Entrustable Professional Activities (EPAs)

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EPA 101 Psychiatry

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.

As of July 2020, the Department of Psychiatry has adopted the Royal College's EPAs. Two are applicable to the Transition to Discipline stage of competency (first 1 - 3 months), five 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 13 are applicable to the Core of Discipline stage of competency (essentially PGY3 and PGY4). There are also six Transition to Practice EPAs to be completed during PGY5.

An overview of the existing EPAs is available here:  EPAs Overview. Detailed information regarding specific EPAs can be found in the Current EPAs section.

How are EPAs Assessed?

As of July 2, 2020, our program will be utilizing ElentraFaculty and Residents will be able to login using their UTORid and password.  Please see our user guide for supervisors below:

PGME has also created a library of resources regarding Elentra and those can be accessed on their website: http://cbme.postmd.utoronto.ca/u-of-t-cbme-faculty-resident-resources/references-resources/elentra-user-guides/

What does Entrustment mean?

Tips on assessing EPAs and entrustment levels

Transition to Royal College EPAs

Residents who started in 2017-2019 have been submitting our homegrown EPAs into the PsychRocks EPA Tool. As of July 2020, we have adopted the Royal College's EPAs and the University's assessment platform - Elentra. Rest assured, previously submitted EPAs will not be lost as we will be transitioning them to their Royal College equivalents and manually entering them into Elentra. This will ensure that residents' full EPA progress is captured on one platform.

Royal College EPAs

All Psychiatry training programs will be adopting the Royal College of Physicians and Surgeon's Entrustable Professional Activities as of July 2020.  The EPAs are available for download and viewing below. 

Transition to Discipline

TTD1 OBTAINING A PSYCHIATRIC HISTORY to inform the preliminary diagnostic impression

TTD2 COMMUNICATING CLINICAL ENCOUNTERS in oral and written/electronic form

Foundations of Discipline

FOD1 Assessing, diagnosing and participating in the management of patients with MEDICAL PRESENTATIONS relevant to psychiatry

FOD2 PERFORMING PSYCHIATRIC ASSESSMENTS referencing a biopsychosocial approach, and developing basic differential diagnoses for patients with mental disorders

FOD3 Developing and implementing MANAGEMENT PLANS for patients with presentations of low to medium complexity

FOD4 Performing RISK ASSESSMENTS that inform the development of an acute safety plan for patients posing risk for harm to self or others

FOD5 Performing CRITICAL APPRAISAL and presenting psychiatric literature

Core of Discipline

COD1 Developing COMPREHENSIVE treatment/management PLANS for adult patients

COD2 Performing psychiatric assessments and providing differential diagnoses and management plans for CHILDREN AND YOUTH

COD3 Performing psychiatric assessments, and providing differential diagnoses and management plans for OLDER ADULTS

COD4 Developing comprehensive biopsychosocial FORMULATIONS for patients across the lifespan

COD5 Identifying, assessing, and managing emergent situations in psychiatric care across the lifespan (EMERGENCIES)

COD6-A Integrating the principles and skills of psychotherapy into patient care (PSYCHOTHERAPY MODALITY)

COD6-C Applying and integrating psychosocial skills and principles in general psychiatric care (INTEGRATING PSYCHOTHERAPY SKILLS)

COD7A-B Integrating the principles and skills of NEUROSTIMULATION into patient care

COD8 Integrating the principles and skills of PSYCHOPHARMACOLOGY into patient care

COD9 Applying relevant legislation and LEGAL principles to patient care and clinical practice

COD10 Providing TEACHING to students, residents, public and other health care professionals

Transition to Practice

TTP1-A Managing the clinical and administrative aspects of a psychiatric practice: patient care (PRACTICE MANAGEMENT - PATIENT)

TTP1-B Managing the clinical and administrative aspects of a psychiatric practice: working with the team (PRACTICE MANAGEMENT - TEAM)

TTP2 SUPERVISING junior TRAINEES

TTP3-A Developing and implementing personalized learning experiences geared to career plans or future practice: DEVELOPING A LEARNING PLAN

TTP3-B Developing and implementing personalized learning experiences geared to career plans or future practice: IMPLEMENTING A TRAINING EXPERIENCE

TTP3-C Developing and implementing personalized learning experiences geared to career plans or future practice: REFLECTING ON LEARNING PLAN EFFICACY

EPA Maps and Rotation Cards

OverviewPsychiatry EPAs by Stage

PGY1 (applicable to learners who started residency in July 2020)

PGY1 Rotation Cards TTD FOD

EPA Map for PGY1 TTD FOD

PGY2 (applicable to learners who started residency in July 2019)

PGY2 Rotation Cards FOD 

EPA Map for PGY2 FOD 

PGY3 (applicable to learners who started residency in July 2018, 2019)

PGY3 Rotation Cards COD

EPA Map for PGY3 COD 

PGY4 (applicable to learners who started residency in July 2017, 2018, 2019)

PGY4 Rotations Cards COD 

EPA Map for PGY4 COD