Evolving concepts of assessment in a competency-based world

Abstract

Competency-based medical education (CBME) is an approach to the design of educational systems or curricula that focuses on graduate abilities or competencies. It has been adopted in many jurisdictions, and in recent years an explosion of publications has examined its implementation and provided a critique of the approach. Assessment in a CBME context is often based on observations or judgments about an individual’s level of expertise; it emphasizes frequent, direct observation of performance along with constructive and timely feedback to ensure that learners, including clinicians, have the expertise they need to perform entrusted tasks. This paper explores recent developments since the publication in 2010 of Holmboe and colleagues’ description of CBME assessment. Seven themes regarding assessment that arose at the second invitational summit on CBME, held in 2013, are described: competency frameworks, the reconceptualization of validity, qualitative methods, milestones, feedback, assessment processes, and assessment across the medical education continuum. Medical educators interested in CBME, or assessment more generally, should consider the implications for their practice of the review of these emerging concepts.

Disclosure statement

The supplement coeditors and authors declare that they have no competing interests. Resources and secretariat support for this project was provided by the Royal College of Physicians and Surgeons of Canada.

Notes on contributors

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

Farhan Bhanji, MD, is an 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

Maureen Topps, MB ChB, is an Associate Dean, Postgraduate Medical Education, and Associate Professor, Department of Family Medicine, University of Calgary, Canada.

Shelley Ross, PhD, is an 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.

Steven A. Lieberman, MD, is a Professor and Senior Dean for Administration, Office of the Dean of Medicine, Department of Internal Medicine, Division of Endocrinology, University of Texas Medical Branch at Galveston, USA.

Jason R. Frank, MD, is the 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.

Linda Snell, MD, is a 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.

Jonathan Sherbino, MD, is an Associate Professor in the Department of Medicine, McMaster University, and an Assistant Dean with Program for Education Research and Development, McMaster University, Canada.