Table 2 Example of an EPA for lumbar puncture [30]
From: Developing a CPD model for Eswatini—a participatory action research study
Key competencies | Behaviour requiring corrective action | Developing behaviours | Expected behaviour for an Entrustable practitioner | |
|---|---|---|---|---|
Technical skills | Lacks required Skills, Fails to follow sterile technique | Variably Applied, completes procedure Unreliably, Uses universal precautions and aseptic technique inconsistently | Approaches procedures as mechanical tasks and often initiated after request of others, Struggles in adapting approach when required | Makes necessary preparation before performance of procedure, Correctly performs procedure on many occasions over time. Makes consistent use of both aseptic technique and universal precautions |
Knowledge | lack of awareness of knowledge gaps | Does not understand key Issues like indications, contraindications, risks, benefits, has limited, knowledge of procedural complications or prevention of these | Describes most of these key Issues Has knowledge of Common complications but struggles to manage them | Has adequate knowledge of essential anatomy, physiology, indications, contraindications, risks, benefits, and alternatives for the procedure Knows and can take steps to prevent and manage complications |
Communication | Does not communicate effectively- Uses inaccurate Language, presents distorted Information, Disregards patient’s and family’s wishes Fails to obtain appropriate consent before performing a procedure | Uses jargon or other ineffective communication techniques unable to read emotional response from the patient, fails to engage patient in shared decision making | Conversations are respectful and mostly free of jargon and considers patient’s wishes, When focused on the procedure may have difficulties recognising emotional response from the patient | Demonstrates patient-centred behaviour such as avoiding jargon, enabling shared decision making, and regards patient’s emotional response), obtains appropriate informed consent |
confidence | Overconfident takes actions that could endanger patients or others | Displays a lack of confidence that increases patient’s stress or discomfort, or overconfidence that erodes patient’s trust when practitioner struggles to perform the procedure, Accepts help when offered | Asks for help with complications | Seeks timely help Has confidence commensurate with level of knowledge and skill that puts patients and families at ease |