Theme	Subtheme	Meaning Unit	Summary of Meaning
Challenges in Implementing EPAs	Demanding Workload	Inability to Provide Immediate Feedback	Instructors may be unable to provide timely feedback to residents due to their heavy workload, leading to the potential loss of critical learning opportunities, as the rationale behind clinical decisions may be forgotten.
			Allocating sufficient time for feedback is essential, yet challenging, especially in high-volume clinical settings where patient care demands often take precedence.
		Demanding Workload	Teaching responsibilities can only be effectively carried out when the workload is manageable and the instructor is mentally prepared and focused.
			Balancing teaching duties with clinical responsibilities requires significant additional time and cognitive effort, which can contribute to instructor fatigue and reduce the overall quality of teaching.

Int J Med Educ. 2025; 16:128-137; doi: 10.5116/ijme.687b.7d22