To transform the workforce to be better prepared, more equitably distributed, and more deeply connected to rural, underserved, and tribal communities, the COMPADRE Curriculum team aimed to answer the question:

“How do we best train providers to thrive in rural, indigenous, and underserved settings?”

The COMPADRE EPAs were created as a response to the above question using a modified Delphi method and building on existing rural competency domains. The EPAs describe tasks that a provider must master to thrive in a rural, underserved, indigenous health setting. While many of these tasks are not unique to these settings, they are particularly challenged in rural, underserved, and indigenous health settings, and particularly necessary for success. These are tasks for which a master clinician could make decisions about how entrustable a learner was to accomplish these tasks.

EPAs are tasks or responsibilities that can be entrusted to a trainee to perform unsupervised once they have obtained sufficient skills. They are intended to be representative of the real world work that doctors do. Rather than breaking down a task to multiple sub-components or competencies a learner is assessed by how well an experienced teacher or mentor would trust them to complete the entire task. EPAs are affected by several factors: attributes of trainee, attributes of supervisor, context, the nature of the EPA (complex or simple).

Each EPA below has an explanatory paragraph to expand on the intentions and challenges addressed, key functions that are required to achieve entrustability, and the progression of skills around which programs should build curricular activities. The learning strategies include a single exemplary tool for each instructional method, but are intended to be accompanied by the longer Learning Strategies Toolkit, a repository of many different tools that can be used and modified for the programmatic context.

Have a recommendation for a tool to share or content we can add to the site? Please share with us via the Suggestion Box!

EPA 1: Adapts	Expands or adapts skills and methods to meet community health and health care needs
EPA 2: Partners with community	Partners with the community to address challenges and barriers to health
EPA 3: Collaborates in health care	Collaborates across the health care system to improve health for all
EPA 4: Mentors	Mentor and invest in future rural/underserved health care professionals
EPA 5: Accountability and Transparency	Balances personal and community needs in a defined community context that demands accountability and transparency.
EPA 6: Dual relationships	Negotiates dual relationships with integrity and role fidelity
EPA 7: Resilience	Demonstrates the ability to face adversity and use difficult situations to grow personally and professionally and sustain wellness in concert with the community
EPA 8: Decolonizing Practices	Recognizes knowledge, power, and wisdom from people in the community.
EPA 9: Respect for Place	Incorporates ways of inhabiting a place into identity and health of self, patients, and communities.
EPA 10: Addressing Structural Inequities	Engages with community in anti-racist ways