Entrustable professional activities for medical students and graduates of Austrian medical universities : Results of a national development and harmonization process.

BACKGROUND: Entrustable professional activities (EPAs) translate competency-based medical education into observable clinical work and can clarify expectations at the undergraduate-postgraduate transition. In Austria, undergraduate EPA implementation has been heterogeneous, limiting transparency and comparability across medical universities. METHODS: We conducted a national, multiphase development and harmonization process to define EPAs for students entering and completing the clinical practical year (KPJ). International EPA frameworks were identified by literature review and mapped to the Austrian Clinical Learning Objectives Catalogue (KLK). Draft EPAs were formulated using descriptors recommended by the Association for Health Professions Education (AMEE), linked to CanMEDS roles, assessment profiles and supervision levels and validated through a two-round national consultation process with expert groups from all Austrian public medical universities/faculties. Consensus was predefined as ≥ 75% agreement. RESULTS: The process yielded a nationally endorsed set of 11 EPAs covering key tasks along the patient-care continuum, including history taking, clinical examination, clinical reasoning, diagnostics, common procedures, recognition of emergencies and first measures, evidence-based treatment planning, documentation and interprofessional communication, patient safety/quality and prevention counselling. Assessment profiles prioritized workplace-based assessment (e.g., Mini-CEX, DOPS, OSCE components) supported by structured feedback and complementary approaches (e.g., handovers, ward rounds, multisource feedback). Expected supervision levels were specified for KPJ entry and completion, with progression from predominantly direct supervision to mainly indirect supervision, differentiated by EPA. CONCLUSION: Austria's harmonized undergraduate EPA catalogue endorsed by all public Austrian medical universities/faculties provides a practice-oriented national qualification profile that can support curricular mapping, more comparable workplace-based assessment, mobility between Austrian universities, and clear expectations for students and supervisors.