Describing the Process to Develop Core Entrustable Professional Activities for Entrance Into Physical Therapist Practice: Applying a National Consensus Approach

INTRODUCTION: A component step in developing a competency-based education (CBE) program is to define a set of consensus-driven learner performance outcomes that will meet the physical therapy (PT) needs of society. REVIEW OF LITERATURE: Entrustable professional activities (EPAs) represent observable units of practice that integrate critical competencies that must be demonstrated in the care of patients. EPAs serve as a framework for teaching, learning, and assessment of key skills and responsibilities. The purpose of this manuscript is to describe the iterative, four-phase national consensus-based process, capturing multiple perspectives, on a core set of EPAs that Doctor of Physical Therapy (DPT) students should be entrusted to perform independently upon entering clinical practice for the first time, regardless of setting. SUBJECTS: Fifteen physical therapists served as members of the national EPA drafting group. Purposive selection was used to recruit 190 participants to serve as members of a Reactor Panel. METHODS: A modified Delphi was utilized that included 4 iterative phases. Each phase comprised work completed by the EPA drafting group, supported by experts in EPAs, followed by a reactor panel providing broader community feedback via a modified Delphi to facilitate consensus. Consensus was defined a priori as agreement among >80% of respondents. RESULTS: Nineteen core EPAs were identified as essential activities that all graduates of entry-level DPT programs should be able to perform safely and without the need for supervision, regardless of the practice setting. Each EPA has 5-7 critical competencies mapped to it that are aligned to learner characteristics required to be entrusted to that essential task. DISCUSSION: These core entry-level EPAs can serve as the national standard for minimum core performance outcomes required at entrance into clinical practice. CONCLUSION: This EPA framework can be used for teaching and assessing the critical competencies necessary for safe and efficient entry-level practice.