Development of entrustable professional activities for novice nurses: A modified Delphi study

Abstract

AimThis study aimed to develop a tailored EPA framework for novice nurses to support their integration and performance in hospital settings. BackgroundNovice nurses often struggle with the transition from education to practice due to the gap between theoretical knowledge and practical skills. EPAs help bridge this gap by defining and assessing key competencies, but a framework specific to novice nurses is needed to address their unique challenges. DesignA modified Delphi method was used. MethodsConducted from October 2023 to March 2024, the study followed a four-stage process: team formation, identification, revision and evaluation of EPAs. Initial EPAs were identified through literature reviews, clinical guidelines and focus groups, then refined using the EQual rubric. Two Delphi rounds were conducted for validation. Experts rated the importance of EPAs in the first round, followed by online discussions, with the second round focusing on dimensions including Focus, Observable, Realistic, Generalizable and Multiple competencies. ResultsThe final framework included 12 EPAs: 1) Manage Admission and Discharge, 2) Provide Basic Care, 3) Collect Specimens, 4) Administer Medications, 5) Perform Non- Medication Therapies, 6) Monitor Conditions, 7) Respond to Emergencies, 8) Educate Patients, 9) Prevent Adverse Events, 10) Conduct Handovers, 11) Document Care and 12) Operate Equipment. ConclusionThis EPA framework integrates theory and practice to improve training and assessment. Future research should focus on its implementation and refinement in diverse clinical settings to ensure broader applicability.