# Developing entrustable professional activities for residents in physical and rehabilitation medicine: A Delphi study

Claire Hentzen, Olivier Remy-Neris, Charles Pradeau, Laurent Bensoussan, François Constant Boyer, Jean-Christophe Daviet, Christelle Nguyen, Xavier de Boissezon

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## To cite this version:

Claire Hentzen, Olivier Remy-Neris, Charles Pradeau, Laurent Bensoussan, François Constant Boyer, et al.. Developing entrustable professional activities for residents in physical and rehabilitation medicine: A Delphi study. Annals of Physical and Rehabilitation Medicine, 2025, 68 (4), pp.101978. 10.1016/j.rehab.2025.101978. hal-05524879

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Research letter

# Developing entrustable professional activities for residents in physical and rehabilitation medicine: A Delphi study

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Claire Hentzen<sup>a,*</sup>, Olivier Remy-Neris<sup>b</sup>, Charles Pradeau<sup>c,d,e</sup>, Laurent Bensoussan<sup>f</sup>,
François Constant Boyer<sup>g</sup>, Jean-Christophe Daviet<sup>h,i</sup>, Christelle Nguyen<sup>j,k,l</sup>,
Xavier De Boissezon<sup>m,n</sup>

## ARTICLE INFO

**Article History:**
Received 17 November 2024
Accepted 6 March 2025

**Keywords:**
Entrustable professional activities
Physical and rehabilitation medicine
Residency
Educational measurement

## ABSTRACT

Entrustable professional activities (EPAs) are set to assess residents' capacity to perform professional units close to the context of their future clinical practice. The aim was to define a concise list of EPAs covering the broad specialty of Physical and Rehabilitation Medicine (PRM) to implement a systematic and consistent assessment of trainees' competencies during their residency. A list of EPAs was developed based on a literature review and working group. This list was then submitted to academic PRM professors for validation via a Delphi process. Two rounds were planned with intermediate and final discussion meetings by an external steering committee. Ten EPAs were developed in a first draft. Each of the seven parts of the EPAs obtained validation through the Delphi process. A list of 11 clinical contexts of application was approved to integrate the EPAs in the different areas of PRM. The next step will be the deployment of these EPAs for the validation of residency internships.

© 2025 The Authors. Published by Elsevier Masson SAS. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

Dear Editor,

Over the past 10 years, Entrustable Professional Activities (EPA) have gained significant popularity in assessing residents' competencies. Since their first description in 2005 by ten Cate [1], many

specialties such as internal medicine [2], pulmonary and critical care medicine [3], and general surgery [4], have developed their own EPAs using various validation methods, including literature review, interviews, working groups, and the Delphi process [5]. An EPA is "a unit of professional practice that can be fully entrusted to a trainee, once he or she has demonstrated the necessary competence to execute this activity unsupervised." [6] This assessment method aims to integrate competencies and professional skills while linking progressive proficiency to increasing autonomy in individual care [6]. A unit can be a discrete task or a bundle of

Abbreviations: COFEMER, French College of Physical and Rehabilitation Medicine; EBPRM, European Board of Physical and Rehabilitation Medicine; EPA, Entrustable Professional Activities; ETR, European Training Requirements; PRM, Physical and Rehabilitation Medicine

<footnote><sup>a</sup> Sorbonne University, GRC 01, GREEN Group of clinical REsEarch in Neurourology, AP-HP, Hôpital Pitié Salpétrière, 43-87 bd de l'Hôpital, F-75013 Paris, France</footnote>

<footnote><sup>b</sup> Université de Brest, CHU de Brest, INSERM, UMR 1101, 22 rue Camille Desmoulins, Brest 29200, France</footnote>

<footnote><sup>c</sup> Hôpitaux Universitaires de Strasbourg, Pôle de médecine Physique et de Réadaptation, 1 pl de l'Hôpital, Strasbourg 67000, France</footnote>

<footnote><sup>d</sup> Institut Universitaire de Réadaptation Clemenceau, Pôle de Médecine Physique et de Réadaptation, 45 bd Clemenceau, Strasbourg 67000, France</footnote>

<footnote><sup>e</sup> Université de Strasbourg, Unité de Recherche 3072, Centre Européen d'Enseignement, de Recherche et d'Innovation en Physiologie de l'exercice, 1 pl de l'Hôpital, Strasbourg 67000, France</footnote>

<footnote><sup>f</sup> Aix Marseille Université, CNRS, INT UMR 7289, 27 bd Jean Moulin - 13005 Marseille, France; Department of Physical and Rehabilitation Medicine, Marseille University Hospital, 64, rue Saint Pierre, 13385 Marseille CEDEX, France; UGECAM Institut Universitaire de Réadaptation de Valmante Sud, Marseille 13009, France</footnote>

<footnote><sup>g</sup> Unités de Médecine Physique et de Réadaptation, UR3797 VieFra, Université Reims Champagne Ardenne (URCA), Centre Hospitalier Universitaire de Reims, Hôpital Sébastopol, 48 rue de Sébastopol, Reims Cedex 51098, France</footnote>

<footnote><sup>h</sup> Université de Limoges, HAVAE, UR 20217, 123 avenue Albert Thomas, Limoges Cedex 87060, France</footnote>

<footnote><sup>i</sup> CHU Limoges, Department Physical Medicine and Rehabilitation, 2 Av. Martin Luther King, Limoges 87000, France</footnote>

<footnote><sup>j</sup> Université Paris Cité, Faculté de Santé, UFR de Médecine, 15 Rue de l'École de Médecine, Paris 75006, France</footnote>

<footnote><sup>k</sup> AP-HP.Centre-Université Paris Cité, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, 27 Rue du Faubourg Saint-Jacques, Paris 75014, France</footnote>

<footnote><sup>l</sup> INSERM UMR-S 1124, Campus Saint-Germain-des-Prés, 45 Rue des Saints-Pères, Paris 75006, France</footnote>

<footnote><sup>m</sup> ToNIC, Université de Toulouse, Inserm, UT3, Pl. du Dr Joseph Baylac, Toulouse 31300, France</footnote>

<footnote><sup>n</sup> Department of Physical and Rehabilitation Medicine, Pole Neurosciences, University Hospital of Toulouse, Hôpital de Purpan, Pl. du Dr Joseph Baylac, Toulouse 31300, France</footnote>

<footnote>* Corresponding author.</footnote>

<footnote>E-mail address: claire.hentzen@aphp.fr (C. Hentzen).</footnote>
tasks in healthcare practice and allow flexibility in the creation of EPAs.

The first EPAs in Physical and Rehabilitation Medicine (PRM) were published in 2017 [7]. These EPAs, the result of a Delphi study led by members of the American Association of Academic Physiatrists, were based on the existent American PRM curriculum and described competencies and milestones. In Europe, the required knowledge and skills in PRM are outlined in the White Book on Physical and Rehabilitation Medicine [8]. A previous work, completed in 2010 by the French academic PRM college (COFEMER), led to a list of >120 activities that residents were expected to observe, practice, and master. This list was designed to align with the specific characteristics of PRM training in France and was used for several years to assess residents' competencies. However, it was gradually abandoned due to its unfriendly and time-consuming nature. As a result, there is currently no standardized assessment of PRM residents' professional skills across different internships. This lack of consistency can hinder individual progress and penalize future employers during their recruitment process. Therefore, a new validated and easily applicable method for assessing residents' skills, tailored to the language and curriculum specificities in France, is necessary. This work aimed to define a concise list of EPAs covering the broad specialty of PRM and to implement a systematic and consistent assessment of trainees' competencies during their residency.

For this purpose, a literature review was performed to identify any existing EPAs in PRM and to define the mandatory sections for creating EPAs, in accordance with existing guidelines.

A first draft of EPA was proposed by a writing committee composed of 4 academic PRM professors with significant experience as trainers of PRM residents, and 4 PRM residents. The draft was then discussed with other academic PRM members for rephrasing if necessary. More specifically, the general form of the EPAs, such as broad items but in a limited number, with details about their context of application, was validated by the PRM educational board. This view aligned with the core concepts of PRM. For example: a person/functioning oriented specialty, with the resourcefulness to make a functional assessment, and play a key role at leading a multi-professional rehabilitation team [9]. Alignment of the subsequent version of the EPA with the guidelines was checked and adjusted, and if necessary, reviewed by an external PRM expert [6].

A steering committee of 6 members used the Delphi process to validate the different sections of the EPAs, without external consultation on the method [10,11]. The Delphi study included closed questions with a 7-point Likert scale, ranging from 1 (totally inappropriate proposal) to 7 (totally appropriate proposal). General comments were also possible. Based on different guidelines for conducting a Delphi process (especially those provided by the French High Authority for Health to establish a formal consensus), agreement was defined as a median proposal score ≥ 6, with all responses between 4 and 7 in the first round, and ≥ 80 % of the responses between 4 and 7 in the second round [12,13]. Experts were defined as academic professors or associate professors of PRM, or PRM department leads, as they are directly involved in residents' training. Residents were not included in the voting process. Following a general information session about the Delphi study during an annual PRM college meeting, invitations to participate and complete the online questionnaire (via SurveyMonkey®) were sent by email. To prevent participant dropout due to the lengthy process, the list of EPAs was divided into two parts, and two groups of experts were randomly invited to evaluate either the first or second part of the EPAs. However, the complete document was provided to all participants to ensure an overview of the covered areas. The minimum number of experts per group was set at 9 to ensure the reliability of the agreement and the validity of the conclusions.

The steering committee reviewed all proposals that did not reach an agreement after the first round and rephrased them if necessary.

Project progress was presented at PRM college meetings to maintain the interest of experts between rounds. Participants received feedback on the median score from the previous round in the second round. If a participant's answers deviated significantly from the median, they were required to provide a justification. After the second round, the steering committee convened to discuss any remaining proposals that had not reached an agreement and to determine whether a third round was necessary. Quasi-anonymity was ensured, as none of the experts were aware of the identities of the other participants. One steering committee member was responsible for organizing, sending reminders, and collecting responses, while the remaining steering committee members were blinded to participant identities. All data was presented anonymously.

The EPAs were divided into 7 sections according to ten Cate's guidelines: title, detailed description, most relevant competency domains, required knowledge, skills, attitudes, and experiences, information sources to assess progress and support summative entrustment, description of the progression of acquired competencies, and entrustment/supervision level expected at which stage of training [6]. Thus, 70 items were submitted to the experts. A core competency matrix summarizing the EPAs and a list of applicable clinical situations were also submitted for rating. Two sections described in the EPA guidelines, potential risks in case of failure, and time to expiration if not practiced, were not detailed as they were deemed inappropriate in this context.

The first draft outlined 10 EPAs. A list of 10 clinical contexts of application was proposed based on the PRM landscape in France. This version was submitted to the Delphi validation process between September and December 2023.

Thirty five experts (Group 1) were invited to participate in the validation process for the first part of the EPAs, and 36 experts (Group 2) were invited for the second part of the EPAs. Seventeen experts (46 %) from Group 1 and 14 experts (37 %) from Group 2, participated in the first round. The participants were considered representative of the entire PRM college, although the proportion of women was higher (Supplementary Table S.1). This first round led to the validation of 45 of 70 items. None of the items were dismissed, and the lowest median score for proposals lacking agreement was 6, suggesting a high likelihood of reaching an agreement in subsequent rounds. The clinical application contexts and competency matrix did not reach an agreement. An additional clinical context was added. The steering committee reviewed participants' comments and amended 4 items with minor changes. The 25 remaining items were resubmitted to the first-round participants for a second evaluation.

<table><caption>**Table 1**
List of EPAs in PRM</caption><thead><tr><th></th><th>List of EPA</th></tr></thead><tbody><tr><td>EPA 1</td><td>Assess needs in the acute, sub-acute and chronic phases, and propose a PRM program and/or referral during a consultation</td></tr><tr><td>EPA 2</td><td>Organize a management for an individual hospitalized in a PRM department: admit, assess and propose a program of care including rehabilitation</td></tr><tr><td>EPA 3</td><td>Assess the progress of a rehabilitation program and adapt management for an individual hospitalized in a PRM department</td></tr><tr><td>EPA 4</td><td>Coordinating a multidisciplinary synthesis meeting</td></tr><tr><td>EPA 5</td><td>Announcing disability to individuals and their relatives</td></tr><tr><td>EPA 6</td><td>Discharge an individual from PRM hospitalization to an appropriate living environment</td></tr><tr><td>EPA 7</td><td>Managing an acute medical situation of an individual in a PRM department</td></tr><tr><td>EPA 8</td><td>Referring individuals to other specialties (including multidisciplinary meetings)</td></tr><tr><td>EPA 9</td><td>Assess the indication, perform and interpret diagnostic and therapeutic medical-technical procedures in the field of PRM</td></tr><tr><td>EPA 10</td><td>Assessing needs and providing (therapeutic) individual education</td></tr></tbody></table>

Abbreviations: EPA, Entrustable professional activities; PRM, Physical and rehabilitation medicine.
<table><caption>**Table 2**
Competency matrix for the 10 EPAs in physical and rehabilitation medicine</caption><thead><tr><th></th><th>EPA 1</th><th>EPA 2</th><th>EPA 3</th><th>EPA 4</th><th>EPA 5</th><th>EPA 6</th><th>EPA 7</th><th>EPA 8</th><th>EPA 9</th><th>EPA 10</th></tr></thead><tbody><tr><td>Medical expert</td><td>xx</td><td>xx</td><td>xx</td><td>x</td><td>x</td><td>x</td><td>x</td><td>x</td><td>xx</td><td>x</td></tr><tr><td>Communicator</td><td>x</td><td>x</td><td>x</td><td>xx</td><td>xx</td><td>x</td><td>x</td><td>x</td><td>xx</td><td>xx</td></tr><tr><td>Collaborator</td><td></td><td>x</td><td>xx</td><td>xx</td><td></td><td>x</td><td>xx</td><td>xx</td><td></td><td>x</td></tr><tr><td>Scholar</td><td></td><td>x</td><td></td><td>x</td><td></td><td>x</td><td></td><td></td><td>xx</td><td>xx</td></tr><tr><td>Leader</td><td></td><td>x</td><td>x</td><td>xx</td><td></td><td>x</td><td></td><td></td><td>x</td><td>x</td></tr><tr><td>Health Advocate</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td>x</td></tr><tr><td>Professional</td><td>x</td><td>x</td><td>x</td><td>x</td><td>x</td><td>xx</td><td>x</td><td>x</td><td>xx</td><td>x</td></tr></tbody></table>

Abbreviation: EPA, Entrustable professional activities.

Nine experts (53%) from Group 1 and 9 experts (64%) from Group 2 completed the second round of the Delphi process (Figure S.1). Twenty-three items reached an agreement. The remaining 2 items were discussed by the steering committee and were ultimately accepted. The competency matrix and clinical contexts were also accepted following the incorporation of participants' feedback. The Delphi process was concluded after these rounds, resulting in the validation of 10 EPAs (Table 1). In addition, 11 clinical contexts of application were validated including rehabilitation in the following fields: post-critical care, spinal cord injury, cerebral damage, neurology, orthopedics, sports medicine, pediatric, geriatric, cardiorespiratory, functional explorations along with other specialties not previously mentioned. A competency matrix was also validated (Table 2). The full document is available in Appendix A (in French). These results were presented to the French PRM college during the annual seminar and received positive feedback.

This work successfully validated 10 EPAs in PRM, covering clinical practice in France. The literature review identified only one prior attempt to create EPAs in PRM [7]. In that U.S. study, 19 EPAs were validated with a Delphi study with two rounds of voting. Twelve EPAs were specifically dedicated to a group of pathologies for instance musculoskeletal syndromes, disabling conditions of childhood, and spinal cord injury. Another 6 were general, such as coordinating medical management and leading an interdisciplinary rehabilitation team, 1 EPA focused on pain management. Due to the differences in how PRM is practiced in each country, directly adapting these EPAs in the French system was not appropriate. Indeed, certain tasks are marginally performed in PRM departments in France, and therefore, were not relevant (eg, performing an electrodiagnostic consultation and examination). The EPAs validated with our process may be compared with more general EPAs than in the U.S. study, however an effort has been made to represent all the different professional situations encountered by a PRM physician. We believe these newly developed EPAs reflect the holistic approach required of PRM specialists and are tailored to specific contexts. Consequently, this should enable the assessment of most EPAs during every traineeship, whereas only 1 or 2 of the previously published EPAs might be applicable in a specialized department [7]. One potential limitation of this broad approach is that it may not fully capture the complexity of certain clinical situations, as it relies on a limited number of observations. However, broad EPAs facilitate a comprehensive view of the learner and are easily implemented [5,14].

Recently, the European Board of Physical and Rehabilitation Medicine (EBPRM), updated the European Training Requirements for the Specialty (ETRs) to standardize PRM physician qualifications across Europe [15,16]. A notable addition to this version of the ETRs is the inclusion of EPAs as an Annex. These EPAs were designed to encompass the wide range of clinical scenarios that PRM physicians may encounter, but they form a complex framework that may be difficult to use as a routine assessment tool during the four-years residency period. Moreover, they do not adhere to the latest EPAs guidelines and describe only 3 levels of autonomy [6]. Our EPAs were

deliberately kept short and limited in number to avoid trainer disengagement in daily practice.

Despite their concise format, successful implementation of these EPAs will require specific evaluator training. Several studies have assessed residents' perception of EPAs and revealed a high degree of variability in their experience [17–19]. More than determining a resident's level of competency, the feedback provided by trainers are the most crucial aspect of the assessment. Without relevant feedback, EPAs may be perceived as stressful by the trainees and could negatively impact learning and trainer-trainee relationships if residents must request assessment for mandatory EPAs [18]. Conversely, in departments where trainers are committed to implementing EPAs, residents report an increased frequency of direct observation and consider narrative feedback as valuable [19].

The next steps involve implementing these EPAs across different PRM departments. Initially, a limited number of departments will use this version to verify the model's suitability before national deployment, and amendments will be discussed if necessary. Evaluator training will be conducted to prevent premature abandonment and to highlight the key elements for providing relevant feedback. Finally, assessing the effectiveness, relevance, and residents' perceptions of this new evaluation method will require further, but essential, studies.

## Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

## Authors' contribution

CH: methodology, formal analysis, writing original draft, visualization; ORN: conceptualization, methodology, writing – review and edits; CP: conceptualization, writing – review and edits; LB: conceptualization, methodology, writing – review and edits; JCD: conceptualization, methodology, writing – review and edits; CN: conceptualization, methodology, writing – review and edits; XDB: conceptualization, methodology, writing – review and edits, supervision, project administration.

## Additional material

Table S.1: Characteristics of participants and comparison with the whole college of PRM.

Figure S.1: Flow chart of the Delphi study.

Appendix A: Complete list of EPAs in Physical and Rehabilitation Medicine (French).

Appendix B: Delphistar report.

## Data availability

Data will be made available on request.
**Declaration of interest**

None.

**Supplementary materials**

Supplementary material associated with this article can be found, in the online version, at doi:10.1016/j.rehab.2025.101978.

**References**

[1] Ten Cate O, Scheele F. Competency-based postgraduate training: can we bridge the gap between theory and clinical practice? Acad Med J Assoc Am Med Coll 2007;82:542-7. doi: 10.1097/ACM.0b013e31805559c7.

[2] Taylor DR, Park YS, Smith CA, Karpinski J, Coke W, Tekian A. Creating entrustable professional activities to assess internal medicine residents in training: a mixed-methods approach. Ann Intern Med 2018;168:724-9. doi: 10.7326/M17-1680.

[3] Fessler HE, Addrizzo-Harris D, Beck JM, Buckley JD, Pastores SM, Piquette CA, et al. Entrustable professional activities and curricular milestones for fellowship training in pulmonary and critical care medicine: report of a multisociety working group. Chest 2014;146:813-34. doi: 10.1378/chest.14-0710.

[4] Nel D, Jonas E, Burch V, Cairncross L, Nel A, Alseidi A, et al. Entrustable professional activities in postgraduate general surgery training: a scoping review. Ann Surg 2024;10-1097. doi: 10.1097/SLA.00000000000006400.

[5] O'Dowd E, Lydon S, O'Connor P, Madden C, Byrne D. A systematic review of 7 years of research on entrustable professional activities in graduate medical education, 2011-2018. Med Educ 2019;53:234-49. doi: 10.1111/medu.13792.

[6] Ten Cate O, Taylor DR. The recommended description of an entrustable professional activity: AMEE Guide No. 140. Med Teach 2021;43:1106-14. doi: 10.1080/0142159X.2020.1838465.

[7] Mallow M, Baer H, Moroz A, Nguyen VQC. Entrustable professional activities for residency training in physical medicine and rehabilitation. Am J Phys Med Rehabil 2017;96:762-4. doi: 10.1097/PHM.0000000000000741.

[8] European Physical and Rehabilitation Medicine Bodies Alliance. White Book on Physical and Rehabilitation Medicine (PRM) in Europe. Chapter 6. Knowledge and skills of PRM physicians. Eur J Phys Rehabil Med 2018;54:214-29. doi: 10.23736/S1973-9087.18.05150-X.

[9] European Physical and Rehabilitation Medicine Bodies Alliance. White Book on Physical and Rehabilitation Medicine (PRM) in Europe. Chapter 3. A primary medical specialty: the fundamentals of PRM. Eur J Phys Rehabil Med 2018;54:177-85. doi: 10.23736/S1973-9087.18.05146-8.

[10] de Villiers MR, de Villiers PJT, Kent AP. The Delphi technique in health sciences education research. Med Teach 2005;27:639-43. doi: 10.1080/13611260500069947.

[11] Humphrey-Murto S, Varpio L, Wood TJ, Gonsalves C, Ufholz L-A, Mascioli K, et al. The use of the Delphi and other consensus Group methods in Medical education research: a review. Acad Med J Assoc Am Med Coll 2017;92:1491-8. doi: 10.1097/ACM.00000000000001812.

[12] Diamond IR, Grant RC, Feldman BM, Pencharz PB, Ling SC, Moore AM, et al. Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies. J Clin Epidemiol 2014;67:401-9. doi: 10.1016/j.jclinepi.2013.12.002.

[13] Haute Autorité de Santé. Élaboration de recommandations de bonne pratique Méthode « recommandations par consensus formalisé ». https://www.has-sante.fr/upload/docs/application/pdf/2011-11/guide_methodologiqueCF_40_pages_2011-11-03_15-40-2_278.pdf; 2010.

[14] van Loon KA, Driessen EW, Teunissen PW, Scheele F. Experiences with EPAs, potential benefits and pitfalls. Med Teach 2014;36:698-702. doi: 10.3109/0142159X.2014.909588.

[15] Barotsis N, Oral A, Zampolini M, Janssen W, Frischknecht R, Tederko P, et al. Setting the European standards for training in Physical and Rehabilitation medicine. Eur J Phys Rehabil Med 2024;60:552. doi: 10.23736/S1973-9087.24.08577-0.

[16] European Training Requirements for the Specialty of Physical and Rehabilitation Medicine European Standards of Postgraduate Medical Specialist Training First Update. https://uems-prm.eu/wp-content/uploads/2024/04/uems-2023.13-european-training-requirements-in-physical-and-rehabilitation-medicine.pdf; 2022.

[17] Johnson D, Chopra S, Bilgic E. Exploring the use of natural language processing to understand emotions of trainees and faculty regarding entrustable professional activity assessments. J Grad Med Educ 2024;16:323-7. doi: 10.4300/JGME-D-23-00526.1.

[18] Ahn E, LaDonna KA, Landreville JM, Mcheimech R, Cheung WJ. Only as strong as the weakest link: resident perspectives on entrustable professional activities and their impact on learning. J Grad Med Educ 2023;15:676-84. doi: 10.4300/JGME-D-23-00204.1.

[19] Martin L, Sibbald M, Brandt Vegas D, Russell D, Govaerts M. The impact of entrustment assessments on feedback and learning: trainee perspectives. Med Educ 2020;54:328-36. doi: 10.1111/medu.14047.