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Development and inclusion of an entrustable professional activity (EPA) scale in a simulation-based medicine dispensing assessment

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Background and purpose: Effective, safe, and patient-centred dispensing is a core task of community pharmacists. Entrustable professional activities (EPAs) offer a way of defining and assessing these daily practice activities. Although EPAs have become popular within competency-based medical education programs, their use is new to pharmacy education and assessment. Educational activity and setting: A simulation-based assessment framework containing a scale of entrustment was developed to evaluate the readiness of Year 4 undergraduate pharmacy students to safely manage the supply of prescribed medicine(s) in a community pharmacy. The assessment framework was piloted in a fourth year “Transition to Practice” course with 28 simulation-based assessments conducted. Findings: An entrustment framework was developed and implemented successfully with Year 4 undergraduate pharmacy students. The EPA for medicine dispensing integrates competency domains that include information gathering, providing patient-centred care, clinical reasoning, medicine dispensing, and professional communications. On a scale ranging from level 1 to level 5, the majority (73%) of entrustment ratings were level 2 or level 3; and of the students who achieved different ratings between clinical scenarios, 75% of students improved on their second simulation attempt. There was a strong correlation between the global EPA ratings with the total score achieved across the domains. Using simulation-based assessment, entrustment decision making can be incorporated in “entry to profession” undergraduate and postgraduate pharmacy courses to assess students' readiness to transition between learning and professional practice.




Croft, H., Gilligan, C., Rasiah, R., Levett-Jones, T., & Schneider, J. (2020). Development and inclusion of an entrustable professional activity (EPA) scale in a simulation-based medicine dispensing assessment. Currents in Pharmacy Teaching and Learning, 12(2), 203–212.

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