Standardized residency training(SRT)constitutes a crucial component in developing clinically competent physicians. Current systems face challenges including unidimensional assessment methods and insufficient standardization of implementation protocols. Within the competency-based medical education (CBME) framework, entrustable professional activities (EPA) offer a novel approach by deconstructing clinical competencies into observable, assessable tasks.This study comprehensively reviews global applications of EPA and comparatively analyzes regional variations in framework development, implementation strategies, and evaluation systems. Internationally,EPA scholarship and clinical integration exhibit relative maturity,while domestic adoption remains nascent.Further exploration should prioritize three domains:(1) enhancing clinical decision-making through task-specific competency mapping;(2) aligning curricula with workplace demands;and (3) fostering competency progression frameworks.These findings offer theoretical and methodological insights for advancing China’s SRT reform, proposing evidence-driven strategies to harmonize medical education quality and standardization.

Li Congwei, Liu Fang, Li Xiaowei, Fu Qilu, Liu Ying. Advances in the Application of Entrustable Professional Activities in Standardized Residency Training. Academic Journal of Medicine & Health Sciences(2025), Vol. 6, Issue 4: 7-13. https://doi.org/10.25236/AJMHS.2025.060402.

[1] WANG L M, et al. Management of standardized residency training documents [J]. Zhejiang Archives, 2013, (3):58-59.

[2] CHEN H Y, et al. A systematic review of the current status of standardized residency training in China [J]. Health Economics Research, 2022, (39):73-77.

[3] Ten Cate, O. & Scheele, F. Viewpoint: competency-based postgraduate training: can we bridge the gap between theory and clinical practice? [J]. Academic Medicine, 2007, (82).

[4] Chen, H. C., et al. The case for use of entrustable professional activities in undergraduate medical education [J]. Academic Medicine, 2015, (90).

[5] Lurie, S. J., et al. Measurement of the general competencies of the accreditation council for graduate medical education: a systematic review [J]. Academic Medicine, 2009, (84).

[6] Ten Cate,O. Entrustability of professional activities and competency-based training [J]. Medical Education, 2005, (39).

[7] Ten Cate, O., et al. Curriculum development for the workplace using entrustable professional activities (epas): amee guide no. 99 [J]. Medical Teacher, 2015, (37).

[8] QI X. Discussion on the relationship between entrustable professional activities and residency competency [J]. Chinese Journal of Medical Education, 2020, 40:306-310.

[9] CHEN X H, et al. Development and implications of international entrustable professional activities research in medical education [J]. Chinese Journal of Medical Education, 2020, 40:945-950.

[10] Pinilla, S., et al. Working with entrustable professional activities in clinical education in undergraduate medical education: a scoping review [J]. Bmc Medical Education, 2021, (21).

[11] XI J, et al. Advances and implications of entrustable professional activities in international undergraduate medical education [J]. Chinese Journal of Medical Education Research, 2023, 22: 1451-1457. 

[12] CAO Y B, JIANG Z S, PAN J. Analysis and prospects of entrustable professional activities in promoting the reform of stomatology practice education [J]. Chinese Journal of Practical Stomatology, 2024, 17(3):336-341.

[13] Ten Cate, O. Entrustment as assessment: recognizing the ability, the right, and the duty to act [J]. Journal of Graduate Medical Education, 2016, (8).

[14] DONG W J, et al. Progress in the application of entrustable professional activities in advanced practice nurse training [J]. Chinese Nursing Research, 2024, 38:624-629.

[15 ]Meyer, E. G., et al. Scoping review of entrustable professional activities in undergraduate medical education [J]. Academic Medicine, 2019, (94).

[16] Favier, R. P., et al. Identifying entrustable professional activities for surgical skills training in companion animal health [J]. Veterinary Record, 2020, (186).

[17] Association of American Medical Colleges. Core Entrustable Professional Activities for Entering Residency: Curriculum Developers’Guide[EB/OL].www.mededportal.org/icollaborative/resource/887

[18] Meyer, E. G., et al. Equal rubric evaluation of the association of american medical colleges’core entrustable professional activities for entering residency [J]. Academic Medicine, 2020, (95).

[19] Obeso V.,et al. Toolkits for the 13 Core Entrustable Professional Activities for Entering Residency. Washington, DC: Association of American Medical Colleges[EB/OL]. 2017.www.aamc.org/initiatives/coreepas/publicationsandpresentations.

[20] Association of Faculties of Medicine of Canada. AFMC Entrustable Professional Activities for the Transition from Medical School to Residency [EB/OL].https://www.afmc.ca/wp-content/uploads/2022/10/AFMC_Entrustable-Professional-Activities_EN_Final.pdf

[21] Ten, C. O. & Taylor, D. R. The recommended description of an entrustable professional activity: amee guide no. 140 [J]. Medical Teacher, 2021, (43).

[22] Sandhu, G., et al. Progressive entrustment to achieve resident autonomy in the operating room [J]. Annals of Surgery, 2017, (265).

[23] Lomis, K., et al. Implementing an entrustable professional activities framework in undergraduate medical education: early lessons from the aamc core entrustable professional activities for entering residency pilot [J]. Academic Medicine, 2017, (92).

[24] Englander, R., et al. Toward defining the foundation of the md degree: core entrustable professional activities for entering residency [J]. Academic Medicine, 2016, (91).

[25] Abdel Nasser, A., et al. Online training in entrustable professional activities and work place‐based assessment (portfolio) for clinical educators [J]. Medical Education, 2024, (58).

[26] Lindeman, B. M., et al. Graduating students’and surgery program directors’views of the association of american medical colleges core entrustable professional activities for entering residency: where are the gaps? [J]. Journal of Surgical Education, 2015, (72).

[27] Peters, H., et al. Twelve tips for the implementation of epas for assessment and entrustment  decisions [J]. Medical Teacher, 2017, (39).

[28] Hennus, M. P., et al. Twelve tips to develop entrustable professional activities [J]. Medical Teacher, 2023, (45).

[29] Linsenmeyer, M., et al. Assessment considerations for core entrustable professional activities for entering residency [J]. The Journal of the American Osteopathic Association, 2018, (118).

[30] Taylor, D. R., et al. Equal, a novel rubric to evaluate entrustable professional activities for quality and structure [J]. Academic Medicine, 2017, (92).

[31] Karpinski, J. & Frank, J. R. The role of epas in creating a national system of time-variable competency-based medical education [J]. Academic Medicine, 2021, (96).

[32] JIN Z, et al. Application of entrustable professional activities in clinical medical education [J]. Chinese Journal of Medical Education, 2019, 39:314-320.

[33] Discussion on the Chinese translation of entrustable professional activities [J]. Chinese Journal of Medical Education, 2021, 41(2): 97-98.

[34] WEN D L, et al. Foundation and research progress of entrustable professional activities [J]. Chinese Journal of Medical Education, 2021, 41:99-103.

[35] Mallow, M., et al. Entrustable professional activities for residency training in physical medicine and rehabilitation [J]. American Journal of Physical Medicine & Rehabilitation, 2017, (96).

[36] Taylor, D. R., et al. Creating entrustable professional activities to assess internal medicine residents in training: a mixed-methods approach [J]. Annals of Internal Medicine, 2018, (168).

[37] Tanaka, A., et al. Development of entrustable professional activities for residents rotating nephrology department in a japanese university hospital: a delphi study [J]. Bmj Open, 2021, (11).

[38] Amare, E. M., et al. Development of an entrustable professional activities (epa) framework to inform surgical residency training programs in ethiopia: a three-round national delphi method study [J]. Journal of Surgical Education, 2022, (79).

[39] Kessoku, T., et al. Development of a list of competencies and entrustable professional activities for resident physicians during death pronouncement: a modified delphi study [J]. Bmc Medical Education, 2022, (22).

[40] Lerch, S. P., et al. Trainee doctors' preparedness for clinical work in geriatric psychiatry: a survey on 18 preliminary entrustable professional activities [J]. International Journal of Geriatric Psychiatry, 2023, (38).

[41] QI X, et al. Development of entrustable professional activities for residency training [J]. Chinese Journal of Medical Education, 2021, 41:104-108.

[42] LIU Z, et al. Application of entrustable professional activities scale in residency evaluation [J]. Chinese Journal of Medical Education, 2023, 43:156-160.

[43] LI S, et al. Construction of a formative evaluation system for pediatric residents based on entrustable professional activities [J]. Chinese Journal of Graduate Medical Education, 2021, 5: 193-196,201.

[44] ZHANG L G, et al. Development of a clinical skills database for psychiatric residency training oriented by entrustable professional activities [J]. Journal of Clinical Psychiatry, 2023, 33:94-98.

[45] ZHANG L G, et al. Construction of entrustable professional activities assessment indicators for psychiatric residency training [J]. Chinese Mental Health Journal, 2024, 38: 232-239.

[46] Yan, F., et al. Establishing entrustable professional activities for psychiatry residents in china [J]. Bmc Medical Education, 2023, (23).

[47] ZHANG Q F, SHEN Y. Construction and application of formative evaluation in obstetrics and gynecology residency training based on entrustable professional activities [J]. Journal of Southeast University (Philosophy and Social Science Edition), 2024, 26:180-184.

[48] TAN M M, et al. Development of entrustable professional activities for entry-level residents [J]. Chinese Journal of Medical Education Research, 2024, 23:179-184.

[49] Hoyt, K. S., et al. Making a case for entrustable professional activities for nurse practitioners in emergency care [J]. Advanced Emergency Nursing Journal, 2017, (39).

[50] DU Y R, et al. Current status and prospects of entrustable professional activities in general practice [J]. Chinese General Practice, 2022, 25:2307-2314.

[51] Mulder, H. et al. Building a competency-based workplace curriculum around entrustable professional activities: The case of physician assistant training. [J].Med Teach. 2010;32(10):e453-e459. 

[52] WU F, WANG L. Enhancing the quality of talent cultivation through the development of new medical disciplines [J]. Chinese Health Resources, 2023, 26: 1-8.