Competency-based medical education: Theory to practice.
Abstract
Although competency-based medical education (CBME) has attracted renewed interest in recent years among educators and policy-makers in the health care professions, there is little agreement on many aspects of this paradigm. We convened a unique partnership - the International CBME Collaborators - to examine conceptual issues and current debates in CBME. We engaged in a multi-stage group process and held a consensus conference with the aim of reviewing the scholarly literature of competency-based medical education, identifying controversies in need of clarification, proposing definitions and concepts that could be useful to educators across many jurisdictions, and exploring future directions for this approach to preparing health professionals. In this paper, we describe the evolution of CBME from the outcomes movement in the 20th century to a renewed approach that, focused on accountability and curricular outcomes and organized around competencies, promotes greater learner-centredness and de-emphasizes time-based curricular design. In this paradigm, competence and related terms are redefined to emphasize their multi-dimensional, dynamic, developmental, and contextual nature. CBME therefore has significant implications for the planning of medical curricula and will have an important impact in reshaping the enterprise of medical education. We elaborate on this emerging CBME approach and its related concepts, and invite medical educators everywhere to enter into further dialogue about the promise and the potential perils of competency-based medical curricula for the 21st century.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
CBME and programmatic assessment have the potential to improve the practice of feedback by promoting frequent observation of learners, feedback conversations, and coaching for improvement.
“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 [10]
Cites
The Cambridge Handbook of Expertise and Expert Performance
Ericsson, K. A., Charness, N. H., Feltovich, P. J., Hoffman, R. R., Michelene, T. H., Hunt, E., Prietula, M. J., Amirault, R. J., Branson, R. K., Buchanan, B. G., et al. (2006) · Cambridge University Press eBooks · doi:10.1017/cbo9780511816796 · Cited by 3,160 · see citing works
Defining and Assessing Professional Competence
Epstein, R. M. (2002) · JAMA · doi:10.1001/jama.287.2.226 · Cited by 3,114 · see citing works
Basic Principles of Curriculum and Instruction
Tyler, R. W. (1969) · University of Chicago Press eBooks · doi:10.7208/chicago/9780226820323.001.0001 · Cited by 3,034 · see citing works
Ericsson, K. A. (2004) · Academic Medicine · doi:10.1097/00001888-200410001-00022 · Cited by 2,988 · cited 1× · see citing works
“The current view of physician competence is that it involves multiple domains of ability, in keeping with the work of Epstein and Hundert (2002), Gardner’s work on multiple intelligences (2006), and expertise theory (Ericsson 2004; Ericsson et al. 2006).”
ResultThompson, K. (1985) · The San Francisco Jung Institute Library Journal · doi:10.1525/jung.1.1985.5.4.40 · Cited by 1,626 · see citing works
The Five-Stage model of adult skill acquisition
Dreyfus, S. E. (2004) · Bulletin of Science, Technology & Society · doi:10.1177/0270467604264992 · Cited by 1,261 · cited 1× · see citing works
“For each domain of competence, there is a corresponding spectrum of ability from novice to master, as described by Dreyfus (2004; see also Carraccio et al. 2008).”
BackgroundEntrustability of professional activities and competency‐based training
ten Cate, O. (2005) · Medical Education · doi:10.1111/j.1365-2929.2005.02341.x · Cited by 1,238 · see citing works
Self-citationten Cate, O., & Scheele, F. (2007) · Academic Medicine · doi:10.1097/acm.0b013e31805559c7 · Cited by 1,162 · see citing works
Self-citationThe CanMEDS initiative: implementing an outcomes-based framework of physician competencies
Frank, J. R., & Danoff, D. S. (2007) · Medical Teacher · doi:10.1080/01421590701746983 · Cited by 1,005 · see citing works
Self-citationCarraccio, C. L., Wolfsthal, S. D., Englander, R., Ferentz, K. S., & Martin, C. (2002) · Academic Medicine · doi:10.1097/00001888-200205000-00003 · Cited by 979 · see citing works
Self-citationFrank, J. R., Mungroo, R., Ahmad, Y., Wang, M., De Rossi, S., & Horsley, T. (2010) · Medical Teacher · doi:10.3109/0142159x.2010.500898 · Cited by 781 · see citing works
Self-citationOutcome-based education : critical issues and answers
Spady, W. G. (1995) · Cited by 722 · see citing works
AMEE Guide No. 14: Outcome-based education: Part 1-An introduction to outcome-based education
Harden, R. M. (1999) · Medical Teacher · doi:10.1080/01421599979969 · Cited by 708 · see citing works
Self-citationThe CanMEDS 2005 Physician Competency Framework: Better standards. Better physicians. Better care.
Frank, J. R. (2005) · Medical Entomology and Zoology · Cited by 643 · see citing works
Self-citationHarden, J. (1999) · Medical Teacher · doi:10.1080/01421599978951 · Cited by 461 · see citing works
Basic Principles of Curriculum and Instruction
Kridel, C. (2010) · Encyclopedia of Curriculum Studies · doi:10.4135/9781412958806.n36 · Cited by 410 · see citing works
The Royal College of Physicians and Surgeons of Canada
Lewis, D. S. (1962) · The Canadian Journal of Psychiatry · doi:10.1177/070674377902400512 · Cited by 357 · see citing works
Simpson, J. G., Furnace, J., Crosby, J., Cumming, A. D., Evans, P. A., David, M. F. B., Harden, R. M., Lloyd, D. J., McKenzie, H., McLachlan, J. C., et al. (2002) · Medical Teacher · doi:10.1080/01421590220120713 · Cited by 356 · see citing works
Self-citationCarraccio, C. L., Benson, B. J., Nixon, L. J., & Derstine, P. L. (2008) · Academic Medicine · doi:10.1097/acm.0b013e31817eb632 · Cited by 342 · see citing works
Self-citationCompetency based medical training: review.
Leung, W. (2002) · PubMed · Cited by 319 · see citing works
Monkey see, monkey do: a critique of the competency model in graduate medical education
Talbot, M. D. (2004) · Medical Education · doi:10.1046/j.1365-2923.2004.01794.x · Cited by 313 · see citing works
Self-citationDefining characteristics of educational competencies
Albanese, M. A., Mejicano, G. C., Mullan, P. B., Kokotailo, P. K., & Gruppen, L. D. (2008) · Medical Education · doi:10.1111/j.1365-2923.2007.02996.x · Cited by 300 · see citing works
Technical-Skills Training in the 21st Century
Aggarwal, R. K., & Darzi, A. W. (2006) · New England Journal of Medicine · doi:10.1056/nejme068179 · Cited by 278 · see citing works
Leung, W., & Diwakar, V. (2002) · BMJ · doi:10.1136/bmj.325.7366.693 · Cited by 276 · see citing works
Competency-based Residency Training
Long, D. M. (2000) · Academic Medicine · doi:10.1097/00001888-200012000-00009 · Cited by 271 · see citing works
Self-citationProblem Doctors: Is There a System-Level Solution?
Leape, L. L., & Fromson, J. A. (2006) · Annals of Internal Medicine · doi:10.7326/0003-4819-144-2-200601170-00008 · Cited by 259 · see citing works
Competency‐Based Learning Models: A Necessary Future
Voorhees, R. A. (2001) · New Directions for Institutional Research · doi:10.1002/ir.7 · Cited by 247 · see citing works
Preparing instructional objectives : a critical tool in the development of effective instruction
Mager, R. F. (1997) · Medical Entomology and Zoology · Cited by 234 · see citing works
Preparing the 21st century global healthcare workforce
Pruitt, S. D., & Epping‐Jordan, J. E. (2005) · BMJ · doi:10.1136/bmj.330.7492.637 · Cited by 205 · see citing works
Competency Based Education: A Bandwagon in Search of a Definition
Spady, W. G. (1977) · Educational Researcher · doi:10.3102/0013189x006001009 · Cited by 178 · see citing works
Analysing the concept of context in medical education
Koens, F., Mann, K. V., Custers, E. J. F. M., & ten Cate, O. (2005) · Medical Education · doi:10.1111/j.1365-2929.2005.02338.x · Cited by 161 · see citing works
Self-citationSchools, society, and mastery learning
Block, J. H. (1974) · Holt, Rinehart and Winston eBooks · Cited by 151 · see citing works
The similarity and frequency of proposals to reform US medical education. Constant concerns
Christakis, N. A. (1995) · JAMA · doi:10.1001/jama.274.9.706 · Cited by 133 · see citing works
On Competence: A Critical Analysis of Competence-Based Reforms in Higher Education
Gibbons, R. D. (1980) · The Journal of Higher Education · doi:10.1080/00221546.1980.11780106 · Cited by 97 · see citing works
Perspectives on competency-based medical education from the learning sciences
Swing, S. R., & Collaborators, F. T. I. C. (2010) · Medical Teacher · doi:10.3109/0142159x.2010.500705 · Cited by 96 · see citing works
Self-citationOn Competence: A Critical Analysis of Competence-Based Reforms in Higher Education
Gibbons, R. D., & Grant, G. A. (1980) · The Journal of Higher Education · doi:10.2307/1981175 · Cited by 94 · see citing works
The Similarity and Frequency of Proposals to Reform US Medical Education
Christakis, N. A. (1995) · JAMA · doi:10.1001/jama.1995.03530090038019 · Cited by 86 · see citing works
Competency-Based Curriculum Development in Medical Education
McGaghie, W. C., Ge, M., Sajid, A., & Telder, T. V. (1978) · Cited by 79 · see citing works
Identifying and Comparing Competencies for Social Work Management:
Menefee, D., & Thompson, J. J. (1994) · Administration in Social Work · doi:10.1300/j147v18n03_01 · Cited by 47 · see citing works
Wang, N., Schnipke, D. L., & Witt, E. A. (2005) · Educational Measurement Issues and Practice · doi:10.1111/j.1745-3992.2005.00003.x · Cited by 40 · see citing works
Demand-side medical education: educating future physicians for Ontario.
Neufeld, V. R., Maudsley, R. F., Pickering, R. J., Walters, B. C., Turnbull, J., Spasoff, R. A., Hollomby, D. J., & LaVigne, K. J. (1993) · Europe PMC (PubMed Central) · Cited by 40 · see citing works
Using Competencies to Connect the Workplace and Postsecondary Education
Paulson, K. (2001) · New Directions for Institutional Research · doi:10.1002/ir.10 · Cited by 35 · see citing works
Outcomes in Medical Education: What is the Standard and Outcome of Care Delivered by our Graduates?
Tamblyn, R. M. (1999) · Advances in Health Sciences Education · doi:10.1023/a:1009893715930 · Cited by 34 · see citing works
Competency-based education in family practice.
Bell, H. S., Kozakowski, S. M., & Winter, R. O. (1998) · PubMed · Cited by 30 · see citing works
Creating and Implementing Competency‐Based Learning Models
Voorhees, A. B. (2001) · New Directions for Institutional Research · doi:10.1002/ir.13 · Cited by 30 · see citing works
Achieving Excellence through Outcome-Based Instructional Delivery.
Rubin, S. E., & Spady, W. G. (1984) · Educational leadership · Cited by 21 · see citing works
Continuing Medical Education: A Primer.
(1987) · Annals of Internal Medicine · doi:10.7326/0003-4819-106-5-789_4 · Cited by 21 · see citing works
Process and Product: Development of Competency-Based Measures for Psychiatry Residency
Bienenfeld, D. (2000) · Academic Psychiatry · doi:10.1176/appi.ap.24.2.68 · Cited by 19 · see citing works
Designing Competency-based Instructional Systems
Houston, W. R. (1973) · Journal of Teacher Education · doi:10.1177/002248717302400306 · Cited by 16 · see citing works
Usefulness of CanMEDS Competencies for Chiropractic Graduate Education in Europe
Wangler, M. (2009) · Journal of Chiropractic Education · doi:10.7899/1042-5055-23.2.123 · Cited by 16 · see citing works
Practical, ongoing competency-assessment program for hospital pharmacists and technicians
Marshall, J. M., Adams, J. P., & Janich, J. A. (1997) · American Journal of Health-System Pharmacy · doi:10.1093/ajhp/54.12.1412 · Cited by 12 · see citing works
Developing a competency-based curriculum for eye care managers in Sub-Saharan Africa
Dutoit, R., Cook, C., Minnies, D., & Brian, G. R. (2010) · Rural and Remote Health · doi:10.22605/rrh1278 · Cited by 7 · see citing works
Flagged first, then by citations
1 of the 53 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Simulation in healthcare education: A best evidence practical guide. AMEE Guide No. 82
Motola, I., Devine, L., Chung, H. S., Sullivan, J. E., & Issenberg, S. B. (2013) · Medical Teacher · doi:10.3109/0142159x.2013.818632 · Cited by 1,223 · see citing works
ten Cate, O., Chen, H. C., Hoff, R. G., Peters, H., Bok, H. G. J., & van der Schaaf, M. F. (2015) · Medical Teacher · doi:10.3109/0142159x.2015.1060308 · Cited by 792 · see citing works
Self-citationten Cate, O. T. J., Kusurkar, R. A., & Williams, G. C. (2011) · Medical Teacher · doi:10.3109/0142159x.2011.595435 · Cited by 697 · see citing works
Self-citationCompetency-based medical education in postgraduate medical education
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., et al. (2010) · Medical Teacher · doi:10.3109/0142159x.2010.500709 · Cited by 478 · see citing works
Self-citationEntrustment Decision Making in Clinical Training
ten Cate, O., Hart, D., Ankel, F., Busari, J., Englander, R., Glasgow, N., Holmboe, E., Iobst, W., Lovell, E., Snell, L. S., et al. (2016) · Academic Medicine · doi:10.1097/acm.0000000000001044 · Cited by 478 · see citing works
Self-citationEnglander, R., Cameron, T., Ballard, A. J., Dodge, J., Bull, J., & Aschenbrener, C. A. (2013) · Academic Medicine · doi:10.1097/acm.0b013e31829a3b2b · Cited by 565 · see citing works
The Case for Use of Entrustable Professional Activities in Undergraduate Medical Education
Chen, H. C., den Broek, W. E. S. V., & ten Cate, O. (2014) · Academic Medicine · doi:10.1097/acm.0000000000000586 · Cited by 432 · see citing works
Self-citationImplementation of competency‐based medical education: are we addressing the concerns and challenges?
Hawkins, R. E., Welcher, C. M., Holmboe, E. S., Kirk, L. M., Norcini, J. J., Simons, K. B., & Skochelak, S. E. (2015) · Medical Education · doi:10.1111/medu.12831 · Cited by 409 · see citing works
Self-citationCompetencies for the Use of Artificial Intelligence–Based Tools by Health Care Professionals
Russell, R. G., Lovett Novak, L., Patel, M., Garvey, K. V., Craig, K. J. T., Jackson, G. P., Moore, D., & Miller, B. M. (2023) · Academic Medicine · doi:10.1097/acm.0000000000004963 · Cited by 320 · see citing works
Programmatic assessment of competency-based workplace learning: when theory meets practice
Bok, H. G., Teunissen, P. W., Favier, R. P., Rietbroek, N. J., Theyse, L. F., Brommer, H., Haarhuis, J. C., van Beukelen, P., van der Vleuten, C. P., & Jaarsma, D. A. (2013) · BMC Medical Education · doi:10.1186/1472-6920-13-123 · Cited by 303 · see citing works
A call to action: The controversy of and rationale for competency-based medical education
Holmboe, E. S., Sherbino, J., Englander, R., Snell, L. S., Frank, J. R., & Collaborators, O. B. O. T. I. (2017) · Medical Teacher · doi:10.1080/0142159x.2017.1315067 · Cited by 276 · see citing works
Self-citationSchumacher, D. J., Englander, R., & Carraccio, C. L. (2013) · Academic Medicine · doi:10.1097/acm.0b013e3182a6e8f8 · Cited by 263 · see citing works
Self-citationLinking Simulation-Based Educational Assessments and Patient-Related Outcomes
Brydges, R., Hatala, R. A., Zendejas, B., Erwin, P. J., & Cook, D. A. (2014) · Academic Medicine · doi:10.1097/acm.0000000000000549 · Cited by 253 · see citing works
Parting the Clouds: Three Professionalism Frameworks in Medical Education
Irby, D. M., & Hamstra, S. J. (2016) · Academic Medicine · doi:10.1097/acm.0000000000001190 · Cited by 254 · see citing works
Entrustable professional activities in health care education: a scoping review
Shorey, S., Lau, T. C., Lau, S. T., & Ang, E. N. K. (2019) · Medical Education · doi:10.1111/medu.13879 · Cited by 238 · see citing works
Carraccio, C. L., & Englander, R. (2013) · Academic Medicine · doi:10.1097/acm.0b013e318299396f · Cited by 231 · see citing works
Self-citationFrost, H., & Regehr, G. (2013) · Academic Medicine · doi:10.1097/acm.0b013e3182a34b05 · Cited by 229 · see citing works
Ng, S., Kinsella, E. A., Friesen, F., & Hodges, B. D. (2015) · Medical Education · doi:10.1111/medu.12680 · Cited by 224 · see citing works
The Role for Virtual Patients in the Future of Medical Education
Berman, N. B., Durning, S. J., Fischer, M. R., Huwendiek, S., & Triola, M. M. (2016) · Academic Medicine · doi:10.1097/acm.0000000000001146 · Cited by 211 · see citing works
Implementing competency-based medical education: Moving forward
Frank, J. R., Snell, L. S., Englander, R., Holmboe, E. S., & Collaborators, O. B. O. T. I. (2017) · Medical Teacher · doi:10.1080/0142159x.2017.1315069 · Cited by 220 · see citing works
Self-citationToward a shared language for competency-based medical education
Englander, R., Frank, J. R., Carraccio, C. L., Sherbino, J., Ross, S., Snell, L. S., & Collaborators, O. B. O. T. I. (2017) · Medical Teacher · doi:10.1080/0142159x.2017.1315066 · Cited by 209 · see citing works
Self-citationOverarching challenges to the implementation of competency-based medical education
Caverzagie, K. J., Nousiainen, M. T., Ferguson, P. C., ten Cate, O., Ross, S., Harris, K. A., Busari, J. O., Bould, M. D., Bouchard, J., Iobst, W. F., et al. (2017) · Medical Teacher · doi:10.1080/0142159x.2017.1315075 · Cited by 209 · see citing works
Self-citationMulder, H., ten Cate, O., Daalder, R., & Berkvens, J. (2010) · Medical Teacher · doi:10.3109/0142159x.2010.513719 · Cited by 206 · see citing works
Self-citationHall, A. K., Nousiainen, M. T., Campisi, P., Dagnone, D., Frank, J. R., Kroeker, K. I., Brzezina, S., Purdy, E. I., & Oswald, A. (2020) · Medical Teacher · doi:10.1080/0142159x.2020.1766669 · Cited by 202 · see citing works
Self-citationThe evolution of an integrated ultrasound curriculum (iUSC) for medical students: 9-year experience
Hoppmann, R., Rao, V. V., Bell, F. E., Poston, M. B., Howe, D. B., Riffle, S., Harris, S. G., Riley, R. A., McMahon, C., Wilson, L. B., et al. (2015) · The Ultrasound Journal · doi:10.1186/s13089-015-0035-3 · Cited by 198 · see citing works
Gottlieb, M. A., Chan, T. M., Zaver, F., & Ellaway, R. (2021) · Medical Education · doi:10.1111/medu.14592 · Cited by 210 · see citing works
ten Cate, O., Schwartz, A., & Chen, H. C. (2020) · Academic Medicine · doi:10.1097/acm.0000000000003427 · Cited by 186 · see citing works
Self-citationCompetency‐based education: programme design and challenges to implementation
Gruppen, L. D., Burkhardt, J., Fitzgerald, J. T., Funnell, M. M., Haftel, H. M., Lypson, M. L., Mullan, P. B., Santen, S. A., Sheets, K. J., Stalburg, C. M., et al. (2016) · Medical Education · doi:10.1111/medu.12977 · Cited by 185 · see citing works
Ultrasound Curricula in Undergraduate Medical Education: A Scoping Review
Tarique, U., Tang, B., Singh, M., Kulasegaram, K. M., & Ailon, J. (2017) · Journal of Ultrasound in Medicine · doi:10.1002/jum.14333 · Cited by 183 · see citing works
Medical Student Ultrasound Education: A WFUMB Position Paper, Part I
Dietrich, C. F., Hoffmann, B., Abramowicz, J. S., Badea, R., Braden, B., Cantisani, V., Chammas, M. C., Cui, X., Dong, Y., Gilja, O. H., et al. (2018) · Ultrasound in Medicine & Biology · doi:10.1016/j.ultrasmedbio.2018.09.017 · Cited by 183 · see citing works
Entrustable Professional Activities for Pharmacy Practice
Pittenger, A. L., Chapman, S. A., Frail, C. K., Moon, J. Y., Undeberg, M. R., & Orzoff, J. H. (2016) · American Journal of Pharmaceutical Education · doi:10.5688/ajpe80457 · Cited by 182 · see citing works
Guidelines for the Management of Snake-bites
Warrell, D. A. (2010) · Cited by 181 · see citing works
Towards a program of assessment for health professionals: from training into practice
Eva, K. W., Bordage, G., Campbell, C. B., Galbraith, R. M., Ginsburg, S., Holmboe, E. S., & Regehr, G. (2015) · Advances in Health Sciences Education · doi:10.1007/s10459-015-9653-6 · Cited by 181 · see citing works
Self-citationO’Dowd, E., Lydon, S., O'Connor, P. E., Madden, C., & Byrne, D. (2019) · Medical Education · doi:10.1111/medu.13792 · Cited by 180 · see citing works
Structuring Feedback and Debriefing to Achieve Mastery Learning Goals
Eppich, W., Hunt, E. A., Duval‐Arnould, J., Siddall, V. J., & Cheng, A. (2015) · Academic Medicine · doi:10.1097/acm.0000000000000934 · Cited by 179 · see citing works
Growth mindset in competency-based medical education
Richardson, D. L., Kinnear, B., Hauer, K. E., Turner, T. L., Warm, E. J., Hall, A. K., Ross, S., Thoma, B., Melle, E. V., & Collaborators, O. B. O. T. I. (2021) · Medical Teacher · doi:10.1080/0142159x.2021.1928036 · Cited by 185 · see citing works
Self-citationCompetence and competency-based nursing education: Finding our way through the issues
Pijl, E. M., Barton, S. S., Konkin, J., Awosoga, O., & Caine, V. (2013) · Nurse Education Today · doi:10.1016/j.nedt.2013.09.007 · Cited by 173 · see citing works
Drawing Boundaries: The Difficulty in Defining Clinical Reasoning
Young, M. E., Thomas, A., Lubarsky, S., Ballard, T. N. S., Gordon, D., Gruppen, L. D., Holmboe, E. S., Ratcliffe, T. A., Rencic, J. J., Schuwirth, L., et al. (2018) · Academic Medicine · doi:10.1097/acm.0000000000002142 · Cited by 168 · see citing works
Self-citationMcNamara, P. J., Jain, A., EL-Khuffash, A. F., Giesinger, R. E., Weisz, D. E., Freud, L., Levy, P. T., Bhombal, S., de Boode, W. P., Leone, T. A., et al. (2024) · Journal of the American Society of Echocardiography · doi:10.1016/j.echo.2023.11.016 · Cited by 166 · see citing works
Competency‐based medical education: origins, perspectives and potentialities
ten Cate, O., & Billett, S. R. (2014) · Medical Education · doi:10.1111/medu.12355 · Cited by 163 · see citing works
Self-citationThe importance of faculty development in the transition to competency-based medical education
Dath, D., Iobst, W. F., & Collaborators, F. T. I. C. (2010) · Medical Teacher · doi:10.3109/0142159x.2010.500710 · Cited by 158 · see citing works
Self-citationWhen Assessment Data Are Words: Validity Evidence for Qualitative Educational Assessments
Cook, D. A., Kuper, A., Hatala, R. A., & Ginsburg, S. (2016) · Academic Medicine · doi:10.1097/acm.0000000000001175 · Cited by 155 · see citing works
Kogan, J. R., Hatala, R. A., Hauer, K. E., & Holmboe, E. S. (2017) · Perspectives on Medical Education · doi:10.1007/s40037-017-0376-7 · Cited by 161 · see citing works
Self-citationDefining the Key Roles and Competencies of the Clinician–Educator of the 21st Century
Sherbino, J., Frank, J. R., & Snell, L. S. (2014) · Academic Medicine · doi:10.1097/acm.0000000000000217 · Cited by 152 · see citing works
Self-citationEvolving concepts of assessment in a competency-based world
Harris, P., Bhanji, F., Topps, M. H., Ross, S., Lieberman, S. A., Frank, J. R., Snell, L. S., Sherbino, J., & Collaborators, O. B. O. T. I. (2017) · Medical Teacher · doi:10.1080/0142159x.2017.1315071 · Cited by 155 · see citing works
Self-citationEntrustment decision making: extending miller’s pyramid.
ten Cate, O., Carraccio, C., Damodaran, A., Gofton, W., Hamstra, S. J., Hart, D. E., Richardson, D., Ross, S., Schultz, K., Warm, E. J., et al. (2021) · Academic Medicine · doi:10.1097/acm.0000000000003800 · Cited by 160 · see citing works
Self-citationCompetency-Based, Time-Variable Education in the Health Professions: Crossroads
Lucey, C. R., Thibault, G. E., & ten Cate, O. (2018) · Academic Medicine · doi:10.1097/acm.0000000000002080 · Cited by 149 · see citing works
Self-citationReconceptualizing Variable Rater Assessments as Both an Educational and Clinical Care Problem
Kogan, J. R., Conforti, L. N., Iobst, W. F., & Holmboe, E. S. (2014) · Academic Medicine · doi:10.1097/acm.0000000000000221 · Cited by 148 · see citing works
Self-citationThe R2C2 Model in Residency Education: How Does It Foster Coaching and Promote Feedback Use?
Sargeant, J., Lockyer, J. M., Mann, K., Armson, H., Warren, A., Zetkulic, M., Soklaridis, S., Könings, K. D., Ross, K., Silver, I., et al. (2018) · Academic Medicine · doi:10.1097/acm.0000000000002131 · Cited by 148 · see citing works
Self-citationFrank, J. R., Taber, S., van Zanten, M., Scheele, F., Blouin, D., & on behalf of the International Health Professions Accreditation Outcomes Consortium (2020) · BMC Medical Education · doi:10.1186/s12909-020-02121-5 · Cited by 147 · see citing works
Self-citationMedical Education’s Wicked Problem: Achieving Equity in Assessment for Medical Learners
Lucey, C. R., Hauer, K. E., Boatright, D. B., & Fernández, A. (2020) · Academic Medicine · doi:10.1097/acm.0000000000003717 · Cited by 147 · see citing works
Competency-based continuing professional development
Campbell, C. B., Silver, I., Sherbino, J., ten Cate, O., Holmboe, E. S., & Collaborators, F. T. I. C. (2010) · Medical Teacher · doi:10.3109/0142159x.2010.500708 · Cited by 143 · see citing works
Self-citationEQual, a Novel Rubric to Evaluate Entrustable Professional Activities for Quality and Structure
Taylor, D. R., Park, Y. S., Egan, R. G., Chan, M., Karpinski, J., Touchie, C., Snell, L. S., & Tekian, A. S. (2017) · Academic Medicine · doi:10.1097/acm.0000000000001908 · Cited by 140 · see citing works
Self-citationDesy, J. R., Reed, D. A., & Wolanskyj, A. P. (2017) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2016.10.026 · Cited by 138 · see citing works
Ottawa 2020 consensus statement for programmatic assessment – 1. Agreement on the principles
Heeneman, S., de Jong, L. H., Dawson, L. J., WILKINSON, T. J., Ryan, A., Tait, G. R., Rice, N. E., Torre, D. M., Freeman, A., & van der Vleuten, C. P. M. (2021) · Medical Teacher · doi:10.1080/0142159x.2021.1957088 · Cited by 150 · see citing works
Artino, A. R., Holmboe, E. S., & Durning, S. J. (2012) · Medical Teacher · doi:10.3109/0142159x.2012.651515 · Cited by 134 · see citing works
Self-citationHauer, K. E., ten Cate, O., Boscardin, C., Iobst, W. F., Holmboe, E. S., Chesluk, B. J., Baron, R. B., & O’Sullivan, P. (2016) · Journal of Graduate Medical Education · doi:10.4300/jgme-d-15-00144.1 · Cited by 136 · see citing works
Self-citationLongitudinal Assessment of Resident Performance Using Entrustable Professional Activities
Schumacher, D. J., West, D. C., Schwartz, A., Li, S. T., Millstein, L. S., Griego, E. C., Turner, T. L., Herman, B. E., Englander, R., Hemond, J., et al. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.19316 · Cited by 136 · see citing works
Self-citationAssessment and feedback methods in competency-based medical education
Lee, G. B., & Chiu, A. M. (2021) · Annals of Allergy Asthma & Immunology · doi:10.1016/j.anai.2021.12.010 · Cited by 149 · see citing works
Reflections on Competency-Based Education and Training for Surgical Residents
Sonnadara, R., Mui, C., McQueen, S. A., Mironova, P., Nousiainen, M. T., Safir, O. A., Kraemer, W. J., Ferguson, P. C., Alman, B. A., & Reznick, R. K. (2013) · Journal of surgical education · doi:10.1016/j.jsurg.2013.06.020 · Cited by 135 · see citing works
Henry, S. G., Holmboe, E. S., & Frankel, R. M. (2013) · Medical Teacher · doi:10.3109/0142159x.2013.769677 · Cited by 127 · see citing works
Self-citationWani, S. B., Han, S. S., Simon, V. C., Hall, M., Early, D. S., Aagaard, E., Abidi, W. M., Banerjee, S., Baron, T. H., Bartel, M. J., et al. (2019) · Gastrointestinal Endoscopy · doi:10.1016/j.gie.2019.01.030 · Cited by 126 · see citing works
Competence, competency‐based education, and undergraduate dental education: a discussion paper
Chuenjitwongsa, S., Oliver, R. G., & Bullock, A. D. (2016) · European Journal Of Dental Education · doi:10.1111/eje.12213 · Cited by 125 · see citing works
Hoppmann, R., Mladenovic, J., Melniker, L. A., Badea, R., Blaivas, M., Montorfano, M. A., Abuhamad, A., Noble, V. E., Hussain, A., Prosen, G., et al. (2022) · The Ultrasound Journal · doi:10.1186/s13089-022-00279-1 · Cited by 123 · see citing works
Competency-Based Education: Milestones or Millstones1?
Norman, G. R., Norcini, J. J., & Bordage, G. (2014) · Journal of Graduate Medical Education · doi:10.4300/jgme-d-13-00445.1 · Cited by 122 · see citing works
Whittaker, J. L., Ellis, R. F., Hodges, P. W., O'Sullivan, C. M., Hides, J. A., Carnero, S. F., Arias‐Buría, J. L., Teyhen, D. S., & Stokes, M. J. (2019) · British Journal of Sports Medicine · doi:10.1136/bjsports-2018-100193 · Cited by 122 · see citing works
Reviewing Residents’ Competence
Hauer, K. E., Chesluk, B. J., Iobst, W. F., Holmboe, E. S., Baron, R. B., Boscardin, C., ten Cate, O., & O’Sullivan, P. (2015) · Academic Medicine · doi:10.1097/acm.0000000000000736 · Cited by 121 · see citing works
Self-citationLörwald, A. C., Lahner, F.-M., Nouns, Z. M., Berendonk, C., Norcini, J., Greif, R., & Huwendiek, S. (2018) · PLOS ONE · doi:10.1371/journal.pone.0198009 · Cited by 117 · see citing works
Plunkett-Rondeau, J., Hyland, K. M., & Dasgupta, S. (2015) · Genetics in Medicine · doi:10.1038/gim.2014.208 · Cited by 119 · see citing works
Chang, A., Bowen, J. L., Buranosky, R. A., Frankel, R. M., Ghosh, N., Rosenblum, M. J., Thompson, S. A. J., & Green, M. L. (2012) · Journal of General Internal Medicine · doi:10.1007/s11606-012-2193-3 · Cited by 119 · see citing works
CPD of the future: a partnership between quality improvement and competency‐based education
Sargeant, J. M., Wong, B. M., & Campbell, C. M. (2017) · Medical Education · doi:10.1111/medu.13407 · Cited by 124 · see citing works
Self-citationFunk, E., Riddell, J., Ankel, F., & Cabrera, D. (2018) · Academic Medicine · doi:10.1097/acm.0000000000002326 · Cited by 118 · see citing works
EFSUMB Statement on Medical Student Education in Ultrasound [long version]
Cantisani, V., Dietrich, C. F., Badea, R., Dudea, S. M., Prosch, H., Cerezo, E., Nuernberg, D., Serra, A. L., Sidhu, P. S., Radziņa, M., et al. (2016) · Ultrasound International Open · doi:10.1055/s-0035-1569413 · Cited by 118 · see citing works
Ferguson, P. C., Kraemer, W. J., Nousiainen, M. T., Safir, O. A., Sonnadara, R., Alman, B. A., & Reznick, R. K. (2013) · Journal of Bone and Joint Surgery · doi:10.2106/jbjs.m.00314 · Cited by 117 · see citing works
Tan, K., Chong, M. C., Subramaniam, P., & Wong, L. P. (2018) · Nurse Education Today · doi:10.1016/j.nedt.2017.12.030 · Cited by 115 · see citing works
Saudi Meds: A competence specification for Saudi medical graduates
Zaini, R. G., Abdulrahman, K. A. B., Alkhotani, A., Al-Hayani, A. A., Al-Alwan, I. A., & Jastaniah, S. D. (2011) · Medical Teacher · doi:10.3109/0142159x.2011.578180 · Cited by 114 · see citing works
Bogo, M., Katz, E., Regehr, C., Logie, C. H., Mylopoulos, M., & Tufford, L. (2012) · Social Work Education · doi:10.1080/02615479.2012.738662 · Cited by 113 · see citing works
Hanson, J. L., Rosenberg, A. A., & Lane, J. L. (2013) · Frontiers in Psychology · doi:10.3389/fpsyg.2013.00668 · Cited by 113 · see citing works
Czabanowska, K., Smith, T., Könings, K. D., Šumskas, L., Otok, R., Bjegovic-Mikanovic, V. M., & Brand, H. (2013) · European Journal of Public Health · doi:10.1093/eurpub/ckt158 · Cited by 113 · see citing works
Competency-based medical education, entrustment and assessment
Modi, J. N., Gupta, P., & Singh, T. (2015) · Indian Pediatrics · doi:10.1007/s13312-015-0647-5 · Cited by 113 · see citing works
Simulación en educación médica: una sinopsis
Corvetto, M., Bravo, M. P., Montaña, R., Ramírez, F. U., Escudero, E., Boza, C., Varas, J., & Dagnino, J. A. (2013) · Revista médica de Chile · doi:10.4067/s0034-98872013000100010 · Cited by 111 · see citing works
Implementation of Competency-Based Pharmacy Education (CBPE)
Koster, A. S., Schalekamp, T., & Meijerman, I. (2017) · Pharmacy · doi:10.3390/pharmacy5010010 · Cited by 111 · see citing works
Eight-year outcomes of a competency-based residency training program in orthopedic surgery
Nousiainen, M. T., Mironova, P., Hynes, M. K., Takahashi, S. G., Reznick, R. K., Kraemer, W. J., Alman, B. A., Ferguson, P. C., & The CBC Planning Committee (2018) · Medical Teacher · doi:10.1080/0142159x.2017.1421751 · Cited by 110 · see citing works
Fullerton, J. T., Thompson, J. B., & Johnson, P. (2013) · Midwifery · doi:10.1016/j.midw.2013.07.006 · Cited by 105 · see citing works
Teaching nurses teamwork: Integrative review of competency-based team training in nursing education
Barton, G., Bruce, A., & Schreiber, R. S. (2017) · Nurse Education in Practice · doi:10.1016/j.nepr.2017.11.019 · Cited by 111 · see citing works
Competency-based education in transitioning nurse practitioner students from education into practice
Hodges, A. L., Konicki, A. J., Talley, M. H., Bordelon, C., Holland, A. C., & Galin, F. S. (2019) · Journal of the American Association of Nurse Practitioners · doi:10.1097/jxx.0000000000000327 · Cited by 108 · see citing works
Alpert, A., CichoskiKelly, E. M., & Fox, A. D. (2017) · Journal of Homosexuality · doi:10.1080/00918369.2017.1321376 · Cited by 107 · see citing works
What Are the Principles That Guide Behaviors in the Operating Room?
Madani, A., Vassiliou, M. C., Watanabe, Y., Al‐Halabi, B., Al-Rowais, M. S., Deckelbaum, D., Fried, G. M., & Feldman, L. S. (2016) · Annals of Surgery · doi:10.1097/sla.0000000000001962 · Cited by 106 · see citing works
Competency‐based education in pharmacy: A review of its development, applications, and challenges
Katoue, M. G., & Schwinghammer, T. L. (2020) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.13362 · Cited by 117 · see citing works
Competency-based medical education: An overview and application in pharmacology
Desai, C., Shah, N., Jorwekar, G., Badyal, D., & Singh, T. (2016) · Indian Journal of Pharmacology · doi:10.4103/0253-7613.193312 · Cited by 191 · see citing works
Performance evaluation of nursing students following competency-based education
Fan, J., Wang, Y. H., Chao, L.-F., Jane, S., & Hsu, L. (2014) · Nurse Education Today · doi:10.1016/j.nedt.2014.07.002 · Cited by 105 · see citing works
Sistermans, I. J. (2020) · Asia Pacific Education Review · doi:10.1007/s12564-020-09658-6 · Cited by 134 · see citing works
Competency‐based medical education: the discourse of infallibility
Boyd, V. A., Whitehead, C. R., Thille, P., Ginsburg, S., Brydges, R., & Kuper, A. (2017) · Medical Education · doi:10.1111/medu.13467 · Cited by 103 · see citing works
Wani, S. B., Keswani, R. N., Han, S. S., Aagaard, E., Hall, M., Simon, V. C., Abidi, W. M., Banerjee, S., Baron, T. H., Bartel, M. J., et al. (2018) · Gastroenterology · doi:10.1053/j.gastro.2018.07.024 · Cited by 102 · see citing works
Competency-based training: who benefits?
Brightwell, A., & Grant, J. (2012) · Postgraduate Medical Journal · doi:10.1136/postgradmedj-2012-130881 · Cited by 102 · see citing works
How to set standards on performance-based examinations: AMEE Guide No. 85
McKinley, D. W., & Norcini, J. J. (2013) · Medical Teacher · doi:10.3109/0142159x.2013.853119 · Cited by 101 · see citing works
Falender, C. A., & Shafranske, E. P. (2011) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-011-9198-9 · Cited by 100 · see citing works
Ingrassia, P. L., Foletti, M., Djalali, A., Scarone, P., Ragazzoni, L., Corte, F. D., Kaptan, K., Lupescu, O., Arculeo, C., von Arnim, G., et al. (2014) · Prehospital and Disaster Medicine · doi:10.1017/s1049023x14000235 · Cited by 100 · see citing works
The Development of Entrustable Professional Activities for Internal Medicine Residency Training
Caverzagie, K. J., Cooney, T. G., Hemmer, P. A., & Berkowitz, L. R. (2014) · Academic Medicine · doi:10.1097/acm.0000000000000564 · Cited by 100 · see citing works
Embracing standardisation and contextualisation in medical education
Bates, J., Schrewe, B., Ellaway, R., Teunissen, P. W., & Watling, C. (2018) · Medical Education · doi:10.1111/medu.13740 · Cited by 100 · see citing works
- Authors
- 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., Harden, R. M., Iobst, W., Long, D. M., Mungroo, R., Richardson, D. L., Sherbino, J., Silver, I., Taber, S., Talbot, M., & Harris, K. A.
- Affiliations
- University of Ottawa (CA)
- McGill University (CA)
- University Medical Center Utrecht (NL)
- American Board of Internal Medicine (US)
- University of Maryland, Baltimore (US)
- Accreditation Council for Graduate Medical Education (US)
- UNSW Sydney (AU)
- Australian National University (AU)
- Royal College of Physicians and Surgeons of Canada (CA)
- University of Dundee (GB)
- Johns Hopkins University (US)
- University of Toronto (CA)
- University of London (GB)
- Western University (CA)
- Corresponding author
- Frank, Jason R.
- ORCID
- Venue
- Medical Teacher
- Publisher
- Informa UK Limited
- Published
- 2010-07-27
- Volume
- 32
- Issue
- 8
- Pages
- 638-645
- ISSN
- 0142-159X (ISSN-L)
- 1466-187X
- OpenAlex
- W2157641530
- Semantic Scholar
- 15d85edcb3f68177a567bcab4c1f05945697f6ea
- Cited by
- 2,883
- References
- 53
- Citations by year
- 2026: 465 · 2025: 270 · 2024: 228 · 2023: 268 · 2022: 221 · 2021: 261 · 2020: 186 · 2019: 166 · 2018: 168 · 2017: 153 · 2016: 133 · 2015: 139 · 2014: 73 · 2013: 73 · 2012: 50
- FWCI
- 46.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Teacher (publishedVersion)
- PubMed (publishedVersion)
- ANU Open Research (Australian National University) (submittedVersion)
- 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
- Health Sciences › Health Professions › General Health Professions › Health and Medical Education
- Social Sciences › Psychology › Social Psychology › Competency Development and Evaluation
- Keywords
- competency-based medical education, medical curriculum development, accountability, student-centered learning, competency definition, medical education reform, consensus conference
- MeSH terms
- Competency-Based Education, Education, Medical, Undergraduate, Humans, Models, Theoretical, History, 20th Century
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review