Supplementary Material for: Establishing an EPA-based curriculum for postgraduate respiratory medicine training: a national consensus process

Introduction Postgraduate training in adult respiratory medicine in Switzerland has traditionally relied on fixed training times and procedural numbers. In line with Competency-Based Medical Education (CBME), the Swiss Society of Pneumology (SGP/SSP) initiated the development of an Entrustable Professional Activities (EPA)-based curriculum to better align training with clinical practice and outcomes. Methods In 2023, the SGP Postgraduate Training Commission formed a multidisciplinary working group representing all Swiss linguistic regions and training centre types. Through a structured consensus process - including literature review, iterative consensus meetings using a modified Delphi process, and coaching by the Swiss Institute for Medical Education (SIME/SIWF/ISFM) - a national EPA list was created. All EPAs have been elaborated using the EQual rubric as a quality standard. Final approval was granted by the SGP and SIME in 2025. Discussion The novel EPA-based curriculum represents a shift from time- and numbers-based requirements to competency-oriented postgraduate education in adult respiratory medicine. We describe the development process, conceptual framework, and key lessons learned. By integrating programmatic assessment and EPAs with frequent workplace-based assessments it aims to enhance feedback culture, entrustment decisions, and individualized learning, providing a model for other national training programs and specialties adopting CBME.

引言 瑞士成人呼吸内科住院医师培训传统上以固定培训时长与操作例数为考核依据。为契合以胜任力为导向的医学教育（Competency-Based Medical Education, CBME）理念，瑞士呼吸病学会（Swiss Society of Pneumology, SGP/SSP）启动了基于可授权专业活动（Entrustable Professional Activities, EPA）的培训课程开发工作，旨在让培训更贴合临床实践与诊疗结局。

方法 2023年，瑞士呼吸病学会住院医师培训委员会组建多学科工作组，覆盖瑞士所有语言区域与各类培训中心。通过包含文献综述、改良德尔菲法迭代共识会议、瑞士医学教育研究所（Swiss Institute for Medical Education, SIME/SIWF/ISFM）专业指导在内的结构化共识流程，最终制定了国家级EPA清单。所有EPA均以EQual评分量表作为质量规范完成细化，并于2025年获瑞士呼吸病学会与瑞士医学教育研究所最终审定通过。

讨论 这套全新的EPA导向型培训课程，标志着瑞士成人呼吸内科住院医师培训从基于时长与例数的要求，转向以胜任力为核心的毕业后医学教育模式。本文阐述了该课程的开发流程、概念框架与核心经验总结。通过将项目式评估与EPA结合高频基于工作场所的评估，该课程旨在优化反馈文化、完善授权决策机制、推进个性化学习，可为其他采用CBME理念的国家级培训项目与专科领域提供参考范式。