• Kelly J Caverzagie, Thomas G Cooney, Paul A Hemmer, and Lee Berkowitz.
• Dr. Caverzagie is associate professor and associate dean for educational strategy, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska. Dr. Cooney is professor and vice chair for educational programs, Department of Medicine, Oregon Health & Science University, Portland, Oregon. Dr. Hemmer is professor and vice chair for educational programs, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland. Dr. Berkowitz is professor and associate chair for education, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
• Acad Med. 2015 Apr 1; 90 (4): 479-84.

PurposeThe Alliance for Academic Internal Medicine charged its Education Redesign Committee with the task of assisting internal medicine residency program directors in meeting the challenges of competency-based assessment that were part of the Accreditation Council for Graduate Medical Education's (ACGME's) Next Accreditation System.MethodRecognizing the limitations of the ACGME general competencies as an organizing framework for assessment and the inability of the milestones to provide the needed context for faculty to assess residents' competence, the Education Redesign Committee in 2011 adopted the work-based assessment framework of entrustable professional activities (EPAs). The committee selected the EPA framework after reviewing the literature on competency-based education and EPAs and consulting with experts in evaluation and assessment. The committee used an iterative approach with broad-based feedback from multiple sources, including program directors, training institutions, medical organizations, and specialty societies, to develop a set of EPAs that together define the core of the internal medicine profession.ResultsThe resulting 16 EPAs are those activities expected of a resident who is ready to enter unsupervised practice, and they provide a starting point from which training programs could develop assessments and curricula. The committee also provided a strategy for the use of these EPAs in competency-based evaluation.ConclusionsThese EPAs are intended to serve as a starting point or guide for program directors to begin developing meaningful, work-based assessments that inform the evaluation of residents' competence.

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