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Core Entrustable Professional Activities

Core EPAs: The Guiding Principles

The AAMC's pilot group recommends that institutions intending to design and implement educational systems utilizing the framework of Core Entrustable Professional Activities for Entering Residency should:

  • Employ a systematic approach to map educational opportunities and assessments for each EPA
  • Explicitly measure the attribute of trustworthiness in addition to the specific knowledge, skills and attitudes required for each EPA
  • Create a longitudinal view of each learner’s performance via, at minimum, aggregated performance evidence; and consider the added value of longitudinal relationships and formal coaching structures in informing entrustment decisions
  • Gather multi-modal performance evidence from multiple assessors about each learner for each EPA
  • Include global professional judgments about entrustment of each learner in the body of evidence that supports entrustment decisions
  • Ensure a process for formative feedback along the trajectory to entrustment to provide opportunities for both remediation and potential acceleration of responsibilities
  • Create a process to render and maintain formal entrustment decisions by a trained group (entrustment committee) that reviews performance evidence for each student
  • Ensure that each learner is an active participant in the entrustment process: aware of expectations, engaged in gathering and review of performance evidence, and generating individualized learning plans to attain entrustment
  • Align formal entrustment decisions regarding individual students with nationally established performance expectations, as currently described in the Core EPAs for Entering Residency Curriculum Developer’s Guide




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