The Use of Entrustable Professional Activities in Pediatric Postgraduate Medical Education: A Systematic Review

Abstract

Background: Entrustable Professional Activities (EPAs) provide a framework to make judgments of trainees' abilities in several settings including postgraduate medical education. No systematic review of the role of EPAs in pediatrics has yet been performed.

Objectives: In our systematic review, we sought to determine the use of EPAs in pediatrics to identify research gaps, summarize and discuss evidence relating to the development, implementation, and assessment.

Data sources: Medline, Scopus, PsycINFO, MedEdPortal, and Web of Science.

Study eligibility criteria: Two independent reviewers used a structured screening protocol in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Association for Medical Education in Europe's guide for systematic reviews to include all articles reporting on EPAs in postgraduate medical education and pediatrics in particular. There were no restrictions due to language, study design, or participants.

Study appraisal and synthesis methods: Data on development, implementation, feasibility, acceptance, and assessment of EPAs were extracted and analyzed by the 2 independent researchers.

Results: Twenty-eight articles published between 2014 and 2020 were included in the review. We found an increase in publications and a notable shift from descriptions of development processes toward aspects beyond development, ie, implementation, feasibility, acceptance/perception, and assessment.

Limitations: Studies from non-English-speaking countries are scarce which might lead to an inaccurate representation of actual international practice.

Conclusions and implications of key findings: We provide a comprehensive overview of EPAs in pediatrics to guide future curriculum developers in collaborative development, implementation and assessment of EPAs in pediatric postgraduate medical education.

Keywords: clinical competence/standards; competency-based education; education; graduate; internship and residency; medical; pediatrics.