Competency-Based Medical Education: Benefits, Challenges and Future

CBME is an outcomes-based approach to medical education and one of the key aspects that it reforms are assessments. These assessments must be performed in real-time. 1 [McMaster CBME Guide, pg 3,7] In order to achieve this, CBME takes advantage of technology, allowing for an improved educational experience for residents. This technology should be used in all aspects of teaching and assessment. 2 [Nousiainen, pg 5]

The benefits to residents include:

• Individualized learning
• Increased flexibility
• Innovative assessments
• Preparedness for practice

The benefits to faculty include:

• Real-time assessments
• Learner-driven
• Well-defined learning outcomes
• Focus on observable competencies

The benefits to patients include:

• Patient-centered care
• Resident assessments
• Physician accountability

However, there are some major challenges that need to be considered before implementing CBME.

The Challenges of Implementing CBME

There are two major challenges:

1. The sheer size of university programs, which would require organizational changes to handle CBME implementation
2. How to assess residents based on the CBME curriculum and address questions such as:3 [Caccia, pg 2,4]
   • How do you assess residents in real time with direct observation in the clinical setting?
   • How do you implement formative assessment?
   • How do you detect residents who need help, earlier?
3. Given these challenges, how do you implement CBME successfully?

The Successful Implementation of CBME

In a recent case study, we discussed how some universities had successfully tackled these challenges by:

• Creating a departmental structure to handle all CBME-related curriculum and implementation issues
• Incorporating a robust electronic platform that could manage CBME across all residency programs and faculties

The benefits of using such a SYSTEM include:

• An intuitive platform with a quick onboarding process
• An inclusive solution that worked for both the Royal College of Physicians and  Surgeons of Canada and the College of Family Physicians of Canada.
• Real-time, automatic form building of all assessment forms based on templates. This allowed for instantaneous reporting of things such as: Learner Summary Reports, Stage Reports, EPA Summary Reports, EPA Milestone Reports, and other real-time reports
• A mobile interface that allowed for daily, direct observation. Instead of one assessment per block under the previous system, assessments could now be submitted on the mobile interface, allowing for real-time CBME observation
• A single solution that worked for everyone, including residents, supervisors, and competency committees. This allowed for a single source for all documentation, saving time and resources

This allowed McMaster University to successfully roll out CBME across the majority of its residency programs. Using their example, other programs and institutions can also make the transition as pain-free as possible.

In conclusion, the paradigm shift in the teaching and learning approach to medical education, known as CBME, will help create physicians who are able to meet the needs of today’s complex healthcare environment where healthcare systems and patient care needs are changing dramatically.4 [Ross, pg 1,2] The shift to CBME has already begun across North America and Europe, with the RCPSC and the CFPC, implementing these changes across Canadian medical residency programs.1,3,6 [McMaster, pg 3] [Caccia, pg 5] [CFPC, pg 4] And although there are challenges to its implementation, the benefits are definitely far greater.

Key Takeaways

• CBME is the future of medical education and is already being implemented across Canada
• The benefits of CBME apply to not only residents and faculty but also to patients
• The challenge of implementing CBME includes the need for a robust electronic platform to manage it across all programs and individuals
• LGI Education is a complete and robust solution that meets the needs of CBME implementation for medical schools and residency programs

LGI Education is a cloud solution, designed in collaboration with faculty and administrators from medical schools with the goal to streamline the management and administration of medical education.

Learn More by Downloading our Webinar

Do you play a role in implementing and improving competency-based medical education programs? We encourage you to download our recorded webinar, Mitigating the Challenges of CBME: The Need for the Right Platform, to learn how you can leverage technology to drive positive change in medical education.

References

References: 1. McMaster University. A Guide to CBME/CBD. Available at: https://psychiatry.mcmaster.ca/docs/default-source/default-document-library/mac-cbme-guide.pdf?sfvrsn=0. Accessed: December 2020. 2. Caccia N, et al. Competency-based medical education: the wave of the future. Journal of Obstetrics and Gynaecology Canada 2015; 349–353. 3. Nousiainen MT, et al. Implementing competency-based medical education: What changes in curricular structure and processes are needed? Medical Teacher 2017;39(6):594–598. 4. Ross S, et al. Outcomes are what matter: Competency-based medical education gets us to our goal. MedEdPublish 2018. DOI: 10.15694/mep.2018.0000085. 5. CFPC. Triple C Competency-based Curriculum. Available at: https://portal.cfpc.ca/resourcesdocs/uploadedFiles/Education/_PDFs/WGCR_TripleC_Report_English_Final_18Mar11.pdf. Accessed: December 2020.