Implementing Competency-Based Medical Education in Family Medicine: A Scoping Review on Residency Programs and Family Practices in Canada and the United States.

Abstract

While family medicine has been one of the first specialties to implement competency-based medical education (CBME) in residency, the nature and level of its integration with continuing professional development (CPD) is neither well understood nor well studied. The purpose of this review was to examine the current state of CBME implementation in family medicine residency and CPD programs in the North American education literature, with the aim of identifying implementation concepts and strategies that are generalizable to other medical settings to inform the design and implementation of residency training and CPD. Using an Arksey and O'Malley six-step framework, we searched five online databases and the gray literature over the period between January 2000 through April 2017. We included full-text articles that focused on the key words CBME, residency, CPD, and family medicine. Of the articles reviewed, 37 met the inclusion criteria and were selected for full review. Eighty six percent of included articles focused on foundation elements related to designing competency-based curriculum and assessment strategies rather than program evaluation or other outcome measures. Only 19% of the articles were related to CPD that focused only on the implementation at the program and/or institution/organization levels. Given that the implementation of CBME is in its relative infancy, the pattern of implementation activities described in this scoping review reflected a limited focus on a broad range of issues related to fidelity of implementation of this complex intervention.