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Transforming Medical Training: Perspectives on Competency-Based Education

Transforming Medical Training: Perspectives on Competency-Based Education 1024 557 Madison Storm

The alternative approach would move away from traditional time-based education to a more flexible, competency-focused approach.

Imagine a world where medical education is tailored to each student’s pace and learning style, ensuring every graduate is fully competent in real-world clinical settings.

A recent perspective piece, published in Current Problems in Pediatric and Adolescent Health Care, dives into the advantages and potential challenges of evaluating medical trainees using Competency-Based Medical Education (CBME) from the perspectives of learners, faculty and program leaders.

“Competency-based medical education is a new paradigm of thinking about how we do medical education,” says Debra Boyer, MD, MHPE, chief medical education officer, designated institutional official and transplant pulmonologist at Nationwide Children’s Hospital and senior author of the publication.

CBME emphasizes the achievement of specific competencies, which are observable and measurable abilities that learners must demonstrate. The goal is to produce physicians who are both knowledgeable and proficient in applying their knowledge in real-world clinical settings.

Currently in the United States, medical training uses a time-based progression standard. Some countries though, such as the Netherlands, have moved more toward competency-based medical education. One pilot study in the U.S., Education and Pediatrics Across the Continuum (EPAC) is using CBME to teach and assess learners, resulting in positive feedback thus far. Pilot studies like this help to develop a stronger growth mindset among medical trainees.

“By getting all of this feedback, the trainees felt like they had really developed that [growth mindset] early on and were comfortable seeking feedback, which is one of the goals of CBME,” Dr. Boyer says.

One of the key advantages of CBME is its flexibility. Unlike traditional medical education, which often follows a rigid timeline, CBME allows learners to progress at their own pace. This means that students can advance once they demonstrate mastery of a competency, rather than waiting for a predetermined period to pass.

Implementation of CBME would require a robust assessment system and a strong balance between competency and experience. Dr. Boyer discusses ways to overcome these hurdles, such as giving residents more independence in work duties once deemed competent.

“If you’re going to do a competency-based system, things are going to look different,” Dr. Boyer says. “I think we have to culturally change that expectation that everything has to be the same and acknowledge that we all require different things.”

Dr. Boyer and the pulmonary team are developing and working to implement entrustable professional activities, a component of CMBE, in the residency and fellowship programs at Nationwide Children’s, noting that these concepts are much easier for people to understand than the more ambiguous Milestones assessment.

“I think we’re doing well, but we could do a lot better. We could develop our learners into even better physicians and help them develop that lifelong learning skill with
CBME,” Dr. Boyer says.

 

Reference:

Card A, Daniels G, Bluth P, Chiel L, Herman B, O’Connor M, Plevinsky J, Boyer D. Competency-based medical education (CBME) in graduate medical education: Perspectives from learners, faculty and program leaders. Current Problems in Pediatrics and Adolescent Health Care. 2024;54(10);101677

Image credit: Adobe Stock

About the author

Senior Strategist, Research Communications | Website

Madison Storm is the Senior Strategist of Research Communications at Nationwide Children's Hospital. She earned her bachelor's in multimedia journalism from Virginia Tech in 2021 and went on to achieve her master's in health communication from Johns Hopkins University in 2023. Her passion for transforming the complex to clear is supported by various experiences writing for consumer audiences.

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