EPA Thinking - Becoming Entrustable | Texas Tech University Health Sciences Center

Learning lessons does not end. There is no part of life that does not contain its lessons. If you are alive, there are lessons to be learned.

From the book, “If Life is a Game, These are the Rules” by Cherie Carter-Scott, Ph.D.

Course Materials for "EPA Thinking - Becoming Entrustable"

Everything is provided here with free access for a medical school to introduce students to the type of thinking needed to perform the Core Entrustable Professional Activities for Entering Residency (EPAs).  Residency programs consider all thirteen EPAs to be essential on day 1 of their postgraduate education.  They are derived from a previously determined set of clinical competencies that are required by the ACGME to evaluate progress of resident physicians in the acquisition of clinical skills. 

Current goal:

  • The current goal is to invite all interested institutions to use the materials for conducting trial courses in EPA Thinking and, where the interest permits, to collaborate with me by pooling Quality Improvement survey data to support a publication. 
  • At the point of publication, appropriate updates will be made to make the contents here consistent with published information.
  • Prior experience with each part of this teaching approach has already worked well in comparable settings here at Texas Tech and at other schools where I have consulted.  There are significant increases in both degree of integration and degree of engagement of student participants over time. 

Long term goal:

  • The long term goal is to facilitate the general awareness that EPA Thinking is simply the outcome of skilled thinking producing skilled learning.  
  • EPA Thinking can prepare a student to achieve success even prior to medical school because it does not depend on performance of actual clinical activities.  Rather, it depicts a way of thinking that is both a practice and a goal.  
  • In an ideal world, the students in undergraduate medical education will know more about themselves as learners and about the opportunities for EPA Thinking than those who are evaluating them.  

- John Pelley

EPA "Thinking"

Awareness of the process by which students think and learn is the most important and yet least understood contributor to the acquisition of clinical skill.  It is not generally well understood, for example, that people have different preferences for taking in information, for organizing information, for retrieving learned information, for generating alternative hypotheses about a problem, and for prioritizing the likelihood of the most logical hypothesis.  As a result, educators tend to have an erroneous belief that students are limited to their current way of thinking and that this limitation can only be addressed through improved teaching and hard work by the students. 

  • There is ample evidence that students can both strengthen and diversify their thinking skills by teaching themselves through self-regulated deliberate practice.  The evidence from brain research has produced several prominent national reports with findings that knowledge of metacognition is the primary means to accomplish this. 
  • This course in EPA Thinking will guide students in acquiring an awareness that learning results from a specific thinking process, namely the Experiential Learning Cycle (ELC), and that the ELC itself is processed by specialized areas in the brain cortex. 
  • Knowledge of this learning process is systematically explored throughout the course, and applied to the current curriculum, so that both the students and their teachers can identify individualized strategies designed to build the skills needed for EPA Thinking.