# Developing Entrustable Professional Activities for Hematology Residency Program in a Low-Resource Setting: A Modified Delphi Study

## TL;DR

This study develops and validates 14 Entrustable Professional Activities for hematology training in a low-resource setting using a Delphi method.

## Contribution

The study introduces a set of validated EPAs for hematology residency tailored to low-resource contexts like Pakistan.

## Key findings

- 14 out of 16 EPAs reached consensus among experts for hematology training.
- Two EPAs on Platelet Function Disorders and Von Willebrand Disease failed to achieve consensus.
- Teaching and assessment strategies were finalized for the accepted EPAs.

## Abstract

The concept of Entrustable Professional Activities (EPAs) is central to competency-based medical education, which enables the assessment and guidance of learners in clinical settings. While EPAs have been widely adopted in various medical specialties, their application in hematopathology training remains underexplored. This study aimed to develop and validate a set of Entrustable Professional Activities (EPAs) tailored for hematology training in pathology residency programs.

This cross-sectional Delphi study was conducted in 2023 at Aga Khan University Hospital, Pakistan, to seek consensus for EPAs. Sixteen essential EPAs for hematology postgraduate education were identified through literature review and faculty expertise, aligning with core ACGME competencies. Teaching/learning and assessment strategies were detailed for each EPA. The modified Delphi method, involving two iterative rounds, was employed to achieve expert consensus. The panel comprised 22 experts, 16 of whom participated from various institutions.

In the first Delphi round, 14 out of 16 EPAs reached the desired consensus of more than 80%, along with certain teaching/assessment strategies. The second round aimed to finalize consensus on the remaining items. Two EPAs related to Platelet Function Disorders and Von Willebrand Disease failed to reach the predefined consensus criteria. Lectures as a teaching strategy and certain assessment strategies also lacked consensus. The study concluded with the acceptance and finalization of 14 EPAs and their associated teaching and assessment strategies.

The study identified essential EPAs, competencies, and effective teaching and assessment strategies. This collaborative effort advances hematology medical education and guides curriculum development, preparing competent hematologists for the unique context of the Pakistani and related healthcare systems.