Implementation of entrustable professional activities in emergency medicine: perspectives from clinical instructors.

Objectives: To explore how clinical instructors in emergency medicine perceive and integrate Entrustable Professional Activities (EPAs) into their teaching practices, identify challenges they face, and explore the support required for effective implementation.

Methods: This study utilized grounded theory methodology to explore the pedagogical experiences of clinical instructors within emergency medicine. A qualitative approach was adopted, involving semi-structured interviews with participants recruited through purposive and snowball sampling techniques. A total of 18 emergency physicians, each with over five years of clinical teaching experience in a teaching hospital, were included in the study.

Results: The study revealed several critical insights: (a) Emergency medicine clinical instructors are integral in supervising, training, and providing feedback to residents, facilitating their development. (b) The implementation of EPAs is hindered by limited resources, time constraints, and the challenges of delivering real-time feedback. Instructors often experience a lack of confidence in their teaching efficacy, observe diminished motivation among residents, and encounter difficulties in assessing residents' soft skills. (c) The effective implementation of EPAs necessitates a supportive educational environment, a robust reward system, and objective feedback mechanisms. (d) Instructors derive a significant sense of fulfillment from witnessing the progression of residents into competent and autonomous practitioners, underscoring the importance of empowering educators through enhanced training and institutional support.

Conclusions: The findings offer valuable insights for developing of emergency medical education programs and underscore the need for targeted strategies to enhance the quality of clinical instruction in emergency settings.