Implementing competency-based medical education: What changes in curricular structure and processes are needed?

Abstract

Medical educators must prepare for a number of challenges when they decide to implement a competency-based curriculum. Many of these challenges will pertain to three key aspects of implementation: organizing the structural changes that will be necessary to deliver new curricula and methods of assessment; modifying the processes of teaching and evaluation; and helping to change the culture of education so that the CBME paradigm gains acceptance. This paper focuses on nine key considerations that will support positive change in first two of these areas. Key considerations include: ensuring that educational continuity exists amongst all levels of medical education, altering how time is used in medical education, involving CBME in human health resources planning, ensuring that competent doctors work in competent health care systems, ensuring that information technology supports CBME, ensuring that faculty development is supported, ensuring that the rights and responsibilities of the learner are appropriately balanced in the workplace, preparing for the costs of change, and having appropriate leadership in order to achieve success in implementation.

Disclosure statement

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

Notes on contributors

Markku T. Nousiainen, MD, is Associate Professor, Department of Surgery, University of Toronto, and Program Director, Division of Orthopaedic Surgery, University of Toronto, Canada.

Kelly J. Caverzagie, MD, is Associate Dean for Educational Strategy, College of Medicine, University of Nebraska Medical Center and Vice-President for Education, Nebraska Medicine, USA.

Peter C. Ferguson, MD, is Associate Professor, University Musculoskeletal Oncology Unit, Mount Sinai Hospital, University of Toronto, Canada.

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.