Table 2. The final set of end-of-training entrustable professional activities (EPAs) for Nephrology fellowship training program in Saudi Arabia
EPA MeanRound 1 SD MeanRound 2 SD
A.       Clinical assessment        
  A1. Obtaining comprehensive history and performing physical examinations in patients with renal presentations. 4.9 0.2 5 0
  A2. Composing diagnostic approach and treatment plans for patients with renal diseases. 4.7 0 5 0
  A3. Applying basic medical knowledge in daily medical practice (including anatomy, physiology, immunology, pathology, genetics and laboratory medicine). 4.6 0.7 4.9 0.3
  A4. Demonstrating expertise in the indications for and interpretation of diagnostic tests relevant to the evaluation of patients with suspected or established renal diseases. 4.4 0.6 4.761 0.4
  A5. Interpreting laboratory results or data related to the administration and/or contraindication of immunomodulatory therapy. 4.7 0.6 4.76 0.4
  A6. Demonstrating expertise in the indications for and interpretation of imaging studies relevant to the evaluation of patients with suspected or established renal diseases. 4.47 0.7 4.71 0.5
  A7. Recognizing rare renal disease presentations. 3.9 0.9    
B.       Clinical Management        
  B1. Providing initial assessment and plan for investigation and management for patients with acute kidney disease or chronic kidney disease. 4.9 0.3 5 0
  B2. Composing initial assessment and plan for investigation and management for patients with complex fluid and electrolyte abnormalities. 4.9 0.2 4.9 0.3
  B3. Assessing and managing patients with hematuria and or proteinuria. 5 0 4.85 0.4
  B4. Triaging and proposing initial management of patients with emergency renal conditions. 4.8 0.4 4.95 0.2
  B5. Prescribing with proper adjustments of all modalities of renal replacement therapy. 4.8 0.4 4.85 0.4
  B6. Providing assessment and management plans for patients with acute or chronic complications of all modalities of renal replacement therapy. 4.7 0.4 4.9 0.3
  B7. Facilitating patients’ transition to an ESRD treatment modality, or to end of life care. 4.6 0.5 4.76 0.5
  B8. Applying longitudinal management for patients receiving chronic dialysis. 4.6 0.5 4.66 0.6
  B9. Providing pre- and post-operative care for renal transplant recipients with complicated and uncomplicated courses. 4.5 0.7 4.61 0.6
  B10. Providing assessment and management for patients with common complications of renal transplantation. 4.6 0.6 4.57 0.7
  B11. Assessing the suitability of deceased donors and potential living donors for kidney transplantation 4.4 0.9258201    
  B12. Assessing the eligibility of patients with renal disease for kidney transplantation. 4.5 0.7 4.8 0.4
  B13. Monitoring patients receiving immune modulating therapy and managing complications. 4.7 0.5 4.85 0.4
  B14. Integrating knowledge of the effects of pregnancy, pregnancy outcomes, renal disease, and its treatments in the care of women with renal disease. 4.7 0.4 4.8 0.4
  B15. Applying guidelines, evidence-based literature, and/or consensus treatment plans to the care of patients. 4.6 0.5 4.85 0.4
C.      Procedure        
  C1. Performing and interpreting the results the urine microscopy. 4.6 0.9 4.6 0.6
  C2. Performing the placement of hemodialysis catheters and the removal of tunneled, cuffed hemodialysis catheters. 4.3 0.9    
  C3. Performing native and transplant kidney biopsy. 3.4      
D.      Transferable skills        
  D1. Counselling patients and/or families regarding diagnosis and treatment plans for renal diseases. 4.7 0.5 4.95 0.2
  D2. Implementing the principles of quality assurance and patient safety. 4.3 0.7 4.76 0.5
  D3. Developing a personal learning plan for future practice and ongoing professional development. 4.6 0.6 4.57 0.7
  D4. Participating in and/or leading educational or administrative activities. 4.3 0.7 4.61 0.6
  D5. Delivering scholarly teaching to a variety of audiences, including peers, junior trainees and/or other health professionals. 4.3 0.7 4.52 0.7
  D6. Completing written documentation for patient care. 4.5 0.5 4.76 0.7
  D7. Managing a longitudinal clinic. 4.6 0.6 4.61 0.7
  D8. Working with the interprofessional team to coordinate the care of patients with renal diseases. 4.6 0.6 4.71 0.7
  D9. Monitoring one’s own practice and performance. 4.4 0.7 4.8 0.4
  D10. Critiquing and appraising current renal literatures. 4.5 0.6 4.47 0.7
  D11. Demonstrating professional consultancy skills utilizing resources and considering other specialties. 4.5 0.6 4.61 0.7
  D12. Promoting health in response to society needs. 4.1 0.9    
  D13. Providing/recommending appropriate referrals to other health care providers necessary for adjunctive evaluation and/or management. 4.6 0.5 4.71 0.5
  D14. Providing consultative care for patients with known renal disease admitted with other medical or surgical problems. 4.6 0.5 4.76 0.5

EPA= Entrustable Professional Activities; SD= Standard Deviation; ESKD= End Stage Kidney Disease; The EPAs in red color were removed.

Int J Med Educ. 2025; 16:92-99; doi: 10.5116/ijme.6819.d7ce