Entrustable Professional Activities and Entrustment Decision-Making in Health Professions Education

Since the turn of the millennium, competency-based education (CBE) has become a new standard for training in the health professions in many countries. Early work to operationalize CBE has included development of detailed frameworks of competencies that every physician should demonstrate. However, these models were criticized because of a lack of connection with the everyday work in health care, and with what it means to be a health professional. For that reason, the concept of entrustable professional activities (EPAs) was introduced in 2005, to supply the missing link between competency frameworks, and the practice of healthcare. EPAs are units of professional practice that may be entrusted to trainees once they show the competencies needed to execute them without supervision. EPAs constitute a holistic concept, requiring a coherent integration of various competencies. EPAs have become popular within competency-based programs in many countries, with numerous examples not only in