Making sense of competency-based medical education (CBME) literary conversations: A BEME scoping review: BEME Guide No. 78

Abstract

Background

Competency-based medical education (CBME) received increased attention in the early 2000s by educators, clinicians, and policy makers as a way to address concerns about physician preparedness and patient safety in a rapidly changing healthcare environment. Opinions and perspectives around this shift in medical education vary and, to date, a systematic search and synthesis of the literature has yet to be undertaken. The aim of this scoping review is to present a comprehensive map of the literary conversations surrounding CBME.

Methods

Twelve different databases were searched from database inception up until 29 April 2020. Literary conversations were extracted into the following categories: perceived advantages, perceived disadvantages, challenges/uncertainties/skepticism, and recommendations related to CBME.

Results

Of the 5757 identified records, 387 were included in this review. Through thematic analysis, eight themes were identified in the literary conversations about CBME: credibility, application, community influence, learner impact, assessment, educational developments, organizational structures, and societal impacts of CBME. Content analysis supported the development of a heat map that provides a visual illustration of the frequency of these literary conversations over time.

Conclusions

This review serves two purposes for the medical education research community. First, this review acts as a comprehensive historical record of the shifting perceptions of CBME as the construct was introduced and adopted by many groups in the medical education global community over time. Second, this review consolidates the many literary conversations about CBME that followed the initial proposal for this approach. These findings can facilitate understanding of CBME for multiple audiences both within and outside of the medical education research community.

Keywords:

• Competency-based medical education
• evaluation
• implementation
• medical education
• scoping review

Acknowledgements

The authors express gratitude to Robin Featherstone, MLIS for her introductory work on the search strategy for this complex review and Liza Bialy, MSc for her early work assisting with the project.

Disclosure statement

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

Glossary

Literary conversation: A written account or discussion about CBME, the implementation of CBME, and/or the real/anticipated outcomes of CBME.

Additional information

Funding

Part of this work was supported by the Alberta Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit Knowledge Translation Platform, which is funded by Alberta Innovates and the Canadian Institutes of Health Research. Part of this work was supported by the Graduate Student Internship Program at the University of Alberta and the Northern Alberta Academic Family Medicine Fund from the University of Alberta.

Notes on contributors

Deena M. Hamza

Dr. Deena M. Hamza, PhD, Implementation Scientist, Director of Research and Evaluation, Postgraduate Medical Education, University of Alberta, Canada.

Karen E. Hauer

Dr. Karen E. Hauer, MD/PhD, Associate Dean of Competency Assessment and Professional Standards, Professor of Medicine, University of California, San Francisco, United States.

Anna Oswald

Dr. Anna Oswald, MD/MMEd, Professor, Director of CBME for Postgraduate Medical Education, University of Alberta, Canada.

Elaine van Melle

Dr. Elaine van Melle, PhD, Consultant, Royal College of Physicians and Surgeons of Canada, Ottawa, Canada.

Zeenat Ladak

Zeenat Ladak, MSc, Graduate Student Intern, Postgraduate Medical Education, University of Alberta, Canada.

Ines Zuna

Ines Zuna, MSc, Medical Student, Undergraduate Medical Education, University of Alberta, Canada.

Mekdes E. Assefa

Dr. Mekdes E. Assefa, MD MPH, Graduate Student Intern, Postgraduate Medical Education, University of Alberta, Canada.

Gabrielle N. Pelletier

Gabrielle N. Pelletier, MEd, Graduate Student Intern, Postgraduate Medical Education, University of Alberta, Canada.

Meghan Sebastianski

Meghan Sebastianski, PhD, Project Manager, Alberta Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit Knowledge Translation Platform, University of Alberta.

Diana Keto-Lambert

Diana Keto-Lambert, MLIS, Information Scientist, Alberta Strategy for Patient-Oriented Research (SPOR) SUPPORT Unit Knowledge Translation Platform, University of Alberta.

Shelley Ross

Dr. Shelley Ross, PhD, Associate Professor, Director of Research & Development, CBAS Support Program, Department of Family Medicine, University of Alberta, Canada.