ENTRUSTABLE PROFESSIONAL ACTIVITIES IN COMPETENCY-BASED MEDICAL EDUCATION: ADVANCES, CHALLENGES, AND FUTURE PERSPECTIVES
Background: Competency-Based Medical Education (CBME) has transformed medical education by shifting the focus from time-based training to the progressive development of observable competencies. Within this framework, Entrustable Professional Activities (EPAs) have emerged as an effective strategy for translating competencies into authentic professional tasks that support learner assessment and progressive clinical autonomy. However, evidence regarding their implementation and educational impact remains fragmented. Objective: To analyze the scientific evidence on the use of Entrustable Professional Activities (EPAs) in Competency-Based Medical Education, highlighting their educational contributions, implementation challenges, and implications for contemporary medical education. Methods: An integrative literature review was conducted following the principles of Evidence-Based Practice. The review question was developed using the PICo framework. Searches were performed in PubMed/MEDLINE, Scopus, Web of Science, and ERIC for studies published between 2020 and 2026. Data were extracted using a standardized instrument, methodological quality was characterized according to the Joanna Briggs Institute Levels of Evidence, and findings were synthesized through interpretive thematic analysis. Results: The included studies demonstrated that EPAs have become a key framework for operationalizing CBME across undergraduate medical education, clerkships, residency training, and faculty development. EPAs strengthen performance-based assessment, clinical supervision, longitudinal feedback, and entrustment decisions related to learner progression. Nevertheless, successful implementation requires sustained faculty development, standardized assessment practices, curricular integration, and institutional support. Conclusions: EPAs represent a paradigm shift in medical education by aligning competency development with authentic clinical practice. Their integration into programmatic assessment, continuous feedback, and competency-based curricula can strengthen educational decision-making and support the preparation of competent, reflective physicians capable of meeting contemporary healthcare needs.