Toward a definition of competency-based education in medicine: a systematic review of published definitions
Abstract
BACKGROUND: Competency-based education (CBE) has emerged in the health professions to address criticisms of contemporary approaches to training. However, the literature has no clear, widely accepted definition of CBE that furthers innovation, debate, and scholarship in this area. AIM: To systematically review CBE-related literature in order to identify key terms and constructs to inform the development of a useful working definition of CBE for medical education. METHODS: We searched electronic databases and supplemented searches by using authors' files, checking reference lists, contacting relevant organizations and conducting Internet searches. Screening was carried out by duplicate assessment, and disagreements were resolved by consensus. We included any English- or French-language sources that defined competency-based education. Data were analyzed qualitatively and summarized descriptively. RESULTS: We identified 15,956 records for initial relevancy screening by title and abstract. The full text of 1,826 records was then retrieved and assessed further for relevance. A total of 173 records were analyzed. We identified 4 major themes (organizing framework, rationale, contrast with time, and implementing CBE) and 6 sub-themes (outcomes defined, curriculum of competencies, demonstrable, assessment, learner-centred and societal needs). From these themes, a new definition of CBE was synthesized. CONCLUSION: This is the first comprehensive systematic review of the medical education literature related to CBE definitions. The themes and definition identified should be considered by educators to advance the field.
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The implementation of OSCE-style assessment demonstrates strong alignment with competency-based education frameworks, which emphasise demonstration of specific, measurable skills rather than written articulation.
“The implementation of OSCE-style assessment demonstrates strong alignment with competency-based education (CBE) frameworks, which emphasise demonstration of specific, measurable skills rather than written articulation [29,30].”
From Clinical assessment meets laboratory science: adapting OSCE methodology for authentic biosciences evaluation in the age of generative AI (2025) · cites this paper as [29]
The successful cross-disciplinary transfer from medical to laboratory education suggests that assessment design strategies focusing on authentic performance demonstration may be more effective than blanket AI restrictions for maintaining academic integrity.
“The successful cross-disciplinary transfer from medical to laboratory education suggests that assessment design strategies focusing on authentic performance demonstration may be more effective than blanket AI restrictions for maintaining academic integrity [4,29].”
From Clinical assessment meets laboratory science: adapting OSCE methodology for authentic biosciences evaluation in the age of generative AI (2025) · cites this paper as [29]
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Greenhalgh, T., & Peacock, R. (2005) · BMJ · doi:10.1136/bmj.38636.593461.68 · Cited by 2,045 · cited 1× · see citing works
“One reviewer searched all sites using a snowballing technique that allowed for examination of both the site itself and of records embedded within each site (Greenhalgh & Peacock 2005).”
MethodWhat Is eHealth (3): A Systematic Review of Published Definitions
Oh, H., Jadad, A., Rizo, C., Enkin, M., Powell, J., & Pagliari, C. (2005) · Journal of Medical Internet Research · doi:10.2196/jmir.7.1.e1 · Cited by 1,015 · see citing works
Building a competency-based curriculum: the agony and the ecstasy
Albanese, M. A., Mejicano, G., Anderson, W. M., & Gruppen, L. (2010) · Advances in Health Sciences Education · doi:10.1007/s10459-008-9118-2 · Cited by 93 · see citing works
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Competency-based medical education: Theory to practice.
Frank, J. R., Snell, L. S., Cate, O. T., Holmboe, E. S., Carraccio, C., Swing, S. R., Harris, P., Glasgow, N. J., Campbell, C., Dath, D., et al. (2010) · Medical Teacher · doi:10.3109/0142159x.2010.501190 · Cited by 2,883 · see citing works
Self-citationImplementation of competency‐based medical education: are we addressing the concerns and challenges?
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Challenges and opportunities for educating health professionals after the COVID-19 pandemic
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Advancing competency-based medical education: A charter for clinician–educators.
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- Authors
- Frank, J. R., Mungroo, R., Ahmad, Y., Wang, M., De Rossi, S., & Horsley, T.
- Affiliations
- University of Ottawa (CA)
- University of Toronto (CA)
- Corresponding author
- Frank, Jason R.
- Venue
- Medical Teacher
- Publisher
- Informa UK Limited
- Published
- 2010-07-27
- Volume
- 32
- Issue
- 8
- Pages
- 631-637
- ISSN
- 0142-159X (ISSN-L)
- 1466-187X
- OpenAlex
- W2150453984
- Cited by
- 781
- References
- 3
- Citations by year
- 2026: 67 · 2025: 56 · 2024: 63 · 2023: 65 · 2022: 74 · 2021: 72 · 2020: 52 · 2019: 57 · 2018: 61 · 2017: 51 · 2016: 43 · 2015: 35 · 2014: 37 · 2013: 21 · 2012: 19
- FWCI
- 2.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Teacher (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Health Professions › General Health Professions › Health and Medical Education
- Social Sciences › Psychology › Social Psychology › Competency Development and Evaluation
- Keywords
- competency-based education, medical education, assessment, student-centered learning, societal needs, organizational framework
- MeSH terms
- Competency-Based Education, Education, Medical, Undergraduate, Humans, Terminology as Topic
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