Outcome Based Education

Competency based
Trusted to do
Entrustable Professional Activities

Which is more important. What you have seen and done once or what you are trusted to do without supervision?


David Black, Medical Director for the Joint Royal Colleges of Physicians Training Board in London outlined Entrustable Professional Activities which will become part of the Foundation programme curriculum. BMJ Careers p500 18th June 2016. Go to careers.bmj.com

Competency based

Both trainees and trainers have difficulty working through a check list of task specific competencies in on line portfolios. A tick list of what has been observed or done once, which can feel separate from day to day work. Doing something once under observation is not a certificate to say it will be done well every time in the reality of day to day practice.

Trusted to do

What is more relevant are those tasks that a trainee is actually trusted to do on their own. This is what trainers, bosses and employers look for. There is a difference between whether a task can be done and trusting someone to do it consistently well every day.

Entrustable Professional Activities (EPAs)

Also known as Competencies in practice (CiP) these help focus the trainee, trainer and curriculum writers on what is most important and relevant to the trainees education. The aim is to move closer to actual practice with all the real life variation that can occur.
If a person does not meet the overall competencies in practice then they can look at the individual component competencies and identify which area needs further education.