Development of entrustable professional activities for competency-based prosthodontic specialty training programmes

OBJECTIVES: This study aimed to develop and validate a set of Entrustable Professional Activities (EPAs) for prosthodontics specialty training using a structured multi-step approach. METHODS: An initial list of EPAs was generated through a comprehensive literature review, examination of prosthodontics competency standards, and an asynchronous online nominal group technique involving national prosthodontists and a dental education expert. This process was used to develop and confirm the EPA set. The EPAs were then evaluated for quality and structure using the Equal rubric, resulting in the refinement and confirmation of relevant EPAs. Subsequently, a two-round modified Delphi method was employed, engaging prosthodontics educators from multiple countries in a consensus-building process. In the modified Delphi rounds, panellists reviewed a predefined list of EPAs and provided quantitative ratings and qualitative comments on indispensability (Round 1-2), title clarity (Round 1-2), specification/limitations (Round 1-2), information supporting entrustment decisions (Round 2), and expected entrustment level at each stage of training (Round 2). Based on median ratings and content validity index analysis the EPAs were revised accordingly. Aggregated scores for each EPA and synthesised group feedback for consensus development were provided in Round 2. RESULTS: The expert group confirmed 11 of the 20 initially identified EPAs. All 11 preliminary EPAs reflected activities that were deemed essential to the clinical practice of prosthodontists. Based on median ratings and content validity index analysis, 8 EPAs needed revision. A high degree of consensus among experts was reached in the second Delphi round. The final set of 11 EPAs provide a succinct and comprehensive overview of the core tasks of specialist prosthodontists. CONCLUSION: This study developed 11 EPAs for prosthodontics specialty training programmes, representing an essential first step toward developing a structured assessment system for prosthodontic trainees. CLINICAL SIGNIFICANCE: This study provides a further step towards competency-based specialty training in prosthodontics.