Facilitators and barriers to a nationwide implementation of competency-based postgraduate medical curricula: A qualitative study
Open accessAbstract
BACKGROUND: Postgraduate medical education (PGME) curricula are being redesigned across the western world. AIM: This study examined the implementation process (what works where and why) of new competency-based PGME curricula and relevant factors influencing this process. METHODS: In a nationwide project (2006-2010) in the Netherlands, competency-based PGME curricula were implemented for residents in Pediatrics and Obstetrics & Gynecology. The authors conducted 25 semi-structured interviews and used a multi-level theoretical framework to guide coding. RESULTS: The implementation process proved to be highly dynamic, non-linear, and influenced by many factors. These could be divided into attributes of the innovations/adopters, the implementation process, and the organization. The context determined the speed, quality, and direction of the process and how a factor affected the process. CONCLUSIONS: We identified specific features of PGME innovation: the challenge of implementing other competencies than that of the medical expert; the importance of regional implementation strategies and educational support; the balance between training and patient care; and the need for regional inter-organizational networks of hospitals. The authors recommend: design the curriculum with the needs of the users in mind; facilitate knowledge sharing; organize educational support; translate the national curriculum to the local workplace; and promote regional inter-organizational networks between hospitals.
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Historically, faculty development in feedback delivery has been the primary approach to improving the quality and effectiveness of feedback.
“Historically, faculty development in feedback delivery has been the primary approach to improving the quality and effectiveness of feedback [29, 73].”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [73]
Different individual trainees may respond to different approaches.
“Although no one technique of giving feedback has proven superiority and different individual trainees may respond to different approaches, there is evidence that it has been helpful to train supervisors in techniques of providing feedback constructively, and their behaviour changes in providing more useful feedback [73].”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [73]
No one technique of giving feedback has proven superiority.
“Although no one technique of giving feedback has proven superiority and different individual trainees may respond to different approaches, there is evidence that it has been helpful to train supervisors in techniques of providing feedback constructively, and their behaviour changes in providing more useful feedback [73].”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [73]
There is evidence that it has been helpful to train supervisors in techniques of providing feedback constructively.
“Although no one technique of giving feedback has proven superiority and different individual trainees may respond to different approaches, there is evidence that it has been helpful to train supervisors in techniques of providing feedback constructively, and their behaviour changes in providing more useful feedback [73].”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [73]
Supervisors' behaviour changes in providing more useful feedback after training.
“Although no one technique of giving feedback has proven superiority and different individual trainees may respond to different approaches, there is evidence that it has been helpful to train supervisors in techniques of providing feedback constructively, and their behaviour changes in providing more useful feedback [73].”
From Guidelines: The do’s, don’ts and don’t knows of feedback for clinical education. (2015) · cites this paper as [73]
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Self-citation
- Authors
- Jippes, E., Van Luijk, S. J., Pols, J., Achterkamp, M. C., Brand, P. L. P., & Van Engelen, J. M. L.
- Affiliations
- University Medical Center Groningen (NL)
- University of Groningen (NL)
- Corresponding author
- Jippes, E.
- Venue
- Medical Teacher
- Publisher
- Informa UK Limited
- Published
- 2012-04-10
- Volume
- 34
- Issue
- 8
- Pages
- e589-e602
- ISSN
- 0142-159X (ISSN-L)
- 1466-187X
- OpenAlex
- W2161196238
- Cited by
- 58
- References
- 35
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 4 · 2023: 4 · 2022: 3 · 2021: 9 · 2020: 2 · 2019: 5 · 2018: 5 · 2017: 5 · 2016: 4 · 2015: 6 · 2014: 1 · 2013: 6
- FWCI
- 4.02
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Medical Teacher (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
- Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Health Professions › General Health Professions › Health and Medical Education
- Keywords
- competency-based medical education, graduate medical education, curriculum implementation, implementation barriers and facilitators, residency training, pediatric residency, obstetrics and gynecology residency, interorganizational networks, educational support, knowledge sharing, multilevel theory
- MeSH terms
- Competency-Based Education, Diffusion of Innovation, Education, Medical, Graduate, Gynecology, Humans, Netherlands, Obstetrics, Pediatrics, Qualitative Research
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