Development, Implementation, and Evaluation of Entrustable Professional Activities (EPAs) for Medical Radiation Technologists in Taiwan: A Nationwide Experience

Abstract

Abstract Background: Competency-based medical education (CBME) is an outcomes-oriented approach focused on developing competencies that translate into clinical practice. Entrustable professional activities (EPAs) bridge competency assessment and clinical performance by delineating essential day-to-day activities that can be entrusted to trainees. EPAs have been widely adopted internationally, but not yet implemented for medical radiation professionals in Taiwan. Materials and Methods: A nationwide consensus process engaged 97 experts in radiation technology education representing diagnostic radiography, radiation therapy, and nuclear medicine. Preliminary EPAs were developed through nominal group technique and modified Delphi technique. Final EPAs were established through expert consensus meetings and evaluated for quality using the QUEPA and EQual tools. Additionally, 177 clinical staff were trained on EPA-based assessment. Results: Through iterative consensus building, 6 core EPAs with 18 component observable practice activities (OPAs) were developed, encompassing routines specific to each radiation technology specialty. QUEPA and EQual questionnaire data verified the EPAs were valid, reliable, and of high quality for clinical teaching and evaluation. Self-efficacy ratings demonstrated the training significantly improved clinical teachers’ EPA knowledge and implementation abilities across specialties. Conclusion: Consensus development of tailored EPAs and associated training enables rigorous competency assessment during medical radiation technology education in Taiwan. Further EPA expansion and training of clinical staff will enhance care quality by producing competent professionals.