Unlocking Findings of Entrustable Professional Activities for Trainee Development, Entrustment, and Practice Readiness in Pre-registration Pharmacy Training: A Systematic Review

Abstract

Objective

To explore key findings on the use of entrustable professional activities (EPAs) in preregistration pharmacy training, with a focus on their role in trainee development, entrustment decision-making, and practice readiness.

Methods

A systematic search was conducted across 5 electronic databases (MEDLINE, Embase, Scopus, Emcare, and Cumulative Index to Nursing and Allied Health Literature (CINAHL)) to identify studies reporting on the use of EPAs in preregistration pharmacy training. Studies that described how EPAs influenced trainee development, entrustment decision-making, and practice readiness were included. Two independent reviewers screened and extracted data from the included studies. Key findings were synthesized into thematic domains. The Mixed Methods Appraisal Tool 2018 was used to evaluate the quality of the included studies.

Results

A total of 581 articles were screened, with 27 meeting the inclusion criteria (17 quantitative descriptive, 7 mixed methods, and 3 qualitative studies). A narrative synthesis of the eligible studies revealed 3 key findings: EPAs support the progressive entrustment of trainees across different time points in training, EPA implementation enhances trainees’ self-directed learning and self-awareness skills, and supervisor entrustment decisions are influenced by a range of contextual, personal, and trainee-related factors. Although EPAs were consistently associated with increased trainee autonomy, entrustment practices among supervisors remained relatively variable. Most included studies were assessed as medium to high quality.

Conclusion

The use of EPAs in pharmacy education fosters trainee autonomy, self-assessment, and professional growth in trainees. However, variability in supervisor decision-making highlights the need for further research to support consistent EPA implementation and supervisor training in authentic practice environments.