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Competency-based medical education: a new model of educational design

Explore the concept of professional competence in medical education, detailing the key competencies, assessment methods, and transition towards a competency-based model for enhancing medical training.

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Competency-based medical education: a new model of educational design

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  1. Competency-based medical education: a new model of educational design Fabrizio Consorti University Sapienza of Rome Società Italiana di Pedagogia Medica SIPeM

  2. PROFESSIONAL COMPETENCE “The habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice for the benefit of the individuals and communities being served” Epstein RM., Assessment in medical education, N Engl J Med 2007;356(4):387-96

  3. PROFESSIONAL COMPETENCE WHAT IS “PROFESSIONAL COMPETENCE”? ABILITY TO USE PROFESSIONAL CONTEXT KNOWLEDGE ATTITUDE SKILL

  4. PROFESSIONAL COMPETENCE

  5. TUNING MEDICINE

  6. TUNING MEDICINE 12 FIRST LEVEL COMPETENCIES carry out a consultation with a patient (history, examination ...) assess clinical presentations, order investigations, make differential diagnoses, and negotiate a management plan provide immediate care of medical emergencies, including First Aid and resuscitation prescribe drugs

  7. TUNING MEDICINE 12 FIRST LEVEL COMPETENCIES carry out practicalprocedures communicate effectively in a medical context apply ethical and legal principles in medical practice assess psychological and social aspects of a patient's illness

  8. TUNING MEDICINE 12 FIRST LEVEL COMPETENCIES apply the principles, skills and knowledge of evidence-based medicine use information and information technology effectively in a medical context apply scientific principles, method and knowledge to medical practice and research promote health, engage with population health issues and work effectively in a health care system

  9. MEDICAL COMPETENCIES- ACGME

  10. CANMEDS SEVEN FIRST LEVEL “ROLES” MEDICAL EXPERT COMMUNICATOR COLLABORATOR LEADER HEALTH ADVOCATE SCHOLAR PROFESSIONAL

  11. THE “MILESTONES”

  12. CANMEDS A COMPETENCE CONTINUUM Milestones at each stage describe terminal competencies

  13. LIMITS OF MILESTONES • They are: • Granular (= each milestone refers to only one domain of competence) • Many… too manymilestones  millstones

  14. FROM MILESTONES TO ENTRUSTABLE PROFESSIONAL ACTIVITIES (EPAs) • EPAs are: • Professional activitiesthat can beperformedby a student/residentwithout supervision • Theyrely on the intuitive conceptof “trust” • Theyallowtoinfer the global levelofcompetence

  15. AMERICAN BOARD OF PEDIATRICS17 EPAs https://www.abp.org/entrustable-professional-activities-epas

  16. ASSESSING PROFESSIONAL COMPETENCE WHAT IS “PROFESSIONAL COMPETENCE”? ABILITY TO USE PROFESSIONALCONTEXT KNOWLEDGE ATTITUDE SKILL

  17. HOW DO WE ASSESS COMPETENCE • Kirkpatrick’s model (4 levels) forcompetence • Reaction: self-confidencequestionnaires • Learning: objectiveassessmenttestsof the “abilitytouse” • Knowledge: professionalproblemsolving • Skills: simulation, directobservationofproceduralskills (DOPS) • Attitudes: simulation, on-the-jobdirectobservation • Behavior: auditbypeers, on-the-jobdirectobservation • Results: evaluationof the organisation, effect on target population

  18. HOW DO WE MOVE TO A COMPETENCY-BASED EDUCATION?

  19. HOW DO WE MOVE TO A COMPETENCY-BASED EDUCATION? • Two cornerstones: • A systemic approach: think globally, act locally • Faculty development program

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