Competency-based Medical Education: Philosophy, What, How, Why, and the Challenges Therein

Francis I. Achike ； Shaheen E. Lakhan ； Mohsin Yakub

《Journal of Medical Education》 23卷1期 (2019/03) Pp. 1-13

https://doi.org/10.6145/jme.201903_23(1).0006

摘要

Regulatory bodies worldwide have observed unacceptable levels of competence deficit among resident physicians. This has prompted their championing of competency-based medical education (CBME), an outcome-based paradigm that is compatible with self-directed, life-long learning philosophy and focuses on graduate competencies rather than a predetermined time frame for graduation. With the increasing spread of this paradigm around the globe, regulatory bodies have developed competency frameworks to guide curriculum, but there are significant challenges to its actualization within medical curricula. We are currently at the stage of CBME evolution where medical educators are working on establishing a common understanding of the concept and its workings. Medical schools and educators still struggle with defining the various terminologies in the CBME lexicon. Implementation of this new medical education paradigm would require a change in mindset that calls for an intense focus on individualized learning with greater use of ipsative and criterion-referenced assessments that focus on individual progression rather than the commonly used norm-referenced assessment that evaluates the trainee relative to whole class performance. A full-blown CBME has the potential to revolutionize medical education management with admissions of cohorts of students with variable (individualized) graduation dates in curricula based on standardization of outcomes and individualization of learning. That may be difficult to fathom but is perhaps the way to the future of medical education. Understanding the fundamental precepts of this educational philosophy, including its history, etymology, and application would be essential to tackling the potential challenges to its successful implementation. The philosophical basis and interplay of these factors are discussed.

關鍵字

competency-based medical education ； entrustable professional activity ； ipsative assessment ； outcome-based education

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