Table 1. EPAs and Related Supervision Levels.
| EPA | Supervision Levels |
|---|---|
| EPA 1: Provide consultation to other health care providers caring for children | Level 1: Trusted to observe only Level 2: Trusted to execute with direct supervision and coaching Level 3: Trusted to execute with indirect supervision and discussion of information conveyed for most simple and some complex cases Level 4: Trusted to execute with indirect supervision and may require discussion of information conveyed but only for selected complex cases Level 5: Trusted to execute without supervision |
| EPA 2: Provide recommended pediatric health screening EPA 3: Care for the well newborn EPA 4: Manage patients with acute, common diagnoses in an ambulatory, emergency, or inpatient setting EPA 5: Provide a medical home for well children of all ages (entrustment decisions for this EPA may require stratification by age group) EPA 6: Provide a medical home for patients with complex, chronic, or special health care needs (entrustment decisions for this EPA may require stratification by age group) EPA 7: Recognize, provide initial management and refer patients presenting with surgical problems EPA 8: Facilitate the transition from pediatric to adult health care EPA 9: Assess and manage patients with common behavior/mental health problems EPA 10: Resuscitate, initiate stabilization of the patient and then triage to align care with severity of illness (entrustment decisions for this EPA may require stratification by two age groups: neonate and non-neonate) EPA 17: Demonstrate competence in performing the common procedures of the general pediatrician |
Level 1: Trusted to observe the EPA Level 2: Trusted to practice EPA only under proactive, full supervision as a coactivity with the supervisor Level 3: Trusted to practice EPA only under proactive, full supervision with the supervisor in the room and ready to step in as needed Level 4: Trusted to practice EPA only under reactive, on-demand supervision with supervisor immediately available and ALL findings double checked Level 5: Trusted to practice EPA only under reactive, on-demand supervision with supervisor immediately available and KEY findings double checked Level 6: Trusted to practice EPA only under reactive, on-demand supervision with supervisor distantly available (eg, by phone), findings reviewed Level 7: Trusted to practice EPA unsupervised Level 8: Trusted to supervise others in practice of EPA (where supervision means: ability to assess patient and learner needs ensuring safe, effective care and further trainee development by tailoring supervision level) |
| EPA 11: Manage information from a variety of sources for both learning and application to patient care | Level 1: Trusted to perform with direct supervision Level 2: Trusted to perform with indirect supervision with supervisor checking findings Level 3: Trusted to perform with indirect supervision with supervisor available for requested help Level 4: Trusted to perform without supervision Level 5: Trusted to supervise others |
| EPA 12: Refer patients who require consultation | Level 1: Trusted to observe only Level 2: Trusted to execute with direct supervision and coaching Level 3: Trusted to execute with indirect supervision and discussion of information conveyed for most simple and some complex cases Level 4: Trusted to execute with indirect supervision and may require discussion of information conveyed but only for selected complex cases Level 5: Trusted to execute without supervision |
| EPA 13: Contribute to the fiscally sound, equitable and collaborative management of a health care workplace | Level 1: Trusted to observe only Level 2: Trusted to perform with direct supervision and coaching with supervisor verifying work product for accuracy Level 3: Trusted to perform with supervisor serving as a consultant for all tasks Level 4: Trusted to perform with supervisor serving as a consultant but only for complex tasks Level 5: Trusted to perform without supervision |
| EPA 14: Apply public health principles and quality improvement methods to improve population health | Level 1: Trusted to observe only Level 2: Trusted to contribute with direct supervision and coaching as a member of a collaborative effort to improve care at the institutional level Level 3: Trusted to contribute without direct coaching as a member of a collaborative effort to improve care at the institutional level Level 4: Trusted to lead collaborative efforts to improve care for populations and systems at the institutional level Level 5: Trusted to lead collaborative efforts to improve care at the level of populations and systems at the regional and/or national level |
| EPA 15: Lead an interprofessional health care team | Level 1: Trusted to participate only Level 2: Trusted to lead with direct supervision and coaching Level 3: Trusted to lead with supervisor occasionally present to provide advice Level 4: Trusted to lead without supervisor present but requires coaching to improve member and team performance Level 5: Trusted to lead without supervision to improve member and team performance |
| EPA 16: Facilitate handovers to another health care provider either within or across settings | Level 1: Trusted to observe only Level 2: Trusted to execute with direct supervision and coaching Level 3: Trusted to execute with indirect supervision with verification of information after the handover for most simple and some complex cases Level 4: Trusted to execute with indirect supervision and verification of information after the handover for selected complex cases Level 5: Trusted to execute without supervision |
Abbreviation: EPA, entrustable professional activity.