Workshop Focuses on Enhanced Training of Novice Registrars

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Representatives from the Workplace Based Assessment (WBA) National Steering Group hosted a workshop focused on introducing entrustable professional activities (EPAs) as a framework for the holistic training of Master of Medicine (MMed) students, also known as registrars or medical doctors undergoing specialist training.

The representatives were Professor Vanessa Burch, Professor Sumiaya Adams and Professor Veena Singaram of the Colleges of Medicine of South Africa (CMSA) and the South African Committee of Medical Deans (SACoMD).

The workshop was attended by multidisciplinary academics and heads of clinical disciplines at UKZN’s College of Health Sciences. Singaram, UKZN School of Clinical Medicine (SCM) Academic Leader of Research, said EPAs were introduced globally to help bridge the gap between competencies and clinical practice. ‘Competency-based medical education has gained popularity. With that change in conceptual models, the number of tools for workplace-based assessment in under- and postgraduate health professions education has steadily increased and evolved.’

Singaram described an EPA as a unit of professional practice that can be entrusted to a sufficiently competent trainee. ‘An EPA requires proficiency in multiple competencies simultaneously, and is a more suitable focus for assessment than separate competencies,’ she said. ‘EPAs can also stimulate more feedback-type conversations with supervisors. It is envisaged that registrars commencing their studies in the latter half of 2024 will need to complete WBA observations as part of their entry requirements to their final examination offered by the CMSA.’

Burch, a rheumatologist and health professions educationalist who is CMSA’s Executive Director for Education and Assessment, further explained: ‘Unlike competencies which are descriptors of the clinician, EPAs are descriptors of the work done - they translate competencies into clinical practice and require multiple competencies in an integrated, holistic nature,’ she said.

‘The knowledge explosion has made it difficult for novice specialists to know what to learn,’ said Burch. She gave practical examples of how EPAs can be used as a curriculum framework, covering the five essential components of a curriculum. These are: the desired product (expected outcomes of the training programme); the syllabus (learning in terms of knowledge, skills and attributes); method (the portfolio of learning activities to be undertaken); resources (prescribed materials, opportunities, and other support for learning); and assessment (the longitudinal process of advancing entrustment [competent to practice]).

Also, in attendance was SCM’s Academic Leader for Registrar Training, Dr Kimesh Naidoo.

The group activities encouraged participants to develop and implement EPAs as part of WBA in their postgraduate disciplines. The participants are expected to engage with their discipline-specific working groups to develop the EPAs for their discipline within the next three to six months in preparation for a follow-up discipline-specific workshop.

The facilitators emphasised that the idea was to leave no one behind by involving as many institutions and disciplines as possible in integrating EPAs into postgraduate medical education to enhance the quality of specialist training in South Africa.

Words and photograph: Lunga Memela