Preparation for practice

Entrustable professional activities - a new way to ensure Edinburgh graduates in medicine are prepared for practise

Team Members: Alan Jaap ,David Hope, Avril Dewar, Helen Cameron


Newly graduated doctors feel unprepared for practice. There may be several reasons for this. With increasing concerns about patient safety, clinical supervisors are reluctant to permit students to contribute to patient care, and medical schools focus on assessments of theory and simulated practice for reliability. Additionally supervisors receive little guidance on the level of responsibility that new doctors are ready to safely take on.

Accurately assessing student competence in the workplace is challenging, and new methods are required. Entrustable Professional Activities (EPAs) have been pioneered internationally in the postgraduate arena. This system involves assessing a learner in real units of work such as “Assessing a New Patient”, or “Discharging a Patient”, using milestones to describe levels of entrustability or required supervision within each task. As yet, virtually no work on the utility of EPAs has taken place within undergraduate medical education in the UK.

This project involves making Edinburgh a hub of expertise in this area by (a) conducting a thorough review of all existing work, (b) implementing a site-wide meeting of a variety of staff and students to establish a list of essential EPAs and (c) recruiting a world-leading expert to support development of EPAs at Edinburgh. This project will result in a significant curriculum innovation - the integration of EPAs into the assessment of final year medical students to promote learning and patient safety. This project will ensure Edinburgh can sustainably run and evaluate EPAs and become a national leader in this area.

Final Project Report

The final project report may be downloaded from here.

Further Project Outcomes

- Poster presentation (March 2016) at the Association for Medical Education in Europe Annual Conference, Barcelona may be downloaded here.