Competency-based Education Research Articles

Evaluation of Elective Posting on Adverse Drug Reaction and Pharmacovigilance under Competency-based Medical Education Curriculum among Undergraduates: A New Step in Medical Education

Abstract Context: The revised competency-based medical education, the students of 3rd-year part I MBBS are required to undergo elective postings of 1 month based on the student’s needs and choice. Aims: This study was undertaken to evaluate the outcome of elective posting of pharmacovigilance and adverse drug reaction (ADR) reporting as a new teaching tool in pharmacology among 3rd-year part I MBBS students. Settings and Design: The students undergoing the elective posting of pharmacovigilance and ADR reporting were evaluated for their knowledge, completeness score (out of 10) of ADRs reported, and their feedback with respect to the posting, in a pretested questionnaire. Subjects and Methods: It was a descriptive cross-sectional type conducted in the Pharmacology Department of Dr. Balasaheb Vikhe Patil Rural Medical College and Dr. Vitthalrao Vikhe Patil Pravara Rural Hospital, Loni. Results: Six students participated in the study, who reported 96 ADRs. Most of the ADRs (39, 40.6%) were reported immediately after their appearance. The average completeness score of the ADRs reported was 9.44 ± 0.41. The students gave an average score of 1.2 for overall experience of the posting (1 – best and 5 – worst). Conclusions: The elective posting with pharmacovigilance and ADR reporting module had a positive impact on the quality of ADR reporting in terms of completeness, causality assessment as well as time of reporting. The students felt confident in reporting ADRs and reflected positively toward the training module.

IJCM_394A: Participation of Undergraduate Medical Students in Health Research and Factors Influencing It in a Medical College of Puducherry- A Cross-Sectional Study

Background: Developing, maintaining, and sustaining undergraduate medical students’ research involvement will enable future healthcare practitioners to practice more appropriate evidence-based clinical medicine. Objective: To assess the participation in health research and factors promoting it among undergraduate medical students in Puducherry. Methodology: A descriptive cross-sectional study was conducted among undergraduate medical students in Puducherry over a period of three months (August-October 2023). Systematic random sampling was applied to recruit 360 study participants based on Chellaiyan et al. A pre-tested, semi-structured questionnaire was used to collect the data, including socio-demographic characteristics, academic performance, participants’ attitudes, perceived motivational and barrier factors towards health research, and current involvement in health research. Data were entered in MS Excel 2019 and analyzed using SPSS v16.0. Results: A total of 360 participants were interviewed, of whom 51.6% were female and the majority (86.7%) were hostelers. Among the 360 study participants, only around one-tenth of the participants”41 (11.39%)” have participated in the health research. The factors of gender, competency-based medical education approach, and grade of the participants in the recent university exam were associated with participation in health research. The majority (90.4%) of the participants were highly motivated to participate in health research. The main barriers identified are lack of funds, collaboration, mentorship, time to conduct, and systematic training in the research methodology. Conclusion: Participation in health research has doubled since the introduction of competency-based medical education. Still, participation could be improved by addressing the identified barriers. Studentship programs, young researcher awards, systematic training programs integrated into the curriculum, etc. could also compute the participation in health research among undergraduate medical students.

Motivations for Entrustable Professional Activity Assessment: Gaps Between Curriculum Theory and Resident Reality.

Background Previous research demonstrates mixed reactions from residents toward competency-based medical education (CBME), and entrustable professional activities (EPAs) specifically. However, understanding what motivates residents to obtain EPAs may be vital to the longevity of CBME, given the emphasis on assessment for learning under this paradigm. Objective This study explored resident perspectives across 3 domains: motivation for obtaining EPAs, perceived importance of EPAs, and overall thoughts on CBME curriculum. Methods This was a sequential exploratory mixed-methods study involving 2 phases of data collection. Phase 1 was semi-structured interviews with residents enrolled in CBME at one Canadian institution from November 2019 to July 2020. Analyses included thematic and manifest content analysis. Phase 2 was an electronic close-ended survey to capture residents' primary motivation for requesting EPAs and importance of EPAs for learning. Survey data were analyzed descriptively. Results Of 120 eligible residents, 25 (21%) and 107 (89%) participated in the interview and survey, respectively. Program requirement was the dominant motivation for obtaining EPAs. There was variability in perceived importance of EPAs on learning. Increased resident workload, gaming the system to maximize EPA scores, and lack of shared ownership from preceptors were cited as critiques of the curriculum. Survey responses corroborated interview findings. Conclusions Although many residents recognize the value of EPAs, the majority are not intrinsically motivated to seek out assessment under the current CBME framework.

Advancing Nursing Practice: The Evolution and Impact of Continuing Professional Development.

American Nurses Credentialing Center (ANCC) Accreditation in Nursing Continuing Professional Development (NCPD) emphasizes the importance of maintaining competence, ensuring patient safety, and supporting career advancement in nursing through learning and development. It underscores the shift toward competency-based and outcome-oriented education models, addressing challenges such as misconceptions about the demands of NCPD and focusing more on the impact. This column provides the "why" for organizations, leaders, and nurses to engage in ANCC accredited NCPD educational programs. It further explores a future where NCPD fosters a skilled, equitable, and diverse health care workforce, promoting transformational learning experiences. [J Contin Educ Nurs. 2024;55(4):153-156.].

143 Training & Sustaining: Training and learning collaborative outcomes across a statewide network for early diagnosis of children with autism

OBJECTIVES/GOALS: Community-based primary care autism diagnostic models are one promising solution to delays in autism diagnosis. Our objective is to describe the development and report on outcomes related to primary care professional (PCP) training and sustained engagement in a longitudinal learning collaborative across a statewide network for autism diagnosis. METHODS/STUDY POPULATION: We developed ADAPT (i.e., Accelerating the Diagnosis of Autism with Primary care Training), a training program to prepare PCPs to develop independent competency in evaluation of autism in children ages 14-48 months. ADAPT includes didactic and case-based modules and expert practice-based coaching delivered by a diagnostic specialist; following training PCPs participate in a longitudinal learning collaborative. Aligned with competency-based medical education standards, measures of autism evaluation knowledge and diagnostic competency are collected. RESULTS/ANTICIPATED RESULTS: To date, 13 PCPs have completed ADAPT didactic and practicum training reaching competency in independent autism evaluation. Clinicians demonstrated significant improvement in total autism knowledge following didactic training (p=.02). There was an overall trend toward increased scoring agreement on an autism observational assessment over case observations and practicum evaluations. Similarly, PCPs demonstrated improved evaluation competence, moving on average from Advanced Beginner to Competent Performer as rated by expert trainers. Following training, PCPs attended 57% of monthly learning collaborative sessions. DISCUSSION/SIGNIFICANCE: Training PCPs to deliver autism evaluations as part of community-based models of care is a promising solution to address access and waitlist challenges. ADAPT is an intensive, standard PCP training model which results in achievement of independent competency and sustained engagement in in autism evaluation.

강의계획서에 기반한 의과대학 교육과정 분석

This study aims to analyze the syllabi of all courses in the A Medical School curriculum, including basic medicine, preclinical, clinical practice, medical humanities and social sciences, and student research programs. The purpose is to evaluate the appropriateness of each component and utilize the results as a basis for curriculum improvement. The main research findings are as follows. First, the curriculum objectives present clinical competence, competence as a medical scientist and educator, and competence as a professional and leader in order to achieve the graduation outcomes of the medical school. However, there are not many courses dealing with professional and leadership competencies in the basic medicine and preclinical education courses, so they need to be strengthened through curriculum improvement. Second, various teaching methods such as lectures, PBL, practice, discussion, and presentation are utilized. Appropriate teaching methods are used according to the characteristics of each course. Third, student assessment is conducted through written exams, assignments, practice, and learning attitude to evaluate knowledge, skills, and attitude. Written exams, learning attitude, and attendance are mostly included in all courses. Fourth, feedback is an essential element of competency-based education. A Medical School plans feedback for each course, and the feedback plan was more than 80%. When feedback was planned as a group, it mainly consisted of quizzes and problem solving, and the proportion of individual feedback was high in the clinical practice and student research courses. Although most courses have feedback plans, it is necessary to specify the timing and method of feedback. Through the results of the study, it was confirmed that the A Medical School curriculum has a foundation for competency-based education, but some courses need improvement. It is expected that the quality of medical education will be improved if the syllabi are appropriately established and implemented in the future.

Exploring the effect of MBKM as a New Curriculum in Indonesia

Higher education in Indonesia has faced significant challenges in presenting a curriculum that is responsive and relevant to the demands of the times. The Competency-Based Education Model (MBKM) has been adopted as a new approach in updating the college curriculum. This study aims to explore the influence of MBKM as a new curriculum in Indonesia. The research methods used qualitative analysis through interviews, surveys, and literature studies. The findings show that the implementation of MBKM has had a significant impact in strengthening students' skills, knowledge, and attitudes. In addition, MBKM has also changed the learning paradigm from a center of teaching activities to a center of competency achievement. However, challenges remain in integrating MBKM into the established academic culture and improving the quality of implementation consistently across universities in Indonesia. The implication of this research is the need for continuous support from various stakeholders to ensure the sustainability and effectiveness of MBKM as a new curriculum that is competitive in the global context. Further research is also needed to evaluate the long-term impact of MBKM implementation on the quality of higher education in Indonesia, These include requiring courses as prerequisites, improving coordination with schools, modifying curriculum order, and clarifying credit transfer policies.

Harnessing Information Technology in Learning: Exploring Emerging Trends and Innovative Approaches

In today's education landscape, incorporating information technology is crucial for changing teaching methods and improving learning experiences. This paper delves into the ever-evolving landscape of pedagogy, shedding light on emerging trends that are reshaping educational practices and unique approaches. This paper examines the evolving use of information technology in education, focusing on current trends like multi-agent educational systems, virtual worlds, and web-based learning. By synthesizing insights from scholarly literature and recent research, this paper identifies, and examines key trends such as personalized learning, competency-based education, and immersive learning experiences. Through an imaginative exploration of these innovative methods, this paper aims to highlight their potential to transform teaching and learning. Through a creative exploration of these innovative, and approaches, this paper aims to inspire educators and policymakers to embrace new paradigms in teaching and advanced learning. Drawing from academic literature and recent studies, this paper offers insights into the theoretical basis, practical applications, and future implications of information technology in education. By combining varied viewpoints and presenting innovative ideas, this paper strives to encourage educators and policymakers to embrace the transformative power of information technology in shaping the future of education.

In EPAs we trust, is quality and safety a must? A cross-specialty analysis of entrustable professional activity guides

Purpose The inclusion of quality improvement (QI) and patient safety (PS) into CanMEDS reflects an expectation that graduating physicians are competent in these areas upon training completion. To ensure that Canadian postgraduate specialty training achieves this, the translation of QI/PS competencies into training standards as part of the implementation of competency-based medical education requires special attention. Methods We conducted a cross-specialty, multi-method analysis to examine how QI/PS was incorporated into the EPA Guides across 11 postgraduate specialties in Canada. Results We identify cross-specialty variability in how QI/PS is incorporated, positioned, and emphasized in EPAs and milestones. QI/PS was primarily referenced alongside clinical activities rather than as a sole competency or discrete activity. Patterns were characterized in how QI/PS became incorporated into milestones through repetition and customization. QI/PS was also decoupled, conceptualized, and emphasized differently across specialties. Conclusions Variability in the inclusion of QI/PS in EPAs and milestones has important implications considering the visibility and influence of EPA Guides in practice. As specialties revisit and revise EPA Guides, there is a need to balance the standardization of foundational QI/PS concepts to foster shared understanding while simultaneously ensuring context-sensitive applications across specialties. Beyond QI/PS, this study illuminates the challenges and opportunities that lie in bridging theoretical frameworks with practical implementation in medical education, prompting broader consideration of how intrinsic roles and emergent areas are effectively incorporated into competency-based medical education.

Assessment approaches in undergraduate health professions education: towards the development of feasible assessment approaches for low-resource settings

BackgroundFeasible and effective assessment approaches to measuring competency in health sciences are vital in competency-based education. Educational programmes for health professions in low- and middle-income countries are increasingly adopting competency-based education as a strategy for training health professionals. Importantly, the organisation of assessments and assessment approaches must align with the available resources and still result in the fidelity of implementation. A review of existing assessment approaches, frameworks, models, and methods is essential for the development of feasible and effective assessment approaches in low-resource settings.MethodsPublished literature was sourced from 13 electronic databases. The inclusion criteria were literature published in English between 2000 and 2022 about assessment approaches to measuring competency in health science professions. Specific data relating to the aims of each study, its location, population, research design, assessment approaches (including the outcome of implementing such approaches), frameworks, models, and methods were extracted from the included literature. The data were analysed through a multi-step process that integrated quantitative and qualitative approaches.ResultsMany articles were from the United States and Australia and reported on the development of assessment models. Most of the articles included undergraduate medical or nursing students. A variety of models, theories, and frameworks were reported and included the Ideal model, Predictive Learning Assessment model, Amalgamated Student Assessment in Practice (ASAP) model, Leadership Outcome Assessment (LOA) model, Reporter-Interpreter-Manager-Educator (RIME) framework, the Quarter model, and the model which incorporates four assessment methods which are Triple Jump Test, Essay incorporating critical thinking questions, Multistation Integrated Practical Examination, and Multiple Choice Questions (TEMM) model. Additional models and frameworks that were used include the Entrustable Professional Activities framework, the System of Assessment framework, the Reporter-Interpreter-Manager-Educator (RIME) framework, the Clinical Reasoning framework (which is embedded in the Amalgamated Student Assessment in Practice (ASAP) model), Earl’s Model of Learning, an assessment framework based on the Bayer–Fetzer Kalamazoo Consensus Statement, Bloom's taxonomy, the Canadian Medical Education Directions for Specialists (CanMEDS) Framework, the Accreditation Council for Graduate Medical Education (ACGME) framework, the Dreyfus Developmental Framework, and Miller's Pyramid.ConclusionAn analysis of the assessment approaches, frameworks, models, and methods applied in health professions education lays the foundation for the development of feasible and effective assessment approaches in low-resource settings that integrate competency-based education.Trial registrationThis study did not involve any clinical intervention. Therefore, trial registration was not required.

Competence By Design: a transformational national model of time-variable competency-based postgraduate medical education.

Postgraduate medical education is an essential societal enterprise that prepares highly skilled physicians for the health workforce. In recent years, PGME systems have been criticized worldwide for problems with variable graduate abilities, concerns about patient safety, and issues with teaching and assessment methods. In response, competency based medical education approaches, with an emphasis on graduate outcomes, have been proposed as the direction for 21st century health profession education. However, there are few published models of large-scale implementation of these approaches. We describe the rationale and design for a national, time-variable competency-based multi-specialty system for postgraduate medical education called Competence by Design. Fourteen innovations were bundled to create this new system, using the Van Melle Core Components of competency based medical education as the basis for the transformation. The successful execution of this transformational training system shows competency based medical education can be implemented at scale. The lessons learned in the early implementation of Competence by Design can inform competency based medical education innovation efforts across professions worldwide.

Satisfaction with continuing education at alevel1 trauma center-Results of asurvey and development of acompetency-based continuing education concept

Structured competency-based training is one of the most frequently articulated wishes of residents. Asurvey of 19residents was conducted regarding their satisfaction with the resident education at alevel1 trauma center. In this article the development of arevised competency-based education concept was carried out. The survey reflected uncertainty as to whether the current structures could meet the requirements of the residency regulations. The improved competency-based education concept consists of clinical mentoring, competency-based catalogs of learning objectives, regular theoretical and practical workshops as well as regular and structured staff evaluations. The education concept presented reflects the attempt to establish acontemporary surgical training program which will be evaluated as it progresses.

Implementation and Impact of an Adapted Digital Perioperative Competency-Building Tool to Enhance Teaching, Learning And Feedback in Postgraduate Competency-Based Medical Education

The purpose of this educational intervention was to introduce, iteratively adapt, and implement a digital formative assessment tool in a surgical speciality. The study also evaluated the intervention's impact on perioperative teaching, learning, feedback, and surgical competency. A participatory action research model with a mixed methods approach. This study was performed over 10 months in an institutional hospital in South Africa with a general surgery department. Twelve supervising surgical trainers/faculty and 12 surgical trainees/residents consented to participate in the intervention. The first 4 months of the intervention focused on relationship building, a multi-stakeholder contextual needs assessment and training sessions to support a shared mindset and shift in the teaching and learning culture. The final adapted perioperative competency-building tool comprised a 23-item assessment with four open-text answers (Table 1). Over the following 6-month period, 48 workplace-based competency-building perioperative evaluations were completed. Most trainees took less than 5 minutes to self-assess (67%) before most trainers (67%) took less than 5 minutes to give oral feedback to the trainee after the perioperative supervised learning encounter. On average, the digital tool took 6 minutes to complete during the bidirectional perioperative teaching and learning encounter with no negative impact on the operational flow. All trainers and trainees reported the training and implementation of the digital tool to be beneficial to teaching, learning, feedback, and the development of surgical competency. Analysis of the completed tools revealed several trainees showing evidence of progression in surgical competency for index procedures within the speciality. The focus groups and interviews also showed a change in the teaching and learning culture: more positively framed, frequent, structured, and specific feedback, improved accountability, and trainee-trainer perioperative readiness for teaching. Highlighted changes included the usefulness of trainee self-assessment before perioperative trainer feedback and the tool's value in improving competency to Kirkpatrick Level 4. Implementing an adapted digital Workplace-Based Assessment (WBA) tool using a participatory action research model has proven successful in enhancing the effectiveness of supervised perioperative teaching and learning encounters. This approach has improved teaching and feedback practices, facilitated the development of surgical competency, and ultimately impacted the overall culture to Kirkpatrick level 4. Importantly, it has positively influenced the trainee-trainer relationship dynamic. Based on these positive outcomes, we recommend using this effective method and our relationship-centred framework for implementing formative competency-building tools in future studies. By doing so, larger-scale and successful implementation of Competency-Based Medical Education (CBME) could be achieved in various contexts. This approach can potentially enhance teaching and learning encounters, promote competency development, and improve the overall educational experience for surgical trainees and trainers.

Validity of Entrustable Professional Activities in a National Sample of General Surgery Residency Programs.

The American Board of Surgery has endorsed competency-based education as vital to the assessment of surgical training. From 2018 to 2020, a national pilot study was conducted at 28 general surgery programs to evaluate feasibility of implementing entrustable professional activities (EPAs) for 5 common general surgical conditions. ACGME core competency Milestones were also rated for each resident by program clinical competency committees. This study aimed to evaluate the validity of general surgery EPAs compared with Milestones. Prospectively collected, de-identified EPA Pilot Study data were analyzed. EPAs studied were EPA-1 (gallbladder), EPA-2 (inguinal hernia), EPA-3 (right lower quadrant pain), EPA-4 (trauma), and EPA-5 (consult). Variables abstracted included levels of EPA entrustment (1 to 5) and corresponding ACGME Milestone subcompetency ratings (1 to 5) for the same study cycle. Spearman's correlations were used to evaluate the relationship between summative EPA scores and corresponding Milestone ratings. A total of 493 unique residents received a summative entrustment decision. EPA summative entrustment scores had moderate-to-strong positive correlation with mapped Milestone subcompetencies, with median rho value of 0.703. Among operation-focused EPAs, median rho values were similar between EPA-1 (0.688) and EPA-2 (0.661), but higher for EPA-3 (0.833). EPA-4 showed a strong positive correlation with diagnosis and communication competencies (0.724), whereas EPA-5, mapped to the most Milestone subcompetencies, had the lowest median rho value (0.455). Moderate-to-strong positive correlation was noted between EPAs and patient care, medical knowledge, and communication Milestones. These findings support the validity of EPAs in general surgery and suggest that EPA assessments can be used to inform Milestone ratings by clinical competency committees.

대학 자체 교육과정 인증제 개선을 위한 대학 간 상호 인증체계 구축에 관한 탐색적 연구

Objectives This research aims to examine the current status of individual university operation after the introduction of the university curriculum internal educational accreditation in South Korea, ten years since its implementation. The study focuses on identifying the limitations of the internal educational accreditation system and exploring possible ways for improvement.
 Methods Initially, a literature review was conducted to analyze recent trends in internal educational accreditation. Case studies of two medium-sized local universities, W University and G University, were examined to compare and analyze key elements of their respective internal educational accreditation. Based on the analysis results, limitations and improvement suggestions were derived, and through a meta-evaluative perspective, the researchers discussed and extracted a mutual authentication system as one of the factors and solutions that can be generalized.
 Results The comparison revealed similarities in both universities implementing accreditation as part of their revamped competency-based major education programs, contingent upon voluntary participation from departments. However, differences were observed in accreditation stages, targets, types of accreditation decisions, accreditation procedures, and education consulting methods. These variations can stem from differences in each university's educational conditions and approaches to curriculum redesign. Regardless of the approach, limitations are inevitable. Therefore, this study proposes a mutual accreditation system model focused on inter-university exchange and collaboration as an improvement strategy for the current internal educational accreditation system.
 Conclusions Such a mutual accreditation system could enhance objectivity and fairness in accreditation while generating new ideas for curriculum improvement, facilitating the development of new courses, and discovering joint educational programs aligned with future trends in higher education. Moreover, the proposed model suggests different application scopes based on the degree of participation and level of collaboration during curriculum development, operation, or evaluation. This differentiated approach aims to provide important insights for universities seeking improvements in their internal educational accreditation systems.

Navigating competency-based medical education in ophthalmology: Addressing challenges and charting future trajectories

Based Medical Education (CBME) has emerged as a transformative approach to medical training, emphasizing skills acquisition and holistic competence over traditional knowledge retention. Ophthalmology, as a specialized field, presents unique challenges and opportunities within this framework. This article critically examines the implementation of CBME in ophthalmology, highlighting challenges faced and proposing strategies for enhancement. By addressing stakeholder perspectives and strategic interventions, this viewpoint aims to foster a comprehensive understanding of CBME's implications for ophthalmological education.

Consenso Delphi sobre la formación de grado en medicina paliativa (EDUPAL-Ar)

Palliative care is an “ethical responsibility of healthcare systems”. The WHO proposes undergraduate and postgraduate medical education as one dimension to assess its development in a country. In Latin America, 15% of medical schools have an undergraduate palliative care course. In Argentina, there is still no consensus on the essential content of undergraduate medical curricula. MethodThis study sought to reach a consensus on what an undergraduate curriculum in palliative medicine should look like in Argentina using the Delphi methodology (2019–2020). Sociodemographic data, profession, years of experience, university education, thematic content, pedagogical modality, study plan and hourly load were collected. Quantitative analysis was performed using percentages and mean values to indicate the level of agreement on 5-point scales. Interquartile ranges were calculated to provide indicators of agreement and consensus. Thematic content analysis was carried out. ResultsTwo hundred fifty experts were convened, of whom 85 responded to two rounds of consultation. A high degree of agreement was reached on ten general, dynamic, and flexible recommendations adapted to different contexts. 98% considered it necessary to teach palliative care transversally and suggested a specific course contextualised to chronic patients and end-of-life situations. However, there was a tension between the traditional training model and competency-based education. Experiential learning is appropriate, but linking theory and practice was recommended. ConclusionFor the first time in Argentina, a consensus of experts was reached, which defined a set of recommendations on content, teaching methodology, academic cycle and competencies in palliative care.

AI in medical education: uses of AI in construction type A MCQs

BackgroundThe introduction of competency-based education models, student centers, and the increased use of formative assessments have led to demands for high-quality test items to be used in assessments. This study aimed to assess the use of an AI tool to generate MCQs type A and evaluate its quality.MethodsThe study design was cross-sectional analytics conducted from June 2023 to August 2023. This study utilized formative TBL. The AI tool (ChatPdf.com) was selected to generate MCQs type A. The generated items were evaluated using a questionnaire for subject experts and an item (psychometric) analysis. The questionnaire to the subject experts about items was formed based on item quality and rating of item difficulty.ResultsThe total number of recurrent staff members as experts was 25, and the questionnaire response rate was 68%. The quality of the items ranged from good to excellent. None of the items had scenarios or vignettes and were direct. According to the expert’s rating, easy items represented 80%, and only two had moderate difficulty (20%). Only one item out of the two moderate difficulties had the same difficulty index. The total number of students participating in TBL was 48. The mean mark was 4.8 ± 1.7 out of 10. The KR20 is 0.68. Most items were of moderately difficult (90%) and only one was difficult (10%). The discrimination index of the items ranged from 0.77 to 0.15. Items with excellent discrimination represented 50% (5), items with good discrimination were 3 (30%), and only one time was poor (10%), and one was none discriminating. The non-functional distractors were 26 (86.7%), and the number of non-functional distractors was four (13.3%). According to distractor analysis, 60% of the items were excellent, and 40% were good. A significant correlation (p = 0.4, r = 0.30) was found between the difficulty and discrimination indices.ConclusionItems constructed using AI had good psychometric properties and quality, measuring higher-order domains. AI allows the construction of many items within a short time. We hope this paper brings the use of AI in item generation and the associated challenges into a multi-layered discussion that will eventually lead to improvements in item generation and assessment in general.

Navigating the Roadmap for Trauma-Informed Medical Education: Application of Undergraduate Medical Education Competencies.

Trauma is common in the United States, increases risk of long-term adverse health effects, and individuals who experience it often find seeking medical care difficult. Trauma-informed care (TIC) builds trust and fosters healing relationships between clinicians and patients; however medical education has lacked consistent training in TIC. Using recently published competencies for undergraduate medical education (UME), this manuscript provides curricular examples across 8 domains to assist faculty in developing educational content. The authors identified published curricula for each of the 8 competency domains using a published search strategy and publicly available database. Inclusion criteria were published works focused on UME in the United States; abstracts and curricula not focused on UME were excluded. The authors used a consensus-based process to review 15 eligible curricula for mapping with the competencies. Of 15 published UME curricula, 11 met criteria and exemplify each of the 8 UME competency domains. Most of the available curricula fall into the Knowledge for Practice and Patient Care domains. Most were offered in the first 2 years of medical school. Competency-based medical education for TIC is new, and most current educational offerings are foundational in nature. Additional innovation is needed in the competency domains of Professionalism, Systems-Based Practice, Interprofessional Collaboration, and Personal/Professional Development. This manuscript offers a set of curricular examples that can be used to aid efforts at implementing TIC competencies in UME; future work must focus on improving assessment methods and developmental sequencing as more students are exposed to TIC principles.

Clinician Educator Milestones: Assessing and Improving Educators' Skills.

The importance of the clinician educator (CE) role in delivery of competency-based medical education is well recognized. There is, however, no formal mechanism to identify when faculty have the knowledge, skills, and attitudes to be successful CEs. In 2020, the Accreditation Council for Graduate Medical Education, Accreditation Council for Continuing Medical Education, Association of American Medical Colleges, and American Association of Colleges of Osteopathic Medicine convened a workgroup of 18 individuals representing multiple medical specialties and diverse institutions in the United States, including nonphysician educators, a medical student, and a resident, to develop a set of competencies, subcompetencies, and milestones for CEs.A 5-step process was used to create the Clinician Educator Milestones (CEMs). In step 1, the workgroup developed an initial CEM draft. Through brainstorming, 141 potential education-related CE tasks were identified. Descriptive statements for each competency and developmental trajectories for each subcompetency were developed and confirmed by consensus. The workgroup then created a supplemental guide, assessment tools, and additional resources. In step 2, a diverse group of CEs were surveyed in 2021 and provided feedback on the CEMs. In step 3, this feedback was used by the workgroup to refine the CEMs. In step 4, the second draft of the CEMs was submitted for public comment, and the CEMs were finalized. In step 5, final CEMs were released for public use in 2022.The CEMs consist of 1 foundational domain that focuses on commitment to lifelong learning, 4 additional domains of competence for CEs in the learning environment, and 20 subcompetencies. These milestones have many potential uses for CEs, including self-assessment, constructing learning and improvement plans, and designing systematic faculty development efforts. The CEMs will continue to evolve as they are applied in practice and as the role of CEs continues to grow and develop.