Development of entrustable professional activities for residents rotating nephrology department in a Japanese university hospital: a Delphi study

OBJECTIVES: Training strategies regarding entrustable professional activities (EPAs) vary from country to country; one such strategy is for residents. However, there are no reports of EPAs developed for residents who rotate to the nephrology departments. We aimed to construct such EPAs, which could be generalised to other institutions. DESIGN: Purposive design and a modified Delphi method to build consensus. SETTING: The department of nephrology in a university hospital in Aichi Prefecture, Japan. PARTICIPANTS: Based on the attainment goals used in our department, an initial list was developed within the research group. The expert panel included 25 nephrologists from our affiliate hospital. Responses were based on a 5-point method and agreement was reached if both (A) and (B) were met: (A) mean≥4 with a SD <1; (B) more than 75% of respondents rated the item 4 or more. With agreement, the item was left for the next round. This round was repeated. RESULTS: An initial list of 11 items was developed; after three Delphi rounds and revisions, eight items remained that were then established as the final EPAs. These items can serve as a list of goals to be reached by residents who rotate to the department of nephrology. The results indicated that most of the experts believed residents should be able to perform tasks deemed necessary or urgent for all physicians, such as those that deal with hyperkalaemia and heart failure. CONCLUSIONS: The concept of EPAs enabled us to develop goals and evaluation criteria for residents’ training in nephrology. This study can serve as a springboard for future discussions and contribute to the development of resident education in nephrology.