Entrustable Professional Activities for Subspecialties

Entrustable professional activities (EPAs), or "everyday pediatrician activities," are observable, routine activities that a pediatric subspecialist should be able to perform safely and effectively to meet the needs of their patients. The ABP has worked with the pediatrics community to develop an EPA framework for general pediatrics and all of the subspecialties. Seven EPAs are common to all subspecialties, and each subspecialty has three or more additional EPAs that are unique to the subspecialty. This EPA framework can be used for both assessment and curricular development across the entire education continuum and can be found below.

More information on EPAs in pediatrics can be found in this quick, four-minute video: EPAs 101: What is an Entrustable Professional Activity.
 

EPAs That are Common to all Subspecialties

Individual EPAs, with their corresponding curricular components, are below.

EPA: Provide consultation to other health care providers caring for children and adolescents and refer patients requiring further consultation to other subspecialty providers if necessary


EPA: Contribute to the fiscally sound, equitable, and collaborative management of a health care workplace
Curricular components supporting the functions of the EPA


EPA: Use Population Health Strategies and Quality Improvement Methods to Promote Health and Address Racism, Discrimination, and Other Contributors to Inequities Among Pediatric Populations
Curricular components supporting the functions of the EPA


EPA: Lead an interprofessional health care team
Curricular components supporting the functions of the EPA


EPA: Facilitate handovers to another health care provider either within or across settings
Curricular components supporting the functions of the EPA


EPA: Engage in scholarly activities through the discovery, application, and dissemination of new knowledge (broadly defined)
Curricular components supporting the functions of the EPA


EPA: Lead within the subspecialty profession
Curricular components supporting the functions of the EPA


Subspecialty-Specific EPAs

EPAs for individual subspecialties, with corresponding supervision scales, are in the accordions below.
 

Adolescent Medicine

EPA 1

Provide care for adolescent and young adult patients with acute physical and mental health issues
Curricular components supporting the functions of the EPA

EPA 2

Provide continuity of care for adolescent and young adult patients with chronic medical problems and complex health conditions
Curricular components supporting the functions of the EPA

EPA 3

Provide preventive health care that includes the conditions specific to the adolescent and young adult population
Curricular components supporting the functions of the EPA

EPA 4

Transition care of the adolescent and young adult patient to adult health care settings
Curricular components supporting the functions of the EPA

Cardiology

EPA 1

Acquire the imaging skills required for all aspects of pediatric and cardiology care
Curricular components supporting the functions of the EPA

EPA 2

Care for patients who require catheter-based interventions
Curricular components supporting the functions of the EPA

EPA 3

Diagnosis and management of patients with arrhythmias and conduction abnormalities
Curricular components supporting the functions of the EPA

EPA 4

Diagnose, initially manage, and refer children with advanced or end stage heart failure and/or pulmonary hypertension to experts for medical therapy, ECMO, ventricular assist devices, and/or cardiac transplantation
Curricular components supporting the functions of the EPA

EPA 5

Diagnosis and management of patients with congenital or acquired cardiac problems
Curricular components supporting the functions of the EPA

EPA 6

Diagnosis and management of patients with acute congenital or acquired cardiac problems requiring intensive care
Curricular components supporting the functions of the EPA

Child Abuse Pediatrics

EPA 1

Provide subspecialty medical evaluation for children and adolescents who are suspected victims of sexual abuse or assault
Curricular components supporting the functions of the EPA

EPA 2

Engage in behaviors and use coping strategies that will mitigate the emotional stress of caring for patients that have been abused, neglected, or maltreated
Curricular components supporting the functions of the EPA

EPA 3

Provide subspecialty medical evaluation in cases of suspected child neglect and other forms of child maltreatment
Curricular components supporting the functions of the EPA

EPA 4

Provide Subspecialty Medical Evaluation in Cases of Suspected Child Physical Abuse 
Curricular components supporting the functions of the EPA

Critical Care Medicine

EPA 1

Acute management of the critically ill patient, including those with underlying chronic disease
Curricular components supporting the functions of the EPA

EPA 2

Manage and coordinate care in pediatric critical care units for optimal patient outcomes
Curricular components supporting the functions of the EPA

EPA 3

Management of patients at the end of life
Curricular components supporting the functions of the EPA

Developmental-Behavioral Pediatrics

EPA 1

Effectively advocate for children and families affected by developmental and behavioral disorders
Curricular components supporting the functions of the EPA

EPA 2

Effectively communicate with families, schools, and community organizations to facilitate their understanding of children’s developmental-behavioral diagnoses and to promote their engagement in clinical decision-making and treatment
Curricular components supporting the functions of the EPA

EPA 3

Perform comprehensive histories and physical and neurodevelopmental examinations to make accurate diagnoses for patients presenting with developmental-behavioral concerns from infancy through young adulthood
Curricular components supporting the functions of the EPA

EPA 4

Recognize and longitudinally manage behavioral variations, problems, and disorders in typically developing children and children with developmental disorders
Curricular components supporting the functions of the EPA

EPA 5

Recommend appropriate medical workup and evidence-based medical, therapeutic, educational, and behavioral interventions for children with developmental-behavioral disorders
Curricular components supporting the functions of the EPA

Emergency Medicine

EPA 1

Recognize and provide care for acutely ill and/or injured pediatric patients presenting to the Emergency Department (ED)
Curricular components supporting the functions of the EPA

EPA 2

Recognize and provide care for medically and technologically complex pediatric patients in the ED
Curricular components supporting the functions of the EPA

EPA 3

Demonstrate competence in performing common procedures associated with the practice of pediatric emergency medicine
Curricular components supporting the functions of the EPA

EPA 4

Provide patient triage, resuscitation, and stabilization; align care provided with severity of illness
Curricular components supporting the functions of the EPA

EPA 5

Emergency Department Management: Manage the emergency department to optimize patient care
Curricular components supporting the functions of the EPA

EPA 6

Provide supervision for emergency personnel to enhance patient care quality and assure patient safety
Curricular components supporting the functions of the EPA

Endocrinology

EPA 1

Know the indications for performing the common procedures of the pediatric endocrinologist and be able to interpret the results
Curricular components supporting the functions of the EPA

EPA 2

Facilitate the transition of patients with endocrine disorders from pediatric to adult health care
Curricular components supporting the functions of the EPA

EPA 3

Manage patients with acute endocrine disorders in ambulatory, emergency, or inpatient settings
Curricular components supporting the functions of the EPA

EPA 4

Manage patients with chronic endocrine disorders in ambulatory, emergency, or inpatient settings
Curricular components supporting the functions of the EPA

Gastroenterology

EPA 1

Care of infants, children, and adolescents with acute and chronic gastrointestinal disorders
Curricular components supporting the functions of the EPA

EPA 2

Care of infants, children, and adolescents with acute and chronic liver diseases, biliary/cholestatic diseases, pancreatic disorders, and those requiring liver transplantation
Curricular components supporting the functions of the EPA

EPA 3

Care for infants, children, and adolescents with common outpatient GI, liver/biliary, pancreatic, and nutritional issues
Curricular components supporting the functions of the EPA

EPA 4

Care of infants, children, and adolescents with nutritional issues, deficiencies, and obesity
Curricular components supporting the functions of the EPA

EPA 5

Perform medical procedures related to gastrointestinal and liver disease for screening, diagnosis, and intervention
Curricular components supporting the functions of the EPA

Hematology-Oncology

EPA 1

Manage patients with hematology-oncology conditions, whether acute or chronic, simple or complex, in an ambulatory, emergency, or inpatient setting
Curricular components supporting the functions of the EPA

EPA 2

Enroll and treat patients on clinical research trials
Curricular components supporting the functions of the EPA

EPA 3

Provide a medical home for patients with hematologic, oncologic, or stem cell transplant needs
Curricular components supporting the functions of the EPA

EPA 4

Introduce and facilitate the integration of palliative care for patients with advanced disease
Curricular components supporting the functions of the EPA

EPA 5

Demonstrate competence in performing and interpreting common procedures of a pediatric hematologist/oncologist
Curricular components supporting the functions of the EPA

EPA 6

Facilitate the transition of care
Curricular components supporting the functions of the EPA

Hospital Medicine

EPA 1

Care for acutely ill patients in hospital settings
Curricular components supporting the functions of the EPA

EPA 2

Direct and coordinate care for patients with unclear diagnoses and complex patients
Curricular components supporting the functions of the EPA

EPA 3

Perform common procedures associated with the practice of pediatric hospital medicine
Curricular components supporting the functions of the EPA

EPA 4

Anticipate, facilitate, and lead comprehensive, coordinated, and safe transitions of care
Curricular components supporting the functions of the EPA

EPA 5

Apply science of safety concepts in advocating for pediatric patients within the hospital system
Curricular components supporting the functions of the EPA

EPA 6

Teach, provide feedback, and assess learners across a competency-based medical education continuum and engage in interprofessional education
Curricular components supporting the functions of the EPA

Infectious Diseases

EPA 1

Promoting antimicrobial stewardship based on microbiological principles
Curricular components supporting the functions of the EPA

EPA 2

Management and prevention of infections associated with medical/surgical devices, surgery, and trauma
Curricular components supporting the functions of the EPA

EPA 3

Management of healthy patients with pediatric infectious diseases
Curricular components supporting the functions of the EPA

EPA 4

Management of pediatric patients with complex medical problems and a proven or suspected infectious disease
Curricular components supporting the functions of the EPA

EPA 5

Prevention and containment of infection
Curricular components supporting the functions of the EPA

Neonatal-Perinatal Medicine

EPA 1

Management patients with acute, common single system diseases in an inpatient setting
Curricular components supporting the functions of the EPA

EPA 2

Manage patients with complex, multisystem diseases in the NICU
Curricular components supporting the functions of the EPA

EPA 3

Provide care to patients in the NICU with surgical problems in collaboration with pediatric and subspecialty surgeons
Curricular components supporting the functions of the EPA

EPA 4

Provide resuscitation and stabilization of neonates and infants that aligns care with severity of illness
Curricular components supporting the functions of the EPA

EPA 5

Management of neonatal care systems
Curricular components supporting the functions of the EPA

Nephrology

EPA 1

Care of children with acute electrolyte and kidney disorders, including hypertension and disorders of the urinary tract
Curricular components supporting the functions of the EPA

EPA 2

Care of children with chronic electrolyte and kidney disorders, including hypertension and disorders of the urinary tract
Curricular components supporting the functions of the EPA

EPA 3

Care of the pediatric patient with ESKD and kidney transplant
Curricular components supporting the functions of the EPA

EPA 4

Provision and supervision of kidney-related procedures including native and transplant kidney biopsy, peritoneal dialysis
Curricular components supporting the functions of the EPA

Pulmonology

EPA 1

Manage patients with acute complex respiratory disease in an ambulatory, emergency, or inpatient setting
Curricular components supporting the functions of the EPA

EPA 2

Manage patients with complex chronic respiratory disease through all settings and phases of life
Curricular components supporting the functions of the EPA

EPA 3

Demonstrate competence in communicating a new diagnosis of a life-altering disease using a patient and family centered approach
Curricular components supporting the functions of the EPA

EPA 4

Manage the use of supplemental respiratory equipment such as oxygen, ventilators, and airway clearance devices
Curricular components supporting the functions of the EPA

EPA 5

Demonstrate competence in performing the common procedures of the pediatric pulmonary subspecialist
Curricular components supporting the functions of the EPA

Rheumatology

EPA 1

Demonstrate competence in the utilization of immunomodulatory therapy for pediatric rheumatology patients
Curricular components supporting the functions of the EPA

EPA 2

Manage patients with acute or chronic complex multi-system rheumatic disease in an ambulatory, emergency, or inpatient setting
Curricular components supporting the functions of the EPA

EPA 3

Provide or coordinate a medical home for patients with complex and chronic rheumatic disease
Curricular components supporting the functions of the EPA

Pediatric Transplant Hepatology

EPA 1

Care for infants, children, and adolescents who are pre-, peri-, and post-liver transplant
Curricular components supporting the functions of the EPA

EPA 2

Care for infants, children, and adolescents who have been exposed to and/or are chronically infected with viral hepatitis
Curricular components supporting the functions of the EPA

EPA 3

Care for infants, children, and adolescents with acute and chronic biliary/cholestatic diseases
Curricular components supporting the functions of the EPA

General Pediatrics EPAs

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