The introduction of competency-based medical education for postgraduate training in South Africa

Abstract

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Teaching Philosophy in a Teaching Portfolio: Domain Knowledge and Guidance

“…77 This is an outcomes-based education (OBE) approach, meaning that the learning outcomes guide the training and assessment, and the teaching program does not just focus on the array of knowledge objectives. 78 Competency-based medical education (CBME) 79 is a type of OBE, and the students are expected to progress in their proficiency levels during a tailored/structured learning program to attain at least the required minimum level of competence in the discipline. This involves a de-emphasis on time-based training due to recognizing that various students achieve the required competence at different paces.…”

“…The framework explains that the graduating medical trainee should be competent as a health-care practitioner, communicator, collaborator, leader and manager, health advocate, scholar and professional. 78,82 To assess the competence of the students, entrustable professional activities (EPAs) are evaluated, these being observable and measurable units of medical practices that a graduate (or a trainee at a particular level of training) in that discipline is expected to undertake without supervision. 78,83,84 Therefore, workplace-based learning should be teachable, authentic, reportable, measurable, and recordable for successful implementation.…”

“…78,82 To assess the competence of the students, entrustable professional activities (EPAs) are evaluated, these being observable and measurable units of medical practices that a graduate (or a trainee at a particular level of training) in that discipline is expected to undertake without supervision. 78,83,84 Therefore, workplace-based learning should be teachable, authentic, reportable, measurable, and recordable for successful implementation. The teacher should provide regular feedback to the students, who should be given the opportunity to respond to refute or affirm the report from the teacher.…”

Specialist training: workplace-based assessments impact on teaching, learning and feedback to support competency-based postgraduate programs

“…There is good evidence that feedback from well-implemented WBAs results in a positive effect on clinical practice [6]. Feedback gives trainees insight into their action and informs them about the progress made towards their personal objectives [28].…”

“…In 2017, the national conversations about mandatory WBAs were initiated but progress has been slow, and implementation has been limited [ 5 ]. However, there is a renewed interest to achieve this goal by the Colleges of Medicine of South Africa, the specialist examination board, and the South African Committee of Medical Deans [ 6 ]. Specialist training programmes in South Africa are conducted in hospitals affiliated to educational institutions with the summative examinations regulated by the different specialties within the Colleges of Medicine of South Africa.…”