How to define core entrustable professional activities for entry into residency?

Background: Institutions considering to employ core Entrustable Professional Activities (EPAs) for entry into postgraduate training as outcomes for their undergraduate medical programs can partly build on published examples, but also have to undergo their own content validation process to take their specific context into consideration. This process involves several challenges and is not well-described in the literature. Here, we report in detail on a systematic, literature-based approach we recently utilised at our institution to define core EPAs for entry into residency.Main body: Central to the process was a modified Delphi consent procedure. It involved a multistep interaction between a writing team and a multidisciplinary panel of experienced physicians. Panel members provided both quantitative ratings and qualitative feedback on the EPA categories title, specification/limitations, conditions and implications of entrustment decision, knowledge, skills, and attitude. Consent was achieved when a Content Validity Index (CVI) of ≥80% was reached. The writing team adjusted the EPA category descriptions on the basis of panel members´ ratings and comments, and specified the EPA categories' link to competencies and assessment sources. This process produced a description and definition of a full set of core EPAs for entry into residency adapted to our context.Conclusions: This process description for locally adapted core EPAs for entry into residency may support and guide other medical schools in the development and implementation of EPAs into their programs