Clinical competencies in advanced practice respiratory therapy education: Is it time to entrust the learner?

The field of clinical education in health care has undergone several paradigm shifts in regards to its original theoretical frameworks across multiple healthcare professions. One of the most common evaluation and assessment tools undergoing equal amounts of change and research is competency-based education. In that vein, the respiratory care profession is also experiencing similar challenges to better asses and evaluate clinical competency. One of the emerging professional directions in respiratory care is the establishment of the advanced practice respiratory therapist (APRT) at the graduate level. This new advanced degree profession currently relies on competency-based education as an evaluation and assessment framework to fulfill the competency domains required by the professions accrediting agency, the Commission on Accreditation for Respiratory Care (CoARC). Since advanced practice, respiratory therapists will be considered advanced practice providers, a more robust assessment tool should be considered to assess and evaluate their clinical performance. The purpose of this article is to establish a higher evaluation and assessment framework, the Entrustable Professional Activity (EPA) tool. Entrusting the learner to be competent practitioners involves many aspects of practice skills, tasks, and other intangible areas such as behaviors and critical thinking that may not typically part of a competency-based education framework. We thus propose a sample EPA framework that is aligned with current CoARC APRT core competencies and a recommendation for an implementation strategy to assist the respiratory care community at large.