Using entrustable professional activities to guide curriculum development in psychiatry training

Abstract

Background: Clinical activities that trainees can be trusted to perform with minimal or no supervision have been labelled as Entrustable Professional Activities (EPAs). We sought to examine what activities could be entrusted to psychiatry trainees in their first year of specialist training.

Methods: We conducted an online survey of Fellows of the Royal Australian and New Zealand College of Psychiatrists (RANZCP).

Results: The majority of respondents considered initiating patients with the common medications, discharging patient suffering from schizophrenia, bipolar disorder or following a crisis admission, conducting risk assessments and managing psychiatric emergencies were activities that trainees could be entrusted with by the end of the first stage of training.

Conclusions: Four activities were identified that trainees should be entrusted with by the end of their first year of training. Each of these activities comprises a set of competencies in each of the CanMEDS roles. When a trainee is unable to satisfactorily perform an EPA, deficits in the underpinning competencies can be a focus for remediation. Further EPAs are being identified in areas of more specialised practice for use within more advanced training.

Figure 1

Responses to question asking whether initiating treatments should be an activity a trainee could be expected to perform by the end of the first stage of training.

Figure 2

Relationship between an EPA and the underlying competencies.