Abstract
In postgraduate medical education, required competencies are described in detail in existing competency frameworks. This study proposes an alternative strategy for competency-based medical education design, which is supported by change management theories. We demonstrate the value of allowing room for re-invention and creative adaptation of innovations. This new strategy was explored for the development of a new generic competency framework for a harmonised European curriculum in Obstetrics and Gynaecology. The generic competency framework was developed through action research. Data were collected by four European stakeholder groups (patients, nurses, midwives and hospital boards), using a variety of methods. Subsequently, the data were analysed further in consensus discussions with European specialists and trainees in Obstetrics and Gynaecology. These discussions ensured that the framework provides guidance, is specialty-specific, and that implementation in all European countries could be feasible. The presented generic competency framework identifies four domains: ‘Patient-centred care’, ‘Teamwork’, ‘System-based practice’ and ‘Personal and professional development’. For each of these four domains, guiding competencies were defined. The new generic competency framework is supported by European specialists and trainees in Obstetrics and Gynaecology, as well as by their European stakeholders. According to change management theories, it seems vital to allow room for re-invention and creative adaptation of the competency framework by medical professionals. Therefore, the generic competency framework offers guidance rather than prescription. The presented strategy for competency framework development offers leads for implementation of competency-based medical education as well as for development of innovations in postgraduate medical education in general.
Highlights
Patients expect their physicians to be experts in their medical field, and to work effectively in teams, deliver patient-centred care and communicate well with patients and colleagues for the sake of quality of care and patient safety (Gillam and Siriwardena 2014; Goleman 2006)
We aimed to answer the following research question: Based on a change management perspective, which generic competencies do European Obstetrics and Gynaecology (OBGYN) specialists need to develop during training, according to the stakeholders? In order to optimally involve the stakeholders in this research, we chose an action research approach
This study describes a first step in the exploration of an alternative strategy for competency-based medical education (CBME) design, namely to consider the implementation of CBME from a change management perspective
Summary
Patients expect their physicians to be experts in their medical field, and to work effectively in teams, deliver patient-centred care and communicate well with patients and colleagues for the sake of quality of care and patient safety (Gillam and Siriwardena 2014; Goleman 2006). Leading examples of internationally applicable competency frameworks that have been developed through extensive research are the ‘Canadian Medical Education Directions for Specialists (CanMEDS)’, the ‘Core Competencies’, the ‘Tomorrow’s Doctor’ and the ‘Scottish Doctor’ (Frank et al 2015; Rubin and Franchi-Christopher 2002; Simpson et al 2002; Swing 2007) These frameworks describe the required competencies into detail, based on the conviction that offering detail in learning and assessment outcomes facilitates implementation of the frameworks (Bank et al 2017; Hawkins et al 2015). To gain a better understanding of the resistance to implementation of CBME, and of generic competency frameworks, we felt the need to take a step back and explore whether alternative strategies in CBME design may enhance implementation of CBME in PGME
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