Four Dimensions and Implementation Needs for Entrustable Professional Activities in Undergraduate Medical Education: Scoping Review

Oktarina Oktarina; Mohd Nasri Awang Besar; Zaleha Md Isa; Dede Renovaldi; Fika Ekayanti; Cholis Abrori

Author(s)

Oktarina Oktarina Department of Medical Education, Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta, Indonesia

Mohd Nasri Awang Besar Department of Medical Education, Faculty of Medicine, Universiti Kebangsaan Malaysia, Malaysia

Zaleha Md Isa Department of Public Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Malaysia

Dede Renovaldi Department of Biomedical Sciences, Faculty of Medicine and Health, Universitas Muhammadiyah Jakarta, Indonesia

Fika Ekayanti Department of Medical Education, Faculty of Medicine, Universitas Islam Negeri Syarif Hidayatullah, Indonesia

Cholis Abrori Department of Medical Education, Faculty of Medicine, Universitas Jember, Indonesia

Abstract

Objective: Implementing Entrustable Professional Activities (EPAs) in the undergraduate setting requires guidance. This review aimed to identify evidence about the essential dimensions and needs for implementing EPAs. Method: This review followed Joanna Briggs Institute guidance and PRISMA-ScR standards. English articles (2020-2023) on EPA implementation in undergraduate medical programs were searched from WoS, Scopus and EBSCO. Four independent reviewers screened records using Rayyan.ai, excluding reviews, postgraduate programs and non-medical professions. Three reviewers independently extracted and coded data using NVivo, with all disagreements resolved through discussion. Result: There were 790 unique records and 19 studies were extracted. Four essential dimensions for EPA implementation, namely EPA development (n = 9), EPA application (n = 13), entrustment (n = 10) and change management (n = 13), were identified. From this review, it was found that EPA development needs conceptualization, determining the development method and aligning with the curriculum. Whilst the needs for EPA application were students' and teachers' factors, feedback provision, curriculum characteristics, etc. Entrustment decision entails raters' cognition, a competencies committee and an awarding process. Change management needs leadership, commitment, a task force, resources, etc. Conclusion: This review establishes a comprehensive framework of four essential dimensions and their specific requirements for EPA implementation in undergraduate medical education. These evidence-based findings serve as foundational guidance for institutions planning EPA implementation and provide a basis for developing assessment tools to evaluate institutional readiness.

Publication Details

Page(s) 89-97

DOI DOI not available

Published Journal: Journal of Pioneering Medical Sciences, Volume: 15, Issue: 1, Year: 2026

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Keywords

Competency-Based, Needs, medical education, implementation, Entrustable Professional, Outcome-Based, Undergraduate, EPA

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