Conceptualization of Competency-Based Medical Education Terminology in Family Medicine Postgraduate Medical Education and Continuing Professional Development: A Scoping Review

BACKGROUND AND OBJECTIVES: While family medicine has been one of the first specialties to implement competency-based medical education (CBME) in residency, the nature and level of its integration with continuing professional development (CPD) is neither well understood nor well studied. The purpose of this review was to examine the current state of CBME implementation in family medicine residency and CPD programs in the North American education literature, with the aim of identifying implementation concepts and strategies that are generalizable to other medical settings to inform the design and implementation of residency training and CPD. METHODS: Using an Arksey and O’Malley six-step framework, we searched five online databases and the gray literature over the period between January 2000 through April 2017. We included full-text articles that focused on the key words CBME, residency, CPD, and family medicine. RESULTS: Of the articles reviewed, 37 met the inclusion criteria and were selected for full review. Eighty six percent of included articles focused on foundation elements related to designing competency-based curriculum and assessment strategies rather than program evaluation or other outcome measures. Only 19% of the articles were related to CPD that focused only on the implementation at the program and/or institution/organization levels. CONCLUSIONS: Given that the implementation of CBME is in its relative infancy, the pattern of implementation activities described in this scoping review reflected a limited focus on a broad range of issues related to fidelity of implementation of this complex intervention.

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Implementing Competency-Based Medical Education in Family Medicine: A Narrative Review of Current Trends in Assessment

Family Medicine ◽

10.22454/fammed.2021.453158 ◽

2021 ◽

Vol 53 (1) ◽

pp. 9-22

Author(s):

Natalia Danilovich ◽

Simon Kitto ◽

David W. Price ◽

Craig Campbell ◽

Amanda Hodgson ◽

...

Keyword(s):

Medical Education ◽

Family Medicine ◽

Thematic Analysis ◽

Evaluation Studies ◽

Continuing Professional Development ◽

Assessment Methods ◽

Integrated System ◽

Narrative Review ◽

Competency Based Medical Education ◽

Competency Based

Background and Objectives: The implementation of effective competency-based medical education (CBME) relies on building a coherent and integrated system of assessment across the continuum of training to practice. As such, the developmental progression of competencies must be assessed at all stages of the learning process, including continuing professional development (CPD). Yet, much of the recent discussion revolves mostly around residency programs. The purpose of this review is to synthesize the findings of studies spanning the last 2 decades that examined competency-based assessment methods used in family medicine residency and CPD, and to identify gaps in their current practices. Methods: We adopted a modified form of narrative review and searched five online databases and the gray literature for articles published between 2000 and 2020. Data analysis involved mixed methods including quantitative frequency analysis and qualitative thematic analysis. Results: Thirty-seven studies met inclusion criteria. Fourteen were formal evaluation studies that focused on the outcome and impact evaluation of assessment methods. Articles that focused on formative assessment were prevalent. The most common levels of educational outcomes were performance and competence. There were few studies on CBME assessment among practicing family physicians. Thematic analysis of the literature identified several challenges the family medicine educational community faces with CBME assessment. Conclusions: We recommend that those involved in health education systematically evaluate and publish their CBME activities, including assessment-related content and evaluations. The highlighted themes may offer insights into ways in which current CBME assessment practices might be improved to align with efforts to improve health care.’

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Competency-based medical education and continuing professional development: A conceptualization for change

Medical Teacher ◽

10.1080/0142159x.2017.1315064 ◽

2017 ◽

Vol 39 (6) ◽

pp. 617-622 ◽

Cited By ~ 21

Author(s):

Jocelyn Lockyer ◽

Ford Bursey ◽

Denyse Richardson ◽

Jason R. Frank ◽

Linda Snell ◽

...

Keyword(s):

Professional Development ◽

Medical Education ◽

Continuing Professional Development ◽

Competency Based Medical Education ◽

Competency Based

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Competency-based medical education in postgraduate medical education

Medical Teacher ◽

10.3109/0142159x.2010.500709 ◽

2010 ◽

Vol 32 (8) ◽

pp. 651-656 ◽

Cited By ~ 207

Author(s):

William F. Iobst ◽

Jonathan Sherbino ◽

Olle Ten Cate ◽

Denyse L. Richardson ◽

Deepak Dath ◽

...

Keyword(s):

Medical Education ◽

Postgraduate Medical Education ◽

Competency Based Medical Education ◽

Competency Based

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Analyzing the Administrative Burden of Competency Based Medical Education

Canadian Association of Radiologists Journal ◽

10.1177/08465371211038963 ◽

2021 ◽

pp. 084653712110389

Author(s):

Kevin Cheung ◽

Christina Rogoza ◽

Andrew D. Chung ◽

Benjamin Yin Ming Kwan

Keyword(s):

Medical Education ◽

Postgraduate Medical Education ◽

Assessment Process ◽

Full Time ◽

Equal Distribution ◽

Competency Based Medical Education ◽

Quantitative Evidence ◽

Administrative Burden ◽

Professional Activities ◽

Competency Based

Purpose: Postgraduate residency programs in Canada are transitioning to a competency-based medical education (CBME) system. Within this system, resident performance is documented through frequent assessments that provide continual feedback and guidance for resident progression. An area of concern is the perception by faculty of added administrative burden imposed by the frequent evaluations. This study investigated the time spent in the documentation and submission of required assessment forms through analysis of quantitative data from the Queen’s University Diagnostic Radiology program. Methods and Materials: Data regarding time taken to complete Entrustable Professional Activities (EPA) assessments was collected from 24 full-time and part-time radiologists over a period of 18 months. This data was analyzed using SPSS to determine mean time of completion by individuals, departments, and by experience with the assessment process. Results: The average time taken to complete an EPA assessment form was 3 minutes and 6 seconds. Assuming 3 completed EPA assessment forms per week for each resident (n = 12) and equal distribution among all staff, this averaged out to an additional 18 minutes of administrative burden per staff member over a 4 week block. Conclusions: This study investigated the perception by faculty of additional administrative burden for assessment in the CBME framework. The data provided quantitative evidence of administrative burden for the documentation and submission of assessments. The data indicated that the added administrative burden may be reasonable given mandate for CBME implementation and the advantages of adoption for postgraduate medical education.

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Continuing Professional Development for Doctors in Pakistan is need of the hour

Health Professions Educator Journal ◽

10.53708/hpej.v3i1.714 ◽

2020 ◽

Vol 3 (1) ◽

pp. 7-8

Author(s):

Ahsan Sethi ◽

Gohar Wajid

Keyword(s):

Professional Development ◽

Medical Education ◽

Health Professionals ◽

Postgraduate Medical Education ◽

National Level ◽

Continuing Professional Development ◽

Extended Period ◽

Regulatory Compliance ◽

New Drugs ◽

World Federation

In Pakistan, health professionals get their professional undergraduate and postgraduate qualifications after thorough training and assessment criteria as defined by their respective national regulatory bodies. These qualifications help them get registered and get a license for clinical practice in their respective domains. Any registrations and licenses are renewed by paying the prescribed fee without any requirements for reassessment or recertifications. Over the last few decades, health sciences have shown rapid advancements with the invention of new drugs and technologies. Due to this exponential increase in knowledge, no practitioner can hope to remain competent for more than a few years after graduation without a program of active learning. As such, a well-structured and regulated program of lifelong learning must be followed by all health professionals. To keep health professionals abreast with these changes and to ensure the maintenance of certain minimum competencies, there is a need for Continuing Professional Development (CPD) to be implemented at the national level with strict regulatory compliance. According to World Federation for Medical Education (World Federation for Medical Education, 2015), Continuing Professional Development (CPD) is a process of education and training commencing after completion of basic and postgraduate medical education, thereafter, continuing as long as the health professional is engaged in professional activities. CPD mainly implies self-directed and practice-based learning activities in addition to supervised education, and rarely involves supervised training for an extended period of time. The terms ‘Continuing Medical Education (CME)’ and ‘Continuing Professional Development (CPD)’ are often used synonymously.

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Towards a shared mental model of progressive competence in postgraduate medical education

Canadian Medical Education Journal ◽

10.36834/cmej.43389 ◽

2018 ◽

Vol 9 (3) ◽

pp. e115-118

Author(s):

Eric Prost

Keyword(s):

Medical Education ◽

Mental Model ◽

Postgraduate Medical Education ◽

Competency Based Medical Education ◽

Shared Mental Model ◽

Competency Based ◽

The Military ◽

Postgraduate Medicine

Many professions have hierarchies and a promotion structure. Postgraduate medicine has a tradition of promoting residents based on time spent in a certain specialty. The military, too, may promote its personnel based on factors other than just merit. Both professions have been criticized for divorcing competence from promotion. While Competency-Based Medical Education (CBME) partly solves this problem in medicine, many models of CBME, including the Canadian one, retain distinct stages of training. We urgently need a shared mental model of what a learner in each stage looks like. Some models have been proposed but fall short.

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From prescription to guidance: a European framework for generic competencies

Advances in Health Sciences Education ◽

10.1007/s10459-019-09910-8 ◽

2019 ◽

Vol 25 (1) ◽

pp. 173-187 ◽

Cited By ~ 1

Author(s):

Jessica E. van der Aa ◽

Anna J. M. Aabakke ◽

Betina Ristorp Andersen ◽

Annette Settnes ◽

Peter Hornnes ◽

...

Keyword(s):

Medical Education ◽

Change Management ◽

Postgraduate Medical Education ◽

Competency Framework ◽

Competency Based Medical Education ◽

Generic Competencies ◽

Obstetrics And Gynaecology ◽

Competency Based ◽

Hospital Boards ◽

Management Theories

Abstract In postgraduate medical education, required competencies are described in detail in existing competency frameworks. This study proposes an alternative strategy for competency-based medical education design, which is supported by change management theories. We demonstrate the value of allowing room for re-invention and creative adaptation of innovations. This new strategy was explored for the development of a new generic competency framework for a harmonised European curriculum in Obstetrics and Gynaecology. The generic competency framework was developed through action research. Data were collected by four European stakeholder groups (patients, nurses, midwives and hospital boards), using a variety of methods. Subsequently, the data were analysed further in consensus discussions with European specialists and trainees in Obstetrics and Gynaecology. These discussions ensured that the framework provides guidance, is specialty-specific, and that implementation in all European countries could be feasible. The presented generic competency framework identifies four domains: ‘Patient-centred care’, ‘Teamwork’, ‘System-based practice’ and ‘Personal and professional development’. For each of these four domains, guiding competencies were defined. The new generic competency framework is supported by European specialists and trainees in Obstetrics and Gynaecology, as well as by their European stakeholders. According to change management theories, it seems vital to allow room for re-invention and creative adaptation of the competency framework by medical professionals. Therefore, the generic competency framework offers guidance rather than prescription. The presented strategy for competency framework development offers leads for implementation of competency-based medical education as well as for development of innovations in postgraduate medical education in general.

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Electronic portfolios for assessment in your postgraduate medical education program: essential questions to ask when selecting a platform for competency-based medical education (CBME)

MedEdPublish ◽

10.15694/mep.2017.000066 ◽

2017 ◽

Vol 6 (2) ◽

Cited By ~ 1

Author(s):

Lyn Kathryn Sonnenberg ◽

Patrick von Hauff ◽

Lisa Lemieux

Keyword(s):

Medical Education ◽

Education Program ◽

Postgraduate Medical Education ◽

Electronic Portfolios ◽

Competency Based Medical Education ◽

Medical Education Program ◽

Essential Questions ◽

Competency Based

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Resident evaluations in the age of competency-based medical education: faculty perspectives on minimizing burdens

Journal of Neurosurgery ◽

10.3171/2020.7.jns201688 ◽

2020 ◽

pp. 1-6

Author(s):

Jessica E. Rabski ◽

Ashirbani Saha ◽

Michael D. Cusimano

Keyword(s):

Medical Education ◽

Mobile Application ◽

Postgraduate Medical Education ◽

Professional Activity ◽

Successful Implementation ◽

Neurosurgical Training ◽

Complete Evaluation ◽

Competency Based Medical Education ◽

Main Challenge ◽

Competency Based

OBJECTIVECompetency-based medical education (CBME), an outcomes-based approach to medical education, continues to be implemented across many postgraduate medical education programs worldwide, including a recent introduction into Canadian neurosurgical training programs (July 2019). The success of this educational paradigm shift requires frequent faculty observation and evaluation of residents performing defined tasks of the specialty. A main challenge involves providing residents with frequent performance evaluations and feedback that are feasible for faculty to complete. This study aims to define what is currently happening and what changes are needed to make CBME successful for the certification of neurosurgeons’ competence.METHODSA 55-item questionnaire was emailed nationwide to survey Canadian neurosurgical faculty.RESULTSFifty-two complete responses were received and achieved a distribution highly correlated with the number of faculty neurosurgeons practicing in each Canadian province (Pearson’s r = 0.94). Two-thirds (35/52) of faculty reported currently taking a median of 10 minutes to complete evaluation forms at the end of a resident’s rotation block. Regardless of the faculty’s province of practice (p = 0.50) or years of experience (p = 0.06), they reported 3 minutes (minimum 1 minute, maximum 10 minutes, interquartile range [IQR] 3 minutes) as a feasible amount of time to spend completing an evaluation form following an observation of a resident’s performance of an entrustable professional activity (EPA). If evaluation forms took 3 minutes to complete, 85% of respondents (44/52) would complete EPA evaluations weekly or daily. The faculty recommended 5 minutes as a feasible amount of time to provide oral feedback (minimum 1 minute, maximum 20 minutes, IQR 3.25 minutes), which was significantly higher (p = 0.00099) than their recommended amount of time for completing evaluation forms. The majority of faculty (71%) stated they would prefer to access resident evaluation forms through a mobile application compared to a paper form (12%), an evaluation website (8%), or through a URL link sent via email (10%; p = 0.0032).CONCLUSIONSTo facilitate the successful implementation of CBME into a neurosurgical training curriculum, resident EPA assessment forms should take 3 minutes or less to complete and be accessible through a mobile application.

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