessments can be based on simulation, and assessors can include physicians as well as other Geriatric Medicine health care providers, as specified for each EPA.

Residents should inform preceptors they would like to complete and EPA prior to patient encounter.