SYSTEMATIC REVIEW article
Front. Med.
Sec. Healthcare Professions Education
This article is part of the Research TopicInnovative Teaching and Learning in Health Education and PromotionView all 40 articles
The Development Status of Entrustable Professional Ac;vi;es-Based Curricula in Orthopedic and Neurosurgical Spinal Surgery: A Systema;c Review
Provisionally accepted
- 1LMU Munich University Hospital, Munich, Germany
- 2Brainlab (Germany), Feldkirchen, Germany
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Postgraduate medical training o_en lacks clearly defined, assessable outcomes. Entrustable Professional Ac;vi;es (EPAs) have emerged as a promising framework for competency-based training, aiming to improve transparency, accountability, and efficiency in specialist educa;on. This systema;c review inves;gates the current development status of EPA-based curricula in orthopedic and neurosurgical spinal surgery and highlights their poten;al to address educa;onal challenges in this high-stakes field. Methods: A systema;c review was conducted combining database research (PubMed and Embase) and grey literature screening through professional socie;es' websites and direct inquiries. Two reviewers independently screened, extracted, and synthesized the data. Given the an;cipated heterogeneity among included studies, a narra;ve synthesis was performed, 2 while a quan;ta;ve synthesis was not feasible. No formal risk-of-bias assessment was conducted; however, poten;al sources of bias related to language, scope, and publica;on period were acknowledged and discussed. Results: Out of 15,768 ini;al records, only four relevant papers were iden;fied. The EPAs in these studies were developed primarily through expert consensus methods such as modified Delphi or nominal group techniques. Addi;onally, among ten professional socie;es analyzed, only the AO Founda;on (AO Spine) and the Royal College of Physicians and Surgeons of Canada provided explicit EPA frameworks for spinal surgery, together contribu;ng 26 EPAs. The limited number and heterogeneity of sources underscore the exploratory nature of this review and the current lack of standardized, spine-specific EPA curricula. Conclusions: EPA-based curricula in spinal surgery remain largely undeveloped. While conceptual frameworks exist, their implementa;on into structured residency programs is s;ll in its infancy. This review provides a founda;onal overview of exis;ng EPAs and methodological approaches, offering a reference point for future curriculum development. Collabora;ve ini;a;ves among professional socie;es are strongly encouraged to define, validate, and implement specialty-specific EPAs for spinal surgery, fostering competency-based educa;on and improved training outcomes.
Keywords: Entrustable Professional Ac;vi;es (EPAs), spinal surgery, Medical Educa;on, postgraduate training, competency-based curriculum, Systema;c Review, medical curriculum development
Received: 12 Feb 2025; Accepted: 14 Nov 2025.
Copyright: © 2025 Domann, Phillips, Fischer and Stadler. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Matthias Stadler, matthias.stadler@med.uni-muenchen.de
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.