Entrustable Professional Activities for Subspecialties

Entrustable professional activities (EPAs) are observable, routine activities that a general pediatrician or 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. Core EPAs describe the essential activities needed for practice, and supplemental EPAs have also been developed to address a range of issues and inform these core EPAs. 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, 4 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: Apply public health principles and quality improvement methods to improve population health
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

EPA 2

Provide continuity of care for adolescent and young adult patients with chronic medical problems and complex health conditions

EPA 3

Provide preventive health care that includes the conditions specific to the adolescent and young adult population

EPA 4

Transition care of the adolescent and young adult patient to adult health care settings

Cardiology

EPA 1

Acquire the imaging skills required for all aspects of pediatric and cardiology care

EPA 2

Care for patients who require catheter-based interventions

EPA 3

Diagnosis and management of patients with arrhythmias and conduction abnormalities

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

EPA 5

Diagnosis and management of patients with congenital or acquired cardiac problems

EPA 6

Diagnosis and management of patients with acute congenital or acquired cardiac problems requiring intensive care

Child Abuse Pediatrics

EPA 1

Provide subspecialty medical evaluation for children and adolescents who are suspected victims of sexual abuse or assault

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

EPA 3

Provide subspecialty medical evaluation in cases of suspected child neglect and other forms of child maltreatment

EPA 4

Provide subspecialty medical evaluation in cases of suspected child physical abuse

Critical Care Medicine

EPA 1

Acute management of the critically ill patient, including those with underlying chronic disease

EPA 2

Manage and coordinate care in pediatric critical care units for optimal patient outcomes

EPA 3

Management of patients at the end of life

Developmental-Behavioral Pediatrics

EPA 1

Effectively advocate for children and families affected by developmental and behavioral disorders

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

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

EPA 4

Recognize and longitudinally manage behavioral variations, problems, and disorders in typically developing children and children with developmental disorders

EPA 5

Recommend appropriate medical workup and evidence-based medical, therapeutic, educational, and behavioral interventions for children with developmental-behavioral disorders

Emergency Medicine

EPA 1

Recognize and provide care for acutely ill and/or injured pediatric patients presenting to the Emergency Department (ED)

EPA 2

Recognize and provide care for medically and technologically complex pediatric patients in the ED

EPA 3

Demonstrate competence in performing common procedures associated with the practice of pediatric emergency medicine

EPA 4

Provide patient triage, resuscitation, and stabilization; align care provided with severity of illness

EPA 5

Emergency Department Management: Manage the emergency department to optimize patient care

EPA 6

Provide supervision for emergency personnel to enhance patient care quality and assure patient safety

Endocrinology

EPA 1

Know the indications for performing the common procedures of the pediatric endocrinologist and be able to interpret the results

EPA 2

Facilitate the transition of patients with endocrine disorders from pediatric to adult health care

EPA 3

Manage patients with acute endocrine disorders in ambulatory, emergency, or inpatient settings

EPA 4

Manage patients with chronic endocrine disorders in ambulatory, emergency, or inpatient settings

Gastroenterology

EPA 1

Care of infants, children, and adolescents with acute and chronic gastrointestinal disorders

EPA 2

Care of infants, children, and adolescents with acute and chronic liver diseases, biliary/cholestatic diseases, pancreatic disorders, and those requiring liver transplantation

EPA 3

Care for infants, children, and adolescents with common outpatient GI, liver/biliary, pancreatic, and nutritional issues

EPA 4

Care of infants, children, and adolescents with nutritional issues, deficiencies, and obesity

EPA 5

Perform medical procedures related to gastrointestinal and liver disease for screening, diagnosis, and intervention

Hematology-Oncology

EPA 1

Manage patients with hematology-oncology conditions, whether acute or chronic, simple or complex, in an ambulatory, emergency, or inpatient setting

EPA 2

Enroll and treat patients on clinical research trials

EPA 3

Provide a medical home for patients with hematologic, oncologic, or stem cell transplant needs

EPA 4

Introduce and facilitate the integration of palliative care for patients with advanced disease

EPA 5

Demonstrate competence in performing and interpreting common procedures of a pediatric hematologist/oncologist

EPA 6

Facilitate the transition of care

Hospital Medicine

EPA 1

Care for acutely ill patients in hospital settings

EPA 2

Direct and coordinate care for patients with unclear diagnoses and complex patients

EPA 3

Perform common procedures associated with the practice of pediatric hospital medicine

EPA 4

Anticipate, facilitate, and lead comprehensive, coordinated, and safe transitions of care

EPA 5

Apply science of safety concepts in advocating for pediatric patients within the hospital system

EPA 6

Teach, provide feedback, and assess learners across a competency-based medical education continuum and engage in interprofessional education

Infectious Diseases

EPA 1

Promoting antimicrobial stewardship based on microbiological principles

EPA 2

Management and prevention of infections associated with medical/surgical devices, surgery, and trauma

EPA 3

Management of healthy patients with pediatric infectious diseases

EPA 4

Management of pediatric patients with complex medical problems and a proven or suspected infectious disease

EPA 5

Prevention and containment of infection

Neonatal-Perinatal Medicine

EPA 1

Management patients with acute, common single system diseases in an inpatient setting

EPA 2

Manage patients with complex, multisystem diseases in the NICU

EPA 3

Provide care to patients in the NICU with surgical problems in collaboration with pediatric and subspecialty surgeons

EPA 4

Provide resuscitation and stabilization of neonates and infants that aligns care with severity of illness

EPA 5

Management of neonatal care systems

Nephrology

EPA 1

Care of children with acute electrolyte and kidney disorders, including hypertension and disorders of the urinary tract

EPA 2

Care of children with chronic electrolyte and kidney disorders, including hypertension and disorders of the urinary tract

EPA 3

Care of the pediatric patient with ESKD and kidney transplant

EPA 4

Provision and supervision of kidney-related procedures including native and transplant kidney biopsy, peritoneal dialysis

Pulmonology

EPA 1

Manage patients with acute complex respiratory disease in an ambulatory, emergency, or inpatient setting

EPA 2

Manage patients with complex chronic respiratory disease through all settings and phases of life

EPA 3

Demonstrate competence in communicating a new diagnosis of a life-altering disease using a patient and family centered approach

EPA 4

Manage the use of supplemental respiratory equipment such as oxygen, ventilators, and airway clearance devices

EPA 5

Demonstrate competence in performing the common procedures of the pediatric pulmonary subspecialist

Rheumatology

EPA 1

Demonstrate competence in the utilization of immunomodulatory therapy for pediatric rheumatology patients

EPA 2

Manage patients with acute or chronic complex multi-system rheumatic disease in an ambulatory, emergency, or inpatient setting

EPA 3

Provide or coordinate a medical home for patients with complex and chronic rheumatic disease

Pediatric Transplant Hepatology

EPA 1

Care for infants, children, and adolescents who are pre-, peri-, and post-liver transplant

EPA 2

Care for infants, children, and adolescents who have been exposed to and/or are chronically infected with viral hepatitis

EPA 3

Care for infants, children, and adolescents with acute and chronic biliary/cholestatic diseases