Moving beyond the technical skills and promoting professionalism—the experience of the College of Anaesthesiologists of Ireland with incorporating the Medical Council Eight Domains of Good Professional Practice into Entrustable Professional Activities

Background: The goal of the College of Anaesthesiologists of Ireland (CAI) is to train qualified anaesthesiologists who embody all aspects of professionalism. The Medical Council of Ireland has identified Eight Domains of Good Professional Practice which guide the standards for postgraduate specialist training, including within the CAI. Aims: Entrustable Professional Activities (EPAs) were adopted as the organising framework for a competency-based programme within CAI. The aims were (i) to ensure that the EPA-integrated competencies from across the full range of domains and (ii) to design workplace-based assessment which fosters a culture and practice of feedback above and beyond technical skills. Methods: Four core EPAs were developed for trialling; competencies were tagged to the eight domains in an iterative development process. Feedback Reports were devised as tools for workplace-based assessment. Analysis of the Feedback Report data revealed how well the content reflected the full range of domains. Results: ‘Clinical Skills’ is the domain to which most competencies within the EPAs were tagged. Analysis of the content of Feedback Reports also revealed an overrepresentation of that domain. This highlighted the apparent preference of consultants and trainees for selecting clinical aspects of an EPA to provide and receive feedback on, rather than professionalism or any of the other non-technical domains. Conclusions: We advocate and make recommendations for more effective incorporation of the non-technical domains of professional practice in the processes of curriculum development, teaching, learning, feedback and assessment.