Copyright © by the Association of American Medical Colleges. Unauthorized reproduction of this article is prohibited. Academic Medicine, Vol. 92, No. 6 / June 2017 800 Research Report The principles of patient-centered care have become widely accepted as central to the planning, delivery, and evaluation of health care. These include understanding the whole person, finding common ground, enhancing the clinician–patient relationship, and exploring health, disease, and the illness experience (Table 1). 1 Furthermore, the medical education community, including accrediting agencies, are increasingly recognizing the importance of incorporating the principles of patient-centered care into medical education. To illustrate, one essential criterion Australian medical schools must meet for full accreditation specifies that “Learning and teaching methods in the clinical environment promote the concepts of patient-centred care.” 2 Accordingly, one need is to develop effective strategies and methods to practically integrate these principles into medical curricula and training programs, including in the assessment of learners. Medical educators are rapidly adopting the use of entrustable professional activities (EPAs) in the context of competency-based medical education. 3 EPAs, defined as “a fundamental unit of professional practice that can be fully entrusted to a trainee once he or she has demonstrated the necessary competence to execute the specific activity unsupervised,” 4 are increasingly forming the cornerstone of postgraduate training programs. EPAs focus on clinical tasks and provide a unique opportunity to integrate the principles of patient- centered care into medical assessment. In this study, we approached the growing field of EPA development using the principles of patient-centered care. Given that only a limited selection of EPAs are intended to encompass what is core to a profession, it is imperative that a rigorous approach is taken in developing the content of each. No matter how carefully chosen, EPAs will be unusable and invalid without clear and relevant “EPA descriptors,” which previous authors have defined as specifications and limitations of the activity; expected knowledge, skills, and attitudes; associated competencies; sources of information to assess progress; and the level of entrustment. 5 Published procedures for EPA development highlight the importance of engaging stakeholders, including senior clinicians, residents or fellows (i.e., “training doctors” in the Australian context), and course directors, in defining these descriptors. 5,6 Currently, medical educators are using qualitative research methods such as interviews, focus groups, and Delphi procedures to ascertain stakeholder views when designing EPAs. 4,5,7 Mapping EPAs to a curriculum containing a framework of competencies is also an established process in EPA development. 4 To our knowledge, no studies have investigated the potential role of patients as stakeholders in EPA development. Consulting patients during the process of developing the content of EPAs aligns with the widely accepted principles of patient-centered care. 1,8 According to the Abstract Purpose The medical education community is rapidly accepting the use of entrustable professional activities (EPAs) as a means of assessing residents. Stakeholder engagement is advised in developing EPAs, but no studies have investigated the role of patient input. In this qualitative study, the authors investigated what patient input may add to designing a patient-centered EPA. Method The authors chose “management of acute low back pain (LBP)” as a common, important clinical task on which to base the patient-centered EPA. In 2015, 14 patients who presented to a teaching hospital with acute LBP participated in semistructured interviews exploring their illness experience and expectations of doctors. Clinicians representing multiple disciplines participated in a focus group. The authors used the Framework Method to analyze data, identifying and developing themes, similarities, and differences between patient and clinician input. They used the fndings to develop the EPA. Through an iterative procedure of data review and tracking data sources, they determined how patient and clinician input informed each EPA descriptor. Results Drawing from their frsthand experience of LBP, patients described unique expectations of trainees which directly informed EPA descriptors. For example, the authors primarily used patients’ detailed descriptions of desirable and observable trainee behaviors to inform the required attitudes descriptor. Conclusions Patients can provide unique contributions, complementary to those of clinicians, to EPAs. Consultations with patients led to the development of a patient-centered EPA, which aligned best clinical practice with patient expectations. Educators seeking to apply patient-centered care to EPA development could adopt a similar approach. Acad Med. 2017;92:800–808. First published online February 21, 2017 doi: 10.1097/ACM.0000000000001616 Copyright © 2017 by the Association of American Medical Colleges Please see the end of this article for information about the authors. Correspondence should be addressed to Carlos El-Haddad, Department of Medicine, Campbelltown Hospital, PO Box 149, Campbelltown NSW 2560 Australia; telephone: +61 (02) 46344001; e-mail: C.El-Haddad@westernsydney.edu.au. A Patient-Centered Approach to Developing Entrustable Professional Activities Carlos El-Haddad, MBBS, Arvin Damodaran, MBBS, MMedEd, H. Patrick McNeil, MBBS, PhD, and Wendy Hu, MBBS, MHA, PhD