Shifting Anatomy Away From a Time-Based Model: Competency-Based Education Insights for Anatomy Educators.

In the current competitive and globalized economy, employers and professional organizations call for higher education institutions to deliver graduates with relevant competencies and skills. In response, a growing number of higher educational institutions is introducing competency-based education. This is particularly true for health science programs, which have a tradition of applying a case-based or problem-based learning approach. The effort to merge a problem- or case-based online learning approach with competency-based education offers various opportunities, while facing numerous challenges. To support these efforts, this paper aims at identifying suitable practices, as well as challenges for online course design and online learning activities for higher education health science programs, when integrating competency-based education with an online problem-based and/or case-based learning approach. It found various opportunities for online learning activities that support competency-based education, problem-based learning and case-based learning, whereas challenges relate to logistics, administration, and the affordances of an LMS.

Purpose: Clinically-oriented anatomy education has been proposed as an effective strategy in anatomy curricula. We aimed to explore the level of extent the literature supports the fact that case-based learning (CBL) can play a significant role in anatomy education.Materials and methods: We searched PubMed, Scopus, Education Resources Information Center (ERIC), and Cochrane database to find articles with the purpose to explore the educational outcomes of case-based anatomy learning. We extracted from each paper authors, type of study (comparative or not), number of participants, level of outcome according to the Kirkpatrick hierarchy, outcomes of CBL concerning the acquisition of anatomical knowledge, and the participants’ perceived enjoyment, motivation, and aid to anatomy learning.Results: Nine articles were included. Three of them evaluated the acquisition of anatomical knowledge, while six papers evaluated the participants’ perceptions. All studies showed positive outcomes regarding the students’ anatomy examination performances, reported confidence, enjoyment, motivation, and ability of CBL to facilitate anatomy learning.Conclusion: Although the existing research has mainly evaluated students’ perceptions, the outcomes of CBL in anatomy education encourage more extensive use of this method in anatomy curricula. Further research is expected to shed more light on the role that CBL can play in modern anatomy education and to clarify if it can replace or supplement didactic teaching.

IntroductionSince the early 1900s, time devoted to studying anatomy in medical schools has substantially decreased. Although the number of students enrolled in health professions education programs is increasing, a shortage of formally trained gross anatomists persists. Consequently, anatomy education and learning must be efficient and effective. Programs training the next generation of anatomy educators need to be sure that graduates obtain particular knowledge and skill sets. Competency‐based education (CBE) may provide one such approach. Extensive research on competency‐based education (CBE) exists in medical education that provides developmental milestones and entrustable professional activities (EPAs). A similar process involving CBE and EPAs would benefit anatomy education program development graduates of such programs, students of teachers from such programs, and ultimately patients.AimThe purpose of this research is to identify five key papers in CBE that are most influential for providing a foundation for developing competencies in training the next generation of anatomists as educational specialists.MethodsCritical interpretive synthesis (CIS) will be utilized to identify, summarize, and integrate five key papers into a primer for emerging anatomy educators on competencies highlighted in literature and through professional societies. A comprehensive search of PubMed/MEDLINE, CINAHL, and ERIC databases published in English from 1990–2020 utilizing terms including competency‐based education, faculty development, and anatomy education. Additional searches through relevant journal article’s bibliographies will also be conducted. Papers’ relevance will be given a numerical value based on relevance and usability. A student learning community will be established to generate a cumulative list of the 20 most highyielding papers regarding anatomy education and CBE. These numerical results will go through several iterative processes, inspired by the Delphi methodology, to generate a top five ranked articles that will then be analyzed and integrated into a single CIS paper for publication.ResultsMain concepts from the five key CBE papers will be amalgamated into one primer through CIS to lay the groundwork for developing competencies for future anatomists as education specialists.Discussion and ConclusionResults of this study will aid in helping anatomy educators attain competency and aid in developing and designing curricula to train the next generation of anatomy educators.

Objective To explore the effective evaluation methods of case-based learning (CBL) in critical disease teaching.Methods Totally 53 undergraduate students in department of clinical medicine of Shanghai Jiao Tong University,who practiced in our hospital from 2010 to 2012,were divided into the traditional teaching group and CBL teaching group.We used traditional teaching combining with CBL teaching in CBL group.Common cases of critical illness(severe acute pancreatitis and multiple trauma)in intensive care unit (ICU) were selected for CBL cases.The evaluation of theoretical knowledge,mini-clinical evaluation exercise(Mini-CEX)and direct observation of procedural skills (DOPS) were continued after teaching and practice.Results These was no significant difference in the theoretical knowledge examination between the two groups. In Mini-CEX,the students in CBL group were better concerning the medical interview capacity (P=0.000),humanistic care (P=0.013),clinical diagnosis(P=0.035),counseling(P=0.009) and the overall clinical competence (P=0.008) than those in traditional teaching group.The DOPS scores of endotracheal intubation (P=0.016)and central venous catheterization (P=0.001)discussed in CBL teaching were significantly higher in CBL group.Conclusion Traditional theoretical knowledge examination has little significance in the assessment of CBL teaching,but Mini-CEX and DOPS can reflect the advantages of CBL teaching better in the assessment of clinical abilities and skills. Key words: Case-based learning; Teaching evaluation; Mini-clinical evaluation exercise; Direct observation of procedural skills

Evaluating the Strengths and Barriers of Competency-Based Education in the Health Professions

Advancing leadership in medical radiation sciences: Incorporating systematic leadership education in pre-registration curricula

University of Wisconsin School of Medicine and Public Health.

Anatomy is the important first big subject in medical school. It is a true basic science, because all the other later subjects are dependent on the knowledge of what are the different parts of the body. Gross anatomy looks at the body parts as we observe them in actual life. Histology looks at what are the types of tissues that form these body parts, and how these structures get to work together. Biomolecular studies now look at the basic cellular components and functions at even smaller aspects. Having a firm understanding of what the body parts are gives us better knowledge of how they function, how and where disease develops, and how to manage them. The basic structure of the human body does not change, at least in our lifetimes. Thus, there was the belief and understanding that the science of anatomy may be static. There may not be much excitement in the study of anatomy and thus in the teaching of it. Competent clinicians, however, particularly those in the surgical specialties, need a deep understanding of anatomy for safe clinical procedures. Students may have had very limited exposure to anatomy during clinical training. There is a concern that medical students are ill-prepared in anatomy when entering clerkships and residency programs. 1 It was thus very challenging to teach it and to learn it. A literature review and analysis by Kumar et al. showed that there were deficiencies in anatomical schedule, curriculum, teaching methodologies, and evaluation system in present medical education programs. 2 In recent years, the development of technology and the creative crop of faculty members have made the teaching and learning of anatomy very exciting. This special issue is about the teaching of Anatomy, with articles based on the experiences and research of the faculty of the Department of Anatomy of the University of the Philippines (UP) College of Medicine. A lead article describes a short history of the department, which was actually one of the first departments established in the medical school. The article focuses on its rich experience in the teaching of anatomy which has definitely evolved through the years (Genuino et al., The Department of Anatomy in the University of the Philippines College of Medicine: Dissecting the History). Department most particular. How would the usual teaching of practical anatomy, which generally used a hands-on approach, be done in the period of strict quarantines, and social and physical distancing? The pandemic caused an abrupt transition from face-to-face to online anatomy teaching, learning, and assessment. Although online education has ensured the continuity of anatomy education during the pandemic, its implementation has been challenging, and its effectiveness has been questioned. 3 The Department developed Learning Enhancement in Anatomy Program or LEAP which would address this great need, and prevented any major delay in the teaching and learning activities of batches of medical students (Tecson et al., Student Evaluation of a Learning Enhancement in Anatomy Program (LEAP) during the COVID-19 Pandemic: A Retrospective Study). Online classes for lectures, demonstrations, and group discussions were conducted. A survey among students looked at their impressions and satisfaction when studying histology using virtual and actual light microscopy (Mantaring and Tecson, Satisfaction of Medical Students in Studying Histology Using Virtual and Light Microscopy: A Cross-sectional Study). An overall assessment of the teaching and learning experiences of faculty and students during the pandemic period was also conducted and reported (Mantaring et al., Students and Faculty Experiences, Perceptions and Knowledge on Distress during the COVID-19 Pandemic: A Descriptive Cross-sectional Study). The innovations, changes, and adjustments made either intentionally or serendipitously during the pandemic have made good progress in improving Anatomy education in the Department. There were innovations in teaching materials, using better or different models and specimen. It cannot be thought anymore of as a "dead" subject dealing with "dead people". There were also innovations in teaching strategies and approaches, using various platforms and technology. Learning has now become more interactive, more exciting, and definitely more interesting. It has become an "alive" teaching experience. The best way to teach modern anatomy is by combining multiple pedagogical resources to complement one another. Students appear to learn more effectively when multimodal and system-based approaches are integrated. 1 The Department is on the right track with the modern trends in anatomy education. The traditional anatomy education based on topographical structural anatomy taught by didactic lectures and complete dissection of the body with personal tuition, has been replaced by a multiple range of special study modules, problem-based workshops, computers, plastic models, and many other teaching tools. 4 With a set of motivated, creative, and dedicated faculty in the Department of Anatomy, new approaches were established, more research on using new types of models and innovations in teaching/learning were done, much to the benefit of the students. Significant landmarks can now be added to the history of the Department.

The role of technology in assessment, documentation, and tracking of clinical competencies in radiography education

University of Michigan Medical School.

The aim of undergraduate dental education is to provide competent dentists to serve societal needs and improve population oral healthcare. Competency-based education has influenced the development of dental education for decades but this term is problematic. This article explores components of competency-based undergraduate health professional education in order to help the dental profession have a better understanding of the context and purposes of undergraduate dental education. This is a discussion paper based on a wide reading of the literature on the education of health professionals with a specific focus on competency-based undergraduate education. Competence comprises an integration of knowledge, skills and attitudes indicating a capability to perform professional tasks safely and ethically. The process of becoming a competent practitioner is complex. Four characteristics of competency-based education are: curriculum components and content shaped by societal needs; focused on student-centred learning; learning achievement; and limited attention to time-based training and numerical targets. Alongside a competency-based approach, undergraduate dental education can be influenced by institutional features and external factors but these receive little consideration in the literature. Understanding competence, competency-based education, and institutional and external factors will help to improve educational quality, define roles and professional development for the dental educator, and inform further research.

Background The introduction of clinical scenarios or case-based learning within the practical gross anatomy sessions is one way of vertically integrating anatomy into medical curricula. This study presents the overall outcome of including case-based learning within the practical classes of gross anatomy to undergraduate final anatomy students (semester four), in the Faculty of Medicine, University of Khartoum. Methods This descriptive interventional study was implemented during gross anatomy practical sessions for final anatomy students (semester four) at the Faculty of Medicine, University of Khartoum. Case-based learning was added to traditional prosection-based stations. Data concerning the responses of participants to different items of Likert scale questions were collected through a self-administered questionnaire. The questionnaire covered aspects of gross anatomy teaching and learning. In addition, final anatomy examination scores (students who were exposed to case-based learning) were compared to scores of the previous year (not exposed to case-based learning). Data were analyzed using statistical package for social sciences version 20. Results Participants who responded to the questionnaire were 216 (78 males, 136 females and 2 were missing) out of 313, generating a response rate of 69%. The mean age of the participants in the study was 18.9 ± 0.84 years. Students reported increased satisfaction in all sessions where clinical scenarios casebased learning were included. The percentage of students who chose the options ‘strongly agree’ or ‘agree’ in the different questionnaire items were as follows:84.9 % for ‘’help in formulation of intended learning outcomes’, 76.8% for ‘gain of deep knowledge versus superficial knowledge’, 71.3% for ‘increased retention of anatomical facts’, 62.5% for ‘increased interest in anatomy course’, 74.4% for ‘increased understanding of gross anatomy course’, 76.4% for ‘enjoying gross anatomy’ and 72.9% expressed overall student satisfaction. Most of the students (89.7%) recommended continuation of the integrated casebased learning sessions. There was a significant improvement in students` scores in gross anatomy final examination when compared to previous year’s scores of students who were not exposed to case-based learning. The mean scores were 69.7 ± 16.6 and 64.2 ± 17.9, respectively (d=0.317, P<0.001). Conclusion Introduction of case-based learning within prosection-based gross anatomy sessions resulted in better levels of students’ satisfaction and improved students’ performance in the final gross anatomy examination.

The healthcare education landscape is evolving. Recent years have seen a change in conceptualisations of learning, assessment and time-based versus competency-based education (CBE).1 These changes will influence healthcare provider training and ultimately the clinical care they provide to patients. CBE has elevated the discourse surrounding clinical competencies and entrustable professional activities.2 Inherent to this focus on educational outcomes is a renewed attention on the role of formative clinical experiences: how we engage and empower learners in their own education; how we organise workplace-based learning to provide the graded supervision our trainees require while maintaining patient safety; and how we help our trainees maximise learning from clinical practice and progress in their training through robust assessment and feedback mechanisms.2 ,3 This changing landscape places a heavy burden on busy clinician educators who themselves may require significant training and faculty development to translate the emerging educational science into effective clinical teaching practice. The very nature of CBE requires clinical educators to assess learners frequently in a manner that allows reliable and valid inferences across the spectrum of clinical competencies that are required for their specific training programme.1 In addition, assessment of individual learner competencies will occur in workplace settings where clinical care is a team activity. We see a mismatch between a CBE approach we value and strive for and the relative underemphasis of faculty teaching skills required for its effective implementation and outcomes assessment. Without equal and parallel attention to clinical educator training, we fear this disconnect has the potential to undermine the translation of promising advances gleaned from healthcare education research into widespread clinical education. The increasing adoption of healthcare …

Competency-based education is increasingly being adopted across the health professions. A model for competency-based education in veterinary medicine was recently developed by a working group of the American Association of Veterinary Medical Colleges (AAVMC) and is being used in institutions worldwide. The purpose of this study was to gather information on progress in and barriers to implementing competency-based education (including use of the AAVMC competency-based veterinary education [CBVE] Model) by AAVMC member schools to inform the development of strategies to support institutions in successful implementation of the CBVE Model. A cross-sectional survey was developed and distributed to AAVMC member institutions via an AAVMC web-based communication platform. Thirty-four of 55 AAVMC member institutions responded to the survey (62% response rate). Twenty schools reported using a competency-based education framework. Eleven of these institutions had implemented the AAVMC CBVE Framework, with an additional 12 institutions anticipating implementing it over the next 3 years. Timing, resources, and change management were the most commonly reported challenges to implementation. Suggestions for development of training resources included translation of milestones to pre-clinical courses, development of assessments, guidance on making progress decisions, illustrative overviews of specific components of the CBVE Model (e.g., the AAVMC CBVE Framework, EPAs, entrustment scales, milestones), and curriculum mapping. This study assesses progress in implementing the CBVE Model in AAVMC member schools and aids in identifying key challenges and resources to support faculty and institutions in the successful adoption and implementation of this educational model.

Implications for educator preparation programs considering competency‐based education