Competency-Based, Time-Variable Education in the Health Professions: Crossroads

Abstract

Health care systems around the world are transforming to align with the needs of 21st-century patients and populations. Transformation must also occur in the educational systems that prepare the health professionals who deliver care, advance discovery, and educate the next generation of physicians in these evolving systems. Competency-based, time-variable education, a comprehensive educational strategy guided by the roles and responsibilities that health professionals must assume to meet the needs of contemporary patients and communities, has the potential to catalyze optimization of educational and health care delivery systems. By designing educational and assessment programs that require learners to meet specific competencies before transitioning between the stages of formal education and into practice, this framework assures the public that every physician is capable of providing high-quality care. By engaging learners as partners in assessment, competency-based, time-variable education prepares graduates for careers as lifelong learners. While the medical education community has embraced the notion of competencies as a guiding framework for educational institutions, the structure and conduct of formal educational programs remain more aligned with a time-based, competency-variable paradigm.The authors outline the rationale behind this recommended shift to a competency-based, time-variable education system. They then introduce the other articles included in this supplement to Academic Medicine, which summarize the history of, theories behind, examples demonstrating, and challenges associated with competency-based, time-variable education in the health professions.

The EPA-based Utrecht undergraduate clinical curriculum: Development and implementation

“…for postgraduate training in cardiology, intensive care, emergency medicine, and anesthesiology, and enable a shortening of those residencies (Jonker et al 2017). Realizing true competencybased instead of predominantly time-based education is not easily attainable, as the history of competency-based medical education shows (Touchie and ten Cate 2016;Lucey et al 2018), but the process so far gives hopes that we have moved at least a step forward. What lessons have we learned in this process that are useful to share?…”

“…In 2012, based on the committee's recommendations, a curriculum committee drafted a blueprint for a new Utrecht curriculum, which was delivered and accepted in 2013. Significant innovations proposed included several changes (ten Cate et al 2018), one of which was the introduction of EPAs to operationalize the most important objectives of clinical training and to serve as a backbone of the workplace curriculum.…”

Implementing competency‐based education for athletic therapy in Canada—Are we ready for change?

“…All AT programs in Canada are time‐based meaning there are discrete courses that are mapped and completed semester by semester. However, the limitation of learning within a 4‐month semester time frame may not be completely consistent with the definition of CBE in the literature (ten Cate, Gruppen, Kogan, Lingard, & Teunissen, ; Gruppen, ten Cate, Lingard, Teunissen, & Kogan, ; Lucey, Thibault, & ten Cate, ). However, the reliance on the current curricular structure and model is unlikely to change significantly in the near future.…”

Guia Atualizado sobre Atividades Profissionais Confiáveis (APCs)

“…An Academic Medicine supplement of March 2018 was fully devoted to all the details of time-varying competency-based education. 54…”