Developing Entrustable Professional Activities to Demonstrate Competency During the Training of Chemical Pathologists in South Africa

Abstract

Background: Competency-based medical education (CBME) is recognised as a transformative approach in medical training, emphasising the ability of students to perform specific professional tasks, known as Entrustable Professional Activities (EPAs). These EPAs represent responsibilities that healthcare professionals should be entrusted to execute independently as they advance in their training. In the context of chemical pathology, key competencies include medical expertise, communication, collaboration, leadership, health advocacy, scholarship, and professionalism. Despite the global adoption of EPAs, their implementation in South Africa has been notably slow, largely due to the lack of formalised activities aligned with competency domains. Aim: This study aimed to identify the most significant competency domains within chemical pathology and to develop corresponding EPAs for the top three domains. Data Collection Method: The nominal Group Technique (NGT) was designed to achieve consensus amongst experts, using a modified Potter’s six step process. The NG meeting took place at Wits Medical School in Johannesburg, included nine selected experts from three Gauteng academic institutions. The meeting lasted three and a half hours. Data analysis: Through detailed discussions, participants identified five initial competency domains, which were refined to three through consensus. The analysis involved transcribing the discussions verbatim and applying content analysis to extract the themes relevant to defining the competency domains and developing the associated EPAs. Findings: Medical expertise, communication, and digital literacy were identified as the main competency domains by the NG participants. Interpreting and authorizing laboratory results, monitoring quality v control and implementing quality management were retained as the three most relevant EPAs by consensus. Conclusion: This study used the NGT to define three main competency domains and their corresponding EPAs in training competent chemical pathology registrars. Digital literacy was recognized as an emerging competency domain.