Developing Entrustable Professional Activities (EPAS) for House Officer to Practice Safely and Independently in Dentistry; A Qualitative Study Using Interpretive Paradigm

Abstract

Objective: To develop entrustable professional activities for a one-year house job in dentistry.

Study Design: Qualitative study (Interpretive Paradigm).

Place and Duration of Study: Khyber College of Dentistry and Sardar Begum Dental College, Peshawar Pakistan, from Sep 2017 to May 2018.

Methodology: A five-step approach was used to develop four EPAs for a one-year house job. Using maximum variation sampling, faculty members from eleven disciplines of dentistry working in public and private dental colleges of Khyber Pakhtunkhwa and charge of training dental interns participated in the study. Three focus group interviews and three in-depth interviews were conducted. Data was transcribed and thematic analysis was done.

Results: The EPAs were developed for a one-year house job using the five-step approach. This process resulted in developing the content of four EPAs in detail, analysing the results into competencies aligned with Pakistan medical and dental council, assessment methods such as multisource feedback, direct observation, mini CEX assessment with peer coaching and role modelling teaching strategies for each activity. Participants agreed on trusting the house officer to perform independently with a gradual shift of supervision scale from direct action to indirect and finally enacting the EPAs unsupervised.

Conclusion: This study presents the foundation for using specific EPAs in dentistry, a step towards a competency-based approach. The content of EPAs for a transition period of a one-year house job in dentistry was developed using the 5-stage approach. These EPAs can provide explicit guidance for the engagement of dental house officers in clinical workplace activities.