Gersten Jonker

156   Chapter 8 ABSTRACT Competency frameworks are based on what are considered to be the general essential qualities of a doctor. Competencies, being behavioral descriptors, need a strong link to clinical practice to allow trainers to observe and then use them in assessing trainees’ performance. The emerging concept of entrustable professional activities (EPA) may serve as such a link. An EPA is a description of an essential clinical task that frames competencies in the context of clinical practice. A full set of EPA defines a specialty and constitutes the curriculum of specialty training. After observation of satisfactory performance on an EPA, the resident should be permitted to perform that activity without direct supervision.The terms of this should allowa trainer toprovide justification for this decision. This makes graded assumption of responsibilities possible. We describe the potential benefits of working with EPA in anesthesiology training and set an agenda for curriculum development and research in this area.