Although competency-based medical education (CBME) has attracted renewed interest in recent years among educators and policy-makers in the health care professions, there is little agreement on many aspects of this paradigm. We convened a unique partnership – the International CBME Collaborators – to examine conceptual issues and current debates in CBME. We engaged in a multi-stage group process and held a consensus conference with the aim of reviewing the scholarly literature of competency-based medical education, identifying controversies in need of clarification, proposing definitions and concepts that could be useful to educators across many jurisdictions, and exploring future directions for this approach to preparing health professionals. In this paper, we describe the evolution of CBME from the outcomes movement in the 20th century to a renewed approach that, focused on accountability and curricular outcomes and organized around competencies, promotes greater learner-centredness and de-emphasizes time-based curricular design. In this paradigm, competence and related terms are redefined to emphasize their multi-dimensional, dynamic, developmental, and contextual nature. CBME therefore has significant implications for the planning of medical curricula and will have an important impact in reshaping the enterprise of medical education. We elaborate on this emerging CBME approach and its related concepts, and invite medical educators everywhere to enter into further dialogue about the promise and the potential perils of competency-based medical curricula for the 21st century.

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Competency-based medical education: theory to practice.

The Bologna Declaration The Bologna Declaration of June 1999 calls for the establishment by 2010 of a coherent, compatible and competitive European Higher Educatio n Area, attractive for European students and for students and scholars from other c ontinents. The European Education Ministers identified six action lines in Bologna an d they have added three more in Prague in May 2001 and one more in Berlin in September 2003:

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Tuning Educational Structures in Europe

In educational contexts, understanding the student’s learning must take account of the student’s construction of reality. Reality as experienced by the student has an important additional value. This assumption also applies to a student’s perception of evaluation and assessment. Students’ study behaviour is not only determined by the examination or assessment modes that are used. Students’ perceptions about evaluation methods also play a significant role. This review aims to examine evaluation and assessment from the student’s point of view. Research findings reveal that students’ perceptions about assessment significantly influence their approaches to learning and studying. Conversely, students’ approaches to study influence the ways in which they perceive evaluation and assessment. Findings suggest that students hold strong views about different assessment and evaluation formats. In this respect students favour multiple‐choice format exams to essay type questions. However, when compared with more innova...

/pdf/students-perceptions-about-evaluation-and-assessment-in-3nhhibpv94.pdf

Students' Perceptions about Evaluation and Assessment in Higher Education: A Review.

Introduction: In recent years, the use of portfolios as learning and assessment tools has become more widespread across the range of health professions. Whilst a growing body of literature has acco...

The educational effects of portfolios on undergraduate student learning: A Best Evidence Medical Education (BEME) systematic review. BEME Guide No. 11

Although health professions worldwide are shifting to competency-based education, no common taxonomy for domains of competence and specific competencies currently exists. In this article, the authors describe their work to (1) identify domains of competence that could accommodate any health care profession and (2) extract a common set of competencies for physicians from existing health professions’ competency frameworks that would be robust enough to provide a single, relevant infrastructure for curricular resources in the Association of American Medical Colleges’ (AAMC’s) MedEdPORTAL and Curriculum Inventory and Reports (CIR) sites. The authors used the Accreditation Council for Graduate Medical Education (ACGME)/American Board of Medical Specialties six domains of competence and 36 competencies delineated by the ACGME as their foundational reference list. They added two domains described by other groups after the original six domains were introduced: Interprofessional Collaboration (4 competencies) and Personal and Professional Development (8 competencies). They compared the expanded reference list (48 competencies within eight domains) with 153 competency lists from across the medical education continuum, physician specialties and subspecialties, countries, and health care professions. Comparison analysis led them to add 13 “new” competencies and to conflate 6 competencies into 3 to eliminate redundancy.

/pdf/toward-a-common-taxonomy-of-competency-domains-for-the-22r0xu0tsz.pdf

Toward a common taxonomy of competency domains for the health professions and competencies for physicians.

This paper describes a set of learning outcomes that clearly define the abilities of medical graduates from any of the five Scottish medical schools. The outcomes are divided into 12 domains that fit into one of three essential elements for the competent and reflective medical practitioner.

https://medu.au.dk/fileadmin/www.medu.au.dk/uddannelse/undervisningsudvikling/studiereform/baggrundspapirer/thescottishdoctor.pdf

The Scottish doctor--learning outcomes for the medical undergraduate in Scotland: a foundation for competent and reflective practitioners

This guide is intended to inform medical teachers about the use of portfolios for student assessment. It provides a background to the topic, reviews the range of assessment purposes for which portf...

M. Friedman Ben David

Papers

The Scottish doctor--learning outcomes for the medical undergraduate in Scotland: a foundation for competent and reflective practitioners

AMEE Medical Education Guide No. 24: Portfolios as a method of student assessment