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<p>Entrustable Professional Activities (EPAs) are widely utilized in competency-based medical education (CBME) to assess clinical readiness, yet their application in bioethics remains less explored. This study introduces Entrustable Professional Ethical Actions (EPEAs) to address the ethical complexities faced by medical professionals transitioning to residency or postgraduate training. A structured framework for EPEAs was developed through a systematic review of bioethics literature and the UNESCO Universal Declaration on Bioethics and Human Rights. Competencies were categorized under seven domains, including ethical decision-making, patient-centered communication, and sustainability. Using these competencies, ten core EPEAs were formulated with measurable milestones for entrustment. Validation involved an international panel of 35 experts, who evaluated the EPEAs through a 47-item online questionnaire. Consensus was defined as ≥ 80% agreement on relevance, clarity, and feasibility, with iterative revisions informed by expert feedback. Validation demonstrated high global consensus, with 86.49% of experts rating the EPEAs as highly relevant, 82.86% agreeing on milestone differentiation, and 81.76% endorsing measurability. Content validity indices (S-CVI/AVE: 0.80, I-CVI: 0.85, S-CVI/UA: 0.92) and reliability (ICC: 0.87) confirmed the robustness of the framework. The final set includes ten EPEAs covering critical domains such as informed consent, privacy, confidentiality, shared decision making, equity, sustainability etc. The EPEAs represent a pioneering framework for integrating bioethical decision-making into medical education. By aligning with global ethical principles, these actions equip trainees to navigate complex moral dilemmas in clinical practice while fostering trust among educators, peers, and patients.</p>

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Entrustable professional ethical actions (EPEAs): pioneering a new paradigm for bioethics training & assessment in graduate medical education

  • 期刊论文

  • 发表日期：

    2025年2月21日

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  • Russell Franco D’Souza,
  • Mary Mathew,
  • Krishna Mohan Surapaneni

摘要

Entrustable Professional Activities (EPAs) are widely utilized in competency-based medical education (CBME) to assess clinical readiness, yet their application in bioethics remains less explored. This study introduces Entrustable Professional Ethical Actions (EPEAs) to address the ethical complexities faced by medical professionals transitioning to residency or postgraduate training. A structured framework for EPEAs was developed through a systematic review of bioethics literature and the UNESCO Universal Declaration on Bioethics and Human Rights. Competencies were categorized under seven domains, including ethical decision-making, patient-centered communication, and sustainability. Using these competencies, ten core EPEAs were formulated with measurable milestones for entrustment. Validation involved an international panel of 35 experts, who evaluated the EPEAs through a 47-item online questionnaire. Consensus was defined as ≥ 80% agreement on relevance, clarity, and feasibility, with iterative revisions informed by expert feedback. Validation demonstrated high global consensus, with 86.49% of experts rating the EPEAs as highly relevant, 82.86% agreeing on milestone differentiation, and 81.76% endorsing measurability. Content validity indices (S-CVI/AVE: 0.80, I-CVI: 0.85, S-CVI/UA: 0.92) and reliability (ICC: 0.87) confirmed the robustness of the framework. The final set includes ten EPEAs covering critical domains such as informed consent, privacy, confidentiality, shared decision making, equity, sustainability etc. The EPEAs represent a pioneering framework for integrating bioethical decision-making into medical education. By aligning with global ethical principles, these actions equip trainees to navigate complex moral dilemmas in clinical practice while fostering trust among educators, peers, and patients.