Entrustable Professional Activities (EPA) page

Entrustable Professional Activities (EPAs) are defined as a unit of professional practice (tasks or responsibilities) that a learner with sufficient competence is entrusted to perform without direct supervision. EPAs integrate multiple competencies and capture concrete tasks for daily clinical practice1. The EPAs reflect activities a first year resident is expected to perform without direct supervision (supervisor not in the room but available to provide assistance) on day 1 of residency2. The assessment in Phase 4 includes the following 14 EPAs, which have been linked to the appropriate CanMEDs roles and MD program objectives:

AFMC: EPAs adapted from https://www.afmc.ca/web/en/faculties/entrustable-professional-activities​ 
AAMC: EPa adapted from https://www.aamc.org/what-we-do/mission-areas/medical-education/cbme/core-epas/publications
Memorial University: EPA developed by Faculty of Medicine; pilot introduction for 2021-2022 academic year
Assessment of EPAs uses the concept of entrustment. A learner is either ready to be entrusted to perform a specific task (EPA) without direct supervision (“entrustable”) or not yet ready to do so (“pre-entrustable”). The above documents outline the entrustable and pre-entrustable behaviours for each EPA. Learners should review those descriptors as this may guide their learning. Becoming ready to be entrusted is a longitudinal process and takes time! It is expected that learners will not be assessed as “entrustable” for most EPAs within their first rotations of the Core Experiences course.
Refer to the Assessment during Core page for more information on assessment tools, workflow and progress monitoring.

The EPAs for each discipline are listed in the following documents:

EPAs for Anesthesia
EPAs for Emergency Medicine
EPAs for Internal Medicine
EPAs for Obstetrics and Gynecology
EPAs for Pediatrics
EPAs for Psychiatry
EPAs for Rural Family Medicine
EPAs for Surgery

Medical learners must be appropriately supervised at all times to ensure patient and learner safety. The level of responsibility delegated to learners must take into account their level of training, and the level of supervision must take into account their level of entrustability. Learners who do not feel competent to perform a particular activity must inform their preceptor(s).

More information regarding EPA assessment during Selectives/Electives is outlined in the appropriate Selectives/Electives document. 

1Ten Cate O, Chen HC, Hoff RG, Peters H, Bok H, van der Schaaf M. Curriculum development for the workplace using Entrustable Professional Activities (EPAs): AMEE Guide No. 99. Med Teach. 2015;37(11):983-1002. doi: 10.3109/0142159X.2015.1060308. Epub 2015 Jul 14. PMID: 26172347.
2AFMC: Entrustable Professional Activities for the Transition from Medical School to Residency