[Entrustment: Innovation and Practice in Nursing Education].

Abstract

The World Health Organization has projected a global shortage of 5.7 million nurses by 2030 (World Health Organization, 2024). However, the International Council of Nurses warns that, in light of the COVID-19 pandemic and ongoing workforce shortages, this gap could escalate to as many as 13 million over the same timeframe (International Council of Nurses, 2021). With nursing personnel shortages, rising disease complexity, and aging populations, healthcare systems around the world, including Taiwan, are faced with considerable challenges. To address the challenges faced specifically by the nursing workforce in Taiwan over the next decade, the Ministry of Health and Welfare and the National Health Research Institutes convened a national forum in 2021, bringing together dozens of nursing experts to propose forward-looking strategies and policy recommendations. The forum emphasized the urgent need to reform nursing education and workforce development in order to expand capacity through innovation. Key proposals stressed the importance of enhancing both the quality and quantity of the nursing workforce, aligning educational curricula with real-world demands, and bridging the persistent theory-practice gap that currently impedes new graduates from transitioning smoothly into clinical roles. The aim was to cultivate competent and practice-ready professionals capable of delivering safe, high-quality patient care and contributing to public health (National Health Research Institutes, 2022). This issue turns the spotlight on Entrustable Professional Activities (EPAs) as a new and potentially effective framework for nursing education and workforce preparation. EPAs refer to key professional tasks that a trained professional can be entrusted to perform independently (ten Cate, 2020). Successful implementation of these activities requires trainees' contextual competence in integrating canonical knowledge (including foundational medical science, clinical reasoning, physical assessment, and professional and ethical standards) into actual clinical settings (ten Cate et al., 2024). EPAs emphasize real-world tasks at their core. By directly observing trainees' performance in completing tasks within real situations, educators can evaluate their readiness for independent responsibility, make informed, competence-based entrustment decisions, and appropriately delegate patient care duties (ten Cate et al., 2024; ten Cate & Taylor, 2021). EPAs bridge competencies and tasks, embodying an outcomes-oriented, practical approach to teaching and evaluation (ten Cate & Favier, 2022). This model is rapidly gaining traction globally as a viable approach to cultivating independent and practice-ready nursing professionals (Pietsch et al., 2025). Given the complex and multifaceted nature of nursing tasks, proficiency in isolated skills or knowledge areas alone is insufficient to ensure task readiness. Effective clinical practice demands the integration of knowledge, technical skills, and attitudes. Due to the current and long-term nursing shortage, nursing students, novice nurses, and advanced nursing practitioners must all be equipped with the competencies necessary to perform core clinical responsibilities. Also, facilitating their transformation from trainees into accountable professionals is key to maintaining the safety and quality of patient care. This issue features four articles written by nursing scholars that explore the multifaceted role of EPAs, including their development in nursing education and clinical training, application in student learning and assessment, use in shaping advanced curriculum design and clinical competence, and implementation in clinical training. It is hoped these expert perspectives and experiences will spark thoughtful reflection on the use of EPAs within a model of entrusted professional development. By grounding nursing education in EPAs, nursing can collectively drive innovation in both academic and clinical settings, fostering seamless transition from classroom learning and hands-on practice. Ultimately, this approach aims to cultivate future nurses who are competent in carrying out clinical responsibilities independently to deliver safe and quality care and, through doing so, elevating the impact and visibility of the nursing profession.