The Next Steps in Competency-Based Medical Education: Milestones, Entrustable Professional Activities and Observable Practice Activities

Abstract

Competency-based medical education (CBME) organizes the educational experience around competencies, emphasizes performance outcomes, promises greater accountability to patients and society, and is flexible and learner-centered.1 Competencies are multifaceted and integrated. Hence, our approach to competency assessment must involve an integrated assessment system and focus on performance in the workplace. Focusing on the workplace activities of trainees and inferring competence based on learner performance on those activities is most appropriate.2 Entrustable Professional Activities (EPAs) are an attractive assessment framework because they focus on day-to-day activities and inherently address multiple competencies and skills at once.