Entrustable Professional Activities
Entrustable Professional Activities (EPAs) are important work tasks that trainees need to be able to perform with supervision at a distance by the end of Basic Training.
By the end of Basic Training trainees need to be able to perform each EPA with supervision at a distance.
Each of the EPAs:
- is an exemplar, discrete task, separable from other tasks, which relates to patient care
- can be readily observed and assessed
- relates to safe healthcare in the workplace. There are consequences associated to this task that are not easily reversed.
Entrustable Professional Activities for Basic Trainees in Adult Internal Medicine and Paediatrics & Child Health (PDF 1.1MB)
EPA Behaviours
Each EPA includes the behaviours of a trainee who can perform the task with supervision at a distance and examples of behaviours of a trainee who is not yet ready to perform the task with supervision at a distance. The behaviours are categorised according to the domains of the RACP Professional Practice Framework, however each EPA should be performed and assessed as a complete task.
How to browse related content
Some parts of the curriculum standards relate to content in other curriculum standards. For example, in the Medical Expertise behaviours you can access links to related Competency content. View the related content within each of the following domains by clicking the '+' symbol.
EPA 5 - Transfer of care
Transfer care of patients
This activity requires the ability to:
- transfer care at any transition point, including:
- at admission
- between clinical services
- at changes of shift
- at discharge to ambulatory and community care
- ensure continuation of care
- share patient information with other health care providers in conjunction with the transfer of responsibility for patient care
- select modes of information transfer, such as oral and written format
- communicate (at least):
- patient demographics
- concise medical history
- current problems and issues
- details of pertinent and pending investigation results
- medical and multidisciplinary care plans
- upcoming possibilities
- perform this activity in multiple settings, including inpatient and ambulatory care settings and in emergency departments
Behaviours
Each EPA has lists of behaviours. The behaviours help trainees understand how they can improve, and help supervisors to make decisions about whether trainees can be trusted to do the task with supervision at a distance
Medical expertise
Ready to perform with supervision at a distance
Expected behaviours of a trainee who can routinely perform this activity with supervision at a distance.
The trainee:
- displays understanding of the details of patients’ condition, illness severity, and potential emerging issues with appropriate action and contingency plans
- provides concise, accurate summaries and sophisticated syntheses of information with accurate identification of acute problems or issues
Not yet ready to perform with supervision at a distance
Examples of behaviours of a trainee not yet ready to perform this activity with supervision at a distance.
The trainee may:
- inadequately summarise the active medical problems
Related competency themes
Communication
Ready to perform with supervision at a distance
Expected behaviours of a trainee who can routinely perform this activity with supervision at a distance.
The trainee:
- ensures a suitable environment for handover, including adequate time
- communicates clearly with clinicians and other caregivers
- uses standardised verbal and written templates to improve the reliability of information transfer and prevent errors and omissions
- confirms information has been received and understood, and seeks questions and feedback
Not yet ready to perform with supervision at a distance
Examples of behaviours of a trainee not yet ready to perform this activity with supervision at a distance.
The trainee may:
- have an unstructured approach in transferring oral or written information
- include current problems, but these are not well clarified
- include unnecessary or irrelevant information
- omit significant problems
- inadequately clarify treatment changes and clinical reasoning
- omit ongoing management plans, discharge medications, pending tests at discharge, or patient counselling and instructions
Related competency themes
Quality and safety
Ready to perform with supervision at a distance
Expected behaviours of a trainee who can routinely perform this activity with supervision at a distance.
The trainee:
- ensures complete handover or works to mitigate risks if the handover was incomplete
- ensures all outstanding results or procedures will be followed up by receiving units and clinicians
- provides feedback to individuals instigating handovers on any errors that occurred, including inaccurate information transmission
- communicates accurately and in a timely fashion to ensure an effective transition between settings, and continuity and quality of care
Not yet ready to perform with supervision at a distance
Examples of behaviours of a trainee not yet ready to perform this activity with supervision at a distance.
The trainee may:
- not mitigate the risks associated with changing care teams or environments
Related competency themes
Teaching and learning
Ready to perform with supervision at a distance
Expected behaviours of a trainee who can routinely perform this activity with supervision at a distance.
The trainee:
- takes opportunities to teach junior colleagues during handover as necessary
Related competency themes
Research
Ready to perform with supervision at a distance
Expected behaviours of a trainee who can routinely perform this activity with supervision at a distance.
The trainee:
- refers to evidence-based clinical guidelines
Related competency themes
Cultural competence
Ready to perform with supervision at a distance
Expected behaviours of a trainee who can routinely perform this activity with supervision at a distance.
The trainee:
- includes relevant information regarding patients’ cultural or ethnic background in the handover and whether an interpreter is required
Related competency themes
Ethics and professional behaviour
Ready to perform with supervision at a distance
Expected behaviours of a trainee who can routinely perform this activity with supervision at a distance.
The trainee:
- maintains respect for patients, families, carers, and other health professionals, including respecting privacy and confidentiality
- informs patients that handover of care will take place and to which team, service, or clinician as appropriate
Not yet ready to perform with supervision at a distance
Examples of behaviours of a trainee not yet ready to perform this activity with supervision at a distance.
The trainee may:
- show a lack of respect for patients and other health professionals
- inadequately maintain confidentiality by:
- selecting an inappropriate environment, such as handover in public places or with the office door open
- gathering and displaying confidential information on patients, such as information displayed on a list that the patient’s relatives could access, or sharing information that is not relevant to patient care
Related competency themes
Judgement and decision making
Ready to perform with supervision at a distance
Expected behaviours of a trainee who can routinely perform this activity with supervision at a distance.
The trainee:
- uses a structured approach to thinking about patients’ issues and prioritising these
- ensures patients receive care in the most appropriate facility or setting
- recognises their own limitations and seeks help when required in an appropriate way
Not yet ready to perform with supervision at a distance
Examples of behaviours of a trainee not yet ready to perform this activity with supervision at a distance.
The trainee may:
- show a lack of preparation
- inadequately consult with senior colleagues
Related competency themes
Leadership, management and teamwork
Ready to perform with supervision at a distance
Expected behaviours of a trainee who can routinely perform this activity with supervision at a distance.
The trainee:
- uses a structured approach to handovers that can be applied in and across all institutions or settings, such as:
- emergency room to admitting unit
- admitting unit to intensive care unit
- operation room to admitting unit
- shift A to shift B
- team A to team B
- inter-hospital transfer
- hospital to community
- hospital to rehabilitation
- recognises factors that impact on transfer of care and provides contingency planning and anticipatory guidance
- works to overcome the potential barriers to continuity of care and appreciates the role of handover in overcoming these barriers
Not yet ready to perform with supervision at a distance
Examples of behaviours of a trainee not yet ready to perform this activity with supervision at a distance.
The trainee may:
- inadequately co-ordinate patient care to ensure safe handover
- demonstrate a lack of awareness of the roles, skills, and limitations of those receiving handover
Related competency themes
Health policy, systems and advocacy
Ready to perform with supervision at a distance
Expected behaviours of a trainee who can routinely perform this activity with supervision at a distance.
The trainee:
- factors transport issues and costs to patients into arrangements for transferring patients to other settings
Related competency themes
Related Knowledge Guide
Paediatrics & Child Health