Gersten Jonker

212   Appendices training with its focus on outcomes of training in meeting the goal of accountability. It subsequently describes the concept of EPAs to operationalize competency-based anesthesiology training and overcome some of the problems with competency-based training by linking competencies to essential tasks in clinical practice. With its attention to observation of clinical performance, EPAs may be helpful in making learner progress visible. EPAs allow deliberate, informed, justified decisions on delegation of tasks to trainees. Consequently, EPAs present a way to demonstrate that graduating trainees have the capabilities that the profession, regulatory bodies, and society expect. The chapter concludeswith setting an agenda for curriculumdevelopment and research. The development of an EPA-based curriculum starts with identifying a consensus set of EPAs. Then a toolbox of assessment instruments is compiled for robust evaluation of trainee performance and justified entrustment decisions. Raters need to be trained and calibrated. A portfolio should be designed. This portfolio should be approachable by learning analytic technology to display learner progress, compare learners and institutions, and evaluate implementation and effects of EPA-based anesthesiology training. Research opportunities closely link to curriculum development. Examples are: obtaining consensus on sets of EPAs, comparing (inter-)national programs, validating assessment tools, establishing the role of simulation assessment, identification of markers of professional development, application of performance standards, the use of learning analytics in monitoring effects of EPAs on training, and the process of entrustment decisions. The thesis concludes with a general discussion (Chapter 9). This chapter highlights the major findings of the thesis and puts them into perspective of the literature. It discusses how coherence, motivation, and experiential learning explain the ACTY’s beneficial effect. The chapter proposes a continuum framework of acute care EPAs, It also describes how international postgraduate anesthesiology training is far from uniform and describes current literature on EPAs in anesthesiology. The chapter suggests avenues for further research and concludes with the vision of an education continuum that consists of aligned CBME stages, operationalized with EPAs.