Entrustable Professional Activities (EPA)
In CBD, Entrustable Professional Activities (EPAs) are defined by the Royal College as “authentic tasks of a discipline. A supervisor can delegate a task to a resident and observe their performance in the workplace. Over time, frequent observations of a trainee’s performance of an EPA, will provide a comprehensive image of their competence and inform promotion decisions.” EPA example: Develop and implement a management plan in a patient with a common mental health concern.
EPAs are related to each stage of training (see competency stage graphic here). 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 Department of Psychiatry has developed 18 EPAs thus far. Two are applicable to the Transition to Discipline stage of competency (first 1 - 3 months), seven are applicable to the Foundations of Discipline stage of competency which extends from the end of Transition to Discipline through to the end of PGY2 (e.g. the resident's first 24 months of training), and 9 are applicable to the Core of Discipline stage of competency (essentially PGY3 and PGY4).
An overview of the existing EPAs is available here: EPAs Overview. Detailed information regarding specific EPAs can be found in the Current EPAs section.
Details of each Entrustable Professional Activity (EPA) are included in the EPA specific information sheets here:
Transition to Discipline #1 - Basic History
Transition to Discipline #2 - Documentation & Orders
Foundations of Discipline #1 - Common Assessment
Foundations of Discipline #2 - Common Formulation & Plan
Foundations of Discipline #3 - Risk Assessment
Foundations of Discipline #4 - Legislation
Foundations of Discipline #5 - Medical Stability
Foundations of Discipline #6 - Critical Appraisal
Core of Discipline #1 - Complex Assessment
Core of Discipline #2 - Complex Formulation
Core of Discipline #3 - Complex Plan
Core of Discipline #4 - Medical Emergency
Core of Discipline #5 - Family Meeting
Core of Discipline #6 - Agitation & Aggression
Core of Discipline #7 - Neurostimulation
Core of Discipline #8 - Psychopharmacology
Core of Discipline #9 - Teaching
Core of Discipline #10 - Psychotherapy Modalities