Intro

Hello and welcome to this episode of the Conference Conversations Focus 2022 podcast series. In this episode, Dr Mark Merolli, clinical physiotherapist and senior lecturer and research fellow at the University of Melbourne and Dr Sonya Moore, a physiotherapist and senior lecturer and sports medicine program coordinator at the University of Melbourne, discuss entrustable professional activities.

Before we start this series of conference conversations, podcasts has been brought to you by the Physiotherapy Research Foundation, supporting the promotion and translation of research and supported by Pain Away platinum and content sponsor of the PRF. Let’s get started.

Mark

Welcome to this APA Focus Conference series podcast. Before we start, I’d like to pay respects to the traditional owners of the land upon which we are recording this podcast, the Wurundjeri people of the Kulin Nation and pay respects to elders past, present, and emerging. My name’s Dr Mark Merolli. I’m a physiotherapist clinician with a background in musculoskeletal and sports medicine. I’m a senior lecturer and a research fellow. I’m joined by my colleague, Dr Sonya Moore today, and I’m looking forward to us having a conversation about a topic that might be new to a lot of people, maybe not so new to some, entrustable professional activities. Sonya, if you are happy to introduce yourself.

Sonya

Thanks a lot, Mark. It’s lovely to be here with you. I’m Dr Sonya Moore, an APA sports and exercise physiotherapist. And like you, Mark, I’m both a clinician and an educator, and so I think this topic lends itself really nicely to meeting in the middle of those two places. We’re talking about EPAs, entrustable professional activities, which, as you say, are new to many people. I hope, as we understand this morning, we are aiming to bridge this gap between what clinical practice looks like and also how we might educate and learn how that looks like.

Mark

And what it could look like in some ways. So we’re certainly going to unpack that concept a lot more and hopefully enjoy this discussion. Okay, Sonya, so we’ve both been doing some work in this space and building on this area, this idea of entrustable professional activities. Looking forward to unpacking that concept a little bit more because there are going to be plenty of people that don’t really understand it. We’ll try not to keep it too formal, but we will start with some definitions so that people understand the concept. My work being, obviously is more in the space of digital technology, digital health practice. Yours is more exclusively in the post-registration, postgraduate space. So let’s talk a little bit about what EPAs actually are so that people actually get a bit more context, starting with an actual definition. We know that there have been researchers that have been doing this work for quite some time now.

Researchers like [Tim, Kate and Taylor] papers we’ve cited readily for all intents and purposes, an EPA it’s a unit of professional practise that can be fully entrusted to a trainee once he or she’s demonstrated competence to execute those activities in an unsupervised manner. So I think that’s a nice way to kind of signpost all this to make more sense of it for us. I personally gravitated to the concept from a workforce perspective, education, a nice way to examine skills attainment, et cetera, et cetera. I like the transparency of how it’s described. What gravitated you to the topic?

Sonya

Yeah, that’s right, Mark. Well, I’m a clinician as well as an educator. And so really what comes for me in EPAs, EPAs are a way of defining a unit of professional practise. An end-to-end task that a learner or a clinician can demonstrate and be assessed as, and you mentioned in an unsupervised way, and that’s where the word entrustable comes in. Can I entrust you, Mark, to do this particular skill with a patient or client of mine? And are you able to do that without me looking over your shoulder? Or can you do it by yourself, or do I need to stand with you and give you some support if you need to? So that’s the concept of entrustable, can you do this please? And to have the confidence that I know as an assessor, you know, as a clinician, the patient’s integrity is protected. This skill can be done from end to end in a competent and capable way.

And this lives at the top of what we call Miller’s Apex. This is performance integrated into practice. And that’s another question that comes up is, you know, what’s the difference in terminology between an entrustable professional activity, and you mentioned competence? You know, what’s the difference? Are they one and the same? One of the key differences is the EPA is an end-to-end task. Can you please go and do this? Whereas a competency might be a more granular skill, it’s a really specific learnable skill that might be one part of that end-to-end task.

Mark

Yeah, and that’s exactly, I think, again, what’s helped me kind of steer into that concept a little bit as well because I felt, and in particular, in relation to the work that we’re both doing this idea of competency. And you put it perfectly, people talk about competencies and EPAs sometimes very much in the same light. Like they’re the same concept inherently, and they’re very linked, as we are going to talk about. But if we go into the sort of research landscape, yes. As you said, competencies tend to describe, say, the characteristics of the person who’s attained those competencies. Whereas, like you said, an EPA is end-to-end. It’s tangible, and it’s observable. It essentially describes the actual work that we need to do as physiotherapists.

We’ve already started talking about it. You, you certainly started going there. So if I can maybe get you to keep going, why are EPAs actually important?

Sonya

EPAs are really important because they give us a tangible explanation of what’s expected of us as a clinician and what’s expected of us as a learner or an educator if we backwards design that component of it. The description of an EPA represents what we need to be able to do in clinical practice. It may be a number of clinical skills rolled together, but it really is, what does this look like in real life? The competency is certainly very important, and they represent what we do in real life as well. But can we do this on one occasion? Maybe can we do this in a clinical examination, maybe, hopefully? But actually, are you doing this continuously in your practice? Is this actually just part of your being and part of your professional activities?

And that’s really what these EPAs are capturing, and that’s why they’re important because sometimes that can be quite a difficult concept to capture. What do these skills look like when they’re being performed in real-life practice, and therefore how do we teach and how do we learn those skills so that we know?

Mark

You’ve used some really nice language and phrases there that I think really speak to the heart of this concept. You used words like they’re tangible, they’re real world, and they’re demonstratable. And that’s exactly why, as I said, particularly in an area of technology, and I’ll talk a little bit more about that, these sort of emergent areas and, and areas that we want to use that we do use, but we don’t quite know exactly what to do, how to do, how to make that visible. That, I think, is a really nice key delineation, as we said with EPAs versus competencies. You know, they’re very much real world. They’re in a clinical context. But I want to circle back to something you were talking about before. You’ve used that phrase, we’ve certainly spoken about it. Can you tell me a little bit more about backwards design?

Sonya

Yeah, I really love the concept of backwards design as a clinical educator. I think this really meets us in the middle here or meets us from backwards to start. So when we talk about curriculum design, and this is at the peak of Bloom’s Taxonomy of Learning, what is it that learners, and in this case clinicians, what is it that they need to be able to do with their knowledge? And this is what an EPA captures. So we say, right, what is this clinical skill or clinical skill set? What do learners and clinicians need to be able to do? And therefore, how do we design a curriculum so that people can meet that? And certainly, when you come back a step again, and we say, okay, well, what do people and clinicians, budding clinicians, need to know in order to be able to meet that end outcome?

Mark

You made me think of a conversation I had with one of our colleagues here at the conference, and I was talking to them a little bit about my presentation and my work and EPAs, and it was a nice road test because, as I said, speaking to a lot of people who have never heard the concept before, even though they’ve been around for quite some time. And she said to me, that’s great, but does the EPA concept not dull down what it is that needs to be done? Does it not turn activities into somewhat of a checklist? And I actually thought that was a really good question because I certainly never thought of it like that, but she actually made me think a little bit more about that. And I think this is another important kind of thread to weave through people’s understanding of EPAs.

And that’s that we’re not actually saying that we want to change competency capability. We want to ignore them. And we’ll probably talk, I think, certainly about your work in unpacking e EPA attributes, et cetera. But we need to understand that when we think of EPAs as discrete tasks, we call them units of work, they’re still very well, very intimately linked to competency and capability. So while they might be a checklist of some sort, you know, can this person being entrusted to do X, Y, Z, A, B, C, D, they’ve still got to be linked to knowledge and skills attainment, et cetera.

So we might move that on to talk a little bit about your work. We want to talk a little bit about why EPAs should be linked to professional competency standards, I think, and that’s a nice little segue for us.

Sonya

Yeah, and I do think that links to your point there, Mark, one of the reasons that these can be a checklist and there is an important role for them being a checklist in terms of professional integrity and the standards we must meet for our professional registration. So to an extent, that checklist and that assessment are actually a really important part of EPAs. But that comes around again to the other side of that question. And often, the intent behind it, this is partly about assessment, but it’s also about clinical excellence, and it’s about what this looks like in practice. And no one performance with any one patient or client needs to be exactly the same as the other. But it does need to meet the minimum expected standards and draw upon those things.

But that brings us to that point about why is it important that EPAs are mapped to professional competencies and standards. And that’s one way, it’s not the only way, but that’s a very important way of validating EPAs. I think in part of that Ten Cate’s definition, EPAs are not random skill sets. These are important, if not essential, skill sets for a defined profession. And that’s an important part of the definition. It’s not for anybody, in this case, we’re talking about physiotherapists, for example, sports and exercise physiotherapists. This EPA is important. So the EPA always has a context and a reason, and that’s a really important reason to validate them.

Mark

I think it’s also, when I first started my kind of journey and understanding this area, et cetera, the context, use that word context, I think it’s also important to understand that we’re talking about a clinical, like an actual, well I shouldn’t say delivery of care, but in a healthcare context. And when I first started doing my own reading and understanding EPAs, one of the things that sort of tongue and cheek made me laugh a little bit was that when we talk about EPAs, and as we both know, a lot of the EPA literature is still quite medical focused, medical specialty, perhaps a little bit in pharmacological nursing. But I remember reading one of Ten Cate’s papers on EPA saying that EPAs must be in a clinical context. So conducting an obs assessment on a patient is an EPA. Just because you work in a clinical environment, writing a birthday card to a colleague isn’t an EPA.

So it’s quite important to understand that we’re still talking about the delivery of care. Going back to what you were saying about standards, again, to use that word, one of the things I think for myself is that, and you know, particularly coming from an interest in technology, it’s this area that everyone’s interested in. Everyone’s starting to jump on, wanting to use it, but we really don’t have a common language. There are a lot of competencies out there, they’re emerging by the second, but they’re often quite vague, I found. And they can sometimes be void or detached from the clinical context that they’re actually described in.

And so I think one of the other things that we take for granted a little bit in this space is that if we actually can develop or perhaps shift our thinking towards entrustable professional activities as a way to enact competence, it’s also partly about, one for me, giving employers, the workforce some level of confidence that what they’re getting from their employees and what their employees are delivering is consistent.

But it’s also about safety and confidence in the profession for our patients. So that, you know, almost I’m certified to do this and that even though it’s going to be a little bit different colleague to colleague, it’s going to be relatively in a consistent format. That was certainly one of the things that made sense to me. Let’s talk about EPA attributes. Let’s talk about the work you are currently doing at the moment. Why do EPAs need to be constructed a bit more rigorously using, you know, a variety of attributes? Because we know that they’re not just a title, an EPA in short form doesn’t really tell us much, so why should they be, you know, captured in a more standalone?

Sonya

That’s right. So I think, as well as capturing the competencies in standards that are important and that essential work unit, the EPA framework, as you’ve said, the terminology can be used inconsistently. Often, it’s used interchangeably, and it can be really confusing. But if we think about it with a more nuanced understanding, it really does provide us with a framework really for capturing what the expectation is. If we use an example of managing shoulder pain, what I think is important for managing shoulder pain might be slightly different to what you think is important as a sports and exercise physiotherapist. It might be slightly different to what someone’s thinking if they’re a pain physiotherapist. And so, actually, the EPA has the ability to capture that expectation, and it gives us transparency so that whoever is reading this or interpreting this, we’re all on the same page.

We understand what’s required, we understand what’s expected of us, and we understand what that end outcome might look like in real-world practise and always come back to that point because that’s what EPAs are trying to capture. What’s this real end-world outcome here? And when we talk about attributes, that’s part of Ten Cate and the colleagues’ work since 2005 with the original definition, there’s been some further guidance and it’s really good guidance. Things like, well, we need to make a title that captures the EPA so when we talk about it, we know what we’re talking about. It captures and represents what that EPA is intended to do. And then we go on further to that and say, well, what are the attributes within this EPA?

So once again, we are going through these levels of defining what’s expected, capturing and defining what’s expected. That does come back to the backwards design. So then we can come back and say, okay, well now we can set about realising that.

Mark

Yeah, absolutely. I think, yeah, again, researchers, people who have been working in this space, and as you said, we’ve read a million research papers on this area, particularly in shaping up the review that we did. I think people have good intentions in this space, but often one of the things, and I think you’ll sort of understand is a limitation of the space in the literature even, is that people talk about EPAs, but often they’re not really, they haven’t come up with EPAs, they haven’t described EPAs, they haven’t unpacked an activity that is observable, discernible. It really is still a competency in its wording or its capability.

And as, as you sort of hinted at the work that these researchers have done Ten Cate and Co since 2005, releasing some work even about a year ago that actually said an EPA, as you said, needs to have a clear title. It’s attributes and specifications, I think that is the language that they use. That’s certainly what’s underpinned my technology work. It needs to say what it is and what it isn’t. I think one of the other important things, and maybe you could comment, is they also describe risks of failure of an EPA, and that’s quite important too, because we talked about this is about healthcare delivery, it’s about, as I said, patient safety, efficacy, et cetera.

Why is it important that as part of our framework of an EPA developing EPAs, we use the example of shoulder pain or managing shoulder pain before flipping the coin and looking at it from the other side and saying, actually, this is a risk if it goes wrong, can you comment on sort of risks of failures of EPAs?

Sonya

That is a really good perspective to come at the other way because often, certainly, when we’re talking about strengths-based learning, you know, we take what our strengths are, what our expectation is, what this looks like when it’s beautifully performed and integrated into practice. But part of that also is, is a real appreciation. And this is, this is a deep learning. This is advanced level clinical skills we’re talking about now, is what happens when that doesn’t happen, or what happens when we stray from that expectation or that behavioural expectation?

So there’s almost that reciprocal anti-EPA, I don’t know if that’s, that’s probably introducing another type of terminology. But the EPA represents what it should look like and could look like. And looking at the risks associated when that doesn’t happen is a really important aspect to consider of why that EPA is important. Why that EPA is, I’m going to say, validated, mapped against the competencies and standards, but it’s, it’s valid, and it’s important. And if that doesn’t happen, then there are consequences. And so that comes back to saying, well actually, you know what, this really is important. This represents capability. And if people don’t perform at that level, there’s a different type of consequence.

Mark

Using the standard frame of EPAs and perhaps a nice segue into technology was certainly something though, that risk of failure component, what are the risks if this isn’t enacted properly? If done well certainly speaks very much to technology. I’ve been writing EPAs for digital physiotherapy practice. That’s the work we’re currently doing. In some ways, a lot of those risks are quite consistent in other ways, they’re, I guess more, you know, endemic or contextualised to the specific EPA that you’re writing. But if you think about the digital age and managing people’s electronic health information online, it’s very topical at the moment. But, yeah, some of the sorts of things that I think if we get it wrong, if you know competency isn’t enacted properly, you run the risk of mistrust in the profession. Of, I guess, a negative patient practitioner relationship. Adverse health events, I know that that’s almost a bit doom and gloom, but I think it’s certainly relative to managing someone’s shoulder as much as it is into the safety of documenting a patient’s sensitive health information into an electronic medical record, which so many people are doing as well at the moment.

So I think that that certainly does give us a nice segue into technology because, as I said before, it’s everywhere now. It’s certainly a huge theme of both the conference of the APA strategic plan that they just released. It’s great to see them forward thinking this and looking at the impacts of innovation and technology and these sorts of things. But that’s really what brought me to sort of wanting to do what I’m doing at the moment. And as I said before, competencies are fantastic, capability statements, there’s a bunch of them, they keep coming out, they lay a beautiful foundation for what we’re doing. But as we already said, what capabilities and competency statements don’t really do is tell us what people need to do.

Sonya

That’s right. And I think another important point along that line is that there are levels of risk. You know, there’s catastrophic risk. There’s a middle ground, or dare I say middle ground, what happens when, for example, digital health information is lost or breached, you know, that’s not life or death catastrophic, but that, that’s a pretty significant breach of trust and confidentiality. And if we take the shoulder management scenario can be a very significant risk to the patient if our care is suboptimal versus incapable or incompetent. You know, there’s a spectrum there.

So I think appreciating the level of risk when things don’t go as planned is important, and that brings us around to optimal practice and best practice. I think we’re striving for best practice, but then, you know, we don’t want to dip below that level of incompetent practice or significant risk.

Mark

I’m glad you used the word again, incompetent and competent in the same context because technology, I think, adds that extra layer of complexity. And certainly, what I’ve found, I’ll go back to that phrase of a shiny new toy, it’s the kind of topical thing at the moment, but what does technology mean? It means different things to different people depending on what hat you’re wearing at the time. We’ve got colleagues here at the conference that are telehealth enthusiasts, you know, expertise in telehealth. Whereas, on the other hand, we’ve got people that look at digital health from the perspective of health information management, and they’re doing cybersecurity stuff, platforms, they’re electronic medical record providers, they’re using devices to collect data about people’s metrics, et cetera, et cetera.

So in an area in particular like digital health, that was for me the, as I said, I use that phrase of gravitated towards EPAs because I think it is a beautiful way to put a frame around what do physiotherapists need to be confident and competent in doing, and how can they demonstrate that competency with technology? Because otherwise, we’re talking about electronic medical records, telehealth, mobile apps, so the internet, devices, but no one knows really where to start. And so the EPA offers us a way, you know, exactly to do that, to basically frame it up so that people understand exactly what they need to do in clinical practice.

Sonya

That’s right. I think it’s another really great example and context of backwards design, particularly when you talk about technology, particularly when you mention telehealth, where the practice expectation somewhat exceeds, or it comes first. The practice expectation, we’re thrown into a COVID world, a post-pandemic world, a digital world with technological capability and actually the practise expectation that we can work this and drive this and use it safely, that actually comes first. And then we have to, to backwards design, okay, well, what does this EPA look like? How do we define and capture this skill that we actually do strongly believe that physios need? Because the world’s telling us this. So we need to capture that somehow so that physios in this context, physios and other health professionals can then say, okay, well this is how I need to do this well, and this is how I need to do this safely. And the EPA can capture that.

And in my work recently, or our work together, Mark, in undertaking a scoping review of what EPAs currently exist for postgraduate physiotherapists and healthcare, there’s a telehealth EPA, and someone’s put that together actually very nicely during the pandemic because suddenly there was a need to capture what this skill looks like in the real world. And that now needs to be backwards designed into perhaps competencies and standards, perhaps our registration framework. But there is a point of reference, there’s a common language. Those expectations and skills have been captured. And so clinicians and educators, we now have an opportunity to appreciate what that looks like.

Mark

You talked about a couple of, I guess, impacts. Impacts is an important place to take this discussion. We talked about education, that’s obviously near and dear to both of us and workforce, you started to talk a little bit about accreditation, and I think they’re two key areas that EPAs really offer potential to take those areas forward, particularly in the space of technology, whereby again, universities, professional development providers are starting to think a bit more about these skills and knowledge and competencies around technology.

Perhaps EPAs offer us a way to reenvisage, redesign developed university curricula. That’s one. But also, I think our professional accrediting bodies, and our member organisations are starting to think a little bit more about whether it be refinement or revisiting their professional proficiency standards. And certainly, perhaps that’s a way that we can incorporate some more of the digital health technology into those and bring it forward into the, you know, 21st century, which is really, really nice. And that’s the research that we’re actually doing at the moment in developing EPAs for digital physiotherapy practice, hoping that it will exactly have that impact to revisit our practice proficiencies as well.

Sonya

Yeah, and that’s right, Mark, I think we’ve talked about the importance of incorporating your professional practice standards and competency standards into EPAs as one way and a really important way of validating EPAs. But there are other ways to validate EPAs and validate their importance. And one of them, as you mentioned, we’ve both mentioned, the workforce. Someone has a really pressing need for a skill set, an end-to-end task that needs to be done well. And that might be an expert group that says, look, you know, beyond my opinion that I think telehealth’s important, actually, there’s a group here, a group of experts that are saying this is really important. There’s a workforce or a workplace that says this is a really important task in this work context.

So they can then set about designing an EPA that captures what’s required in that workspace and so that’s another way of validating an EPA. So even if it isn’t competency standard matrix mapped, because that takes time, particularly the backwards design. This takes time and energy and effort and expertise. Actually, experts can design something fit for purpose for a particular practice context. And that doesn’t mean it’s not valid, that just means it’s really valid in that context. There are other ways to emphasise the importance of a skill.

Mark

So, having spoken relatively at length about what EPAs are now, why they’re important, how they can be translated across from competencies, how they’re linked to competencies. Maybe we can share with everyone listening, some maybe more obvious clinical examples. I’ve certainly got a few around what an EPA could look like that demonstrates competency with using digital physiotherapy practice. You’ve certainly got some ideas, whether it be musculoskeletal in around the post-registration context, but maybe we can spend a little bit of time as we kind of wind this up to give some really obvious clinical examples. Do you want to start with a few?

Sonya

Yeah, sure. I think one of my favourite examples is the EPA I’ve come across, which is shared decision-making in postgraduate medical education. And this is an interesting example because this is not matrix mapped to our competency standard frameworks. But I sit here and say, well, anecdotally, I think this sounds really important as an educator and a clinician, I think, well, you know what, shared decision-making with my clients, with my patients, this is a really important part of our practice and an important way forwards.

This EPA was designed for postgraduate medical specialists, and it captures with a title and with, behavioural indicators and also with competencies what shared decision-making would look like in practice. And because it was captured in such detail, and I’ll give some examples. So the EPA is shared decision-making in postgraduate medical education. Some of the competencies within it are explaining that shared decision-making is desirable as a choice needs to be made. The clinician needs to clarify perceptions and preferences regarding the options.

So because this EPA is defined with its attributes and in detail, we can backwards design a curriculum that helps clinicians and helps learners to actually meet this practice outcome. We’ve got this in our postgraduate education now by sharing this article and sharing this EPA with learners and clinicians. Everyone can go, oh, okay, I get that. I think that sounds important, and because we’ve got a stepwise approach to it, we can then sort of start to appreciate what that entails.

As educators, much like we’re doing a little bit here today, Mark, we role-played this EPA. So I sat with a colleague, and we sort of thought, well, what does this EPA look like, or what could it look like in our practice? And so we shared that with the students and shared it with, when I say students, postgraduate clinicians with experience and then they said, “Oh, we like this. Well, I can see how that works in my practice”, and it may not be exactly the same, but we’re all able to follow this framework and adapt it to our contextual needs. And so what we end up doing is translating or backwards designing that EPA into what it could look like in real-life clinical practice in the clinical world.

Mark

And that’s actually another nice reminder for everyone that this concept isn’t just for university students’ entry to practise that are going out. It’s very applicable to seasoned mature physiotherapists who might be doing a masters in sports rehab, musc, et cetera, et cetera. So it really does apply across a variety of years of experience and things like that. For us, in the work that we’re doing with EPA development with digital technology, it’s a little bit different. We don’t really have anything to go by. We’re the ones developing the EPAs, they don’t exist. That’s exciting for me because we’re the ones that are actually going to develop it.

Hopefully, it will get some traction, some international recognition, and we start to apply these digital practice EPAs across the board, but we’re very much at the starting line with it. We don’t have fully framed EPAs with their seven different attributes at the moment what we’re road testing is very much the titles of the EPAs, their component attributes, the specifications that we talked about.

But for example, if we think about some of the obvious clinical applications of digital practise, again, almost starting with that idea of competency, like you said, the sorts of things that if you’ve read your proficiency standards recently, the sort of thing that you probably read that comes up pretty consistently is something in the range of how they normally phrase - understand a client’s rights for using digital communication tools in accordance with medico-legal responsibilities.

You know, I kind of made that up on the fly, but if you go through and read our practice proficiency standards, you know, you’ll read something like that. And again, going back to some of the discussion we had before, that’s semi-helpful as a signpost. But what’s the Act like? Okay, I need to act ethically responsibly, I need to maintain privacy and confidentiality, but what’s the actual activity I’m doing?

So, for example, some of the clinical applications that might speak to demonstrating a competency like that using our EPA language might be things like we’ve developed one of our EPAs and you know, watch this space wording might change a little bit, but something say around the EPA might actually be for that, you know, managing a patient’s health information in a practice management system or electronic health record. So as we said, that could still have other aspects nested underneath it. That might include obtaining informed consent. It might be sharing with a patient, information or links to other reputable resources, but we need to actually make it something that people can do practically to show their boss to show themself, et cetera.

Other examples could be documenting a patient’s encounter in an electronic medical record. It could be sharing with a patient, links to YouTube videos online, you know, to help them manage their condition. It could also have connotations, particularly for our colleagues that are working in, say, the public health sector, hospital space leadership management connotations. Managing digital projects around the implementation of a major electronic medical record or something that’s certainly going on. But then assessing a patient using digital health technology.

Now again, even, even though that’s sort of framed as an EPA, it doesn’t really tell us necessarily what that means. That could be assessing a patient using an app, if I specify it for that, or it could be using sensors. They’re just, you know, some of the examples that we’ve got. But it’s very much an evolving space. I think we probably can slowly wrap this conversation up. Before we do that, is there anything around EPAs that you, you know, any pearls of wisdom you want to finish with?

Sonya

I think really just wrapping it back around to where we started, the whole premise of the EPA is we have knowledge, we have competencies, we have frameworks, and actually the EPAs capturing what we do with this knowledge and how we do it. And I’m going to say doing because you used managing, assessing how are we doing this on a continual basis and what it looks like in practice. It’s not a checklist. It’s not about did I get 80%, did I get 70%, did I get 40%? It’s actually, can I do this and can I do it proficiently and capably and certainly in postgraduate education, can I do this on a regular basis and make my own decisions around this? It’s not a checklist, it’s, can I be entrusted to take the responsibility for continual care at that decision-making peak? Am I entrusted with this skill?

Mark

So at an individual level, in a lot of ways, you know, there’s going to be people listening to this thinking about their own professional development needs. It’s really nice for a skills identification gap type of thing. And certainly, it does perhaps provide a useful framework for education and maybe to sort of tie it together, we said future proficiency, standard updates, accreditation standards, et cetera. So hopefully, as I said for some, it’s a bit of a taster and an introduction to the topic, but gives people that are interested in competencies and capabilities and EPAs hopefully now somewhere to go with it. I’ve certainly enjoyed talking about it. We’ve got a lot of overlapping areas, no doubt we’re going to keep working together, but hopefully, everyone found that interesting. Thanks for joining us, Sonya.

Sonya

Thanks a lot, Mark. It’s lovely to be here.

Outro

That was Dr Mark Merolli, clinical physiotherapist and senior lecturer and research fellow at the University of Melbourne and Dr Sonya Moore, a physiotherapist and senior lecturer and sports medicine program coordinator at the University of Melbourne. You’ve been listening to another episode of Conference Conversations brought to you by the Physiotherapy Research Foundation and Pain Away Platinum and Content sponsor of the PRF. Thanks for listening, and make sure you catch the next episode in the Conference Conversations podcast series.