Student perspective on outcomes and process – Recommendations for implementing competency-based medical education

Abstract

Purpose: Competency-based medical education (CBME) seeks to prepare undergraduate and postgraduate trainees for clinical practice. Its major emphasis is on outcomes, but questions about how best to reach these remain. One key issue is the need to integrate what matters most to students when setting educational goals: this is crucial if we are to design curricula that trainees understand and engage with, and that promote successful achievement of competencies.

Method: We interviewed medical students in years 4 and 6 of a 6-year medical degree and used thematic analysis to understand their main educational priorities and how these fit with the aims of CBME.

Results: Two major themes emerged: features of content and process. For content, students wanted clear guidance on what constitutes competence, finding broad outcome statements abstract and difficult to understand as novices. They also attach critical importance to features of process such as being welcomed, included in clinical teams and being known personally – these promote motivation, understanding, and professional development.

Conclusions: We present recommendations for those designing CBME curricula to emphasize the student perspective: what kind of guidance on outcomes is required, and features of process that must not be neglected if competence is to be achieved.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Glossary

• Competency-Based Medical Education: An outcomes-based approach to the design, implementation, assessment, and evaluation of medical education programs, using an organizing framework of competencies.

• The Bologna Process: Is an EU wide agreement in Higher Education that commits member states to a process of harmonization and convergence.

Additional information

Funding

This project was supported by the University of Edinburgh Principal’s Teaching Award Scheme, receiving a small grant award in Spring 2017.

Notes on contributors

Neill Storrar

Dr Neill Storrar, BSc, MBChB, PgDipClinEd, is a doctor training in hematology, currently working as a clinical fellow in medical education. He is a fellow of the Higher Education Academy. His interests are in the learning environment and peer learning.

David Hope

Dr David Hope, MA, MSc, PhD, is a psychometrician specializing in assessment and feedback. A fellow of the Higher Education Academy, he is closely involved in the assessment of undergraduate and postgraduate medical students. His previous work has received a Teaching Innovation Award from the International Association for Medical Education.

Helen Cameron

Professor Helen Cameron, BSc, MBChB, is the Dean of Medical Education at Aston Medical School and is leading the implementation of a new medical programme there. Previous to this she was Director of the Centre for Medical Education at the University of Edinburgh 2003–17 where she led educational innovation and research.