Effects of an Entrustable Professional Activities (EPA) based Curriculum on the Teaching Performance of Clinical Nursing Instructors

Background: Traditional time-based nursing training may not ensure clinical competence. Therefore, the competency-based Entrustable Professional Activities (EPAs) teaching model has been introduced to help determine a medical trainee’s readiness for independent practice. This study aimed to evaluate the effectiveness of an EPAs measure on clinical instructors and novice nurses. Methods: From November 2023 to January 2025, a structured EPA-based curriculum comprising basic training, expert workshops, and lesson plan development was completed by 30 clinical nursing instructors. The Kirkpatrick four-level model was used for evaluation. Data collection included satisfaction surveys, self-assessment questionnaires, and EPAs entrustment level ratings for novice nurses. The trained instructors subsequently applied the EPA framework to supervise 9 novice nurses, generating 108 entrustment assessments across six biweekly evaluation cycles. Statistical analyses included paired-sample t-tests and the Friedman test. Between December 2024 and March 2025, 9 novice nurses demonstrated significant improvement in entrustment levels across six assessment cycles, with a concurrent downward trend in patient safety incidents. Results: Participants’ satisfaction averaged 4.81 on a 5 point scale. Significant improvements were observed in knowledge, confidence, and teaching skills (p < 0.001). Ten EPA-based lesson plans were developed and implemented in clinical practice. Conclusion: The EPA-based curriculum enhanced teaching effectiveness, novice nurse competence, and patient safety. This model has potential for broader adoption and future digital integration in nursing education.