Building a competency-based workplace curriculum around entrustable professional activities: The case of physician assistant training

Background and aim: Competency-based medical education (CBME) is increasingly dominating clinical training, but also poses questions as to its practical implementation. There is a need for practical guidelines to translate CBME to the clinical work floor. This article aims to provide a practical model, based on the concept of entrustable professional activities (EPAs) to make this translation, derived from curriculum building for physician assistants (PAs). Method: For the training of PAs at the Utrecht University of Applied Sciences, a three-step model was developed to guide competency-based curriculum development, teaching and assessment. It includes specific guidelines for the identification, systematic description and planning of EPAs. Results: The EPA concept appeared to be a useful tool to build competency-based clinical workplace curricula. Implementation of the curriculum requires use of trainee portfolios and progress interviews, statements of rewarded responsibility and training of supervisors. The individualised approach and flexibility that true CBME implies is brought into practice with this model. Discussion: The model may also be transferred to other domains of clinical training, among which postgraduate training for medical specialties.