Competency-based Education Research Articles

Education in Obstetric Anesthesiology: An International Approach

(Int J Obstet Anesth. 2023;55:103896/https://doi.org/10.1016/j.ijoa.2023.103896 0208-5216/) Obstetric anesthesiology has transformed from administering inhaled anesthetics to handling complex cases in pregnant or postpartum patients, driven by enhanced education in the field. Different countries employ diverse approaches to prepare anesthesiology trainees for obstetric anesthesia, but common threads include competency-based education and the challenge of assessing clinical judgment and skills. In the United States, anesthesiologists undergo basic obstetric anesthesia training with optional advanced programs. Maternal mortality reduction in the 20th century reflects improved education. However, racial disparities persist in pregnancy-related morbidity and mortality, emphasizing the ongoing need for evolving obstetric anesthesiology education to help address this issue and maternal safety in general. The process involves residency and optional fellowship, ensuring competence through clinical experience. Board certification and ongoing education further contribute to advancing obstetric anesthesiology.

A Common Language For Competency-Based Education

A Common Language For Competency-Based Education

Integrating innovation and competency-based education in the development of a new direct-entry master of science in nursing program

There has been a call for nursing programs to shift to Competency-based education (CBE). Competency-based education has numerous benefits in nursing education. A curriculum that includes both concepts and competencies helps students and stakeholders understand what new nurse graduates will be able to do with the knowledge they construct throughout the program. Competency-based education is student-centered, flexible, and dependent on students actively engaging in their learning. A small faculty team developed a new direct-entry MSN program, based on essential components of CBE. This article describes the process of incorporating CBE into the development of the program, as well as challenges and barriers to fully implementing CBE into the curriculum.

Reflections on Transformation, Teamwork, and Mentoring: Student Teachers’ Self-Assessed Learning, Equality, and Equity in Competence-Based Education

<p style="text-align:justify">This research concentrated on observing academic student teachers’ teamwork, especially its effectiveness and their attitudes to collaboration and transformation, as well as their reflective, written self-assessments in relation to teamwork. Teams have been studied widely, but these kinds of special contexts are rare. The target group was higher education teachers, the context was an introduction of a new pedagogical program, and the teams acted under the guidance of mentors and occasional lecturers. Besides the content analysis, the study method was a deep analysis of the essays. The most effective positive influencers proved to be social exchanges, including mentoring, peer support, input for learning and the experiences of wellbeing. Individual distrust of working methods in teams, and emotional suspicions of their self-efficacy in transformational settings emerged as latent factors, revealing mainly the difficulty of changing traditional mindsets. The analyses offered individual and community-wide opportunities to steer education in the future.</p>

Protocol for a scoping review study on learning plan use in undergraduate medical education

BackgroundThe current paradigm of competency-based medical education and learner-centredness requires learners to take an active role in their training. However, deliberate and planned continual assessment and performance improvement is hindered by the fragmented nature of many medical training programs. Attempts to bridge this continuity gap between supervision and feedback through learner handover have been controversial. Learning plans are an alternate educational tool that helps trainees identify their learning needs and facilitate longitudinal assessment by providing supervisors with a roadmap of their goals. Informed by self-regulated learning theory, learning plans may be the answer to track trainees’ progress along their learning trajectory. The purpose of this study is to summarise the literature regarding learning plan use specifically in undergraduate medical education and explore the student’s role in all stages of learning plan development and implementation.MethodsFollowing Arksey and O’Malley’s framework, a scoping review will be conducted to explore the use of learning plans in undergraduate medical education. Literature searches will be conducted using multiple databases by a librarian with expertise in scoping reviews. Through an iterative process, inclusion and exclusion criteria will be developed and a data extraction form refined. Data will be analysed using quantitative and qualitative content analyses.DiscussionBy summarising the literature on learning plan use in undergraduate medical education, this study aims to better understand how to support self-regulated learning in undergraduate medical education. The results from this project will inform future scholarly work in competency-based medical education at the undergraduate level and have implications for improving feedback and supporting learners at all levels of competence.Scoping review registration:Open Science Framework osf.io/wvzbx.

Is Competency-Based Medical Education being implemented as intended? Early lessons learned from Physical Medicine and Rehabilitation.

As competency-based medical education (CBME) curricula are introduced in residency programs across Canada, systematic evaluation efforts are needed to ensure fidelity of implementation. This study evaluated early outcomes of CBME implementation in one Canadian Physical Medicine and Rehabilitation program that was an early adopter of CBME, with an aim to inform continuous quality improvement initiatives and CBME implementation nationwide. Using Rapid Evaluation methodology, informed by the CBME Core Components Framework, the intended outcomes of CBME were compared to actual outcomes. Results suggested that a culture of feedback and coaching already existed in this program prior to CBME implementation, yet faculty felt that CBME added a framework to support feedback. The small program size was valuable in fostering strong relationships and individualized learning. However, participants expressed concerns about CBME fostering a reductionist approach to the development of competence. Challenges existed with direct observation, clear expectations for off-service training experiences, and tracking trainee progress. There was trepidation surrounding national curricular change, yet the institution-wide approach to CBME implementation created shared experiences and a community of practice. Program evaluation can help understand gaps between planned versus enacted implementation of CBME, and foster adaptations to improve the fidelity of implementation.

Was it all worth it? A graduating resident perspective on CBME

Background Our institution simultaneously transitioned all postgraduate specialty training programs to competency-based medical education (CBME) curricula. We explored experiences of CBME-trained residents graduating from five-year programs to inform the continued evolution of CBME in Canada. Methods We utilized qualitative description to explore residents’ experiences and inform continued CBME improvement. Data were collected from fifteen residents from various specialties through focus groups, interviews, and written responses. The data were analyzed inductively, using conventional content analysis. Results We identified five overarching themes. Three themes provided insight into residents’ experiences with CBME, describing discrepancies between the intentions of CBME and how it was enacted, challenges with implementation, and variation in residents’ experiences. Two themes – adaptations and recommendations – could inform meaningful refinements for CBME going forward. Conclusions Residents graduating from CBME training programs offered a balanced perspective, including criticism and recognition of the potential value of CBME when implemented as intended. Their experiences provide a better understanding of residents’ needs within CBME curricula, including greater balance and flexibility within programs of assessment and curricula. Many challenges that residents faced with CBME could be alleviated by greater accountability at program, institutional, and national levels. We conclude with actionable recommendations for addressing residents’ needs in CBME.

Sustainable language learning and ePortfolio application

Abstract Adapting engineering education to a sustainable ESP (English for Special Purposes) training and competence-based education requires dedicated effort. Although active learning methodologies are commonly utilised in Higher Education institutions, there remains a need for enhanced curricular coordination and coherence. To address this, we are investigating the latest syllabus updates by introducing and verifying a valuable and student-friendly tool – an electronic portfolio in English. We view the ePortfolio as a comprehensive platform to facilitate students’ academic and professional growth, as well as their development of competences. This quasi-experimental study utilised a pre-/post-training trial design and nonrandomised control group to investigate the implementation of ePortfolios. During the diagnostic assessment, the first questionnaire allowed students to express their ideas regarding their competences, portfolio understanding, ESP and professional growth. The second was used to determine the undergraduates’ learning outcomes and perceptions after three months of training. There was a significant increase in learners’ support of several types of transversal competences, whereas some other competences appeared to be declining. This indicates that the ePortfolio tool stimulated a fresh process of self-reflection among the students. Our research focuses on examining the creation of the ePortfolio in the context of an ESP course to integrate technical students’ reflections on capacity building and advanced professional development in English.

Teaching Evidence-Based Practice Competencies to Meet Professional Practice Needs.

Evidence-based practice (EBP) is a major concept threaded throughout nursing education, yet competencies are not clearly identified in The Essentials. Nurse leaders'EBP competency expectations for professional practice were explored to inform competency-based education for students and practicing nurses. A secondary aim explored potential effects of misinformation on EBP. Descriptive qualitative inquiry was performed with a focus group of 6 clinical nurse leaders. EBP expectations were identified, discriminating between novice entry level and advanced-level nurses. Participants emphasized asking questions, linking evidence to practice, and acknowledging that evidence changes over time. All advanced-level nurses were expected to apply, lead, and teach EBP. Post pandemic, nurses need to reclaim evidence-based practices, critically appraise evidence, and educate patients and families to address misinformation. Information learned will inform competency-based EBP education for students and nurses in academic and clinical settings.

Proposed Framework for Developing and Evaluating Total Worker Health ® Education and Training Programs.

Propose a framework for developing and evaluating Total Worker Health ® (TWH) education and training efforts by implementing institutions. This is a review of TWH information from symposia, workshops, academic offerings, and publications, along with a review of education and training development and evaluation resources applicable across various disciplines. Examples of knowledge, skills, and abilities (KSAs) are provided for each TWH core competency, and a framework for developing and evaluating a TWH competency-based education or training program. The proposed set of KSAs and framework for developing and evaluating TWH education or training programs may inform future pilot testing of KSAs and framework by implementing institutions and help standardize practices across the discipline. Academic, business, community, labor, and government stakeholders are encouraged to provide further input to assist in its maturation and uptake.

The Pathway to Developing a Competency-based Tool for Entry-level Nursing Simulation: A Delphi Study

BackgroundSimulation-based learning experiences allow undergraduate nursing students to develop competence and confidence through deliberate practice with immediate feedback on the learner's performance through debriefing. With the transition to competency-based nursing education, nursing faculty need more guidance in implementing competency-based evaluations in the simulation setting. PurposeThis Delphi study aims to inform the future development of a competency-based tool – SimComp – based on the American Association of Colleges of Nursing (AACN) Essentials. MethodsA Delphi framework was used to recruit expert nursing faculty to complete the surveys via an online platform. Data analysis occurred through open-ended questions and quantitative methods to ensure that the responses from expert panelists were used to form the results. ResultsAfter four rounds of this Delphi study, a consensus was achieved on 111 appropriate items for assessing competence in the simulation-based learning environment. ConclusionWhile further research is warranted, this study provides insight for nursing institutions considering implementing or increasing the use of simulation within their program for competency-based evaluations.

Exploring Medical Student Experiences With Direct Observation During the Pediatric Clerkship.

Direct observation (DO) enables assessment of vital competencies, such as clinical skills. Despite national requirement that medical students experience DOs during each clerkship, the frequency, length, quality, and context of these DOs are not well established. This study examines the quality, quantity, and characteristics of DOs obtained during pediatrics clerkships across multiple institutions. This multimethod study was performed at 6 U.S.-based institutions from March to October 2022. In the qualitative phase, focus groups and/or semistructured interviews were conducted with third-year medical students at the conclusion of pediatrics clerkships. In the quantitative phase, the authors administered an internally developed instrument after focus group discussions or interviews. Qualitative data were analyzed using thematic analysis, and quantitative data were analyzed using anonymous survey responses. Seventy-three medical students participated in 20 focus groups, and 71 (97.3%) completed the survey. The authors identified 7 themes that were organized into key principles: before, during, and after DO. Most students reported their DOs were conducted primarily by residents (62 [87.3%]) rather than attendings (6 [8.4%]) in inpatient settings. Participants reported daily attending observation of clinical reasoning (38 [53.5%]), communication (39 [54.9%]), and presentation skills (58 [81.7%]). One-third reported they were never observed taking a history by an inpatient attending (23 [32.4%]), and one-quarter reported they were never observed performing a physical exam (18 [25.4%]). This study revealed that students are not being assessed for performing vital clinical skills in the inpatient setting by attendings as frequently as previously believed. When observers set expectations, create a safe learning environment, and follow up with actionable feedback, medical students perceive the experience as valuable; however, the DO experience is currently suboptimal. Therefore, a high-quality, competency-based clinical education for medical students is necessary to directly drive future patient care by way of a competent physician workforce.

Using Rapid Mini-Simulations as a Strategy to Increase Competency-Based Education.

Using Rapid Mini-Simulations as a Strategy to Increase Competency-Based Education.

Educational Introspections of Medical Students Post Disability Competencies Training: A Qualitative Study

Background: Despite the substantial presence of persons with disabilities (PWD) in the population, they face many barriers in healthcare. Competency-Based Medical Education (CBME) is increasingly used to address these gaps. Aims and Objective: This study assesses the impact of disability competencies training on medical students' attitudes towards PWD. It aims to explore new perspectives, identify attitudinal shifts, evaluate training effectiveness, and promote solution-oriented learning. Materials and Methods: Five Focus Group Discussions (FGD) with 8 participants each, a series of themes related to the understanding of disability and empathy were explored. The participants, who had undergone training in disability competencies. The FGDs were facilitated by trained moderators and analysed employing thematic analysis and generating tree maps. Results: Key themes evolved from the students' new perspectives towards PWD, which included Inclusion and Responsibility, Empathy and Understanding, Managing patients with disabilities, Equity and rights, and Acceptance. Themes also emerged regarding the impact of training, revealing an Attitudinal Shift, Engagement and Interaction, Personal Impact, and Solution-Oriented Learning. Conclusion: Disability competency training significantly transforms medical students' attitudes, fostering a more inclusive, empathetic approach in healthcare. This shift is crucial for integrating disability competencies into medical education, especially in developing countries

Entrustable Professional Activites for Clinical Competence

Aim: In recent years Entrustable Professional Activities (EPAs) have developed as an essential framework for competency-based medical education (CBME) implementation, which has become an important component of contemporary medical education. The need to close the gap between healthcare professional education, healthcare delivery, and societal demands motivates the transition to CBME. While the competencies describe the attributes that medical professionals should possess, the EPAs describe the practical activities that learners are expected to perform in their medical education and future careers. The difficulty of translating abstract abilities into clinical practice in the real world encouraged the development of EPAs, which are specific activities or responsibilities that may be delegated to learners upon demonstrating competency. With the introduction of EPAs, medical education programs have discovered a more effective means of assessing competencies that aligns them with the professional tasks that students are expected to perform. This alignment promotes a meaningful connection between intended competencies and real-world practice, which ultimately improves the readiness of future medical professionals. Methods: The article was prepared by the traditional review method. Results: This article highlights the particular features of EPAs and the significance of competency-based assessments being grounded in actual clinical situations. EPAs enable learners to advance progressively, fostering preparedness as well as responsibility over time. It is discussed how the incorporation of technology into EPAs has the potential to improve both teaching and learning. The use of technological support and mobile applications can make EPAs more applicable and comprehensible to both faculty and students. Conclusions: The integration of CBME and EPAs is a promising strategy for addressing concerns about medical education’s effectiveness. By actively engaging in real-world tasks, EPAs facilitate the internalization of competencies by learners. By providing a structured, adaptable, and context-specific approach to competency assessment, EPAs enable learners to assume responsibilities progressively, thereby facilitating their path to becoming competent and confident healthcare professionals. By recognizing the complementary nature of EPAs and competences, medical education programs can develop thorough and efficient training techniques that bridge the gaps between theoretical knowledge and practical clinical abilities.

역량기반교육 전환에 따른 경찰리더십 교육의 방향과 과제

Public safety and citizen protection are common goals that police officers must achieve. Developing leadership capacity alongside crisis management skills is essential for effectively responding to various crises within the security field. Additionally, there is active discussion about the leadership that the public sector must possess due to changes in government governance patterns to solve complex problems in future society. Future police education and training will be converted to competency-based education by the Police Future Vision 2050. Accordingly, the purpose is to suggest future tasks for police leadership education. Firstly, it advocates for establishing a police leadership education system based on an independent leadership model. Secondly, it is necessary to restructure police leadership education into a competency-based system. Thirdly, there is a need to integrate leadership functions of educational institutions and establish a management of quality and inspection system for education. Finally, this paper underscores the importance of evaluating and applying research on police leadership competencies.

싱가포르 국가수준 유아교육과정 탐색

Objectives The purpose of this study was to exlore the Singaporean early childhood education curriculum, which emphasizes competency-based education, and to examine insights that can be applied to our own early childhood education curriculum. A literature review was conducted comparing and analyzing the characteristics, significance, and implications of the Singaporean early childhood education curriculum before and after its revision. Methods A literature review was conducted comparing and analyzing the characteristics, significance, and implications of the Singaporean early childhood education curriculum documents before and after revision. Results Firstly, through the revision process, the Singaporean early childhood education curriculum expanded its understanding of children's learning, and emphasized values, socio-emotional competencies, and learning dispositions. Additionally, it streamlined learning areas and altered area names. These changes are aimed at laying the foundation for learning essential for adapting to future society, fostering lifelong learners from early childhood, and enabling them to grow. Secondly, the Singaporean early childhood education curriculum emphasizes the learning of competent learners and underscores the importance of learning experiences tailored for this purpose. It emphasizes the formation of children's competencies and consistently stresses the intention and role of educators. Furthermore, it encourages interest in assessing children's learning, providing guidance on specific learning content and observable behaviors. Conclusions Through exploring the Singaporean early childhood education curriculum, insights were gained into various content and structures that can be incorporated into educational curriculum documents. It also suggests the need for reflection on the scope of documents that contain this content.

Use the right words: evaluating the effect of word choice and word count on quality of narrative feedback in ophthalmology competency-based medical education assessments

Background: The purpose of this study was to investigate the effect of word choice on the quality of narrative feedback in ophthalmology resident trainee assessments following the introduction of competency-based medical education at Queen’s University. Methods: Assessment data from July 2017-December 2020 were retrieved from ElentraTM (Integrated Teaching and Learning Platform) and anonymized. Written feedback was assigned a Quality of Assessment for Learning (QuAL) score out of five based on this previously validated rubric. The correlation between QuAL score and specific coaching words was determined using a Spearman’s Rho analysis. Independent samples t-tests were used to compare the QuAL score when a specific word was used, and when it was absent. Results: A total of 1997 individual assessments were used in this analysis. The number of times the identified coaching words were used within a comment was significantly and positively associated with the total QuAL score, with the exception of “next time” (rho=0.039, p=0.082), “read” (rho = 0.036, p = 0.112), “read more” (rho = -0.025, p = 0.256) and “review” (rho = -0.017, p = 0.440). The strongest correlations were for “continue” (rho = 0.182, p < 0.001), “try(ing)” (rho = 0.113, p < 0.001) and “next step” (rho = 0.103, p < 0.001). The mean value of the QuAL score increased when coaching words were used vs. not used with the largest mean difference of 1.44 (p < 0.001) for “reflect”. A clear positive relationship was demonstrated between word count and QuAL score (rho = .556, p < 0.001). Conclusions: The use of certain coaching words in written comments may improve the quality of feedback.

Knowledge and competences in hematological malignancies amongst radiation oncology residents in Germany-results from anational survey.

Radiation oncology is apivotal modality in the treatment of hematologic malignancies. To enable state-of-the-art patient care, structured education during residency is essential. However, given the lack of detailed data, the scope of educational opportunities available to trainees remains elusive. This prompted our group to perform anational survey amongst radiation oncology residents in Germany assessing the status quo of competences in the treatment of lymphoma and leukemia patients. Furthermore, areas of potential improvement were identified to further the goal of competence-based education for residents. Asurvey-based analysis was conducted to assess the knowledge and competence of radiation oncology residents in Germany regarding hematological malignancies. Adecisive questionnaire covering demographics, self-assessment of competences, and areas for improvement was developed in adaption of asurvey by the Association of Residents in Radiation Oncology and distributed amongst 1439 members of the German Society of Radiation Oncology. Responses were collected anonymously via an online survey tool and analyzed using descriptive statistics and chi-square tests. Atotal of 59complete and 22partial responses were collected, yielding a5.6% response rate. Participants' competence varied, with notable experience gaps in pediatric cases, proton therapy, and large-field techniques like total-skin irradiation or pediatric total body irradiation. While participants felt confident in treatment planning and patient counseling, they showed deficiencies in the definition of the planning target volume for modern involved site radiotherapy. Resources for education included national and international guidelines, scientific reviews, and textbooks. Board-certified radiation oncologists and physicians from specialized lymphoma centers demonstrated higher overall competence levels. This survey highlights the diversity of resident education regarding hematological malignancies in German radiation oncology programs. Knowledge gaps exist in key areas, including pediatric cases and specialized techniques. Competence-based education, interactive teaching formats, and rotations to specialized centers are potential strategies to address these gaps. The study contributes to the understanding of the federal educational landscape, underscoring the need for standardized and comprehensive training to ensure optimal patient care in hematological malignancies within the context of radiation oncology. Further research and collaborations are warranted to enhance training and expertise in this critical domain.

Enhancing Competency-Based Education in Instrumental Analysis: A Novel Approach Using High-Performance Liquid Chromatography for Real-World Problem Solving

Curricula related to instrumental analysis aim for competency-based education to promote the development of teaching strategies that encourage students to successfully tackle the problem-solving and tasks inherent to their profession. However, this endeavor is constrained by the complexity of equipment and the lack of time in laboratory classes. The objective of this work is to present an alternative high-performance liquid chromatography (HPLC) practice that adapts the desired competencies to a shorter and more effective timeframe. It seeks more active participation from the student and contextualizes chromatographic analysis within a real-world problem that encompasses the entire analytical process, from sample to final result. In this scenario, the student receives a solid sample of spicy paprika from a supermarket and must report the level of spiciness in terms of the total amount of capsaicinoids. To achieve this, they must first apply different experimental conditions for extracting the analytes of interest (varying temperatures and solvents) and selecting the most optimal condition. This practice is designed for short sessions, specifically conducted in two 2.5 h laboratory sessions, and has been implemented in the subject “Advanced Techniques in Instrumental Analysis (ATIA)” in the fourth year of the Degree in Biotechnology at the University of Cadiz. The results obtained demonstrated a significant increase in student motivation and an improvement in the acquisition of skills; 100% of the students achieved a grade higher than seven in the final evaluation of their learning process.