Entrustable Professional Activities (EPAs)
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 Elentra. Faculty 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?
EPA Observations and Achievement
PGY1
Pilot Stream Residents (Entry before July 2020)
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.
See our EPA Transition Map
See our EPA Transition Map (112.75 KB) 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
Overview: Psychiatry EPAs by Stage