Advancing anti-oppression and social justice in healthcare through competency-based medical education (CBME)

Abstract

Competency-based medical education (CBME) focuses on preparing physicians to improve the health of patients and populations. In the context of ongoing health disparities worldwide, medical educators must implement CBME in ways that advance social justice and anti-oppression. In this article, authors describe how CBME can be implemented to promote equity pedagogy, an approach to education in which curricular design, teaching, assessment strategies, and learning environments support learners from diverse groups to be successful. The five core components of CBME programs – outcomes competency framework, progressive sequencing of competencies, learning experiences tailored to learners’ needs, teaching focused on competencies, and programmatic assessment – enable individualization of learning experiences and teaching and encourage learners to partner with their teachers in driving their learning. These educational approaches appreciate each learner’s background, experiences, and strengths. Using an exemplar case study, the authors illustrate how CBME can afford opportunities to enhance anti-oppression and social justice in medical education and promote each learner’s success in meeting the expected outcomes of training. The authors provide recommendations for individuals and institutions implementing CBME to enact equity pedagogy.

Keywords:

• Ethics/attitudes
• outcome-based
• medicine
• postgraduate

Acknowledgements

The authors would like to thank Dr Thais Tweed for her initial feedback on the conceptualization of the paper, their home institutions, and fellow members of the international competency based medical educators (ICBME) collaborative for their support of innovation.

Sustainable developmental goals: SDG 10: Reduced inequalities – ‘Reduce inequality within and among countries.’

Disclosure statement

This supplement is not funded by the RCPSC. Most authors are members of the ICBME.

Additional information

Notes on contributors

Jamiu O. Busari

Jamiu O. Busari, MD, PhD, MHPE, FRCPC (Hons), Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; Department of Pediatrics, Dr. Horacio Oduber Hospital, Oranjestad, Aruba.

Linda Diffey

Linda Diffey, MSc, PhD, Max Rady College of Medicine, Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.

Karen E. Hauer

Karen E. Hauer, MD, PhD, Associate Dean for Competency Assessment and Professional Standards, Professor of Medicine, University of California, San Francisco School of Medicine, San Francisco, CA, USA.

Kimberly D. Lomis

Kimberly D. Lomis, MD, Vice President Medical Education Innovations, American Medical Association, Chicago IL, USA.

Jonathan M. Amiel

Jonathan M. Amiel, MD, Office of Innovation in Health Professions Education and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, USA.

Michael A. Barone

Michael A. Barone, MD, MPH, Vice President Competency-based Assessment, NBME. Philadelphia, PA, USA. Adjunct Associate Professor of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Karen Schultz

Karen Schultz, MD, PGME Queen’s University, Kingston, Ontario, Canada; Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada.

H. Carrie Chen

H. Carrie Chen, MD, PhD, Senior Associate Dean of Assessment and Educational Scholarship, Professor of Pediatrics, Georgetown University School of Medicine, Washington DC, USA.

Arvin Damodaran

Arvin Damodaran, MBBS, MmedEd, School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, Australia.

David A. Turner

David A. Turner, MD, Vice President, Competency-Based Medical Education, American Board of Pediatrics, Chapel Hill, NC, USA. Consulting Professor, Department of Pediatrics, Division of Pediatric Critical Care, Duke Health System, Durham, NC, USA.

Benjamin Jones

Benjamin Jones, MD, MHLM, Health Systems Collaborative, Nuffield Department of Medicine, Oxford, UK.

Ivy Oandasan

Ivy Oandasan, MD, MHSc, Clinician Investigator, Toronto General Hospital Research Institute (TGHRI).

Ming-Ka Chan

Ming-Ka Chan, MD, MHPE, FRCPC, Co-Director, Office of Leadership Education, Rady Faculty of Health Sciences and Equity, Diversity, Inclusivity and Social Justice Lead, Department of Pediatrics & Child Health, University of Manitoba and The Children’s Hospital of Winnipeg, Winnipeg, Manitoba, Canada.