Competency-based medical education in postgraduate medical education
Abstract
With the introduction of Tomorrow's Doctors in 1993, medical education began the transition from a time- and process-based system to a competency-based training framework. Implementing competency-based training in postgraduate medical education poses many challenges but ultimately requires a demonstration that the learner is truly competent to progress in training or to the next phase of a professional career. Making this transition requires change at virtually all levels of postgraduate training. Key components of this change include the development of valid and reliable assessment tools such as work-based assessment using direct observation, frequent formative feedback, and learner self-directed assessment; active involvement of the learner in the educational process; and intensive faculty development that addresses curricular design and the assessment of competency.
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Direct observation, feedback, and reflective practice are critical factors that enable the assessment of whether a learner can be entrusted.
“Critical factors that enable the assessment of whether a learner can be entrusted include direct observation, feedback, and reflective practice[9].”
Compared to 'time-in-seat' education, CBME requires collaboration between resident and coach, with responsibility on the learner to be active in reflecting, assessing, and developing PLPs.
“Compared to ‘time-in-seat’ education, CBME requires collaboration between resident and coach, with responsibility on the learner to be active in reflecting, assessing, and developing PLPs[9].”
Residents must possess self-directed learning, self-reflection, and self-assessment skills, which is lacking in some trainees.
“Residents, therefore, must possess self-directed learning, self-reflection, and self-assessment skills, which is lacking in some trainees [9,41,42].”
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- Authors
- Iobst, W. F., Sherbino, J., Cate, O. T., Richardson, D. L., Dath, D., Swing, S. R., Harris, P., Mungroo, R., Holmboe, E. S., Frank, J. R., & Collaborators, F. T. I. C.
- Affiliations
- American Board of Internal Medicine (US)
- Royal College of Physicians and Surgeons of Canada (CA)
- University Medical Center Utrecht (NL)
- University of Toronto (CA)
- Accreditation Council for Graduate Medical Education (US)
- UNSW Sydney (AU)
- University of Ottawa (CA)
- Corresponding author
- Iobst, William F.
- ORCID
- Venue
- Medical Teacher
- Publisher
- Informa UK Limited
- Published
- 2010-07-27
- Volume
- 32
- Issue
- 8
- Pages
- 651-656
- ISSN
- 0142-159X (ISSN-L)
- 1466-187X
- OpenAlex
- W2134541962
- Cited by
- 478
- References
- 24
- Citations by year
- 2026: 29 · 2025: 23 · 2024: 35 · 2023: 27 · 2022: 41 · 2021: 48 · 2020: 32 · 2019: 41 · 2018: 42 · 2017: 31 · 2016: 38 · 2015: 32 · 2014: 18 · 2013: 23 · 2012: 14
- FWCI
- 12.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Teacher (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Social Sciences › Psychology › Social Psychology › Competency Development and Evaluation
- Health Sciences › Health Professions › General Health Professions › Health and Medical Education
- Keywords
- competency-based medical education, graduate medical education, Tomorrow's Doctors, workplace-based assessment, direct observation, formative feedback, faculty development, curricular design, competency assessment
- MeSH terms
- Accreditation, Competency-Based Education, Education, Medical, Graduate, Feedback, Humans, Internship and Residency
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