Entrustable Professional Activities for Emergency Medicine Specialists

Entrustable Professional Activities for Emergency Medicine Specialists | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Entrustable Professional Activities for Emergency Medicine Specialists David Teng, Anantharaman Venkataraman, Andrew Singer, Simon Chu, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7356905/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 25 Nov, 2025 Read the published version in International Journal of Emergency Medicine → Version 1 posted 11 You are reading this latest preprint version Abstract Background Various countries have developed competency frameworks for postgraduate training programs. Identifying Entrustable Professional Activities (EPAs) that are core clinical activities could bridge the gap between competencies and clinical practice. We aim to define essential EPAs required for safe independent practice as an Emergency Medicine (EM) Specialist, aligned with curricular outcomes from the International Federation for Emergency Medicine (IFEM) model curriculum for undergraduate, postgraduate and continuing professional training. Methods A nominal group of six members used consensus methodology to generate and rate essential EPAs for safe, independent practice as an EM specialist. Using existing literature on EPAs and IFEM curricular documents, the nominal group generated and clarified ideas for potential EPAs. Feedback was obtained from the IFEM Core Curriculum and Education committee, which comprises representatives from countries across all six IFEM regions, and integrated with iterative revisions. The EQual: Queen’s EPA Quality Rubric were used to rate how essential each EPA was for safe practice and the quality of each EPA. This approach is more rigorous as it allows for examination of the quality of EPAs generated and how well they align with the key domains of the EPA construct. Results A total of five EPAs were selected and refined from twenty-nine proposed EPAs. The five EPAs were: EPA 1 (Patient resuscitation), EPA 2 (Adult and/or paediatric non-resuscitative emergency care), EPA 3 (Managing multiple emergency patients), EPA 4 (Maintaining quality emergency care), and EPA 5 (Teaching emergency staff). All EPAs were directly mapped to the IFEM model curriculum to ensure relevancy and reliability. They were then rated using the EQual rubrics, with all five EPAs faring excellently and achieving overall median scores of more than four. Conclusion Five EPAs were identified and evaluated to show their importance as essential EPAs required for safe, independent practice as an EM specialist. These EPAs represent a promising framework of EPAs which will serve as a guide for individual countries to develop individual EPAs for training. Entrustable professional activities Consensus methods Competence Assessment Emergency medicine Figures Figure 1 Background There is increasing emphasis on competency-based medical education, with postgraduate training programs in Emergency Medicine (EM) worldwide exploring various competency frameworks at a national level [ 1 , 2 ]. Successful integration of these domain-dependent and domain-independent competencies is required to determine if a trainee is competent in performing specific tasks. Entrustable Professional Activities (EPAs) have been described as units of professional practice, defined as tasks or responsibilities to be entrusted to a trainee once sufficient specific competence is reached to allow for unsupervised practice. They are core specific tasks aligned to a specialty of medicine where a collection of competencies, often from different domains of practice, are combined to perform it independently. Identifying EPAs for specialist practice in EM may bridge the gap between competencies and clinical practice through the integration of competencies across the continuum of medical education [ 2 , 3 ]. EPAs contextualize abstract competencies to real world practice, meaningfully assess the progress and capabilities of trainees, and provide clearer expectations for trainees regarding the clinical tasks they will be required to perform as graduates. These EPAs also represent the work done and competencies required at various milestones of post-graduate training and form a realistic model of the clinician’s ability to meet the demands required of an Emergency Physician [ 4 ]. Therefore, EPAs have been adopted in various forms by various countries to integrate competencies in postgraduate training programs [ 5 – 10 ]. Various specialties in different countries, including internal medicine, family medicine, and psychiatry, have gone further and expressed their curriculum as EPAs rather than lists of competencies within domains of practice, to better illustrate how competency-based education relates to real world medicine [ 5 – 10 ]. The focus of such methods was typically on identifying suitable clinical tasks for EPAs. A rigorous approach towards producing the actual content for different components of EPAs, such as the required knowledge, skills and attitudes for particular tasks, has been scarce. We aimed to identify core EPAs required for safe independent practice as a specialist in EM aligned with the curricular outcomes for postgraduate training in our discipline. These EPAs should be applicable to most Emergency Medicine post-graduate specialist training programs around the world. In contrast to previous studies, these EPAs will be generalizable, suitable for adoption by different countries with different healthcare needs and requirements and allow for various countries to map their EPAs easily to key parts of their proposed curriculum. In addition, we have also assessed the quality of each EPA using the EQual rubrics [ 11 , 12 ], to have a better understanding and a more thorough approach towards the development of our EPAs. Methods A study design involving consensus methodology using a nominal group technique was used to generate and rate the importance of EPAs to achieve consensus on the essential EPAs required for safe, independent practice as an EM specialist. The nominal group technique uses a small group of people with a facilitator to mediate discussion, allowing in depth consideration of the subject matter. Similar approaches using consensus methodology have been used to identify EPAs in undergraduate and postgraduate settings [ 13 , 14 ]. The study was approved by the National Healthcare Group (NHG) Domain Specific Review Board (DSRB) (Reference: 2019/00339). Written informed consent was sought and obtained from all participants and procedures for responsible conduct of research followed, including use only of de-identified raw transcript data during group discussions, to ensure anonymity and confidentiality of the participants’ responses. This study was conducted internationally across all IFEM member countries. Based on published guidelines for the optimal size for nominal group process of between five to nine participants, six members of the IFEM Core Curriculum and Education with expertise in curricular design were recruited to be members of the nominal group. The members of this committee have had extensive experience in developing undergraduate and postgraduate emergency medicine curricula at national and international levels. Informed consent was obtained from all members of the nominal group. The approach incorporated five defined stages (Fig. 1 ), based on the theoretical framework described by ten Cate for designing EPAs [ 15 ]. In the beginning, the nominal group was provided with literature on EPAs, curricular documents from IFEM and IFEM member countries, and examples of EPAs. During phase two, after sufficient understanding of the scope of work, members of the nominal group generated ideas for potential EPAs using existing literature on EPAs and IFEM curricular documents. These were refined to improve clarity in phase three. This ensured that each EPA generated possessed the essential attributes of an EPA as well. Notes were taken to record the discussions which had taken place. During phase four, feedback was obtained from the Core Curriculum and Education committee, which comprises of representatives from countries across all six International Federation for Emergency Medicine (IFEM) regions. This was integrated with iterative revisions after each nominal group meeting. Finally, the nominal group rated each EPA refined previously on a five Point Likert scale: 1, unimportant, little relevance; 2, minor importance; 3, moderate importance; 4, important; 5, very important, essential. Due to the small sample size as well as the non-normal distribution of results, the median for each EPA was calculated to determine the importance of each EPA and the standard deviation as a measure of disagreement among the members of the nominal group. EPAs with a median score of five were included in the final set of EPAs. Those with a median score of four or higher could be included as well after further discussion and agreement by all members of the nominal group. In addition, the EQual rubrics were used to rate how essential each EPA was for safe practice and the quality of each EPA [ 11 , 12 ]. This approach is more rigorous than most studies employing a consensus methodology to identify EPAs. Apart from identifying the importance of each EPA, we also examined the quality of EPAs generated and how well they aligned with the key domains of the EPA construct, or if they will benefit from revisions. Results The following section presents our findings from the development of core EPAs required for safe independent practice as specialists in EM aligned with the curricular outcomes for postgraduate training in our discipline. Five EPAs were selected and refined from an initial list of twenty-nine EPAs (Tables 1 – 5 ). These were mapped to the IFEM model curriculum to ensure relevancy and reliability. These five core EPAs are presented in tables using guidelines for full Entrustable Professional Activities descriptions [ 16 ]. They were rated using the EQual: Queen’s EPA Quality Rubric (Table 6 ). All five EPAs achieved overall scores of more than four, demonstrating a great degree of validity and reliability in their quality. In addition, this study also polled nominal group members if they agreed that the EPAs constructed should be included as an EPA essential to safe, independent practice. Four of these EPAs recorded an agreement amongst five out of six (83%) of the nominal group members that they should be included. However, for one of the EPAs, only four out of six (67%) of the nominal group members agreed on this being included as an essential EPA. Table 1 EPA 1 : Patient resuscitation 1. EPA Title Patient resuscitation 2. Specifications and Limitations a. This activity contains no more and no less than the following elements: 1. Initial management and stabilization of a critically ill medical patient with life threatening organ dysfunction 2. Initial management and stabilization of a critically ill surgical patient with life threatening organ dysfunction 3. Initial management and stabilization of a patient who presents with major trauma and requires emergent treatment 4. Perform life, organ and extremity saving procedures 3. Potential risks in case of failure Mortality and morbidity of patients who are not managed expediently and accurately 4. Most Relevant Competency Domains Medical Knowledge, Communication and interpersonal skills, Patient Care, Professionalism 5. Required Knowledge, Skills, Attitudes and Experience Knowledge : - Develop and apply a full complement of medical knowledge to a full range of emergencies, acute and urgent presentations. - Recognize life-threatening illness or injury and apply principles of stabilization to the early management of these entities. - Recognize and be prepared to intervene, in any age group, for all causes of shock aetiology. - Understand the principles of cerebral resuscitation in brain illness and injury. - Understand the principles of trauma management. Skills : - Acquire basic and advanced life support skills, including the diagnosis and treatment of shock and the related procedural skills, and demonstrate the application of these principles in real or simulated patient care scenarios - Demonstrate proficiency in cardiopulmonary resuscitation - Be proficient at all resuscitative skills including leading a resuscitation of adults and children and be able to perform emergency procedures in most circumstances - Recognize and initiate first aid and definitive therapy for airway obstruction. - Be able to provide rapid stabilization with intravenous access and fluid/blood administration - Demonstrate proficiency in the use of a defibrillator and other advanced methods of cardioversion - Demonstrate mastery of commonly utilized procedural skills, such as airway management and deep venous access. - Demonstrate mastery of basic focused ultrasound skills, including Focused Assessment of Sonography in Trauma (FAST) - Demonstrate trauma management skills such as initial assessment using the ABC approach, full spine immobilization, secondary survey, stabilization, and appropriate consultation Attitudes : - Take and accept the lead of multi-professional teams. - Demonstrate knowledge of a nuanced understanding of the ethical issues associated with emergency medicine including but not limited to assessment and establishment of competency, do not resuscitate and advance directives, informed consent, confidentiality, non-accidental illness and injury, sexual assault, errors in care and lapses in patient safety Experiences : - As determined 6. Assessment Information Sources to assess progress • Written examination • Chart stimulated recall oral examinations • Procedure or case log • Simulations and models • Workplace Based Assessments (Mini-CEX, Direct observations, short practice observations) • Clinical patient examination skills Objective Structured Clinical Examination (OSCE) which includes standardized case based discussion stations and a simulation station of a resuscitation. • Oral examination • Multi-source feedback 7. Entrustment / Supervision Level expected at which stage of training Level 4 (unsupervised practice) 8. Expiration Date Dependent on individual IFEM member country, and the context in which the EPA is used It is acknowledged that adults and children each have their own distinctive sets of special anatomical, physiological and pathological characteristics and thus significantly different modes of behaviour and management. Granularity for specific patient populations (including paediatric populations) can be further achieved with ‘nested EPAs’ with reference to the Graduate Medical Education curriculum. Table 2 EPA 2: Adult and/or paediatric non-resuscitative emergency care 1. EPA Title Adult and/or paediatric non-resuscitative emergency care 2. Specifications and Limitations a. This activity contains no more and no less than the following elements: 1. Understanding the pathophysiology, clinical presentations, complications and initial management of adult and/or paediatric patients with acute medical illnesses for up to 24 hours in the Emergency Department 2. Evaluating mechanisms of injury, clinical presentations, complications and initial management of acute trauma presenting initially to the ED in a haemodynamically stable state. 3. Evaluating mechanisms of illness and injury in special populations including the elderly and children, the impact on the patient during presentation in the ED and their initial management in the ED. 4. Performance of a variety of emergency procedures on adult and/or paediatric patients being managed in the Emergency department, including vascular access, wound management, focused emergency ultrasound, invasive and non-invasive practical procedures and interacting with colleagues, patients, next-of-kin and community in patient management 3. Potential risks in case of failure 1. Patient safety 2. Quality of clinical care provided 3. Delay in definitive care with its adverse consequences 4. Increased morbidity and possible mortality 5. Increased reattendances and complaints to the ED 4. Most Relevant Competency Domains Medical Knowledge, Communication and interpersonal skills, Patient Care, Systems based Practice, Professionalism 5. Required Knowledge, Skills, Attitudes and Experience Knowledge : - Develop a full complement of basic knowledge of emergencies, acute and urgent presentations and be prepared to apply this knowledge to a full range of conditions. - Acquire further specialist knowledge to support clinical care in the emergency department. - Demonstrate the capacity to differentiate among and treat common acute problems. - Analyze clinical findings and develop and modify the differential diagnosis to a full range of clinical circumstances. - Recognize and be prepared to intervene, in any age group, for all causes of shock etiology. - Understand principles of wound care and demonstrate advanced wound care techniques in the management of common injury patterns. - Understand the principles of trauma management. - Recognize life-threatening illness or injury and apply principles of stabilization to the early management of these entities. - Demonstrate the capacity to recognize and treat common toxicological emergencies - Become a recognized expert and understand the role of these situations which are common to Emergency Medicine: all acute critical illness and injury, intoxicated patients, prehospital medicine, disaster management, environmental illness / injury, toxicology, - Develop a keen understanding of the importance and use of administrative perspectives, such as language barriers, injury prevention, out-of-hospital personnel, death notification for sudden unexpected death, media, resource utilization and medical decision making in emergency medicine practice Skills : - Acquire basic and advanced life support skills, including the diagnosis and treatment of shock and the related procedural skills, and demonstrate the application of these principles in real or simulated patient care scenarios. - Demonstrate trauma management skills such as initial assessment using the ABC approach, full spine immobilization, secondary survey, stabilization, and appropriate consultation - Demonstrate mastery of commonly utilized procedural skills, such as airway management and deep venous access. - Demonstrate mastery of basic focused ultrasound skills, including Focused Assessment of Sonography in Trauma (FAST) - Provide a Comprehensive assessment of the undifferentiated patient. Attitudes : - Act as the patient’s advocate, advisor, and guide within the acute phase of his or her illness or injury - Demonstrate knowledge of a nuanced understanding of the ethical issues associated with emergency medicine including but not limited to assessment and establishment of competency, do not resuscitate and advance directives, informed consent, confidentiality, non-accidental illness and injury, sexual assault, errors in care and lapses in patient safety Experiences : As determined 6. Assessment Information Sources to assess progress 1. Sources of information would be one or more of the following: • Written examination • Chart stimulated recall oral examinations • Procedure or case log • Simulations and models • Workplace Based Assessments (Mini-CEX, Direct observations, short practice observations) • Clinical patient examination skills Objective Structured Clinical Examination (OSCE) which includes standardized case based discussion stations and a simulation station of a resuscitation. • Oral examination • Multi-source feedback 2. Owing to the large variety of patient encounters in this EPA, each jurisdiction will need to determine the minimum number of times a candidate would need to be assessed to ensure that he can confidently address the variety expected. Such variety should be captured in a log of such EPA encounters. 3. Persons making such observations should be independent senior observers who are not the immediate supervising emergency physician of the candidate. 4. The decision on whether the candidate has fulfilled the EPA should be after evaluation of the relevant number of EPA encounters by the appropriate Residency Evaluation Committee 7. Entrustment / Supervision Level expected at which stage of training Level 4 (unsupervised practice) 8. Expiration Date Dependent on individual IFEM member country, and the context in which the EPA is used Table 3 EPA 3: Managing multiple emergency patients 1. EPA Title Managing multiple emergency patients 2. Specifications and Limitations a. This activity contains no more and no less than the following elements: 1. Monitoring and adapting to changes of clinical demand in ED 2. Managing patient surges 3. Activation of disaster code and leading a mass casualty event in ED 4. Appropriate deployment of medical and nursing staff, based on skill-mix and demand No limitations. 3. Potential risks in case of failure Patient safety Mis-management of hospital manpower and resources Loss of confidence of community in ability of Emergency Department to manage patient loads 4. Most Relevant Competency Domains Communication and interpersonal skills, Systems based Practice, Professionalism 5. Required Knowledge, Skills, Attitudes and Experience Knowledge : - Knowledge of systems practice, man-management to be competent in coordinating and overseeing the management of multiple patients simultaneously, including mass-casualty incidents - Demonstrate the capacity to prioritize attention to those patients with more urgent conditions. Skills : - Plan and prioritize tasks both in the clinical setting and in professional life. - Develop the skills of delegation to other personnel in the emergency department and the leadership skills required to maintain the pace of others working in clinical environment to ensure that patient needs are met. Attitudes : - Professionalism to demonstrate a commitment to patient care above all other issues - Ability to recognize how to do the most good for the most people Experiences : - Time as team leader during a shift - Team-leading in a mass-casualty incident 6. Assessment Information Sources to assess progress • Workplace Based Assessments (Mini-CEX, Direct observations, short practice observations) • Clinical patient examination skills Objective Structured Clinical Examination (OSCE) which includes standardized case based discussion stations and a simulation station of a resuscitation. • Shift Reports • Multi-source feedback 7. Entrustment / Supervision Level expected at which stage of training Level 4 (unsupervised practice) 8. Expiration Date Dependent on individual IFEM member country, and the context in which the EPA is used Table 4 EPA 4: Maintaining quality emergency care 1. EPA Title Maintaining quality emergency care 2. Specifications and Limitations a. This activity contains no more and no less than the following elements: 1. Creating departmental processes regarding quality patient care 2. Reviewing and improving the emergency department’s clinical functions 3. Planning and implementing new modalities of patient care in the Emergency Department Limited to normal daily operations; does not include special exigencies including heightened response to pandemics/infectious pathogens, or disaster response 3. Potential risks in case of failure 1. Patient harm 2. Mis-management of hospital and departmental manpower and resources 3. Suboptimal Quality of patient care in the Emergency Department 4. Most Relevant Competency Domains Communication and interpersonal skills, Systems based Practice, Professionalism 5. Required Knowledge, Skills, Attitudes and Experience Knowledge : - Complete specified management projects particularly around staff management and complaints. - Be capable of describing the importance of the ED as the link between the general population and the health care system. Skills : - Carry out audit projects, support others in completing audit projects and contribute to the implementation of guidelines, care plans, and other aspects of clinical governance related to emergency medicine issues. - Take and accept the lead of multi-professional teams. - Plan and prioritize tasks both in the clinical setting and in professional life. Attitudes : - Demonstrate knowledge of a nuanced understanding of the ethical issues associated with emergency medicine including but not limited to assessment and establishment of competency, do not resuscitate and advance directives, informed consent, confidentiality, non-accidental illness and injury, sexual assault, errors in care and lapses in patient safety Experiences : As determined 6. Assessment Information Sources to assess progress • Portfolios with guided reflection • Procedure or case log • Simulations and models • Workplace Based Assessments (Mini-CEX, Direct observations, short practice observations) • Clinical patient examination skills Objective Structured Clinical Examination (OSCE) which includes standardized case based discussion stations and a simulation station of a resuscitation. • Multi-source feedback 7. Entrustment / Supervision Level expected at which stage of training Level 4 (unsupervised practice) 8. Expiration Date Dependent on individual IFEM member country, and the context in which the EPA is used Table 5 EPA 5: Teaching emergency staff 1. EPA Title Teaching emergency staff 2. Specifications and Limitations a. This activity contains no more and no less than the following elements: 1. Educate team members 2. Teaching less experience team members while keeping a focus on providing safe and competent clinical care 3. Mentoring junior staff. No limitations. 3. Potential risks in case of failure Psychological damage to team Patient safety Trust amongst members of the team 4. Most Relevant Competency Domains Systems based Practice, Medical Knowledge, Communication and interpersonal skills, Professionalism 5. Required Knowledge, Skills, Attitudes and Experience Knowledge : - Become competent in the delivery of training to other professionals, teach and supervise others in areas of emergency medicine practice as well as develop and demonstrate mentoring and appraisal skills - Develop areas of special interests that facilitate growth as a professional. - Become a recognized expert and understand the role of these situations which are common to Emergency Medicine: all acute critical illness and injury, intoxicated patients, media, out–of–hospital personnel, prehospital medicine, disaster management, language barriers, environmental illness / injury, injury prevention, death notification for sudden unexpected death, toxicology, resource utilization, medical decision making Skills : - Develop the skills needed for a lifetime of self-directed learning and demonstrate the capacity to critically appraise the literature and apply the literature to clinical practice. Attitudes : - Demonstrate knowledge of a nuanced understanding of the ethical issues associated with emergency medicine including but not limited to assessment and establishment of competency, do not resuscitate and advance directives, informed consent, confidentiality, non-accidental illness and injury, sexual assault, errors in care and lapses in patient safety Experiences : As determined 6. Assessment Information Sources to assess progress End of term Report Direct observations of teaching, short practice observations Objective Structured Clinical Examination (OSCE) Global rating of performance Portfolios Record review Simulations and models Student/Teacher feedback 7. Entrustment / Supervision Level expected at which stage of training Level 4 (unsupervised) 8. Expiration Date Dependent on individual IFEM member country, and the context in which the EPA is used Table 6 Evaluation of core EPAs using EQual: Queen’s EM Quality Rubric EPA 1 EPA 2 EPA 3 EPA 4 EPA 5 Rubric 1: This EPA describes work that is essential and important to the profession* 5.00 (SD 0.000) 5.00 (SD 0.00) 5.00 (SD 0.408) 4.00 (SD 0.894) 4.50 (SD 0.816) Rubric 2: Performing this EPA leads to recognised output or outcome of labour* 5.00 (SD 0.837) 4.00 (SD 0.632) 5.00 (SD 0.516) 4.00 (SD 0.408) 4.00 (SD 0.753) Rubric 3: The performance of this EPA in clinical practice is restricted to qualified personnel* 4.00 (SD 0.000) 4.00 (SD 0.516) 4.00 (SD 0.408) 4.00 (SD 0.632) 4.50 (SD 0.816) Rubric 4: This EPA addresses professional work that is suitable for entrustment* 5.00 (SD 0.000) 5.00 (SD 0.408) 4.50 (SD 0.577) 5.00 (SD 0.837) 4.00 (SD 1.37) Median score* 5.00 (SD 0.500) 4.50 (SD 0.577) 4.75 (SD 0.479) 4.00 (SD 0.500) 4.25 (SD 0.289) No. of group members (%) out of six who agree that EPA should be included 5 (83%) 5 (83%) 5 (83%) 5 (83%) 4 (67%) *Results are shown as median scores, with SD (Standard Deviation) indicated with each score Discussion We describe a comprehensive approach to identifying core EPAs required for safe independent practice as a specialist in EM aligned with the curricular outcomes for postgraduate training in our discipline. Competencies can be mapped onto each EPA and assessment methods can be constructively aligned with each EPA within a program of assessment. In practical terms, framing competencies in the context of EPAs may be more meaningful to clinical supervisors. As such, we have completed mapping of the core EPAs described above to IFEM and various countries’ curricula (Tables 8 – 12 ). This allows us to visualise how our suggested list of core EPAs (Table 7 ) provide a model of integration of various competencies and curricular outcomes. Table 7 Proposed list of core Entrustable Professional Activities (EPAs) for Emergency Medicine Specialists. Proposed Entrustable Professional Activity (EPA) EPA 1 Patient resuscitation EPA 2 Adult and/or paediatric non-resuscitative emergency care EPA 3 Managing multiple emergency patients EPA 4 Maintaining quality emergency care EPA 5 Teaching emergency staff Table 8 Review of Proposed EPAs with IFEM Model Curriculum for EM Specialists EPA 1 EPA 2 EPA 3 EPA 4 EPA 5 Develop a full complement of basic knowledge of emergencies, acute and urgent presentations and be prepared to apply this knowledge to a full range of conditions. ✓ ✓ Acquire further specialist knowledge to support clinical care in the emergency department. ✓ ✓ Acquire basic and advanced life support skills, including the diagnosis and treatment of shock and the related procedural skills, and demonstrate the application of these principles in real or simulated patient care scenarios. ✓ ✓ Demonstrate the capacity to differentiate among and treat common acute problems. ✓ Provide a Comprehensive assessment of the undifferentiated patient. ✓ Analyze clinical findings and develop and modify the differential diagnosis to a full range of clinical circumstances. ✓ Demonstrate proficiency in cardiopulmonary resuscitation ✓ Become proficient at all resuscitative skills including leading a resuscitation of adults and children and be able to perform emergency procedures in most circumstances. ✓ Recognize and initiate first aid and definitive therapy for airway obstruction. ✓ Recognize and be prepared to intervene, in any age group, for all causes of shock etiology. ✓ ✓ Be able to provide rapid stabilization with intravenous access and fluid/blood administration. ✓ Understand the principles of cerebral resuscitation in brain illness and injury. ✓ ✓ Demonstrate proficiency in the use of a defibrillator and other advanced methods of cardioversion. ✓ Understand principles of wound care and demonstrate advanced wound care techniques in the management of common injury patterns. ✓ Understand the principles of trauma management. ✓ ✓ Demonstrate trauma management skills such as initial assessment using the ABC approach, full spine immobilization, secondary survey, stabilization, and appropriate consultation ✓ ✓ Demonstrate mastery of commonly utilized procedural skills, such as airway management and deep venous access. ✓ ✓ Demonstrate mastery of basic focused ultrasound skills, including Focused Assessment of Sonography in Trauma (FAST) ✓ ✓ Recognize life-threatening illness or injury and apply principles of stabilization to the early management of these entities. ✓ Plan and prioritize tasks both in the clinical setting and in professional life. ✓ ✓ ✓ Develop the skills of delegation to other personnel in the emergency department and the leadership skills required to maintain the pace of others working in clinical environment to insure that patient needs are met. ✓ Demonstrate the capacity to prioritize attention to those patients with more urgent conditions. ✓ Demonstrate the capacity to recognize and treat common toxicological emergencies ✓ Become competent in the delivery of training to other professionals, teach and supervise others in areas of emergency medicine practice as well as develop and demonstrate mentoring and appraisal skills ✓ Complete specified management projects particularly around staff management and complaints. ✓ Carry out audit projects, support others in completing audit projects and contribute to the implementation of guidelines, care plans, and other aspects of clinical governance related to emergency medicine issues. ✓ Develop the skills needed for a lifetime of self-directed learning and demonstrate the capacity to critically appraise the literature and apply the literature to clinical practice. ✓ Develop areas of special interests that facilitate growth as a professional. ✓ Take and accept the lead of multi-professional teams. ✓ Demonstrate knowledge of a nuanced understanding of the ethical issues associated with emergency medicine including but not limited to assessment and establishment of competency, do not resuscitate and advance directives, informed consent, confidentiality, non-accidental illness and injury, sexual assault, errors in care and lapses in patient safety ✓ ✓ ✓ ✓ Be capable of describing the importance of the ED as the link between the general population and the health care system. ✓ Become a recognized expert and understand the role of these situations which are common to Emergency Medicine: all acute critical illness and injury, intoxicated patients, media, out–of–hospital personnel, prehospital medicine, disaster management, language barriers, environmental illness / injury, injury prevention, death notification for sudden unexpected death, toxicology, resource utilization, medical decision making ✓ ✓ Table 9 Review of Proposed EPAs with RCEM Curriculum 2020 EPA 1 EPA 2 EPA 3 EPA 4 EPA 5 Deliver “Pinnacle” Emergency Care Skills (perform key emergency skills that are time critical and/or life/limb saving) ✓ Care for the injured patient ✓ Care for the paediatric patient ✓ Care for low acuity, high complexity, stable patients ✓ Answer clinical questions on the shop floor ✓ Lead the ED shift as “Emergency Physician in Charge” ✓ Deal with shop floor curve balls (individual shop-floor occurrences that do not pertain directly to clinical evaluation) ✓ ✓ Undertake key administrative tasks ✓ Supervise and appraise junior colleagues ✓ ✓ Educate the team ✓ Understand, apply and contribute to research ✓ Lead an Emergency Medicine Quality Improvement project to completion ✓ Table 10 Review of Proposed EPAs with Entrustable Professional Activity Guide: Emergency Medicine (The Royal College of Physicians and Surgeons of Canada) EPA 1 EPA 2 EPA 3 EPA 4 EPA 5 Recognizing the unstable/critically ill patient, mobilizing the health care team and supervisor, and initiating basic life support ✓ Initiating and assisting in resuscitation of critically ill patients ✓ Resuscitating and coordinating care for critically ill patients ✓ Resuscitating and coordinating care for critically injured trauma patients ✓ Providing airway management and ventilation ✓ Providing emergency sedation and systemic analgesia for diagnostic and therapeutic procedures ✓ ✓ Performing advanced procedures ✓ Performing and interpreting point-of-care ultrasound to guide patient management ✓ Assessing and managing patients with uncomplicated urgent and non-urgent emergency department presentations ✓ Identifying and managing patients with emergent medical or surgical conditions ✓ Diagnosing and managing patients with complicated urgent and non-urgent patient presentations ✓ Managing patients with acute toxic ingestion or exposure ✓ Managing patients with emergency mental health conditions or behavioural emergencies ✓ Managing urgent and emergent presentations for pregnant and post-partum patients ✓ Providing end-of-life care for a patient ✓ Dealing with uncertainty when managing patients with ambiguous presentations ✓ Performing and documenting focused histories and physical exams, and providing preliminary management of cardinal emergency department presentations ✓ Performing basic procedures ✓ Facilitating communication of information between a patient in the emergency department, caregivers, and members of the health care team to organize care and disposition of the patient ✓ ✓ Managing complex interpersonal interactions that arise during the course of patient care ✓ Using clinical informatics to facilitate efficient, safe, patient care ✓ ✓ Managing the emergency department to optimize patient care and department flow ✓ Managing and supporting patients in situational crisis to access health care and community resources ✓ ✓ Recognizing and managing patients who are at risk of exposure to, or who have experienced violence and/or neglect ✓ ✓ Contributing to the shared work of the emergency department health care team to achieve high quality, efficient and safe patient care ✓ Liaising with prehospital emergency medical services ✓ Providing expert EM consultation to physicians or other health care providers ✓ Coordinating and collaborating with health care professional colleagues to safely transition the care of patients, including handover and facilitating interinstitution transport ✓ Teaching and supervising the learning of trainees and other health care professionals ✓ Appraising and integrating new evidence into clinical practice ✓ ✓ ✓ Table 11 Review of Proposed EPAs with Singapore Emergency Medicine Residency EPAs EPA 1 EPA 2 EPA 3 EPA 4 EPA 5 Resuscitate and stabilise critically ill adult medical patients ✓ Resuscitate and stabilise critically ill adult trauma patients ✓ Resuscitate and stabilise critically ill paediatric medical and trauma patients ✓ Manage Adult ambulatory patients ✓ Manage Paediatric ambulatory patients ✓ Manage patients in the Observation Facility ✓ ✓ Manage patients in an Out-of-ED setting ✓ ✓ ✓ Manage End-of-Life care and provide palliative care ✓ Manage ED Clinical Care areas ✓ Manage administrative and operational aspects of the ED ✓ Support, Supervise and facilitate learning of peers, juniors, students & other Healthcare Professionals ✓ Appraise current literature in relation to practice ✓ Table 12 Review of Proposed EPAs with American (United States of America) Core EPAs EPA 1 EPA 2 EPA 3 EPA 4 EPA 5 Manage a low-acuity, low-complexity “stable” patient ✓ Manage a low-acuity, high-complexity “stable” patient ✓ Manage a potentially high-acuity complaint in a “stable” patient ✓ Manage a high-acuity patient with a well-defined presentation, illness or injury ✓ Manage a high-acuity, high-complexity “stable” patient (i.e. the undifferentiated unstable patient) ✓ Manage multiple patients in the emergency department (ED) concomitantly. ✓ ✓ Lead an ED team. ✓ Transition patient care to other healthcare providers. ✓ Manage interactions with consultants. ✓ Manage complex and difficult situations. ✓ ✓ Use recommended patient-safety and quality improvement processes. ✓ The use of the EQual: Queen’s EM Quality Rubric to evaluate the quality of each EPA generated is a novel approach. This strategy sets the EPAs generated aside from others by having them rated objectively (Table 6 ). Should an EPA fall short of the quality benchmarks required of them with a median score of less than four out of five, they have to be re-evaluated and re-considered – this ensures that only EPAs which are of sufficient quality and show that they fulfil the requirements of an EPA will be listed. All of the EPAs have a median score of more than four, with the lowest rating of 4.00 for EPA 4. An additional score indicating the number of group members in agreement that the EPA should be included was also calculated, with most of the EPAs showing general approval for inclusion of the EPAs. Of note, only four out of six (67%) members of the group in agreement that EPA 5 should be included, even if the EPA itself was rated more than four. Within each EPA, median scores of more than 4.00 were achieved. Standard deviations were recorded for each median, with large variations noted for EPA 5. EPA 5, in particular, deals with education and teaching of emergency staff. There was significant debate and discussion if teaching was a level of entrustment, or a specific unit of work which is essential to an Emergency Physician’s practice. In contrast, EPA 1 (Patient resuscitation) and EPA 3 (Managing multiple emergency patients) were rated highest with median scores of 5.00 and 4.75 respectively, reflecting the high level of agreement amongst the nominal group members regarding how these EPAs are of high quality, and genuinely reflect the work that an Emergency Physician is expected to perform independently and competently. Conclusion Five EPAs were identified as essential EPAs required for safe, independent practice as an EM specialist. All five EPAs could be mapped to existing EPAs used in six different member countries of the International Federation for Emergency Medicine (IFEM). These EPAs represent a promising framework of EPAs which will serve as a guide and model examples for individual countries to develop individual EPAs for training. Abbreviations EPA Entrustable Professional Activities EM Emergency Medicine IFEM International Federation for Emergency Medicine NHG National Healthcare Group DSRB Domain Specific Review Board Declarations Ethics Approval and consent to participate The study was approved by the National Healthcare Group (NHG) Domain Specific Review Board (DSRB) (Reference: 2019/00339). Written informed consent was sought and obtained from all participants and procedures for responsible conduct of research followed, including use only of de-identified raw transcript data during group discussions, to ensure anonymity and confidentiality of the participants’ responses. Consent for publication Not Applicable Availability of data and materials The author confirms that all data generated or analysed during this study are included in this published article. Competing interests The authors declare that they have no competing interests. Funding No funding was used for the study. Authors’ contributions AV, AS, SC, AAC, JPT, and TH were members of the nominal group which used consensus methodology to generate and rate EPAs. DT and JK analysed and interpreted the ratings of the final list of EPAs, as well as mapping of EPAs to current curriculum. DT was also a major contributor in writing the manuscript, with JK and AAC proof reading and supervising. All authors read and approved the final manuscript. Acknowledgements Authors would like to express their gratitude to IFEM Core Curriculum and Education Committee members and IFEM Member Country representatives whose time and support were invaluable. References Frank JR, Snell LS, ten Cate O, Holmboe ES, Carraccio C, Swing SR, Harris P, Glasgow NJ, Campbell C, Dath D et al: Competency-based medical education: theory to practice. Med Teach. 2010;32(8):638–45. ten Cate O. Entrustability of professional activities and competency-based training. Med Educ. 2005;39(12):1176–7. ten Cate O, Scheele F. Competency-based postgraduate training: can we bridge the gap between theory and clinical practice? Acad Med. 2007;82(6):542–7. ten Cate O, Young JQ. The patient handover as an entrustable professional activity: adding meaning in teaching and practice. BMJ Qual Saf. 2012;21 Suppl 1:i9–12. Hauer KE, Kohlwes J, Cornett P, Hollander H, ten Cate O, Ranji SR, Soni K, Iobst W, O'Sullivan P: Identifying entrustable professional activities in internal medicine training. J Grad Med Educ. 2013;5(1):54–9. Hauer KE, Soni K, Cornett P, Kohlwes J, Hollander H, Ranji SR, ten Cate O, Widera E, Calton B, O'Sullivan PS: Developing entrustable professional activities as the basis for assessment of competence in an internal medicine residency: a feasibility study. J Gen Intern Med. 2013;28(8):1110–4. Shaughnessy AF, Sparks J, Cohen-Osher M, Goodell KH, Sawin GL, Gravel Jr: Entrustable professional activities in family medicine. J Grad Med Educ. 2013;5(1):112–8. Chang A, Bowen JL, Buranosky RA, Frankel RM, Ghosh N, Rosenblum MJ, Thompson S, Green ML: Transforming primary care training–patient centered medical home entrustable professional activities for internal medicine residents. J Gen Intern Med. 2013;28(6):801–9. Association of American Medical Colleges. Core entrustable professional activities for entering residency. 2014. http://members.aamc.org/eweb/upload/Core%20EPA%20Curriculum%20Dev%20Guide.pdf. Boyce P, Spratt C, Davies M, McEvoy P. Using entrustable professional activities to guide curriculum development in psychiatry training . BMC Med Educ. 2011;11:96 . Taylor D, YS Park, R Egan, MK Chan, J Karpinski, C Touchie, L Snell, A Tekian. EQual, a Novel Rubric to Evaluate Entrustable Professional Activities for Quality and Structure. Academic Medicine 92(11S): p S110-S117 Nov 2017 Meyer E.G., DR Taylor, U Sebastian, SJ Durning. EQual Rubric Evaluation of the Association of American Medical Colleges' Core Entrustable Professional Activities for Entering Residency. Academic Medicine 2020 Nov; 95 (11): 1755-1762 Chen HC, van den Broek WE, Ten Cate O. The case for use of Entrustable professional activities in undergraduate medical education. Acad Med.2015;90(4):431–6. ten Cate O. Trust, competence, and the supervisor’s role in postgraduate training. BMJ. 2006;333(7571):748–51. ten Cate O, Young JQ. The patient handover as an entrustable professional activity: adding meaning in teaching and practice. BMJ Qual Saf. 2012;21 Suppl 1:i9–12. ten Cate. Nuts and Bolts of Entrustable Professional Activities. Journal of Graduate Medical Education, March 2013. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 25 Nov, 2025 Read the published version in International Journal of Emergency Medicine → Version 1 posted Editorial decision: Revision requested 11 Sep, 2025 Reviews received at journal 30 Aug, 2025 Reviews received at journal 29 Aug, 2025 Reviews received at journal 21 Aug, 2025 Reviewers agreed at journal 20 Aug, 2025 Reviewers agreed at journal 20 Aug, 2025 Reviewers agreed at journal 19 Aug, 2025 Reviewers invited by journal 19 Aug, 2025 Editor assigned by journal 13 Aug, 2025 Submission checks completed at journal 13 Aug, 2025 First submitted to journal 12 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7356905","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":503905805,"identity":"9a36128b-dfae-4ee8-85b0-333a06c00fb1","order_by":0,"name":"David Teng","email":"data:image/png;base64,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","orcid":"","institution":"Tan Tock Seng Hospital","correspondingAuthor":true,"prefix":"","firstName":"David","middleName":"","lastName":"Teng","suffix":""},{"id":503905806,"identity":"7f6da4a5-072a-47eb-bac9-22463017f7ac","order_by":1,"name":"Anantharaman Venkataraman","email":"","orcid":"","institution":"Singapore General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Anantharaman","middleName":"","lastName":"Venkataraman","suffix":""},{"id":503905807,"identity":"ab926988-ad13-420f-8a11-30438c2b2e2b","order_by":2,"name":"Andrew Singer","email":"","orcid":"","institution":"Australian National University Medical School","correspondingAuthor":false,"prefix":"","firstName":"Andrew","middleName":"","lastName":"Singer","suffix":""},{"id":503905808,"identity":"70bf4e97-93f1-4ce5-a1a7-1159d91ca11a","order_by":3,"name":"Simon Chu","email":"","orcid":"","institution":"University of Adelaide, Lyell McEwin Hospital","correspondingAuthor":false,"prefix":"","firstName":"Simon","middleName":"","lastName":"Chu","suffix":""},{"id":503905809,"identity":"b50f761e-8e34-425b-b518-5b0d2334218a","order_by":4,"name":"Arif Alper Cevik","email":"","orcid":"","institution":"United Arab Emirates University","correspondingAuthor":false,"prefix":"","firstName":"Arif","middleName":"Alper","lastName":"Cevik","suffix":""},{"id":503905810,"identity":"6c987aa3-777f-4519-8663-e923b22ad06c","order_by":5,"name":"Janis P. Tupesis","email":"","orcid":"","institution":"University of Wisconsin","correspondingAuthor":false,"prefix":"","firstName":"Janis","middleName":"P.","lastName":"Tupesis","suffix":""},{"id":503905811,"identity":"db4bb0c2-6c8b-421d-b062-d7caa0b83a87","order_by":6,"name":"Taj Hassan","email":"","orcid":"","institution":"Leeds Teaching Hospitals NHS Trust","correspondingAuthor":false,"prefix":"","firstName":"Taj","middleName":"","lastName":"Hassan","suffix":""},{"id":503905812,"identity":"cb5ab356-9571-45c3-9adc-4baaad8c383c","order_by":7,"name":"James Kwan","email":"","orcid":"","institution":"Tan Tock Seng Hospital","correspondingAuthor":false,"prefix":"","firstName":"James","middleName":"","lastName":"Kwan","suffix":""}],"badges":[],"createdAt":"2025-08-12 14:38:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7356905/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7356905/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12245-025-01075-z","type":"published","date":"2025-11-25T15:57:00+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":90304073,"identity":"f1558a36-b8c8-4ebf-b5ac-9039ce4b41e8","added_by":"auto","created_at":"2025-09-01 09:10:43","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":461795,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eFive stages of study approach based on theoretical framework described by ten Cate for designing EPAs.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7356905/v1/2e77877d6a8a50b4149c6570.jpeg"},{"id":97178230,"identity":"c75f6d51-6fce-407b-99b7-79873df8435a","added_by":"auto","created_at":"2025-12-01 16:02:53","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2200580,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7356905/v1/62dae8b9-7c89-43a9-b898-72eeeeda1abf.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Entrustable Professional Activities for Emergency Medicine Specialists","fulltext":[{"header":"Background","content":"\u003cp\u003eThere is increasing emphasis on competency-based medical education, with postgraduate training programs in Emergency Medicine (EM) worldwide exploring various competency frameworks at a national level [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Successful integration of these domain-dependent and domain-independent competencies is required to determine if a trainee is competent in performing specific tasks. Entrustable Professional Activities (EPAs) have been described as units of professional practice, defined as tasks or responsibilities to be entrusted to a trainee once sufficient specific competence is reached to allow for unsupervised practice. They are core specific tasks aligned to a specialty of medicine where a collection of competencies, often from different domains of practice, are combined to perform it independently. Identifying EPAs for specialist practice in EM may bridge the gap between competencies and clinical practice through the integration of competencies across the continuum of medical education [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. EPAs contextualize abstract competencies to real world practice, meaningfully assess the progress and capabilities of trainees, and provide clearer expectations for trainees regarding the clinical tasks they will be required to perform as graduates. These EPAs also represent the work done and competencies required at various milestones of post-graduate training and form a realistic model of the clinician\u0026rsquo;s ability to meet the demands required of an Emergency Physician [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eTherefore, EPAs have been adopted in various forms by various countries to integrate competencies in postgraduate training programs [\u003cspan additionalcitationids=\"CR6 CR7 CR8 CR9\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Various specialties in different countries, including internal medicine, family medicine, and psychiatry, have gone further and expressed their curriculum as EPAs rather than lists of competencies within domains of practice, to better illustrate how competency-based education relates to real world medicine [\u003cspan additionalcitationids=\"CR6 CR7 CR8 CR9\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. The focus of such methods was typically on identifying suitable clinical tasks for EPAs. A rigorous approach towards producing the actual content for different components of EPAs, such as the required knowledge, skills and attitudes for particular tasks, has been scarce.\u003c/p\u003e\u003cp\u003eWe aimed to identify core EPAs required for safe independent practice as a specialist in EM aligned with the curricular outcomes for postgraduate training in our discipline. These EPAs should be applicable to most Emergency Medicine post-graduate specialist training programs around the world. In contrast to previous studies, these EPAs will be generalizable, suitable for adoption by different countries with different healthcare needs and requirements and allow for various countries to map their EPAs easily to key parts of their proposed curriculum. In addition, we have also assessed the quality of each EPA using the EQual rubrics [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e], to have a better understanding and a more thorough approach towards the development of our EPAs.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eA study design involving consensus methodology using a nominal group technique was used to generate and rate the importance of EPAs to achieve consensus on the essential EPAs required for safe, independent practice as an EM specialist. The nominal group technique uses a small group of people with a facilitator to mediate discussion, allowing in depth consideration of the subject matter. Similar approaches using consensus methodology have been used to identify EPAs in undergraduate and postgraduate settings [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The study was approved by the National Healthcare Group (NHG) Domain Specific Review Board (DSRB) (Reference: 2019/00339). Written informed consent was sought and obtained from all participants and procedures for responsible conduct of research followed, including use only of de-identified raw transcript data during group discussions, to ensure anonymity and confidentiality of the participants\u0026rsquo; responses.\u003c/p\u003e\u003cp\u003eThis study was conducted internationally across all IFEM member countries. Based on published guidelines for the optimal size for nominal group process of between five to nine participants, six members of the IFEM Core Curriculum and Education with expertise in curricular design were recruited to be members of the nominal group. The members of this committee have had extensive experience in developing undergraduate and postgraduate emergency medicine curricula at national and international levels. Informed consent was obtained from all members of the nominal group.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThe approach incorporated five defined stages (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e), based on the theoretical framework described by ten Cate for designing EPAs [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. In the beginning, the nominal group was provided with literature on EPAs, curricular documents from IFEM and IFEM member countries, and examples of EPAs. During phase two, after sufficient understanding of the scope of work, members of the nominal group generated ideas for potential EPAs using existing literature on EPAs and IFEM curricular documents. These were refined to improve clarity in phase three. This ensured that each EPA generated possessed the essential attributes of an EPA as well. Notes were taken to record the discussions which had taken place. During phase four, feedback was obtained from the Core Curriculum and Education committee, which comprises of representatives from countries across all six International Federation for Emergency Medicine (IFEM) regions. This was integrated with iterative revisions after each nominal group meeting. Finally, the nominal group rated each EPA refined previously on a five Point Likert scale: 1, unimportant, little relevance; 2, minor importance; 3, moderate importance; 4, important; 5, very important, essential.\u003c/p\u003e\u003cp\u003eDue to the small sample size as well as the non-normal distribution of results, the median for each EPA was calculated to determine the importance of each EPA and the standard deviation as a measure of disagreement among the members of the nominal group. EPAs with a median score of five were included in the final set of EPAs. Those with a median score of four or higher could be included as well after further discussion and agreement by all members of the nominal group. In addition, the EQual rubrics were used to rate how essential each EPA was for safe practice and the quality of each EPA [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. This approach is more rigorous than most studies employing a consensus methodology to identify EPAs. Apart from identifying the importance of each EPA, we also examined the quality of EPAs generated and how well they aligned with the key domains of the EPA construct, or if they will benefit from revisions.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe following section presents our findings from the development of core EPAs required for safe independent practice as specialists in EM aligned with the curricular outcomes for postgraduate training in our discipline. Five EPAs were selected and refined from an initial list of twenty-nine EPAs (Tables\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). These were mapped to the IFEM model curriculum to ensure relevancy and reliability. These five core EPAs are presented in tables using guidelines for full Entrustable Professional Activities descriptions [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. They were rated using the EQual: Queen\u0026rsquo;s EPA Quality Rubric (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e). All five EPAs achieved overall scores of more than four, demonstrating a great degree of validity and reliability in their quality. In addition, this study also polled nominal group members if they agreed that the EPAs constructed should be included as an EPA essential to safe, independent practice. Four of these EPAs recorded an agreement amongst five out of six (83%) of the nominal group members that they should be included. However, for one of the EPAs, only four out of six (67%) of the nominal group members agreed on this being included as an essential EPA.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cem\u003eEPA 1\u003c/em\u003e: \u003cem\u003ePatient resuscitation\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1. EPA Title\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePatient resuscitation\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2. \u003cb\u003eSpecifications and Limitations\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ea. This activity contains no more and no less than the following elements:\u003c/p\u003e\u003cp\u003e1. Initial management and stabilization of a critically ill medical patient with life threatening organ dysfunction\u003c/p\u003e\u003cp\u003e2. Initial management and stabilization of a critically ill surgical patient with life threatening organ dysfunction\u003c/p\u003e\u003cp\u003e3. Initial management and stabilization of a patient who presents with major trauma and requires emergent treatment\u003c/p\u003e\u003cp\u003e4. Perform life, organ and extremity saving procedures\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3. \u003cb\u003ePotential risks in case of failure\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMortality and morbidity of patients who are not managed expediently and accurately\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4. \u003cb\u003eMost Relevant Competency Domains\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMedical Knowledge, Communication and interpersonal skills, Patient Care, Professionalism\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5. \u003cb\u003eRequired Knowledge, Skills, Attitudes and Experience\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eKnowledge\u003c/span\u003e:\u003c/p\u003e\u003cp\u003e- Develop and apply a full complement of medical knowledge to a full range of emergencies, acute and urgent presentations.\u003c/p\u003e\u003cp\u003e- Recognize life-threatening illness or injury and apply principles of stabilization to the early management of these entities.\u003c/p\u003e\u003cp\u003e- Recognize and be prepared to intervene, in any age group, for all causes of shock aetiology.\u003c/p\u003e\u003cp\u003e- Understand the principles of cerebral resuscitation in brain illness and injury.\u003c/p\u003e\u003cp\u003e- Understand the principles of trauma management.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eSkills\u003c/span\u003e:\u003c/p\u003e\u003cp\u003e- Acquire basic and advanced life support skills, including the diagnosis and treatment of shock and the related procedural skills, and demonstrate the application of these principles in real or simulated patient care scenarios\u003c/p\u003e\u003cp\u003e- Demonstrate proficiency in cardiopulmonary resuscitation\u003c/p\u003e\u003cp\u003e- Be proficient at all resuscitative skills including leading a resuscitation of adults and children and be able to perform emergency procedures in most circumstances\u003c/p\u003e\u003cp\u003e- Recognize and initiate first aid and definitive therapy for airway obstruction.\u003c/p\u003e\u003cp\u003e- Be able to provide rapid stabilization with intravenous access and fluid/blood administration\u003c/p\u003e\u003cp\u003e- Demonstrate proficiency in the use of a defibrillator and other advanced methods of cardioversion\u003c/p\u003e\u003cp\u003e- Demonstrate mastery of commonly utilized procedural skills, such as airway management and deep venous access.\u003c/p\u003e\u003cp\u003e- Demonstrate mastery of basic focused ultrasound skills, including Focused Assessment of Sonography in Trauma (FAST)\u003c/p\u003e\u003cp\u003e- Demonstrate trauma management skills such as initial assessment using the ABC approach, full spine immobilization, secondary survey, stabilization, and appropriate consultation\u003c/p\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eAttitudes\u003c/span\u003e:\u003c/p\u003e\u003cp\u003e- Take and accept the lead of multi-professional teams.\u003c/p\u003e\u003cp\u003e- Demonstrate knowledge of a nuanced understanding of the ethical issues associated with emergency medicine including but not limited to assessment and establishment of competency, do not resuscitate and advance directives, informed consent, confidentiality, non-accidental illness and injury, sexual assault, errors in care and lapses in patient safety\u003c/p\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eExperiences\u003c/span\u003e:\u003c/p\u003e\u003cp\u003e- As determined\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6. \u003cb\u003eAssessment Information Sources to assess progress\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; Written examination\u003c/p\u003e\u003cp\u003e\u0026bull; Chart stimulated recall oral examinations\u003c/p\u003e\u003cp\u003e\u0026bull; Procedure or case log\u003c/p\u003e\u003cp\u003e\u0026bull; Simulations and models\u003c/p\u003e\u003cp\u003e\u0026bull; Workplace Based Assessments (Mini-CEX, Direct observations, short practice observations)\u003c/p\u003e\u003cp\u003e\u0026bull; Clinical patient examination skills\u003c/p\u003e\u003cp\u003eObjective Structured Clinical Examination (OSCE) which includes standardized case based discussion stations and a simulation station of a resuscitation.\u003c/p\u003e\u003cp\u003e\u0026bull; Oral examination\u003c/p\u003e\u003cp\u003e\u0026bull; Multi-source feedback\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7. \u003cb\u003eEntrustment / Supervision Level expected at which stage of training\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLevel 4 (unsupervised practice)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8. \u003cb\u003eExpiration Date\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDependent on individual IFEM member country, and the context in which the EPA is used\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003eIt is acknowledged that adults and children each have their own distinctive sets of special anatomical, physiological and pathological characteristics and thus significantly different modes of behaviour and management. Granularity for specific patient populations (including paediatric populations) can be further achieved with \u0026lsquo;nested EPAs\u0026rsquo; with reference to the Graduate Medical Education curriculum.\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cem\u003eEPA 2: Adult and/or paediatric non-resuscitative emergency care\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1. EPA Title\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAdult and/or paediatric non-resuscitative emergency care\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2. \u003cb\u003eSpecifications and Limitations\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ea. This activity contains no more and no less than the following elements:\u003c/p\u003e\u003cp\u003e1. Understanding the pathophysiology, clinical presentations, complications and initial management of adult and/or paediatric patients with acute medical illnesses for up to 24 hours in the Emergency Department\u003c/p\u003e\u003cp\u003e2. Evaluating mechanisms of injury, clinical presentations, complications and initial management of acute trauma presenting initially to the ED in a haemodynamically stable state.\u003c/p\u003e\u003cp\u003e3. Evaluating mechanisms of illness and injury in special populations including the elderly and children, the impact on the patient during presentation in the ED and their initial management in the ED.\u003c/p\u003e\u003cp\u003e4. Performance of a variety of emergency procedures on adult and/or paediatric patients being managed in the Emergency department, including vascular access, wound management, focused emergency ultrasound, invasive and non-invasive practical procedures and interacting with colleagues, patients, next-of-kin and community in patient management\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3. \u003cb\u003ePotential risks in case of failure\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1. Patient safety\u003c/p\u003e\u003cp\u003e2. Quality of clinical care provided\u003c/p\u003e\u003cp\u003e3. Delay in definitive care with its adverse consequences\u003c/p\u003e\u003cp\u003e4. Increased morbidity and possible mortality\u003c/p\u003e\u003cp\u003e5. Increased reattendances and complaints to the ED\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4. \u003cb\u003eMost Relevant Competency Domains\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMedical Knowledge, Communication and interpersonal skills, Patient Care, Systems based Practice, Professionalism\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5. \u003cb\u003eRequired Knowledge, Skills, Attitudes and Experience\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eKnowledge\u003c/span\u003e:\u003c/p\u003e\u003cp\u003e- Develop a full complement of basic knowledge of emergencies, acute and urgent presentations and be prepared to apply this knowledge to a full range of conditions.\u003c/p\u003e\u003cp\u003e- Acquire further specialist knowledge to support clinical care in the emergency department.\u003c/p\u003e\u003cp\u003e- Demonstrate the capacity to differentiate among and treat common acute problems.\u003c/p\u003e\u003cp\u003e- Analyze clinical findings and develop and modify the differential diagnosis to a full range of clinical circumstances.\u003c/p\u003e\u003cp\u003e- Recognize and be prepared to intervene, in any age group, for all causes of shock etiology.\u003c/p\u003e\u003cp\u003e- Understand principles of wound care and demonstrate advanced wound care techniques in the management of common injury patterns.\u003c/p\u003e\u003cp\u003e- Understand the principles of trauma management.\u003c/p\u003e\u003cp\u003e- Recognize life-threatening illness or injury and apply principles of stabilization to the early management of these entities.\u003c/p\u003e\u003cp\u003e- Demonstrate the capacity to recognize and treat common toxicological emergencies\u003c/p\u003e\u003cp\u003e- Become a recognized expert and understand the role of these situations which are common to Emergency Medicine: all acute critical illness and injury, intoxicated patients, prehospital medicine, disaster management, environmental illness / injury, toxicology,\u003c/p\u003e\u003cp\u003e- Develop a keen understanding of the importance and use of administrative perspectives, such as language barriers, injury prevention, out-of-hospital personnel, death notification for sudden unexpected death, media, resource utilization and medical decision making in emergency medicine practice\u003c/p\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eSkills\u003c/span\u003e:\u003c/p\u003e\u003cp\u003e- Acquire basic and advanced life support skills, including the diagnosis and treatment of shock and the related procedural skills, and demonstrate the application of these principles in real or simulated patient care scenarios.\u003c/p\u003e\u003cp\u003e- Demonstrate trauma management skills such as initial assessment using the ABC approach, full spine immobilization, secondary survey, stabilization, and appropriate consultation\u003c/p\u003e\u003cp\u003e- Demonstrate mastery of commonly utilized procedural skills, such as airway management and deep venous access.\u003c/p\u003e\u003cp\u003e- Demonstrate mastery of basic focused ultrasound skills, including Focused Assessment of Sonography in Trauma (FAST)\u003c/p\u003e\u003cp\u003e- Provide a Comprehensive assessment of the undifferentiated patient.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eAttitudes\u003c/span\u003e:\u003c/p\u003e\u003cp\u003e- Act as the patient\u0026rsquo;s advocate, advisor, and guide within the acute phase of his or her illness or injury\u003c/p\u003e\u003cp\u003e- Demonstrate knowledge of a nuanced understanding of the ethical issues associated with emergency medicine including but not limited to assessment and establishment of competency, do not resuscitate and advance directives, informed consent, confidentiality, non-accidental illness and injury, sexual assault, errors in care and lapses in patient safety\u003c/p\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eExperiences\u003c/span\u003e:\u003c/p\u003e\u003cp\u003eAs determined\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6. \u003cb\u003eAssessment Information Sources to assess progress\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1. Sources of information would be one or more of the following:\u003c/p\u003e\u003cp\u003e\u0026bull; Written examination\u003c/p\u003e\u003cp\u003e\u0026bull; Chart stimulated recall oral examinations\u003c/p\u003e\u003cp\u003e\u0026bull; Procedure or case log\u003c/p\u003e\u003cp\u003e\u0026bull; Simulations and models\u003c/p\u003e\u003cp\u003e\u0026bull; Workplace Based Assessments (Mini-CEX, Direct observations, short practice observations)\u003c/p\u003e\u003cp\u003e\u0026bull; Clinical patient examination skills\u003c/p\u003e\u003cp\u003eObjective Structured Clinical Examination (OSCE) which includes standardized case based discussion stations and a simulation station of a resuscitation.\u003c/p\u003e\u003cp\u003e\u0026bull; Oral examination\u003c/p\u003e\u003cp\u003e\u0026bull; Multi-source feedback\u003c/p\u003e\u003cp\u003e2. Owing to the large variety of patient encounters in this EPA, each jurisdiction will need to determine the minimum number of times a candidate would need to be assessed to ensure that he can confidently address the variety expected. Such variety should be captured in a log of such EPA encounters.\u003c/p\u003e\u003cp\u003e3. Persons making such observations should be independent senior observers who are not the immediate supervising emergency physician of the candidate.\u003c/p\u003e\u003cp\u003e4. The decision on whether the candidate has fulfilled the EPA should be after evaluation of the relevant number of EPA encounters by the appropriate Residency Evaluation Committee\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7. \u003cb\u003eEntrustment / Supervision Level expected at which stage of training\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLevel 4 (unsupervised practice)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8. \u003cb\u003eExpiration Date\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDependent on individual IFEM member country, and the context in which the EPA is used\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cem\u003eEPA 3: Managing multiple emergency patients\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1. EPA Title\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eManaging multiple emergency patients\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2. \u003cb\u003eSpecifications and Limitations\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ea. This activity contains no more and no less than the following elements:\u003c/p\u003e\u003cp\u003e1. Monitoring and adapting to changes of clinical demand in ED\u003c/p\u003e\u003cp\u003e2. Managing patient surges\u003c/p\u003e\u003cp\u003e3. Activation of disaster code and leading a mass casualty event in ED\u003c/p\u003e\u003cp\u003e4. Appropriate deployment of medical and nursing staff, based on skill-mix and demand\u003c/p\u003e\u003cp\u003eNo limitations.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3. \u003cb\u003ePotential risks in case of failure\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePatient safety\u003c/p\u003e\u003cp\u003eMis-management of hospital manpower and resources\u003c/p\u003e\u003cp\u003eLoss of confidence of community in ability of Emergency Department to manage patient loads\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4. \u003cb\u003eMost Relevant Competency Domains\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCommunication and interpersonal skills, Systems based Practice, Professionalism\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5. \u003cb\u003eRequired Knowledge, Skills, Attitudes and Experience\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eKnowledge\u003c/span\u003e:\u003c/p\u003e\u003cp\u003e- Knowledge of systems practice, man-management to be competent in coordinating and overseeing the management of multiple patients simultaneously, including mass-casualty incidents\u003c/p\u003e\u003cp\u003e- Demonstrate the capacity to prioritize attention to those patients with more urgent conditions.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eSkills\u003c/span\u003e:\u003c/p\u003e\u003cp\u003e- Plan and prioritize tasks both in the clinical setting and in professional life.\u003c/p\u003e\u003cp\u003e- Develop the skills of delegation to other personnel in the emergency department and the leadership skills required to maintain the pace of others working in clinical environment to ensure that patient needs are met.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eAttitudes\u003c/span\u003e:\u003c/p\u003e\u003cp\u003e- Professionalism to demonstrate a commitment to patient care above all other issues\u003c/p\u003e\u003cp\u003e- Ability to recognize how to do the most good for the most people\u003c/p\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eExperiences\u003c/span\u003e:\u003c/p\u003e\u003cp\u003e- Time as team leader during a shift\u003c/p\u003e\u003cp\u003e- Team-leading in a mass-casualty incident\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6. \u003cb\u003eAssessment Information Sources to assess progress\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; Workplace Based Assessments (Mini-CEX, Direct observations, short practice observations)\u003c/p\u003e\u003cp\u003e\u0026bull; Clinical patient examination skills\u003c/p\u003e\u003cp\u003eObjective Structured Clinical Examination (OSCE) which includes standardized case based discussion stations and a simulation station of a resuscitation.\u003c/p\u003e\u003cp\u003e\u0026bull; Shift Reports\u003c/p\u003e\u003cp\u003e\u0026bull; Multi-source feedback\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7. \u003cb\u003eEntrustment / Supervision Level expected at which stage of training\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLevel 4 (unsupervised practice)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8. \u003cb\u003eExpiration Date\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDependent on individual IFEM member country, and the context in which the EPA is used\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cem\u003eEPA 4: Maintaining quality emergency care\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1. EPA Title\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMaintaining quality emergency care\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2. \u003cb\u003eSpecifications and Limitations\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ea. This activity contains no more and no less than the following elements:\u003c/p\u003e\u003cp\u003e1. Creating departmental processes regarding quality patient care\u003c/p\u003e\u003cp\u003e2. Reviewing and improving the emergency department\u0026rsquo;s clinical functions\u003c/p\u003e\u003cp\u003e3. Planning and implementing new modalities of patient care in the Emergency Department\u003c/p\u003e\u003cp\u003eLimited to normal daily operations; does not include special exigencies including heightened response to pandemics/infectious pathogens, or disaster response\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3. \u003cb\u003ePotential risks in case of failure\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1. Patient harm\u003c/p\u003e\u003cp\u003e2. Mis-management of hospital and departmental manpower and resources\u003c/p\u003e\u003cp\u003e3. Suboptimal Quality of patient care in the Emergency Department\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4. \u003cb\u003eMost Relevant Competency Domains\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCommunication and interpersonal skills, Systems based Practice, Professionalism\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5. \u003cb\u003eRequired Knowledge, Skills, Attitudes and Experience\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eKnowledge\u003c/span\u003e:\u003c/p\u003e\u003cp\u003e- Complete specified management projects particularly around staff management and complaints.\u003c/p\u003e\u003cp\u003e- Be capable of describing the importance of the ED as the link between the general population and the health care system.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eSkills\u003c/span\u003e:\u003c/p\u003e\u003cp\u003e- Carry out audit projects, support others in completing audit projects and contribute to the implementation of guidelines, care plans, and other aspects of clinical governance related to emergency medicine issues.\u003c/p\u003e\u003cp\u003e- Take and accept the lead of multi-professional teams.\u003c/p\u003e\u003cp\u003e- Plan and prioritize tasks both in the clinical setting and in professional life.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eAttitudes\u003c/span\u003e:\u003c/p\u003e\u003cp\u003e- Demonstrate knowledge of a nuanced understanding of the ethical issues associated with emergency medicine including but not limited to assessment and establishment of competency, do not resuscitate and advance directives, informed consent, confidentiality, non-accidental illness and injury, sexual assault, errors in care and lapses in patient safety\u003c/p\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eExperiences\u003c/span\u003e:\u003c/p\u003e\u003cp\u003eAs determined\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6. \u003cb\u003eAssessment Information Sources to assess progress\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026bull; Portfolios with guided reflection\u003c/p\u003e\u003cp\u003e\u0026bull; Procedure or case log\u003c/p\u003e\u003cp\u003e\u0026bull; Simulations and models\u003c/p\u003e\u003cp\u003e\u0026bull; Workplace Based Assessments (Mini-CEX, Direct observations, short practice observations)\u003c/p\u003e\u003cp\u003e\u0026bull; Clinical patient examination skills\u003c/p\u003e\u003cp\u003eObjective Structured Clinical Examination (OSCE) which includes standardized case based discussion stations and a simulation station of a resuscitation.\u003c/p\u003e\u003cp\u003e\u0026bull; Multi-source feedback\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7. \u003cb\u003eEntrustment / Supervision Level expected at which stage of training\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLevel 4 (unsupervised practice)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8. \u003cb\u003eExpiration Date\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDependent on individual IFEM member country, and the context in which the EPA is used\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e\u003cem\u003eEPA 5: Teaching emergency staff\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1. EPA Title\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTeaching emergency staff\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2. \u003cb\u003eSpecifications and Limitations\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ea. This activity contains no more and no less than the following elements:\u003c/p\u003e\u003cp\u003e1. Educate team members\u003c/p\u003e\u003cp\u003e2. Teaching less experience team members while keeping a focus on providing safe and competent clinical care\u003c/p\u003e\u003cp\u003e3. Mentoring junior staff.\u003c/p\u003e\u003cp\u003eNo limitations.\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3. \u003cb\u003ePotential risks in case of failure\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePsychological damage to team\u003c/p\u003e\u003cp\u003ePatient safety\u003c/p\u003e\u003cp\u003eTrust amongst members of the team\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4. \u003cb\u003eMost Relevant Competency Domains\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSystems based Practice, Medical Knowledge, Communication and interpersonal skills, Professionalism\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5. \u003cb\u003eRequired Knowledge, Skills, Attitudes and Experience\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eKnowledge\u003c/span\u003e:\u003c/p\u003e\u003cp\u003e- Become competent in the delivery of training to other professionals, teach and supervise others in areas of emergency medicine practice as well as develop and demonstrate mentoring and appraisal skills\u003c/p\u003e\u003cp\u003e- Develop areas of special interests that facilitate growth as a professional.\u003c/p\u003e\u003cp\u003e- Become a recognized expert and understand the role of these situations which are common to Emergency Medicine: all acute critical illness and injury, intoxicated patients, media, out\u0026ndash;of\u0026ndash;hospital personnel, prehospital medicine, disaster management, language barriers, environmental illness / injury, injury prevention, death notification for sudden unexpected death, toxicology, resource utilization, medical decision making\u003c/p\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eSkills\u003c/span\u003e:\u003c/p\u003e\u003cp\u003e- Develop the skills needed for a lifetime of self-directed learning and demonstrate the capacity to critically appraise the literature and apply the literature to clinical practice.\u003c/p\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eAttitudes\u003c/span\u003e:\u003c/p\u003e\u003cp\u003e- Demonstrate knowledge of a nuanced understanding of the ethical issues associated with emergency medicine including but not limited to assessment and establishment of competency, do not resuscitate and advance directives, informed consent, confidentiality, non-accidental illness and injury, sexual assault, errors in care and lapses in patient safety\u003c/p\u003e\u003cp\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eExperiences\u003c/span\u003e:\u003c/p\u003e\u003cp\u003eAs determined\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6. \u003cb\u003eAssessment Information Sources to assess progress\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEnd of term Report\u003c/p\u003e\u003cp\u003eDirect observations of teaching, short practice observations\u003c/p\u003e\u003cp\u003eObjective Structured Clinical Examination (OSCE)\u003c/p\u003e\u003cp\u003eGlobal rating of performance\u003c/p\u003e\u003cp\u003ePortfolios\u003c/p\u003e\u003cp\u003eRecord review\u003c/p\u003e\u003cp\u003eSimulations and models\u003c/p\u003e\u003cp\u003eStudent/Teacher feedback\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e7. \u003cb\u003eEntrustment / Supervision Level expected at which stage of training\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLevel 4 (unsupervised)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8. \u003cb\u003eExpiration Date\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDependent on individual IFEM member country, and the context in which the EPA is used\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eEvaluation of core EPAs using EQual: Queen\u0026rsquo;s EM Quality Rubric\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEPA\u003c/p\u003e\u003cp\u003e1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eEPA\u003c/p\u003e\u003cp\u003e2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eEPA\u003c/p\u003e\u003cp\u003e3\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eEPA\u003c/p\u003e\u003cp\u003e4\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eEPA\u003c/p\u003e\u003cp\u003e5\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRubric 1: This EPA describes work that is essential and important to the profession*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5.00\u003c/p\u003e\u003cp\u003e(SD 0.000)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5.00\u003c/p\u003e\u003cp\u003e(SD 0.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.00\u003c/p\u003e\u003cp\u003e(SD 0.408)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.00\u003c/p\u003e\u003cp\u003e(SD 0.894)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e4.50\u003c/p\u003e\u003cp\u003e(SD 0.816)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRubric 2: Performing this EPA leads to recognised output or outcome of labour*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5.00\u003c/p\u003e\u003cp\u003e(SD 0.837)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.00\u003c/p\u003e\u003cp\u003e(SD 0.632)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5.00\u003c/p\u003e\u003cp\u003e(SD 0.516)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.00\u003c/p\u003e\u003cp\u003e(SD 0.408)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e4.00\u003c/p\u003e\u003cp\u003e(SD 0.753)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRubric 3: The performance of this EPA in clinical practice is restricted to qualified personnel*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4.00\u003c/p\u003e\u003cp\u003e(SD 0.000)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.00\u003c/p\u003e\u003cp\u003e(SD 0.516)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.00\u003c/p\u003e\u003cp\u003e(SD 0.408)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.00\u003c/p\u003e\u003cp\u003e(SD 0.632)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e4.50\u003c/p\u003e\u003cp\u003e(SD 0.816)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRubric 4: This EPA addresses professional work that is suitable for entrustment*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5.00\u003c/p\u003e\u003cp\u003e(SD 0.000)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5.00\u003c/p\u003e\u003cp\u003e(SD 0.408)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.50\u003c/p\u003e\u003cp\u003e(SD 0.577)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5.00\u003c/p\u003e\u003cp\u003e(SD 0.837)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e4.00\u003c/p\u003e\u003cp\u003e(SD 1.37)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedian score*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5.00\u003c/p\u003e\u003cp\u003e(SD 0.500)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.50\u003c/p\u003e\u003cp\u003e(SD 0.577)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.75\u003c/p\u003e\u003cp\u003e(SD 0.479)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.00\u003c/p\u003e\u003cp\u003e(SD 0.500)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e4.25\u003c/p\u003e\u003cp\u003e(SD 0.289)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo. of group members (%) out of six who agree that EPA should be included\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5 (83%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5 (83%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5 (83%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e5 (83%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e4 (67%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e*Results are shown as median scores, with SD (Standard Deviation) indicated with each score\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eWe describe a comprehensive approach to identifying core EPAs required for safe independent practice as a specialist in EM aligned with the curricular outcomes for postgraduate training in our discipline.\u003c/p\u003e\u003cp\u003eCompetencies can be mapped onto each EPA and assessment methods can be constructively aligned with each EPA within a program of assessment. In practical terms, framing competencies in the context of EPAs may be more meaningful to clinical supervisors. As such, we have completed mapping of the core EPAs described above to IFEM and various countries\u0026rsquo; curricula (Tables \u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Tab12\" class=\"InternalRef\"\u003e12\u003c/span\u003e). This allows us to visualise how our suggested list of core EPAs (Table \u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e) provide a model of integration of various competencies and curricular outcomes.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eProposed list of core Entrustable Professional Activities (EPAs) for Emergency Medicine Specialists.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eProposed Entrustable Professional Activity (EPA)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEPA 1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePatient resuscitation\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEPA 2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAdult and/or paediatric non-resuscitative emergency care\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEPA 3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eManaging multiple emergency patients\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEPA 4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMaintaining quality emergency care\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEPA 5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTeaching emergency staff\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eReview of Proposed EPAs with IFEM Model Curriculum for EM Specialists\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEPA 1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eEPA 2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eEPA 3\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eEPA 4\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eEPA 5\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDevelop a full complement of basic knowledge of emergencies, acute and urgent presentations and be prepared to apply this knowledge to a full range of conditions.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAcquire further specialist knowledge to support clinical care in the emergency department.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAcquire basic and advanced life support skills, including the diagnosis and treatment of shock and the related procedural skills, and demonstrate the application of these principles in real or simulated patient care scenarios.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDemonstrate the capacity to differentiate among and treat common acute problems.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProvide a Comprehensive assessment of the undifferentiated patient.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAnalyze clinical findings and develop and modify the differential diagnosis to a full range of clinical circumstances.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDemonstrate proficiency in cardiopulmonary resuscitation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBecome proficient at all resuscitative skills including leading a resuscitation of adults and children and be able to perform emergency procedures in most circumstances.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRecognize and initiate first aid and definitive therapy for airway obstruction.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRecognize and be prepared to intervene, in any age group, for all causes of shock etiology.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBe able to provide rapid stabilization with intravenous access and fluid/blood administration.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUnderstand the principles of cerebral resuscitation in brain illness and injury.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDemonstrate proficiency in the use of a defibrillator and other advanced methods of cardioversion.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUnderstand principles of wound care and demonstrate advanced wound care techniques in the management of common injury patterns.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUnderstand the principles of trauma management.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDemonstrate trauma management skills such as initial assessment using the ABC approach, full spine immobilization, secondary survey, stabilization, and appropriate consultation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDemonstrate mastery of commonly utilized procedural skills, such as airway management and deep venous access.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDemonstrate mastery of basic focused ultrasound skills, including Focused Assessment of Sonography in Trauma (FAST)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRecognize life-threatening illness or injury and apply principles of stabilization to the early management of these entities.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePlan and prioritize tasks both in the clinical setting and in professional life.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDevelop the skills of delegation to other personnel in the emergency department and the leadership skills required to maintain the pace of others working in clinical environment to insure that patient needs are met.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDemonstrate the capacity to prioritize attention to those patients with more urgent conditions.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDemonstrate the capacity to recognize and treat common toxicological emergencies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBecome competent in the delivery of training to other professionals, teach and supervise others in areas of emergency medicine practice as well as develop and demonstrate mentoring and appraisal skills\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eComplete specified management projects particularly around staff management and complaints.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCarry out audit projects, support others in completing audit projects and contribute to the implementation of guidelines, care plans, and other aspects of clinical governance related to emergency medicine issues.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDevelop the skills needed for a lifetime of self-directed learning and demonstrate the capacity to critically appraise the literature and apply the literature to clinical practice.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDevelop areas of special interests that facilitate growth as a professional.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTake and accept the lead of multi-professional teams.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDemonstrate knowledge of a nuanced understanding of the ethical issues associated with emergency medicine including but not limited to assessment and establishment of competency, do not resuscitate and advance directives, informed consent, confidentiality, non-accidental illness and injury, sexual assault, errors in care and lapses in patient safety\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBe capable of describing the importance of the ED as the link between the general population and the health care system.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBecome a recognized expert and understand the role of these situations which are common to Emergency Medicine: all acute critical illness and injury, intoxicated patients, media, out\u0026ndash;of\u0026ndash;hospital personnel, prehospital medicine, disaster management, language barriers, environmental illness / injury, injury prevention, death notification for sudden unexpected death, toxicology, resource utilization, medical decision making\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab9\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 9\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eReview of Proposed EPAs with RCEM Curriculum 2020\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEPA 1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eEPA 2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eEPA 3\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eEPA 4\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eEPA 5\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDeliver \u0026ldquo;Pinnacle\u0026rdquo; Emergency Care Skills (perform key emergency skills that are time critical and/or life/limb saving)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCare for the injured patient\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCare for the paediatric patient\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCare for low acuity, high complexity, stable patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAnswer clinical questions on the shop floor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLead the ED shift as \u0026ldquo;Emergency Physician in Charge\u0026rdquo;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDeal with shop floor curve balls (individual shop-floor occurrences that do not pertain directly to clinical evaluation)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUndertake key administrative tasks\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSupervise and appraise junior colleagues\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEducate the team\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUnderstand, apply and contribute to research\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLead an Emergency Medicine Quality Improvement project to completion\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab10\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 10\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eReview of Proposed EPAs with Entrustable Professional Activity Guide: Emergency Medicine (The Royal College of Physicians and Surgeons of Canada)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEPA 1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eEPA 2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eEPA 3\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eEPA 4\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eEPA 5\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRecognizing the unstable/critically ill patient, mobilizing the health care team and supervisor, and initiating basic life support\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInitiating and assisting in resuscitation of critically ill patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResuscitating and coordinating care for critically ill patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResuscitating and coordinating care for critically injured trauma patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProviding airway management and ventilation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProviding emergency sedation and systemic analgesia for diagnostic and therapeutic procedures\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePerforming advanced procedures\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePerforming and interpreting point-of-care ultrasound to guide patient management\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAssessing and managing patients with uncomplicated urgent and non-urgent emergency department presentations\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIdentifying and managing patients with emergent medical or surgical conditions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDiagnosing and managing patients with complicated urgent and non-urgent patient presentations\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManaging patients with acute toxic ingestion or exposure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManaging patients with emergency mental health conditions or behavioural emergencies\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManaging urgent and emergent presentations for pregnant and post-partum patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProviding end-of-life care for a patient\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDealing with uncertainty when managing patients with ambiguous presentations\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePerforming and documenting focused histories and physical exams, and providing preliminary management of cardinal emergency department presentations\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePerforming basic procedures\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFacilitating communication of information between a patient in the emergency department, caregivers, and members of the health care team to organize care and disposition of the patient\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManaging complex interpersonal interactions that arise during the course of patient care\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUsing clinical informatics to facilitate efficient, safe, patient care\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManaging the emergency department to optimize patient care and department flow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManaging and supporting patients in situational crisis to access health care and community resources\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRecognizing and managing patients who are at risk of exposure to, or who have experienced violence and/or neglect\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eContributing to the shared work of the emergency department health care team to achieve high quality, efficient and safe patient care\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLiaising with prehospital emergency medical services\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eProviding expert EM consultation to physicians or other health care providers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCoordinating and collaborating with health care professional colleagues to safely transition the care of patients, including handover and facilitating interinstitution transport\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTeaching and supervising the learning of trainees and other health care professionals\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAppraising and integrating new evidence into clinical practice\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab11\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 11\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eReview of Proposed EPAs with Singapore Emergency Medicine Residency EPAs\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEPA 1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eEPA 2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eEPA 3\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eEPA 4\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eEPA 5\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResuscitate and stabilise critically ill adult medical patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResuscitate and stabilise critically ill adult trauma patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eResuscitate and stabilise critically ill paediatric medical and trauma patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManage Adult ambulatory patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManage Paediatric ambulatory patients\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManage patients in the Observation Facility\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManage patients in an Out-of-ED setting\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManage End-of-Life care and provide palliative care\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManage ED Clinical Care areas\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManage administrative and operational aspects of the ED\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSupport, Supervise and facilitate learning of peers, juniors, students \u0026amp; other Healthcare Professionals\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAppraise current literature in relation to practice\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab12\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 12\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eReview of Proposed EPAs with American (United States of America) Core EPAs\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEPA 1\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eEPA 2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eEPA 3\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eEPA 4\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eEPA 5\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManage a low-acuity, low-complexity \u0026ldquo;stable\u0026rdquo; patient\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManage a low-acuity, high-complexity \u0026ldquo;stable\u0026rdquo; patient\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManage a potentially high-acuity complaint in a \u0026ldquo;stable\u0026rdquo; patient\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManage a high-acuity patient with a well-defined presentation, illness or injury\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManage a high-acuity, high-complexity \u0026ldquo;stable\u0026rdquo; patient (i.e. the undifferentiated unstable patient)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManage multiple patients in the emergency department (ED) concomitantly.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLead an ED team.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTransition patient care to other healthcare providers.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManage interactions with consultants.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eManage complex and difficult situations.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUse recommended patient-safety and quality improvement processes.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e✓\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe use of the EQual: Queen\u0026rsquo;s EM Quality Rubric to evaluate the quality of each EPA generated is a novel approach. This strategy sets the EPAs generated aside from others by having them rated objectively (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e). Should an EPA fall short of the quality benchmarks required of them with a median score of less than four out of five, they have to be re-evaluated and re-considered \u0026ndash; this ensures that only EPAs which are of sufficient quality and show that they fulfil the requirements of an EPA will be listed.\u003c/p\u003e\u003cp\u003eAll of the EPAs have a median score of more than four, with the lowest rating of 4.00 for EPA 4. An additional score indicating the number of group members in agreement that the EPA should be included was also calculated, with most of the EPAs showing general approval for inclusion of the EPAs. Of note, only four out of six (67%) members of the group in agreement that EPA 5 should be included, even if the EPA itself was rated more than four.\u003c/p\u003e\u003cp\u003eWithin each EPA, median scores of more than 4.00 were achieved. Standard deviations were recorded for each median, with large variations noted for EPA 5. EPA 5, in particular, deals with education and teaching of emergency staff. There was significant debate and discussion if teaching was a level of entrustment, or a specific unit of work which is essential to an Emergency Physician\u0026rsquo;s practice.\u003c/p\u003e\u003cp\u003eIn contrast, EPA 1 (Patient resuscitation) and EPA 3 (Managing multiple emergency patients) were rated highest with median scores of 5.00 and 4.75 respectively, reflecting the high level of agreement amongst the nominal group members regarding how these EPAs are of high quality, and genuinely reflect the work that an Emergency Physician is expected to perform independently and competently.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eFive EPAs were identified as essential EPAs required for safe, independent practice as an EM specialist. All five EPAs could be mapped to existing EPAs used in six different member countries of the International Federation for Emergency Medicine (IFEM). These EPAs represent a promising framework of EPAs which will serve as a guide and model examples for individual countries to develop individual EPAs for training.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eEPA\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eEntrustable Professional Activities\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eEM\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eEmergency Medicine\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eIFEM\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eInternational Federation for Emergency Medicine\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eNHG\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eNational Healthcare Group\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv class=\"DefinitionListEntry\"\u003e\u003cdiv class=\"Term\"\u003eDSRB\u003c/div\u003e\u003cdiv class=\"Description\"\u003e\u003cp\u003eDomain Specific Review Board\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cu\u003eEthics Approval and consent to participate\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the National Healthcare Group (NHG) Domain Specific Review Board (DSRB) (Reference: 2019/00339). Written informed consent was sought and obtained from all participants and procedures for responsible conduct of research followed, including use only of de-identified raw transcript data during group discussions, to ensure anonymity and confidentiality of the participants’ responses.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eConsent for publication\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eAvailability of data and materials\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eThe author confirms that all data generated or analysed during this study are included in this published article.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eCompeting interests\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eFunding\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was used for the study.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eAuthors’ contributions\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eAV, AS, SC, AAC, JPT, and TH were members of the nominal group which used consensus methodology to generate and rate EPAs. DT and JK analysed and interpreted the ratings of the final list of EPAs, as well as mapping of EPAs to current curriculum. DT was also a major contributor in writing the manuscript, with JK and AAC proof reading and supervising. \u0026nbsp;All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003eAcknowledgements\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eAuthors would like to express their gratitude to IFEM Core Curriculum and Education Committee members and IFEM Member Country representatives whose time and support were invaluable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eFrank JR, Snell LS, ten Cate O, Holmboe ES, Carraccio C, Swing SR, Harris P, Glasgow NJ, Campbell C, Dath D et al: Competency-based medical education: theory to practice. Med Teach. 2010;32(8):638\u0026ndash;45.\u003c/li\u003e\n\u003cli\u003eten Cate O. Entrustability of professional activities and competency-based training. Med Educ. 2005;39(12):1176\u0026ndash;7.\u003c/li\u003e\n\u003cli\u003eten Cate O, Scheele F. Competency-based postgraduate training: can we bridge the gap between theory and clinical practice? Acad Med. 2007;82(6):542\u0026ndash;7.\u003c/li\u003e\n\u003cli\u003eten Cate O, Young JQ. The patient handover as an entrustable professional activity: adding meaning in teaching and practice. BMJ Qual Saf. 2012;21 Suppl 1:i9\u0026ndash;12.\u003c/li\u003e\n\u003cli\u003eHauer KE, Kohlwes J, Cornett P, Hollander H, ten Cate O, Ranji SR, Soni K, Iobst W, O\u0026apos;Sullivan P: Identifying entrustable professional activities in internal medicine training. J Grad Med Educ. 2013;5(1):54\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eHauer KE, Soni K, Cornett P, Kohlwes J, Hollander H, Ranji SR, ten Cate O, Widera E, Calton B, O\u0026apos;Sullivan PS: Developing entrustable professional activities as the basis for assessment of competence in an internal medicine residency: a feasibility study. J Gen Intern Med. 2013;28(8):1110\u0026ndash;4.\u003c/li\u003e\n\u003cli\u003eShaughnessy AF, Sparks J, Cohen-Osher M, Goodell KH, Sawin GL, Gravel Jr: Entrustable professional activities in family medicine. J Grad Med Educ. 2013;5(1):112\u0026ndash;8.\u003c/li\u003e\n\u003cli\u003eChang A, Bowen JL, Buranosky RA, Frankel RM, Ghosh N, Rosenblum MJ, Thompson S, Green ML: Transforming primary care training\u0026ndash;patient centered medical home entrustable professional activities for internal medicine residents. J Gen Intern Med. 2013;28(6):801\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eAssociation of American Medical Colleges. Core entrustable professional activities for entering residency. 2014. http://members.aamc.org/eweb/upload/Core%20EPA%20Curriculum%20Dev%20Guide.pdf.\u003c/li\u003e\n\u003cli\u003eBoyce P, Spratt C, Davies M, McEvoy P. Using entrustable professional activities to guide curriculum development in psychiatry training\u003cem\u003e. \u003c/em\u003eBMC Med Educ. 2011;11:96\u003cem\u003e.\u003c/em\u003e\u003c/li\u003e\n\u003cli\u003eTaylor D, YS Park, R Egan, MK Chan, J Karpinski, C Touchie, L Snell, A Tekian. EQual, a Novel Rubric to Evaluate Entrustable Professional Activities for Quality and Structure. Academic Medicine 92(11S): p S110-S117 Nov 2017\u003c/li\u003e\n\u003cli\u003eMeyer E.G., DR Taylor, U Sebastian, SJ Durning. EQual Rubric Evaluation of the Association of American Medical Colleges\u0026apos; Core Entrustable Professional Activities for Entering Residency. Academic Medicine 2020 Nov; 95 (11): 1755-1762\u003c/li\u003e\n\u003cli\u003eChen HC, van den Broek WE, Ten Cate O. The case for use of Entrustable professional activities in undergraduate medical education. Acad Med.2015;90(4):431\u0026ndash;6.\u003c/li\u003e\n\u003cli\u003eten Cate O. Trust, competence, and the supervisor\u0026rsquo;s role in postgraduate training. BMJ. 2006;333(7571):748\u0026ndash;51.\u003c/li\u003e\n\u003cli\u003eten Cate O, Young JQ. The patient handover as an entrustable professional activity: adding meaning in teaching and practice. BMJ Qual Saf. 2012;21 Suppl 1:i9\u0026ndash;12.\u003c/li\u003e\n\u003cli\u003eten Cate. Nuts and Bolts of Entrustable Professional Activities. Journal of Graduate Medical Education, March 2013. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"international-journal-of-emergency-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ijem","sideBox":"Learn more about [International Journal of Emergency Medicine](https://intjem.biomedcentral.com/)","snPcode":"12245","submissionUrl":"https://submission.nature.com/new-submission/12245/3","title":"International Journal of Emergency Medicine","twitterHandle":"@IntJEmergMed","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Entrustable professional activities, Consensus methods, Competence, Assessment, Emergency medicine","lastPublishedDoi":"10.21203/rs.3.rs-7356905/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7356905/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eVarious countries have developed competency frameworks for postgraduate training programs. Identifying Entrustable Professional Activities (EPAs) that are core clinical activities could bridge the gap between competencies and clinical practice. We aim to define essential EPAs required for safe independent practice as an Emergency Medicine (EM) Specialist, aligned with curricular outcomes from the International Federation for Emergency Medicine (IFEM) model curriculum for undergraduate, postgraduate and continuing professional training.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA nominal group of six members used consensus methodology to generate and rate essential EPAs for safe, independent practice as an EM specialist. Using existing literature on EPAs and IFEM curricular documents, the nominal group generated and clarified ideas for potential EPAs. Feedback was obtained from the IFEM Core Curriculum and Education committee, which comprises representatives from countries across all six IFEM regions, and integrated with iterative revisions. The EQual: Queen\u0026rsquo;s EPA Quality Rubric were used to rate how essential each EPA was for safe practice and the quality of each EPA. This approach is more rigorous as it allows for examination of the quality of EPAs generated and how well they align with the key domains of the EPA construct.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eA total of five EPAs were selected and refined from twenty-nine proposed EPAs. The five EPAs were: EPA 1 (Patient resuscitation), EPA 2 (Adult and/or paediatric non-resuscitative emergency care), EPA 3 (Managing multiple emergency patients), EPA 4 (Maintaining quality emergency care), and EPA 5 (Teaching emergency staff). All EPAs were directly mapped to the IFEM model curriculum to ensure relevancy and reliability. They were then rated using the EQual rubrics, with all five EPAs faring excellently and achieving overall median scores of more than four.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eFive EPAs were identified and evaluated to show their importance as essential EPAs required for safe, independent practice as an EM specialist. These EPAs represent a promising framework of EPAs which will serve as a guide for individual countries to develop individual EPAs for training.\u003c/p\u003e","manuscriptTitle":"Entrustable Professional Activities for Emergency Medicine Specialists","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-01 09:10:39","doi":"10.21203/rs.3.rs-7356905/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-09-11T13:01:57+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-31T02:20:56+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-29T15:12:47+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-21T10:10:30+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"163216061356802450484553409286210568552","date":"2025-08-21T00:47:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"317810486615175599620889251717256193409","date":"2025-08-20T14:51:35+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"156595739711544277591009943150596742455","date":"2025-08-20T00:55:37+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-08-20T00:33:37+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-13T06:20:03+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-13T06:18:45+00:00","index":"","fulltext":""},{"type":"submitted","content":"International Journal of Emergency Medicine","date":"2025-08-12T14:34:14+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"international-journal-of-emergency-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ijem","sideBox":"Learn more about [International Journal of Emergency Medicine](https://intjem.biomedcentral.com/)","snPcode":"12245","submissionUrl":"https://submission.nature.com/new-submission/12245/3","title":"International Journal of Emergency Medicine","twitterHandle":"@IntJEmergMed","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b7fae6c2-173b-4ed3-acbf-adb252643be5","owner":[],"postedDate":"September 1st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-12-01T15:59:27+00:00","versionOfRecord":{"articleIdentity":"rs-7356905","link":"https://doi.org/10.1186/s12245-025-01075-z","journal":{"identity":"international-journal-of-emergency-medicine","isVorOnly":false,"title":"International Journal of Emergency Medicine"},"publishedOn":"2025-11-25 15:57:00","publishedOnDateReadable":"November 25th, 2025"},"versionCreatedAt":"2025-09-01 09:10:39","video":"","vorDoi":"10.1186/s12245-025-01075-z","vorDoiUrl":"https://doi.org/10.1186/s12245-025-01075-z","workflowStages":[]},"version":"v1","identity":"rs-7356905","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7356905","identity":"rs-7356905","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}