Entrustable Professional Activities - An interview with Prof. Kakkassery

In order to better structure teaching during the practical year (PJ) and to promote the development of students during the PJ, the Institute for Didactics and Teaching Research in Medicine, together with the clinics, has begun to introduce the concept of "Entrustable Professional Activities". With this approach, training is organized on the basis of concrete, everyday activities. The method gradually gives students more responsibility in preparation for their future tasks.

One of the first clinics to launch this project is the Department of Ophthalmology at Chemnitz Hospital. In the following interview, head physician Prof. Vinodh Kakkassery talks about his experiences.

What motivated you to introduce EPAs in ophthalmology for the PJ?

The motivation arose from a frequently observed situation: students have solid knowledge, but often fail to make the transition to independent medical practice. During the practical year in particular, the question arises very specifically: What can I already trust someone to do responsibly? "Entrustable Professional Activities (EPAs) address precisely this point. They structure medical activities, link them to a comprehensible concept and promote responsibility and trust. Prof. Dr. Marjo Wijnen-Meijer and medical didactic working groups have contributed to a stronger focus on action-taking capacity and preparation for independent work. At the same time, this approach corresponds to an attitude that Prof. Dr. med. D. Michael Albrecht, long-standing Medical Director of the University Hospital Carl Gustav Carus Dresden, has shaped. Good teaching is the basis for quality in care and research. EPAs make this connection tangible in everyday life.

What specific benefits have you noticed from the introduction of EPAs in teaching?

One key effect is clarity in training. Students know better what is important and can assess their progress more realistically. At the same time, it becomes clearer to teachers when responsibility can be handed over in a meaningful way and when it is too demanding. This changes learning. Less passive running along, more active involvement. Defined activities are gradually taken on - initially with support, then increasingly independently. The feedback culture also becomes more concrete. Feedback is based on real situations, making it more precise and helpful. Overall, a learning environment is created that is closer to the reality of medical practice.

Were there any challenges in implementing the EPAs, and how did you overcome them?

© Klinikum Chemnitz

The challenge lay less in the concept than in integrating it into everyday life. EPAs require observation and feedback - things that should be in place but are not always. The decisive step was to see EPAs not as an add-on, but as a "lens" on existing processes. This made it possible to integrate many things without creating additional complexity. At the same time, medical didactic work shows how important continuous reflection is for the profession and for learning. EPAs only develop their value if they are understood at their pedagogical core rather than being worked through.

What tips would you give to other departments considering integrating EPAs into their teaching?

A good start is to begin with a few clearly defined activities and anchor these in everyday life. It is important to always consult with professionals in medical didactics. What is also crucial is good adaptation to clinical reality, not the number of activities. Feedback should be seen as a central component of teaching and learning. Only then does an activity become a learning process. EPAs are not a purely structural project. They change the way we deal with responsibility and development. If this idea is supported, added value is created for students, teachers and the quality of provision.