Entrustable Professional Activity Revised to Set Anti-Racism as Professional Standard

Dr. David TurnerA working group of pediatricians certified by the American Board of Pediatrics (ABP) recently updated the ABP’s entrustable professional activity (EPA) about population health and quality improvement to better address health inequities among children, adolescents, and young adults.

EPAs are essential activities that define what patients need from their pediatricians and pediatric subspecialists. They can be used to build curriculum and as an assessment framework to identify gaps in graduate medical education by determining if a pediatrician is ready to be entrusted to perform specific activities without supervision.

The revised EPA, which applies to both general pediatrics and all pediatric subspecialties, is now titled “Use Population Health Strategies and Quality Improvement Methods to Promote Health and Address Racism, Discrimination, and Other Contributors to Inequities Among Pediatric Populations.”

“We wanted to revise the population health and quality improvement EPA because, despite well-known health care disparities among marginalized youth, important factors such as racism and discrimination were not addressed in our EPA framework,” says David Turner, MD, Vice President for Competency-Based Medical Education at the ABP.

Dr. Ndidi UnakaThe six-member working group, led by Ndidi Unaka MD, MEd, Associate Program Director of the Pediatric Residency Training Program at Cincinnati Children’s Hospital Medical Center, began meeting virtually about a year ago to revise the EPA.

“We went on a journey of reviewing the EPA in its previous form and started by highlighting the areas in which we could enhance it,” Dr. Unaka says. “We needed to be explicit in addressing racism, discrimination, and health disparities that are associated with poor health outcomes in marginalized groups.”

After spending several months making revisions, using evidence as their guide, the group actively sought and received feedback from experts in the field, the pediatric community, leaders of major pediatric organizations, and trainees in pediatrics.

The other members of the working group were Patricia Poitevien, MD, MSc, Adiaha Spinks-Franklin, MD, MPH, Franklin Trimm, MD, and Ariel Winn, MD.

The EPA also includes a thorough list of definitions, sources, and references.

“This work is pivotal because, in the future, EPAs will be part of the eligibility requirements for certification,” says Dr. Turner. “Establishing antiracism as a clear standard in this modified EPA is an important part of the ABP’s approach to improve the health of all children.”

For more information, read Dr. Unaka’s blog post about the revision process or read the revised EPA.