Exploring Perceptions of Competency-Based Medical Education in Undergraduate Medical Students and Faculty: A Program Evaluation

Figures & data

Table 1 Significant Findings When Comparing Medical Students and Faculty in Their Perception of CBME, Understanding of How CBME is Currently Implemented, and Perception of Benefits and Challenges to Implementing CBME in UME

	N	Students % (n)	N	Faculty % (n)	p
Perception of CBME
Strongly Agree/Agree
Learner Perception: “CBME is an approach that”.
I value in my medical education OR I value when teaching students	43	58.1 (25)	46	26.1 (12)	0.012
Future Impact: “CBME is an approach that…”
Will allow students to become better physicians	40	72.5 (29)	44	34.1 (15)	0.007
Will improve the care students provide to future patients	40	67.5 (27)	44	27.3 (12)	0.007
Not Sure
Learner Feedback: “CBME is an approach where feedback is”.
Given regularly	40	5.0 (2)	44	56.8 (25)	0.002
Personalized to students’ strengths and weaknesses	40	10.0 (4)	44	38.6 (17)	0.043
Structured based on a predetermined framework (e.g.CANMEDS)	40	5.0 (2)	44	65.9 (29)	0.002
Understanding of how CBME is currently implemented in UME
Not Sure
In lecture-based learning	51	9.8 (5)	50	36.0 (18)	0.012
In small group discussions	51	2.0 (1)	50	28.0 (14)	0.003
In history-taking and physical exam learning	51	2.0 (1)	50	18.0 (9)	0.043
Challenges of implementing CBME
Is a Challenge
Increased faculty time commitment to teaching	35	48.6 (17)	43	86.0 (37)	0.006

Table 2 Representative Quotes for Themes Identified for Perceived Benefits and Perceived Challenges of Implementing CBME in UME

	Themes	Medical Student Responses	Faculty Responses
Perceived Benefits	Enhanced student learning	“Learning objectives clearly structure content and act as goals for knowledge”. “Delineation of competencies into categories or areas also helps students to easily identify areas for improvement and strengths”.	“Clear expectations, clarity around progression…tasks of a physician introduced in week 1 day 1 of curriculum”. “CBME is an excellent approach to medical education in providing clear expectations for learners with feedback meant to be built upon encounter-to-encounter…It should [provide] regular feedback towards practical competence”.
	Positive future impact	“Increased applicability and better preparation for clinical years”. “Building relationships with facilitators as mentors and other students as colleagues…gives students the courage and practice interacting with profs/facilitators/preceptors in discussing learning goals, which I foresee will help later on in medical school. helps to foster a sense of professional identity and accountability to patients early on in medical education”.	“Foresee benefit of smoother transition between undergrad and postgrad. Potential for informing residency selection process”. “Easier transition to CBME residency programs”.
Perceived Challenges	Increased time commitment	“Way too many feedback forms and becomes an administrative burden. Feedback often very generic and not helpful. Feedback forms not often one size fits all. When I want feedback I just ask my preceptor face to face which I find a lot more helpful”. “It involves a lot of paperwork! Filling out forms but also not knowing what forms we are supposed to fill out and when adds another layer to the list of requirements for learning and makes it more complicated”.	“This seems like a good way to generate a lot of meaningless evaluations”. “Attending physician evaluation fatigue”. “This change has resulted in an enormous amount of work for a process that is very unclear is going to result in any benefit”.
	Logistical challenges	“At this time, failure to meet ‘competencies’ is more likely to result in a Professionalism discussion than genuine teaching or feedback for improvement”. “Administration/faculty seem unclear on what CBME actually is as well, we’re not sure what changes we’re supposed to be seeing”.	“I have found CBME as currently implemented to be competency-based in name only. There is virtually no flexibility in the curriculum to adapt a student’s learning to their strengths and weaknesses”. “Student appears competent and yet just like Swiss cheese there are a lot of holes that we don’t always see”. “Limited faculty development about how different UME CBME is from PGME CBD, faculty doing the same teaching as before, lack of electronic platform for continued quality improvement on CBME parameters”.