{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T17:43:08Z","timestamp":1792690988428,"version":"4.5.0"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Competency-based education (CBE) is gaining prominence in post-secondary education due to its effectiveness in optimizing workforce readiness. However, assessing competence and workforce readiness presents a significant challenge. Entrustable professional activities (EPAs) offer a promising solution by translating competencies into observable, entrustable tasks. While EPAs have been widely adopted in clinical training, their application in non-clinical educational contexts remains minimal. Guided by Rogers\u2019 Diffusion of Innovation theory, this scoping review aims to map the diffusion of EPAs beyond medical education and examine their scalability to non-clinical educational contexts, where real-world practice errors may undermine system integrity, educational outcomes, or public trust. This review will progress through five stages following Arksey and O\u2019Malley\u2019s framework. Searches will be conducted across Ovid MEDLINE, CINAHL, Scopus, ERIC, and Google Scholar. The research question is: \u201cHow have EPAs been adapted, developed and implemented outside of medical education, and what factors influence their adoption in non-clinical educational contexts?\u201d The search will include studies that describe, evaluate, or reflect on the adaptation, development, or implementation of EPAs outside medical education, and exclude studies that only propose, define, or discuss EPAs, focus on medical education, or are not published in English. Titles and abstracts will be reviewed first, followed by the full-text examination of relevant studies. Data will be extracted and summarized to highlight key findings. A two-reviewer protocol will ensure quality during screening and data extraction. The findings from this review may provide practical guidance for faculty, curriculum developers, institutional administration, industry partners, and accrediting or policy bodies involved in curriculum and assessment framework design. Further, the findings may inform the rationale for scaling EPA-based assessment frameworks to non-clinical educational contexts and offer recommendations to guide their adaptation, development, and implementation, addressing CBE assessment challenges and creating a replicable model for future non-clinical program development.<\/jats:p>","DOI":"10.1371\/journal.pone.0330549","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T17:24:30Z","timestamp":1792689870000},"page":"e0330549","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring the diffusion, application, and scalability of entrustable professional activities beyond medical education: A scoping review protocol"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6354-6119","authenticated-orcid":true,"given":"Anjali","family":"Jagannathan","sequence":"first","affiliation":[{"name":"Faculty of Health Science, Ontario Tech University","place":["Oshawa, Ontario, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Micallef","sequence":"additional","affiliation":[{"name":"Faculty of Health Science, Ontario Tech University","place":["Oshawa, Ontario, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otto","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Faculty of Health Science, Ontario Tech University","place":["Oshawa, Ontario, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Dubrowski","sequence":"additional","affiliation":[{"name":"Faculty of Health Science, Ontario Tech University","place":["Oshawa, Ontario, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"issue":"8","key":"pone.0330549.ref001","doi-asserted-by":"crossref","first-page":"638","DOI":"10.3109\/0142159X.2010.501190","article-title":"Competency-based medical education: theory to practice","volume":"32","author":"JR Frank","year":"2010","journal-title":"Med Teach"},{"key":"pone.0330549.ref002","doi-asserted-by":"crossref","DOI":"10.5334\/bdc","volume-title":"Entrustable professional activities and entrustment decision-making in health professions education","author":"O Ten Cate","year":"2024"},{"issue":"12","key":"pone.0330549.ref003","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1111\/j.1365-2929.2005.02341.x","article-title":"Entrustability of professional activities and competency-based training","volume":"39","author":"O Ten Cate","year":"2005","journal-title":"Med Educ"},{"key":"pone.0330549.ref004","doi-asserted-by":"crossref","DOI":"10.1097\/00001888-199009000-00045","article-title":"The assessment of clinical skills\/competence\/performance","volume":"65","author":"GE Miller","year":"1990","journal-title":"Acad Med"},{"issue":"9","key":"pone.0330549.ref005","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1111\/medu.14517","article-title":"Contextual Competence: How residents develop competent performance in new settings","volume":"55","author":"PW Teunissen","year":"2021","journal-title":"Med Educ"},{"issue":"2","key":"pone.0330549.ref006","doi-asserted-by":"crossref","first-page":"92","DOI":"10.4103\/EHP.EHP_3_23","article-title":"Entrustable professional activities in undergraduate medical education: A needs assessment of medical students and faculty","volume":"6","author":"S Park","year":"2023","journal-title":"Educ Health Prof"},{"issue":"10","key":"pone.0330549.ref007","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1097\/ACM.0000000000004130","article-title":"Developing entrustable professional activities for the training of translational scientists: A modified delphi study","volume":"96","author":"MM Weggemans","year":"2021","journal-title":"Acad Med"},{"issue":"4","key":"pone.0330549.ref008","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1080\/0142159X.2021.1998402","article-title":"Developing entrustable professional activities for university teachers in the health professions","volume":"44","author":"L van Bruggen","year":"2022","journal-title":"Med Teach"},{"issue":"5","key":"pone.0330549.ref009","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1016\/j.jsurg.2018.03.003","article-title":"Entrustable professional activities (EPAs) for simulation leaders: The time has come","volume":"75","author":"AK Gardner","year":"2018","journal-title":"J Surg Educ"},{"key":"pone.0330549.ref010","first-page":"1","article-title":"Entrustable professional activities for simulation faculty?! 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