Advancing and sustaining excellence in EPA-based curricula

The quality of health professions education is socially determined and closely linked to the quality of health care. Entrustable professional activities (EPAs) add strength to and operationalize curricula for competency-based education for health professions by focusing on both the patient and trainee, bringing health professions education together with patient care. This social accountability within an EPA-based curriculum emphasizes measurable enhancements to local health services through EPAs. As such, both external quality assurance (QA) and internal QA are crucial for implementing and improving an EPA-based program. External QA involves guidance from the regulating body regarding training policies, procedures, and practices. Internal QA entails self-auditing, utilizing mechanisms like program evaluation (PE) to monitor, evaluate, and improve the assessment and attainment of EPAs. Continuous quality improvement (CQI) can be used to augment PE by serving as a system for accountability and transparency. This section introduces the concepts of PE and CQI to be used within an EPA-based curriculum, models to support PE and CQI processes, examples of actual cases where PE and CQI were beneficial, and solutions to address challenges specific to EPA-based curricula.