Developing and Validating Entrustable Professional Activities for Neurology Residency Training Programs in Saudi Arabia: A Modified Delphi Study

Amal M Alkhotani^1,2*Abdullah Tawakul²Laila A Alharbi²Manal E Alotaibi²Mohammed S Samannodi²Hussam M Alim²Hadeel K Khadawardi²Fahd AlMalki²Ahmad A Imam²Mohammad Dairi²Yosra A Turkistani²Adeeb Bulkhi²Rania Zaini³Hani M Almoallim²

• ¹Faculty of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia., Mecca, Saudi Arabia
• ²Department of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
• ³Department of Community Medicine and Pilgrims Healthcare, Umm Al-Qura University, Makkah, Saudi Arabia

Background and Objective: Entrustable professional activities (EPAs) are tasks that medical professionals can be entrusted to perform in unsupervised settings once they have achieved sufficient specific competencies. Despite their importance, nationally validated neurology EPAs are lacking in Saudi Arabia. This study aimed to develop and validate neurology EPAs in Saudi Arabia. Methods: A list of neurology EPAs was developed after an extensive review of existing neurology training program competencies and EPAs. Neurology experts were invited to participate in two rounds of a modified Delphi technique to review the list of EPAs and assess their relevance and representativeness using a 5-point Likert scale. In total, 21 neurologists participated in the study. Descriptive statistics were used to describe participants' demographic characteristics and group responses to each EPA. Cronbach’s alpha was used to assess the internal consistency of the responses across both Delphi rounds. Results: In the first round, 26 EPAs were validated, 10 were excluded owing to a lack of relevance, and one EPA was added as a modification of the existing items. In the second round, one more EPA was excluded because of a lack of relevance, resulting in a final set of 25 neurology EPAs. Conclusion: This study developed and content-validated a set of EPAs for neurology residency training in Saudi Arabia. It represents an initial step toward implementing an EPA-based curriculum. Further steps are necessary to ensure adequate integration into training programs.