The DOI matches its Crossref record; 36 of the 36 references it cites were found in a registry or an index.
Advancing competency-based medical education: A charter for clinician–educators.
Abstract
The International Competency-Based Medical Education (ICBME) Collaborators have been working since 2009 to promote understanding of competency-based medical education (CBME) and accelerate its uptake worldwide. This article presents a charter, supported by a literature-based rationale, which is meant to provide a shared mental model of CBME that will serve as a path forward in its widespread implementation.At a 2013 summit, the ICBME Collaborators laid the groundwork for this charter. Here, the fundamental principles of CBME and professional responsibilities of medical educators in its implementation process are described. The authors outline three fundamental principles: (1) Medical education must be based on the health needs of the populations served; (2) the primary focus of education and training should be the desired outcomes for learners rather than the structure and process of the educational system; and (3) the formation of a physician should be seamless across the continuum of education, training, and practice.Building on these principles, medical educators must demonstrate commitment to teaching, assessing, and role modeling the range of identified competencies. In the clinical setting, they must provide supervision that balances patient safety with the professional development of learners, being transparent with stakeholders about level of supervision needed. They must use effective and efficient assessment strategies and tools for basing transition decisions on competence rather than time in training, empowering learners to be active participants in their learning and assessment. Finally, advancing CBME requires program evaluation and research, faculty development, and a collaborative approach to realize its full potential.
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“Two recently implemented initiatives in medical education, competencybased medical education (CBME) [9][10][11] and programmatic assessment of learners, 12 have the potential to improve the practice of feedback by promoting frequent observation of learners, feedback conversations, and coaching for improvement.”
From The R2C2 Model in Residency Education: How Does It Foster Coaching and Promote Feedback Use? (2018) · cites this paper as [9]
In the citing paper
“Coaching is developmental, and philosophically it moves feedback away from its historic tie to assessment and moves it closer to learning.9,15,16”
From The R2C2 Model in Residency Education: How Does It Foster Coaching and Promote Feedback Use? (2018) · cites this paper as [9]
In the citing paper
“Foundationally, the principles of programmatic assessment and CBME direct our attention to actively engaging learners in their assessment, feedback, and development activities.9,13,15”
From The R2C2 Model in Residency Education: How Does It Foster Coaching and Promote Feedback Use? (2018) · cites this paper as [9]
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“So far, despite the many admonitions to move from a time-based to competency-based training programs in health care (Snell & Frank 2010; Frank et al. 2010; Carraccio et al. 2016), hardly any program has shown this possibility.”
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van Loon, K. A., & Scheele, F. (2020) · Academic Medicine · doi:10.1097/acm.0000000000003386 · Cited by 17
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Describing Overarching Curricular Goals for Individualized Education
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“Although individualized education is essential to successful implementation of CBME, the transition to curricular methods that support individualized education has been challenging.(9) In the Netherlands, the time-variable and often extended duration of graduate medical training has made individualization more feasibl…”
BackgroundFurther on the journey in a complex adaptive system: Elaborating CBME
Frank, J. R., Snell, L. S., Oswald, A., Hauer, K. E., & Collaborators, F. T. I. C. (2021) · Medical Teacher · doi:10.1080/0142159x.2021.1931083 · Cited by 15
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BackgroundCompetency-Based Education: Will This be the New Training Paradigm in Plastic Surgery?
Reddy, N. K., Applebaum, S. A., & Gosain, A. K. (2022) · Journal of Craniofacial Surgery · doi:10.1097/scs.0000000000009005 · Cited by 15
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Resident Perspectives on Competency-By-Design Curriculum
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“describe and measure learner development (Frank et al. 2010; Carraccio et al. 2016).”
BackgroundA core curriculum for basic EUS skills
Karstensen, J. G., Nayahangan, L. J., Konge, L., & Vilmann, P. (2022) · Endoscopic Ultrasound · doi:10.4103/eus-d-21-00125 · Cited by 14
“[20] As several EUS quality indicators have become widely accepted, we hope this curriculum will facilitate a more efficient training program with steeper learning curves during EUS fellowship, ultimately securing that newly graduated endosonographers fulfill these quality indicators.”
Hitzblech, T., Maaz, A., Rollinger, T., Ludwig, S., Dettmer, S., Wurl, W., Romero, Y. R., Raspe, R., Petzold, M., Breckwoldt, J., et al. (2019) · PubMed Central · doi:10.3205/zma001262 · Cited by 14
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“Wellbeing of medical students becomes particularly important as schools are advancing competency-based medical education [30, 31] and its impact on student wellbeing is yet to be determined.”
BackgroundExploring Faculty Approaches to Feedback in the Simulated Setting
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“Copyright © 2018 by the Society for Simulation in Healthcare and entrustable professional activities attest to acceptable levels of performance.(8) Faculty will need to be skilled in feedback conversations that guide resident development.”
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“2014; Watling 2014) and valuable for performance improvement (Carraccio et al. 2016).”
BackgroundResultAffecting Change: Enhancing Feedback Interactions with Radiology Trainees
Burns, J., Chetlen, A. L., Morgan, D. E., Catanzano, T. M., McLoud, T. C., Slanetz, P. J., & Jay, A. K. (2021) · Academic Radiology · doi:10.1016/j.acra.2021.05.018 · Cited by 13
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“Work in competency-based medical education (CBME) has high-lighted the importance of frequent feedback and comprehensive assessment to promote skill development and allow for appropriate trainee progression [1 – 3].”
BackgroundPJplus - a project improving practical training during the final year of medical education
Lauterjung, M., Ehlers, C., & Guntinas‐Lichius, O. (2021) · Zeitschrift für Evidenz Fortbildung und Qualität im Gesundheitswesen · doi:10.1016/j.zefq.2021.05.009 · Cited by 12
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“The purpose of this study was to (1) assess whether written feedback from EPAs were actionable, valuable, and disruptive to workflow and (2) assess the time required to complete an EPA.”
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Global perspectives on trends in health higher education
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Minimum Supervision Levels Required by Program Directors for Pediatric Pulmonary Fellow Graduation
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“Models of competency-based medical education in which time is variable and outcomes are fixed should be considered (16).”
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“Medical educators and researchers recognize that medical training should not only emphasize knowledge acquisition but also develop skills in clinical reasoning, effective communication, and evidence-based decision-making [1, 3, 4].”
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“Most of the online learning modules were based on the competency‐based educational framework, which emphasizes blending of professional practice with classroom education by health‐care professionals who are also entrusted with governing patient’s health needs.[3,4] Among these learning activities, webinars are frequen…”
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Using Backward Design for Competency-Based Undergraduate Medical Education
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“The fellow usually reaches competence within the span of the initial 6-month intensive training period; however, we take the fellow’s competent performance of the essential activities of consultation, rather than this timeframe itself, as the marker for independence (see Carraccio et al., 2016).”
Ott, M. C., Dengler, L., Hibbert, K., & Ott, M. C. (2024) · Medical Education · doi:10.1111/medu.15475 · Cited by 8
“2,4,7,14,17,20,33 However, as this study of curriculum-making in Competence by Design demonstrates, the problems can be more complicated and the solutions more complex.”
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Peer teacher training develops “lifelong skills”
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“The literature advocates for comprehensive educational strategies that prepare future healthcare professionals for their roles as educators (Carraccio et al. 2016).”
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“The International Competency-Based Medical Education (ICBME) collaborators specifically called for using Competency-BasedMedical Education (CBME) to facilitate a seamless continuum of education, training, and practice [3].”
MethodAssessing an assessment: The review and redesign of a competency-based mid-degree evaluation
Mayowski, C. A., Norman, M. K., & Kapoor, W. N. (2018) · Journal of Clinical and Translational Science · doi:10.1017/cts.2018.321 · Cited by 8
“There is a substantial and growing literature on competency-based medical education [1, 2], examining topics such as its theoretical grounding [3], its application to specialties such as internal medicine and gastronenterology [4, 5], and the competencies required of research coordinators and other clinical research t…”
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A core curriculum for basic EUS skills: An international consensus using the Delphi methodology
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“Discussions after implementation have shown the need for improvement in change management [1, 12, 14, 15], faculty development [2, 16, 17], and orientation of learners [18, 19].”
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“This can be linked to the definition of a competency as a complex integration of knowledge, skills, and attitudes (Carraccio et al., 2016, Frank et al., 2010).”
Sattar, K., & Yusoff, M. S. B. (2025) · BMC Medical Education · doi:10.1186/s12909-024-06595-5 · Cited by 19
“Embedding MP into the undergraduate medical curriculum is important to fostering these attributes, which are expected to support lifelong learning, ethical practice, and the prevention of unprofessional behavior throughout a doctor’s career [3, 4].”
A multicentre investigation of organ and tissue donation education for critical care residents
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“CBME can be based on different competency frameworks that are derived from analysis of societal and patient needs and prepares future physicians for their professional work [7, 8].”
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“This provides more complete support for the spectrum of learners, including early identification of struggling learners so that individualized academic plans can be developed, to early graduation of learners progressing at a rapid pace (Ross et al. , 2018; Carraccio et al. , 2016).”
BackgroundKarnik, R., Robinson, B., Glickstein, J. S., Schwartz, A., Mink, R. B., Neal, A. E., Frank, L. H., McMahon, C. J., Kim, M. E., Turner, D. A., et al. (2023) · Pediatric Cardiology · doi:10.1007/s00246-023-03371-y · Cited by 7
“…training to help some graduates for most simple and some complex cases Level 4: Trusted to diagnose and manage with INDIRECT supervision but may require discussion for a few complex cases Level 5: Trusted to execute independently without supervision be prepared for safe and effective practice.”
Change Management Support in Postgraduate Medical Education: A Change for the Better
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CAEP 2019 Academic Symposium: Got competence? Best practices in trainee progress decisions
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Innovative levers for sustainable integration of gender medicine into medical school curricula
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“medical schools are meeting learners’ pedagogical needs and desired competencies [6, 10].”
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Consensus-Derived Recommended Skills for Transition to Residency Courses
Rustici, M. J., Mutter, M. K., Atkins, K. M., Holmboe, E. S., Morgan, H. K., Olson, A. P. J., Anderson, A. A., Zell, J., Roosevelt, G., & Brainard, J. C. (2024) · Academic Medicine · doi:10.1097/acm.0000000000005687 · Cited by 6
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“…al. 2017; Shrivastava and Shrivastava 2019; Branfield Day et al. 2020; Mann et al. 2020; Hall et al. 2021) and coaching, workplace-based assessment (Carraccio et al. 2016; Harris et al. 2017; Sebok-Syer et al. 2018; Weller et al. 2020; Li et al. 2021), data aggregation (McConnell et al. 2016; Chan…”
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Does variable training lead to variable care?
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Rethinking medical education: introducing peace curricula in medical schools
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“Competency-Based Medical Education frameworks are employed around the world and include the Scottish Doctor Outcomes, CanMEDS, the Australian Curriculum Framework for Junior Doctors, and the Accreditation Council for Graduate Medical Education Competencies (ACGME) (Carraccio et al. 2016).”
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“(Carraccio et al., 2016) also state that employee competencies have a strong correlation with performance.”
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Medical Educator Perceptions of Faculty Effort and Intent to Stay in Academic Medicine
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“This transition to competency-based medical education (CBME) also heralded a new era of expectations for medical school faculty [3].”
(Mis)Alignment in resident and advisor co‐regulated learning in competency‐based training
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“2 6 While the CBD system makes explicit mention of the AA role, it does not mandate whether and how each residency training programme implements the role.”
ToSkORL: Selbst- und Fremdeinschätzung bei der Untersuchung des Kopf-Hals-Bereichs
Sharaf, K., Felicio‐Briegel, A., Widmann, M., Huber, J., Eggersmann, T. K., Stadlberger, U., Schrötzlmair, F., Canis, M., & Lechner, A. (2021) · HNO · doi:10.1007/s00106-021-01097-y · Cited by 5
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Metadata
- Authors
- Carraccio, C., Englander, R., Van Melle, E., ten Cate, O., Lockyer, J., Chan, M.-K., Frank, J. R., & Snell, L. S.
- Affiliations
- C. Carracciois vice president, Competency-Based Assessment, American Board of Pediatrics, Chapel Hill, North Carolina.
- Association of American Medical Colleges (US)
- E. Van Melleis education researcher, Queen’s University, Kingston, Ontario, Canada, and education scientist, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.
- O. ten Cateis professor of medical education and director, Center for Research and Development of Education, University Medical Center, Utrecht, the Netherlands.
- University of Calgary (CA)
- University of Manitoba (CA)
- University of Ottawa (CA)
- McGill University (CA)
- Corresponding author
- Carraccio, Carol
- Venue
- Academic Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-05
- Volume
- 91
- Issue
- 5
- Pages
- 645-649
- ISSN
- 1040-2446 (ISSN-L)
- OpenAlex
- W2332143888
- Cited by
- 372
- References
- 36
- Citations by year
- 2026: 33 · 2025: 31 · 2024: 39 · 2023: 33 · 2022: 39 · 2021: 42 · 2020: 42 · 2019: 43 · 2018: 33 · 2017: 21 · 2016: 13
- FWCI
- 24.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Academic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Education › Innovations in Medical Education
- Health Sciences › Health Professions › General Health Professions › Health and Medical Education
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Competency Development and Evaluation
- Keywords
- competency-based medical education, medical faculty, professional responsibility, clinical supervision, competency assessment, faculty development, program evaluation
- MeSH terms
- Clinical Competence, Competency-Based Education, Education, Medical, Undergraduate, Faculty, Medical, Humans, Staff Development, United States, Models, Educational
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