Development of an Entrustable Professional Activities-Based Assessment Framework for Outpatient Competencies of Chinese General Practice Residents

Background Outpatient consultation competency stands as a core professional capability for general practitioners, yet the systematic evaluation of this skillset remains a notable hurdle. To bridge this void, the present research embraced the internationally acclaimed Entrustable Professional Activities (EPAs) framework—a structured methodology for gauging observable, trust-centric professional performance. This study marks the first endeavor to construct an EPA-based assessment framework for the outpatient consultation competencies of general practice residents. This framework serves as an evidence-informed instrument for assessing residents’ consultation abilities and designing targeted training initiatives, ultimately elevating the quality of general practice workforce development. Methods Conducted in China, this research employed multiple methods approach: A methodical literature review was undertaken to retrieve domestic and international studies pertaining to EPAs and general practice outpatient consultations; Observational studies of clinical outpatient consultations were carried out to extract core practical behaviors; Focus group discussions were organized to initially develop the assessment framework; Two rounds of Delphi consultations were administered to 49 experts hailing from 18 provincial-level administrative regions across China. Results The final assessment framework encompasses 6 core EPA domains, 15 subdomains, and 48 performance indicators. The effective response rate for both rounds of Delphi consultations reached 100%, with expert authority coefficients attaining 0.9584 (Round 1) and 0.9626 (Round 2), respectively. Kendall’s coefficient of concordance (W) yielded p-values < 0.001 for both rounds, indicating that expert opinions were authoritative and consistent. Conclusions The EPA-based assessment framework for general practice residents’ outpatient consultation competencies closely aligns with the core dimensions of general practitioner competencies, encompassing abilities in consultation preparation, clinical diagnosis and management, communication, and continuity of care. It boasts both scientific rigor and methodological reliability. Comprehensive in scope, practice-aligned, and highly practical. This study facilitates the shift from abstract competency frameworks to trust-based, observable professional behaviors in general practice workforce development, fostering continuous improvement in the quality of resident training.