The authors provide an introduction to e-learning and its role in medical education by outlining key terms, the components of e-learning, the evidence for its effectiveness, faculty development needs for implementation, evaluation strategies for e-learning and its technology, and how e-learning might be considered evidence of academic scholarship. E-learning is the use of Internet technologies to enhance knowledge and performance. E-learning technologies offer learners control over content, learning sequence, pace of learning, time, and often media, allowing them to tailor their experiences to meet their personal learning objectives. In diverse medical education contexts, e-learning appears to be at least as effective as traditional instructor-led methods such as lectures. Students do not see e-learning as replacing traditional instructor-led training but as a complement to it, forming part of a blended-learning strategy. A developing infrastructure to support e-learning within medical education includes repositories, or digital libraries, to manage access to e-learning materials, consensus on technical standardization, and methods for peer review of these resources. E-learning presents numerous research opportunities for faculty, along with continuing challenges for documenting

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The impact of E-learning in medical education.

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.

/pdf/competency-based-medical-education-theory-to-practice-2vj42r6ovw.pdf

Competency-based medical education: theory to practice.

This article in the Medical Education series provides a conceptual framework for and a brief update on commonly used and emerging methods of assessment, discusses the strengths and limitations of each method, and identifies several major challenges in assessing professional competence and performance.

/pdf/assessment-in-medical-education-dq8lacehvd.pdf

Assessment in Medical Education

The introduction of competency-based postgraduate medical training, as recently stimulated by national governing bodies in Canada, the United States, the United Kingdom, The Netherlands, and other countries, is a major advancement, but at the same time it evokes critical issues of curricular implementation. A source of concern is the translation of general competencies into the practice of clinical teaching. The authors observe confusion around the term competency, which may have adverse effects when a teaching and assessment program is to be designed. This article aims to clarify the competency terminology. To connect the ideas behind a competency framework with the work environment of patient care, the authors propose to analyze the critical activities of professional practice and relate these to predetermined competencies. The use of entrustable professional activities (EPAs) and statements of awarded responsibility (STARs) may bridge a potential gap between the theory of competency-based education and clinical practice. EPAs reflect those activities that together constitute the profession. Carrying out most of these EPAs requires the possession of several competencies. The authors propose not to go to great lengths to assess competencies as such, in the way they are abstractly defined in competency frameworks but, instead, to focus on the observation of concrete critical clinical activities and to infer the presence of multiple competencies from several observed activities. Residents may then be awarded responsibility for EPAs. This can serve to move toward competencybased training, in which a flexible length of training is possible and the outcome of training becomes more important than its length.

/pdf/viewpoint-competency-based-postgraduate-training-can-we-24bcao9e2k.pdf

Viewpoint: Competency-Based Postgraduate Training: Can We Bridge the Gap between Theory and Clinical Practice?

The task of developing a new questionnaire or translating an existing questionnaire into a different language might be overwhelming. The greatest challenge perhaps is to come up with a questionnaire that is psychometrically sound, and is efficient and effective for use in research and clinical settings. This article provides guidelines for the development and translation of questionnaires for application in medical fields, with a special emphasis on perioperative and pain medicine. We provide a framework to guide researchers through the various stages of questionnaire development and translation. To ensure that the questionnaires are psychometrically sound, we present a number of statistical methods to assess the reliability and validity of the questionnaires.

Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine

# Competency based medical training: review {#article-title-2}

The competency approach has become prominent at most stages of undergraduate and postgraduate medical training in many countries. In the United Kingdom, for example, it forms part of the performance procedures of the General Medical Council (GMC),1 underpins objectively structured clinical examinations (OSCEs) and records of in-training assessment (RITA), and has been advocated for the selection of registrars in general practice and interviews. 2 3 It has become central to the professional lives of all doctors and is treated as if it were a panacea—but there is little consensus among trainees, trainers, and committees on what this approach entails.

I aim to explore the origins and development of the competency approach, evaluate its current role in medical training, and discuss its strengths and limitations.

#### Summary points

The competency approach did not result directly from recent scandals of incompetent doctors. It originated from parallel developments in vocational training in many countries, such as the national qualifications framework in New Zealand, the national training board in Australia, the national skills standards initiative in the United States, and the national vocational qualifications (NVQs) in the United Kingdom.4 This movement was driven largely by the political perceived need to make the national workforce more competitive in the …

https://www.bmj.com/content/bmj/325/7366/693.full.pdf

Competency based medical training: review

Wai-Ching Leung has some practical advice on questionnaires

How to design a questionnaire

Wai-Ching Leung explains how to conduct a good survey

Conducting a survey

The recent implementation of the Human Rights Act 1998 has important implications for UK psychiatric practice but previous studies have demonstrated that psychiatrists generally have poor knowledge of mental health law. The aims of this study were to assess psychiatrists' knowledge of the Human Rights Act and to examine whether knowledge is related to seniority or experience. Questionnaires were sent to 154 psychiatrists in the Northern Region, testing both their factual knowledge of the Human Rights Act and their ability to apply it to clinical scenarios. Ninety-six psychiatrists responded and they demonstrated good overall knowledge and ability to apply the Human Rights Act. However, half of the respondents were not aware that the Act only imposes a duty on public authorities and that a lack of active treatment in itself does not constitute a breach of the Act. Specialist registrars and consultants scored significantly higher than SHOs but there was no significant difference between the specialist registrars and consultants. The scores of psychiatrists who had detained at least one patient under the Mental Health Act 1983 over the last six months were significantly higher than those who had not. The implications of these findings are discussed. There is still a need for further training on relevant aspects of the Human Rights Act.

Psychiatrists' knowledge of the Human Rights Act and its relevance to mental health practice: a questionnaire survey.

Wai-Ching Leung helps you to decide by discussing the evidence

Wai-Ching Leung

Papers

Competency based medical training: review

How to design a questionnaire

Conducting a survey

Psychiatrists' knowledge of the Human Rights Act and its relevance to mental health practice: a questionnaire survey.

Is studying for an intercalated degree a wise career move