The Guideline Applying of Entrustable Professional Activities Development Concept on Psychomotor Skill for Nurses


  • Soiy Anusornteerakul Faculty of Nursing, Rachathani University, Udonthani Campus
  • Raweewan Paokanha Faculty of Nursing, Rachathani University, Udonthani Campus
  • Chanidapa Korsuk Faculty of Nursing, Rachathani University, Udonthani Campus
  • Natthakul Buengmoom Faculty of Nursing, Rachathani University, Udonthani Campus
  • Nongnuch Boonmala Faculty of Nursing, Rachathani University, Udonthani Campus


entrustable professional activities, psychomotor skills, nursing


The significant goal of the competency development on psychomotor skill for professional nurses is the nurse must be able to nursing practice independently without supervision, which can be considered that there are adequate and complete competences, that’s mean entrustable professional activities (EPAs). Application of EPAs concept in the evaluation of professional nursing competency in order to the clients trust and confidence that they will receive a safe and accurate as nursing standard. As the literature review, there are five levels of EPAs: level 1, not able to perform, just observe nursing activities only, level 2, able to perform an EPA with close supervision, level 3, able to perform with supervision nearby and prompt assistant immediately, level 4, able to perform without supervision, and level 5, able to perform without supervision and available to supervise others. The EPAs below level 4 should receive additional training or practice. There are 7 steps to developing EPAs: 1) identify the necessary EPAs 2) define the EPAs components 3) write the necessary competencies components 4) define the EPAs 5) identify the assessment methods or accessible resources 6) assignment of responsibility, and 7) establishing an end-of-assessment period. Therefore, applying the concept of entrustable professional activities into development and evaluation the competency of nurses likely to be promoting nurses with professional competencies, and ready to provide quality care for the clients.


Download data is not yet available.


Wagner SJ, Reeves S. Milestones and entrustable professional activities: The key to practically translating competencies for inter-professional education? J Interprof Care. 2015; 29(5): 507-508.

Pijl-Zieber EM, Barton S, Konkin J, Awosoga O, Caine V. Competence and competency-based nursing education: Finding our way through the issues. Nurse Educ Today. 2014; 34(5): 676-678.

Anusornteerakul S, Tienprasert S, Kanchanabatr B. Entrustable professional activities on psychomotor skills among newly graduated nurses. J Nurs Health Care. 2020; 38(1): 69-77. (in Thai)

Giddens JF, Lauzon Clabo L, Morton PG, Jeffries P, Mc Quade Jones B, Ryan S. Re-envisioning clinical education for nurse practitioner programs: Themes from a national leaders’ dialogue. J Prof Nurs. 2014; 30(3): 273-278.

Lowden K, Hall S, Elloit D, Lewin J. Employers’ perception of the employability skills of new graduates. London: Edge Foundation; 2011.

Kensakoo T, Srithumuk W. The development of registered nurses’care competencies in neurology nursing care, Prasat Neurological Institute. Journal of The Royal Thai Army Nurses. 2020; 21(3): 340-349. (in Thai)

Wagner LM, Dolansky MA, Englander R. Enstrustable professional activities for quality and patient safety. Nurs Outlook. 2018; 66(3): 237-243.

Hauer KE, Soni K, Cornett P, Kohlwes J, Hollander H, Ranji SR, O’Sullivan PS. Developing entrustable professional activities as the basis for assessment of competence in an internal medicine residency: A feasibility study. J Gen Intern Med 2013; 28(8): 1110-1114.

Bhuyan N, Miser, WF, Dickson GM, Jarvis JW, Maxwell L, Mazzone M, Tuggy M. From family medicine milestones to entrustable professional activities [EPAs]. Ann Fam Med 2014; 12(4): 380-381.

Beeson MS, Warrington S, Bradford-Saffles A, Hart D. Entrustable professional activities: making sense of the emergency medicine milestones. J Emerg Med. 2014; 47(4): 441-452.

Royal College of Physicians and Surgeons of Canada. Entrustable professional activity (EPA) fast facts. Canada: Canmeds Royal College Ca; 2016.

Makary MA, Daniel M. Medical error-the third leading course of death in the US. Clinical Research Education. 2016; 353: i2139.

Ng LB, Ng MJ. Entrustable professional activities to enhance continuity of care. BMC Med Educ. 2014; 48(11): 1115.

Chaug A, Bowen JL, Buranosky RA, Frankel RM, Ghosh N, Rosenblum MJ, et al. Transforming primary care training patient centered medical home entrustable professional activities for internal medicine residents. J Gen Intern Med. 2013; 28(6): 801-809.

Yuan CM, Prince LK, Zwettle AJ, Nee R, Oliver JD, Abbott KC. Assessing achievement in the nephology training: Using clinic chart audits to quantitatively screen competency. Am J Kidney Dis. 2014; 64(5): 737-743.

Fesser HE, Addizzo HD, Beck LM, Buckley JD, Pastores SM, Piquette CA, Spevetz A. Entrustable professional activities and curriculum milestones for fellowship training in pulmonary and critical care medicine: report of a multi-society working group Chest. 2014; 146(3): 813-834.

Rose S, Fix OK, Shah BJ, Jones TN, Szyjkowski RD, Bosworth B P, Sedlack RE. Entrustable professional activities for gastroenterology fellowship training. Gastrointestinal Endoscopy. 2014; 80(1): 16–27.

Lohenry KC, Brenneman A, Goldgar C, Hills KJ, Vander Meulen SP, Lane S, Fletcher S. Entrustable professional activities: a new direction for PA education. J Physician Assist Educ. 2017; 28(1): 33-40.

Chen HC, van Den Broek WE, ten Cate O. The case for use of entrustable professional activities in undergraduate medical education. J Assoc Am Med Coll. 2015; 90(4): 431-436.

Pittenger AL, Chaman SA, Frail CK, Moon JK, Undeberg MR, Orzoff JH. Entrustable professional activities for pharmacy practice. Am J Pharm Educ. 2016; 80(4): 57.

Amy LP, Scott AC, Caitlin KF, Jean YM, Megan RU, Jordan HQ. Entrustable professional activities for pharmacy practice. Am J Pharm Educ. 2016; 80(4): 1-4.

Van Loon KA, Driessen EW, Teunissen PW, Scheele F. Experiences with EPAs, potential benefits and pitfalls. Med Teach. 2016; 36(8): 698-702.

Meade LB, Suddarth KH, Jones R, Zaas AK, Albanese T, Yamazaki K., O’Malley CW. Patients, nurses, and physicians working together to develop a discharge entrustable professional activity assessment tool. J Assoc Am Med Coll. 2016; 91(10): 1388-1391.

Wölfel T, Beltermann E, Lottspeich C, Vietz E, Fischer MR, Schmidmaier R. Medical ward round competence in internal medicine-An interview study towards an inter-professional development of an entrustable professional activity (EPA). BMC Med Educ. 2016; 16: 174.

ten Cate O, Chen HC, Hoff RL, Peters H, Bok H, Vander Schaafm. Curriculum development for the workplace using entrustable professional activities (EPAs): AMEE Guide Med Teach 2015; 37(11): 983-1002.

National Education Personnel Health Development Foundation. Recommendations for the development of specialized health education for reforming educational institutions and teaching. Nonthaburi: Office of International Health Policy Development Ministry of Public Health; 2017. (in Thai)

Barnett JS, Minnick AF, Norman LD. A description of US post-graduation nurse residency programs. Nurs Outlook 2014; 62(3): 174-184.

Wiltse Nicely KL, Fairman J. Postgraduate nurse practitioner residency programs: Supporting transition to practice. J Assoc Am Med Coll. 2015; 90(6): 707-709.

ten Cate O, Young JQ. The patient Handover as an entrustable professional activity: adding meaning in teaching and practice. Qualitative Saturation 2012; 21 Suppl: i9-i12.

ten Cate O. AM last page: what entrustable professional activities add to a competencybased curriculum. J Assoc Amn Med Coll 2014; 89(4): 691.

Chunrat P, Jumpamool A. Factors influencing transcultural nursing competency of nurses working in Srinagarind Hospital KhonKaen University. J Nurs Health Care 2018; 36(3): 23-32. (in Thai)

Wirtz Rugen K, Speroff E, Zapatka SA, Brienza R. Veterans Affairs inter-professional nurse practitioner residency in primary care: A competency-based program. J Nurse Pract 2016; 12(6): e267-e273.

Englander R, Flynn T, Call S, Carraccio C, Cleary L, Fulton, TB, Aschenbrener CA. Toward defining the foundation of the MD degree: Core entrustable professional activities for entering residency. J Assoc Am Med Coll 2016; 91(10): 1352-1358.



How to Cite

Anusornteerakul S, Paokanha R, Korsuk C, Buengmoom N, Boonmala N. The Guideline Applying of Entrustable Professional Activities Development Concept on Psychomotor Skill for Nurses. J Royal Thai Army Nurses [Internet]. 2021 Sep. 3 [cited 2022 Oct. 1];22(2):77-85. Available from:



Academic articles