Competency-based medical education: theory to practice

Frank, Jason R.; Snell, Linda; Cate, Olle ten; Holmboe, Eric S.; Carraccio, Carol; Swing, Susan R.; Harris, Peter; Glasgow, Nicholas; Campbell, Craig; Dath, Deepak; Harden, Ronald M.; Iobst, William; Long, Donlin M.; Mungroo, Rani; Richardson, Denyse; Sherbino, Jonathan; Silver, Ivan; Taber, Sarah; Talbot, Martin; Harris, Kenneth A.

doi:10.3109/0142159x.2010.501190

Cited by 1,714 publications

(1,350 citation statements)

References 27 publications

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“…The recent shift to competency‐based medical education has emphasized the development of structured training opportunities and enhanced skill acquisition33. Trainees must now demonstrate competency for required skills specific to their specialty in order to advance to certification.…”

Section: Discussionmentioning

confidence: 99%

Effects of transcranial direct-current stimulation on laparoscopic surgical skill acquisition

et al. 2018

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BackgroundChanges in medical education may limit opportunities for trainees to gain proficiency in surgical skills. Transcranial direct‐current stimulation (tDCS) can augment motor skill learning and may enhance surgical procedural skill acquisition. The aim of this study was to determine the effects of tDCS on simulation‐based laparoscopic surgical skill acquisition.MethodsIn this double‐blind, sham‐controlled randomized trial, participants were randomized to receive 20 min of anodal tDCS or sham stimulation over the dominant primary motor cortex, concurrent with Fundamentals of Laparoscopic Surgery simulation‐based training. Primary outcomes of laparoscopic pattern‐cutting and peg transfer tasks were scored at baseline, during repeated performance over 1 h, and again at 6 weeks. Intent‐to‐treat analysis examined the effects of treatment group on skill acquisition and retention.ResultsOf 40 participants, those receiving tDCS achieved higher mean(s.d.) final pattern‐cutting scores than participants in the sham group (207·6(30·0) versus 186·0(32·7) respectively; P = 0·022). Scores were unchanged at 6 weeks. Effects on peg transfer scores were not significantly different (210·2(23·5) in the tDCS group versus 201·7(18·1) in the sham group; P = 0·111); the proportion achieving predetermined proficiency levels was higher for tDCS than for sham stimulation. Procedures were well tolerated with no serious adverse events and no decreases in motor measures.ConclusionThe addition of tDCS to laparoscopic surgical training may enhance skill acquisition. Trials of additional skills and translation to non‐simulated performance are required to determine the potential value in medical education and impact on patient outcomes. Registration number: NCT02756052 (https://clinicaltrials.gov/).

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Section: Discussionmentioning

confidence: 99%

Effects of transcranial direct-current stimulation on laparoscopic surgical skill acquisition

et al. 2018

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“…32 We chose EPAs as a framework for three reasons. First, EPAs have emerged as an important framework for competency-based medical education in Europe and the U.S. 31,33,34 Second, EPAs operationalize competencies and the complexity of clinical competence. Performing an EPA requires integration of multiple competencies, which, in turn, require activation of multiple skills, knowledge, and attitudes.…”

Section: Preparing For the Summitmentioning

confidence: 99%

Transforming Primary Care Training—Patient-Centered Medical Home Entrustable Professional Activities for Internal Medicine Residents

et al. 2012

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“…78,79 Slightly different models have been used to implement the competencies in the United States and Canada, with the United States using the competencies and Canada using the CanMEDS roles, yet the basic aims are comparable. [78][79][80][81][82] In the United States, nearly ten years into the initial implementation of the competencies, research has yet to produce evidence for the benefits of the current approach. Innovation in the field currently comes through collaborative work among stakeholders in the clinical specialties to develop the educational milestones.…”

Section: Embedding the Competencies In Resident Teaching And Evaluationmentioning

confidence: 99%

Review article: Closing the research gap at the interface of learning and clinical practice

Philibert

2011

Can J Anesth/J Can Anesth

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Purpose The dialogue at the interface of education and clinical practice highlights areas of critical importance to the development of new approaches for educating anesthesiologists. The purpose of this article is to examine the literature on education and acquisition of competence in three areas relevant to the interface of learning and clinical practice, with the aim to suggest a research agenda that adds to the evidence on preparing physicians for independent practice. The three areas are: 1) transitions across the continuum of education; 2) the effect of reductions in hours of clinical training on competence; and 3) efforts to incorporate the competencies and CanMEDS roles into teaching and evaluation. Principal findings Fifty-six articles relevant to one or more of the themes were identified in the review, including 21 studies of transitions (in, during, and after residency education), 19 studies on the effects of duty hour limits on residents' acquisition of competence, and 16 articles that assessed competency-based teaching and assessment in anesthesiology. Overall, the findings suggested a relative paucity of scientific evidence and a need for research and the development of new scientific theory. Studies generally treated one of the themes in isolation, while in actuality they interact to produce optimal as well as suboptimal learning situations, while medical education research often is limited by small samples, brief follow-up, and threats to validity. This suggests a ''research gap'' where editorials and commentaries have moved ahead of an evidence base for education. Promising areas for research include preparation for care deemed important by society, work to apply knowledge about the development of expertise in other disciplines to medicine, and ways to embed the competencies in teaching and evaluation more effectively. Conclusion Closing the research gap in medical education will require clear direction for future work. The starting point, at an institution or nationally, is dialogue within the specialty to achieve consensus on some of the most pressing questions.

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Competency-based medical education: theory to practice

Cited by 1,714 publications

References 27 publications

Effects of transcranial direct-current stimulation on laparoscopic surgical skill acquisition

Effects of transcranial direct-current stimulation on laparoscopic surgical skill acquisition

Transforming Primary Care Training—Patient-Centered Medical Home Entrustable Professional Activities for Internal Medicine Residents

Review article: Closing the research gap at the interface of learning and clinical practice

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