Project Profile: Entrustable Professional Activities

At the 2015 American Association of Colleges of Pharmacy (AACP) Annual Meeting, a charge was made to the 2015-2016 Academic Affairs Committee to examine the role of entrustable professional activities (EPAs) in pharmacy practice. EPAs are units of professional practice, tasks or responsibilities, that can be entrusted to a learner once he or she has attained competency.  They  are currently being used in other areas of health education, such as in the Association of American Medical Colleges guidelines for entering residencies.

A unique focus of the EPA assessment is based off of the idea of trust, a central concept in many aspects of healthcare. The EPA rating levels (level 1 to level 5) focus on the idea of trusting the student to observe the activity only, perform the activity with varying levels of supervision, or to perform the activity independently and supervise others. This rating system also recognizes that students early in practice may only be at a level 1 or 2, but that they are meeting expectations for early learners and will progress to higher levels of trust as they progress through their training.

Seeing the use of EPAs on the horizon, a team of MN- COP faculty took initiative, learning about the EPA philosophy and then implementing EPAs as milestones for first, second, and third year pharmacy students, as well as for grading Advanced Pharmacy Practice Experiences (APPEs).  

Drs. Pittenger, Chapman, Frail, Moon, Undeberg and Orzoff share their experience with exploring the use of EPAs in pharmacy education and recommendations and principles for creating the assessment instruments in this article in AJPE. 

Even though the use of EPAs is in the relatively early stages at the MN-COP, the team already feels that the addition has made an impact for our students and will enhance student development and clinical practice.  Dr. Jean Moon was asked, what do you think was the biggest impact of the EPA project?

The greatest impact of the EPAs was in the creation. With the input of preceptors and clinical faculty, we now have a standard description and framework for our students upon their various stages of patient care skill development. In the EPA framework, students are able to receive feedback on their performance in a way that resonates to clinical practice.”

The 2016-2017 school year is the first full implementation of EPAs in APPEs at the MN-COP.  For many preceptors, this is their first time using EPAs as a tool to assess students’ progress. The team is working closely with other faculty and preceptors to ensure that the use of EPAs is enhancing the student experience and reflective of appropriate clinical development. Dr. Caity Frail speaks about the future of EPAs at MN-COP:

We hope the EPA rubric will create a more objective framework for assessing students on APPE, which can be challenging for preceptors particularly when feedback is not positive. We are excited to assess results from our first APPE year using EPAs, continue to refine our approach, and begin incorporating EPAs further into the curriculum, including IPPE.”

Stay tuned for how the EPA project grows and evolves!