Transforming the learning outcomes of anaesthesiology training into entrustable professional activities: A Delphi study

Abstract

BACKGROUND: True competency-based medical education should produce graduates meeting fixed standards of competence. Current postgraduate programmes are usually based on a pre-determined length of time in training making them poorly suited for an individual approach. The concept of entrustable professional activities (EPAs) enables a more flexible, personalised and less time-dependent approach to training programmes. An EPA is a unit of professional practice, to be entrusted to a trainee to execute without supervision once they demonstrate sufficient competence. As EPAs relate competencies to clinical practice, they structure training and assessment more logically according to the way clinicians actually work. A first step in building an EPA-based curriculum is to identify the core EPAs of the profession. OBJECTIVES: The aim of this study was to identify EPAs for postgraduate training in anaesthesiology and to provide an example of how an existing curriculum can be transformed into an EPA-based curriculum. DESIGN: A modified Delphi method was used as a consensus approach applying three Delphi rounds. SETTING: Postgraduate specialty training in anaesthesiology in the Netherlands. PARTICIPANTS: All programme directors in anaesthesiology in the Netherlands except for a single programme director who was involved as a researcher in this study and could not participate. MAIN OUTCOME MEASURES: Agreement among participants on a list of EPAs. Agreement was specified as a consensus rate of more than 80%. RESULTS: In this study, 27 programme directors (69% overall response rate) reached consensus on a set of 45 EPAs that describe a curriculum in anaesthesiology for the Netherlands. CONCLUSION: This study is a first step toward a more contemporary curriculum in competency-based postgraduate anaesthesiology training.