Entrustable professional activities in Finnish radiology training: a national survey

Abstract

Objectives: This study assessed the practical implementation, experiences, and attitudes toward entrustable professional activities (EPAs) in radiology training across Finland.

Methods: A nationwide, anonymous online survey targeted radiology residents, recently graduated specialists (within 3 years), and instructor specialists. Distributed to all Finnish hospitals involved in radiology training, the survey evaluated EPA completion rates, perceived value, and future development needs. Responses were analyzed to identify trends and differences across groups.

Results: Of 150 respondents (42% residents, 43% instructors, and 14% recent graduates), 65% were from university hospitals. Among residents and recent graduates, 37% had completed EPA assessments, with 87% valuing the feedback received and 73% finding EPAs effective for competency assessment. Overall, 64% considered EPAs well-suited to radiology. Residents showed higher completion rates (43%) than recent graduates (19%), with fourth- and fifth-year residents more engaged (69% vs. 15%). Instructors, while supportive (67% viewed EPAs as meaningful), emphasized a need for more training (54% vs. 49% of residents).

Conclusion: Most Finnish radiology respondents considered EPAs well-suited for training. Residents and recent graduates who completed EPAs greatly valued the feedback and found them effective for assessing competencies, with residents participating more actively than recent graduates. Instructors' desire for better guidance suggests a priority for enhanced support and education. These findings endorse EPA integration and inform refinements in national and European radiology curricula.

Critical relevance statement: Finnish radiologists and residents strongly support EPAs in radiology training, valuing their feedback and competency assessment, though instructors seek enhanced guidance.

Key points: Finnish radiology residents and specialists reported positive experiences and strong support for entrustable professional activity (EPAs). Finland's mandatory, nationally coordinated EPA framework contrasts with subspecialty-focused models elsewhere. Instructors seek more EPA training, signaling a need for enhanced education to sustain their engagement as adoption grows.

Keywords: Curriculum; Graduate medical education; Training program.

Fig. 1

Response distributions of reported experiences from those residents and recently graduated specialists who had completed EPA assessments, with regard to receiving useful feedback (top left), usefulness of EPAs in assessing competencies (top right), convenience in completing EPAs alongside other feedback (bottom left), and whether feedback is more comprehensive in teams that use EPAs (bottom right)

Fig. 2

Response distributions among all respondents on the suitability of EPAs in radiology (top left), meaningfulness of EPAs in assessing competencies (top right), wanting more EPAs in radiology (bottom left), and whether they would like to receive more instructions on EPAs (bottom right)