Toward a research agenda for competency-based medical education

Abstract

Competency-based medical education (CBME) is both an educational philosophy and an approach to educational design. CBME has already had a broad impact on medical schools, residency programs, and continuing professional development in health professions around the world. As the CBME movement evolves and CBME programs are implemented, a wide range of emerging research questions will warrant scholarly examination. In this paper, we describe a proposed CBME research agenda developed by the International CBME Collaborators. The resulting framework includes questions about the meaning of key concepts of CBME and their implications for learners, faculty members, and institutional structures. Other research questions relate to the learning process, the meaning of entrustment decisions, fundamental measurement issues, and the nature and definition of standards. The exploration of these questions will help to solidify the theoretical foundation of CBME, but many issues related to implementation also need to be addressed. These pertain to, among other things, nurturing independent learning, assembling and using assessment results to make decisions about competence, structuring feedback, supporting remediation, and how best to evaluate the longer-term outcomes of CBME. High-quality research on these questions will require rigorous outcome measures with strong validity evidence. The complexity of CBME necessitates theoretical and methodological diversity. It also requires multi-institutional studies that examine effects at multiple levels, from the learner to the team, the institution, and the health care system. Such a framework of research questions can guide and facilitate scholarly discourse on the theoretical and practical body of knowledge related to competency-based health professions education.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article. Resources and secretariat support for this project was provided by the Royal College of Physicians and Surgeons of Canada.

Notes on contributors

Larry Gruppen, PhD, is Professor of Learning Health Sciences and Director of the Master of Health Professions Education Program, Department of Learning Health Sciences, University of Michigan Medical School, USA.

Jason R. Frank, MD, is Director, Specialty Education, Strategy, and Standards in the Office of Specialty Education at the Royal College of Physicians and Surgeons of Canada, and the Director of Educational Research & Development in the Department of Emergency Medicine, University of Ottawa, Canada.

Jocelyn Lockyer, PhD, is Senior Associate Dean of Education, and Professor, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada.

Shelley Ross, PhD, is Associate Professor and Director of Research and Innovation, Competency-Based Achievement System Program, in the Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Canada.

M. Dylan Bould, MB ChB, is Associate Professor, Department of Innovation in Medical Education, University of Ottawa and Associate Professor of Anesthesiology, Department of Pediatric Anesthesia, Children's Hospital of Eastern Ontario, Canada.

Peter Harris, MB BS, is a Senior Lecturer in the Office of Medical Education, University of New South Wales, Australia.

Farhan Bhanji, MD, is Associate Director of Assessment and Clinician Educator at the Royal College of Physicians and Surgeons of Canada, and Professor of Pediatrics and Director of Pediatric Simulation at McGill University, Canada.

Brian D. Hodges, MD, PhD, is Professor in the Faculty of Medicine and Faculty of Education at the University of Toronto, the Richard and Elizabeth Currie Chair in Health Professions Education Research at the Wilson Centre for Research in Education and Vice President Education at the University Health Network, Canada.

Linda Snell, MD, is Professor of Medicine and Core Faculty member, Centre for Medical and Department of General Internal Medicine, McGill University, Canada, and Senior Clinician Educator, Royal College of Physicians and Surgeons of Canada, Canada.

Olle ten Cate, PhD, is Professor of Medical Education and Director of the Centre for Research and Development of Education, University Medical Center Utrecht, the Netherlands.