Evaluating Medical Educators Practices: Core Competencies and Entrustable Professional Activities (EPAs) for Healthcare Professional Educators

By Khadija Farrukh Warraich

Affiliations

1. Department of Medical Education, Bahria University Health Sciences, Karachi, Pakistan

doi: 10.29271/jcpsp.2025.08.1062

ABSTRACT
The objective of this research is to evaluate the core competencies and entrustable professional activities (EPAs) for the structured training of healthcare professional educators. A qualitative case study using the modified Delphi technique was performed at the Department of Medical Education, Bahria University Health Sciences Campus, Karachi, Pakistan, from September 2023 to March 2024. Data were collected from expert medical educationists through email interviews. Snowball sampling technique was used to select participants. Email with an interview questionnaire was shared with a total number of twenty participants; twelve participants responded. After two Delphi rounds, consensus was developed, and seven core competencies and eight EPAs were identified, which were aligned with milestones and the method of assessment. The core competencies identified were educational leadership, educational management, educational research, technology in education, interprofessional teamwork approaches, designing and planning learning, and assessment for learning and reflective practices.

Key Words: Competencies, Entrustable professional activities, Medical educator.

Entrustable professional activities (EPAs) represent tasks or responsibilities within a specific professional domain that can be entrusted to a trainee or learner once they have demonstrated the required competence. The current landscape of existing literature concerning competencies and EPAs in medical education reveals a robust and evolving field. However, mapping competencies to EPAs remains complex and inconsistent across all subjects and domains. Increased emphasis on programmatic assessment and longitudinal evaluation are required for implementation of competency based medical education. Several studies explore the implementation, assessment, and impact of competency-based education frameworks, with a particular focus on EPAs. Articles emphasised the importance of defining clear competencies and describing EPAs to guide curriculum development and assessment practices in medical education. There are many recent research studies which focus on the development of EPAs for undergraduate and postgraduate medical students as well as transdisciplinary domains.^1-3 However, there is a gap in the literature regarding EPAs development for healthcare professional educators.

A qualitative case-study design by using the modified Delphi technique was employed. This study was performed in the Bahria University Health Sciences Campus for the duration of six months, from September 2023 to March 2024. Ethical approval was obtained from the IRB committee of the Bahria University Health Sciences Campus. The Snowball sampling technique was used, in which participants were requested to suggest more participants from their field who met the inclusion criteria of the study. Inclusion criteria for expert selection were medical educationists with a master degree in health professional education, with certificate in health quality assurance, and having five years of teaching experience. Exclusion criteria were medical educators without a master degree in health professional education, without certificate in health quality assurance, and having less than five years of experience.

Data were collected through email interviews. An email containing the interview questionnaire and consent form was sent to twenty participants; twelve of them responded. A modified Three-Circle Framework was used to guide interview questions. Two rounds of interviews were conducted with twelve participants, using controlled feedback to reach participant consensus. Manifest content analysis was used for data analysis. Codes and themes were shared with the participants via email to get feedback on the findings. ATLAS ti-9 was used to make the coding tree.

Core teaching competencies refer to the essential knowledge, skills, and attributes that educators must possess to effectively facilitate learning and promote student success.

Table I: Entrustable professional activities (EPAs) for teaching professionals.

EPAs	Specific competencies	Assessment criteria
EPA 1 Large and small-group teaching sessions	Comp 1- Subject matter knowledge Comp 2- Effective presentation skills Comp 3- Communication skills Comp 4- Presentation skills Comp 5- Classroom management Comp 6- Effective feedback giving skill Comp 7- Technology integration Comp 8- Reflection	Observation Student feedback Faculty reflection
EPA 2 Clinical supervision and practical skills training	Comp 1- Communication skills Comp 2- Problem-solving ability Comp 3- Critical thinking enhancing skills Comp 4- Collaboration Comp 5- Teamwork promotion ability Comp 6- Ethical practice Comp 7- Professionalism	Observation Student feedback Real-time evaluation
EPA 3 Curriculum Development	Comp 1- Subject matter knowledge Comp 2- Collaboration and teamwork Comp 3- Evaluation	Evaluation of the impact of the implemented curriculum using the Krikpatrick model
EPA 4 Effective, constructive, and timely feedback	Comp 1- Student-centred approach Comp 2- Communication skills Comp 3- Interpersonal skills	Observation Student feedback Faculty Reflection
EPA 5 Mentoring	Comp 1- Guidance Comp 2- Counselling Comp 3- Empathy Comp 3- Communication skills Comp 3- Ethics	Student feedback Interviews
EPA 6 Integrating innovative technology in educational practice	Comp 1- Professional development Comp 2- Innovative technology awareness and alignment	Resource evaluation Peer feedback
EPA 7 Inclusive learning environment	Comp 1- Diversity Awareness Comp 2- Cultural sensitivity Comp 3- Ethical Behaviour Comp 4- Professionalism	Observation Interviews
EPA 8 Educational research	Comp 1- Critical appraisal of research Comp 2- Analytical thinking Comp 3- Impact awareness	Published articles evaluation

Figure 1: Core competencies of a medical educator.

These competencies encompass a range of abilities and qualities that enable educators to create engaging learning environments, deliver effective instructions, and support students' academic and professional development (Figure 1). While specific core teaching competencies may vary depend-ing on the educational context and discipline, total seven core competencies identified were educational leadership, educational management, educational research, technology in education, interprofessional teamwork approaches, designing and planning for learning, and assessment for learning, reflective practices (Figure 1). Eight EPAs were identified with each having specific competencies (Table I).Top of FormTop of Form

Many research studies explored the implementation, assessment, and impact of competency-based education frameworks, with a particular focus on EPAs, which highlight the importance of defining clear competencies and delineating EPAs to guide curriculum development and assessment practices in medical education.^4-6 However, this study is unique as it focused on the development of competencies and EPAs for healthcare professional educators. Most of them identified those core competencies that encompass the breadth of knowledge, skills, and attitudes necessary for effective medical practice. Researchers emphasised the need for competency frameworks that are comprehensive, adaptable to evolving healthcare needs, and reflective of diverse clinical settings and patient populations. Furthermore, article delve into the practical aspects of the EPA implementation, including the development of assessment tools, faculty training, and integration into existing curricula.

These core competencies and core EPAs identified by this research will provide a structured way to assess and entrust teaching professionals with specific responsibilities in medical education. They serve as a foundation for evaluating educa-tors' competence and readiness to ensure high-quality medical education programmes.

COMPETING  INTEREST:
The authors declared no conflict of interest.

AUTHORS’  CONTRIBUTION:
KFW: Concept, data collection, data analysis, write-up, and conclusion.
The author approved the final version of the manuscript to be published.

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