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Background: Entrustable Professional Activities (EPAs) have emerged as a new approach to operationalise the workplace performance expectations for the transition from under- to postgraduate medical training. However, the transferability of such EPAs from one context to another appears limited. In this article, we report on the results of our approach to define a full set of core EPAs for entry into residency with the expectation to be performed under distant supervision. Methods: The EPA development involved a modified, three round Delphi study, conducted at the Charité – Universitätsmedizin Berlin. The supervision level was operationalised as supervisor being distantly available and findings being reviewed. The threshold for consent was reaching a content validity index of a least 80%. The Delphi study involved experienced physicians (n=45) and resulted in a set of core EPAs with the descriptions of the categories: title, specification/limitations, conditions and implications of entrustment decision, knowledge, skills, and attitude, link to competencies and assessment sources. Results: The response rates were 76-80% in the Delphi rounds. Key to the content validation process for the performance expectation was deciding on “to act under distant supervision”. The results are full descriptions of 12 core EPAs, organised into 5 overarching EPA domains. Conclusions: Our systematic approach yielded the definition of 12 core EPAs for entry into residency at the level of “act with distant supervision” according to the practice in our context. This report may support other medical schools who plan to implement EPAs into their curricula.

[english] Introduction: Encouraged by the change in licensing regulations the practical professional skills in Germany received a higher priority and are taught in medical schools therefore increasingly. This created the need to standardize the process more and more. On the initiative of the German skills labs the German Medical Association Committee for practical skills was established and developed a competency-based catalogue of learning objectives, whose origin and structure is described here.Goal of the catalogue is to define the practical skills in undergraduate medical education and to give the medical schools a rational planning basis for the necessary resources to teach them.Methods: Building on already existing German catalogues of learning objectives a multi-iterative process of condensation was performed, which corresponds to the development of S1 guidelines, in order to get a broad professional and political support.Results: 289 different practical learning goals were identified and assigned to twelve different organ systems with three overlapping areas to other fields of expertise and one area of across organ system skills. They were three depths and three different chronological dimensions assigned and the objectives were matched with the Swiss and the Austrian equivalent.Discussion: This consensus statement may provide the German faculties with a basis for planning the teaching of practical skills and is an important step towards a national standard of medical learning objectives.Looking ahead: The consensus statement may have a formative effect on the medical schools to teach practical skills and plan the resources accordingly.[german] Einleitung: Angestoßen durch die Änderung der Approbationsordnung haben die berufspraktischen Kompetenzen in Deutschland eine höhere Priorität erhalten und werden in den medizinischen Fakultäten deswegen vermehrt vermittelt. Dadurch entstand die Notwendigkeit, den Prozess mehr und mehr zu standardisieren. Auf Initiative der deutschsprachigen Skills Labs wurde der GMA-Ausschuss für praktische Fertigkeiten gegründet, der einen kompetenzbasierten Lernzielkatalog entwickelte, dessen Entstehung und Struktur hier beschrieben wird.Ziel des Kataloges ist es, die praktischen Fertigkeiten im Medizinstudium zu definieren und damit den Fakultäten eine rationale Planungsgrundlage für die zur Vermittlung praktischer Fertigkeiten notwendigen Ressourcen zu geben.Methodik: Aufbauend auf schon vorhandenen deutschsprachigen Lernzielkatalogen wurde mittels einem mehrfach iterativem Kondensationsprozesses, der der Erarbeitung von S1-Leitlinien entspricht, vorgegangen, um eine breite fachliche und politische Abstützung zu erhalten. Ergebnisse: Es wurden 289 verschiedene praktische Lernziele identifiziert, die zwölf verschiedenen Organsystemen, drei Grenzbereichen zu anderen Kompetenzbereichen und einem Bereich mit organsystemübergreifenden Fertigkeiten zugeordnet. Sie wurden drei verschiedenen zeitlichen und drei verschiedenen Tiefendimensionen zugeordnet und mit dem Schweizer und dem Österreichischem Pendant abgeglichen. Diskussion: Das vorliegende Konsensusstatement kann den deutschen Fakultäten eine Grundlage zur Planung der Vermittlung praktischer Fertigkeiten bieten und bildet einen wichtigen Schritt zu einem nationalen Standard medizinischer Lernziele.Blick in die Zukunft: Das Konsensusstatement soll einen formativen Effekt auf die medizinischen Fakultäten haben, ihre praktischen Unterrichtsinhalte entsprechend zu vermitteln und die Ressourcen danach zu planen.