Point-of-care ultrasound (PoCUS) has evolved from bulky radiology-based machines to a core bedside tool in critical care. Training processes have shifted from informal apprenticeship to structured curricula, yet challenges in standardisation, competence assessment and accreditation persist. This review traces the historical development of PoCUS training and highlights contributions from pioneering educators. A narrative review of published literature, professional society guidelines and historical accounts was undertaken. Key milestones in PoCUS training, innovations in pedagogy and the perspectives of leading educators were synthesised to provide a comprehensive overview. Early PoCUS training relied on apprenticeship and short workshops, which improved knowledge but failed to ensure sustained competence. Longitudinal programmes and fellowships offered more robust outcomes but were resource-intensive and inconsistently implemented. Professional societies issued guidelines, though most were consensus-based rather than evidence-driven, leading to variability in curricula and accreditation standards. Recent innovations include Free Open-Access Medical Education, simulation and artificial intelligence-assisted training. Despite these advances, surveys reveal persistent barriers such as lack of trained faculty, inconsistent assessment tools and medicolegal concerns. The historical trajectory of PoCUS training underscores the tension between rapid clinical adoption and the slower development of robust educational frameworks. While innovations have expanded access, the absence of standardised, validated assessment and accreditation continues to limit training quality and patient safety. PoCUS training has advanced considerably but remains fragmented. Sustainable progress requires longitudinal, evidence-based curricula, validated assessment tools and global collaboration to ensure safe, high-quality training for future clinicians.

Purpose This study aims to explore how frontline managers (FLMs) in Norwegian municipal health care perceive the relevance and practical usefulness of the management competency assessment partnership (MCAP) competency model. While competency models are widely promoted to strengthen health-care management and leadership, fewer studies have examined how such models are experienced by FLMs who work under considerable operational and contextual constraints. Design/methodology/approach A qualitative study was conducted using three focus group discussions with 14 FLMs from three Norwegian municipalities. Before discussions, participants completed the MCAP questionnaire and reflected individually on its strengths, limitations and relevance. Data were analysed inductively using qualitative content analysis. Findings The analysis revealed two interrelated findings. First, FLM perceived MCAP as a relevant and comprehensive model that reflected the formal expectations for their role. Second, they questioned its practical usefulness when considered in relation to everyday work. Large spans of control, broad task scope, time pressure and limited room for manoeuvre constrained managers’ opportunities to develop, prioritise or enact several competencies. This was particularly consequential for interpersonal communication and change management, which were highlighted as the most important competencies by the informants. Originality/value This study contributes a conceptual lens for interpreting competency models as espoused theories and contrasting them with the theories-in-use that managers develop to meet everyday operational demands. It shows that competency mapping alone is no silver bullet for strengthening management. Effective competency development requires organisational conditions that enable FLMs to enact and sustain the competencies that models such as MCAP define.

Educational strategies in prenatal anomaly scanning: teaching, simulation and competence assessment.

Point-of-care testing (POCT) has expanded rapidly across healthcare systems, increasing both program scale and operational complexity. However, quantitative benchmarking data describing how POCT programs are structured and supported across institutions remain limited. We conducted a cross-sectional survey to characterize POCT program support, including program scope, staffing, operational practices, governance, and challenges. The survey was distributed electronically through professional networks, and 93 institutional responses were analyzed. Descriptive analyses were performed, and derived metrics, including sites per point-of-care testing coordinator (POCC), were used to evaluate the relationship between program scale and staffing. POCT programs demonstrated substantial variability in scale, with wide ranges in the number of testing sites and operator populations. Adoption spanned multiple test categories, and many institutions reported use of multiple platforms for the same assays. Training, competency assessment, and quality management activities were primarily supported by laboratory staff and POCCs, with documentation frequently partially electronic. Median POCC staffing increased with program size; however, sites per POCC also increased significantly across program scale tiers (Kruskal-Wallis P < 0.001). Governance structures and operational responsibilities varied across institutions, and common challenges included staffing limitations, training and compliance burden, multisite coordination, and IT/connectivity constraints. POCT programs are expanding in scale and complexity, but workforce capacity and governance structures have not scaled proportionally. This mismatch creates a cumulative and multiplicative operational burden. These findings provide benchmarking data to inform scalable staffing models, governance strategies, and infrastructure development for sustainable POCT program management.

This study aimed to conduct a comparative assessment of mathematical competence, including vocabulary, operations, and mathematical problem-solving, in children diagnosed with Specific Learning Disabilities (SLD) and Attention-Deficit/Hyperactivity Disorder (ADHD). Individual assessments were administered to evaluate intelligence quotient (IQ), mathematical competence, reading, and written language for both groups (SLD: N = 17; ADHD: N = 17). The results revealed statistically significant differences between the groups in several WISC-IIIGR measures, including Verbal IQ, Information (factual knowledge, long-term memory, recall), Arithmetic (attention, concentration, numerical reasoning), Digit Span (short-term auditory memory, concentration), Picture Arrangement (planning, logical thinking, social knowledge), Verbal Comprehension Index (VCI), and Freedom from Distractibility Index (FDI), as well as in Mathematical Operations and Mathematical problem-solving. Both groups demonstrated challenges across several assessed domains. To explore these difficulties in greater depth, canonical correlation analyses (CCA) were conducted on three variable sets. Findings suggest that while both SLD and ADHD are associated with cognitive challenges, they present largely distinct patterns of cognitive deficits. Findings are interpreted in terms of differential cognitive profiles and their potential implications for differentiated instructional approaches. In particular, results are linked to the design of mathematical tasks in 5th-grade mathematics inclusive classrooms, aiming at reducing cognitive load and supporting mathematical learning in students with ADHD and SLD.

Increasing cultural diversity requires effective educational strategies to support nursing students' cultural awareness and readiness for culturally competent practice. An explanatory sequential mixed-methods design was used. Forty-three fourth-year nursing students completed a single-group pre-test/post-test study without a control group using the Cultural Competence Assessment Tool. Four weekly sessions were delivered. Semi-structured interviews were conducted with 23 students and analyzed inductively. Post-test cultural awareness and total cultural competence scores were higher than pre-test scores (both p < .001; dz = 1.07 and dz = 0.67). Self-assessment scores increased in awareness and cultural sensitivity, whereas no significant change was found in self-assessed cultural practice. Qualitative findings highlighted language barriers, limited cultural knowledge, and the method's concise, awareness-raising nature. Pecha Kucha appears to function mainly as a reflective, awareness-oriented pedagogical approach that supports readiness for culturally competent practice, rather than as an intervention producing immediate behavioral competence.

Oncogenetics focuses on identifying and managing hereditary cancer predisposition, enabling risk-reducing interventions and targeted therapies. This descriptive study evaluated the landscape of oncogenetics training within Medical Genetics Residency Programs in Brazil. Data were collected through online questionnaires and interviews with program supervisors. We assessed rotation availability, timing and duration, clinical and theoretical workload, multidisciplinary care, and competency assessment. Data were analyzed using descriptive statistics. All twelve accredited programs participated. Eleven (92%) offered oncogenetics training, primarily in the third year of residency. While half of the programs provided internal rotations, all allowed external rotations to compensate for local infrastructure limitations. Residents completed a mean of 250.1 practical hours (SD 126.5; range 40-400) over approximately 6.5 months, seeing about 13 patients per week (SD 9.2; range 5-30). Theoretical training averaged 31.3h (SD 26.8; range 4-70), resulting in a mean total training workload of 258.7h (SD 159.1; range 4-470). Multidisciplinary care and research opportunities were common; however, formal competency assessments specific to oncogenetics were infrequent. Considerable variability in workload and clinical settings was observed across programs. The findings indicate that oncogenetics is well integrated into Brazilian medical genetics training, aligning with the growing importance of genomic medicine in oncology. Nevertheless, the marked heterogeneity underscores the need for standardized training approaches. The study suggests that establishing inter-institutional networks and formalizing external rotations may help reduce geographic and technological disparities and support more consistent oncogenetics training in medical genetics residency programs across Brazil.

Objective structured clinical examinations (OSCEs) provide a robust assessment of veterinary clinical skills competency and are often used for high-stakes examinations. For students with disabilities, OSCEs can pose challenges that may impact their ability to demonstrate their competency compared with non-disabled peers, resulting in attainment gaps. Reasonable adjustments (RAs) aim to address this problem by providing supportive interventions that allow disabled students to demonstrate their full potential in the exam, creating an equitable assessment. When providing RAs, institutions can tailor these to the individual student using a "medical model approach" or design their OSCEs to be equally accessible for disabled and non-disabled students using a "universal design approach." This article explores challenges and potential solutions to implementing RAs including additional time in OSCEs, using current evidence for both of these approaches while considering students with varied physical, sensory, processing, and anxiety needs. Due to the diverse needs of these students, current best practice is to use a blend of universal design and medical model RAs to optimize specific needs for individuals while simultaneously supporting all students, including those with undiagnosed or undeclared disabilities. The effectiveness of this approach can be monitored by looking for closure of any attainment gaps, as well as through perceived student experience of fairness in the exam. Clear communication between the institution and students regarding what is being implemented/offered, and why, is key to developing an open dialogue and inclusive culture to support fair and equitable assessment outcomes for all students.

Development and Implementation of the Health Informatics Competency Assessment (HICA): A Pilot Study.

We described our first-ever gastrointestinal (GI) motility game (GutMove), designed to enhance teaching and assessment of knowledge on motility across the GI tract. The game has 7 sections: 1 (pre-gastric regions), 2 (upper stomach), 3 (lower stomach), 4 (small intestine and its transition), 5 (large intestine), 6 (stimulating hormones), and 7 (inhibiting hormones). Sections 1 - 4 have 8 cells each on the left side, and 12 e-tokens each scattered on the right side, though only 8 e-tokens are correctly matchable to the corresponding left cells, while the remaining 4 e-tokens are distractors to enhance critical thinking. Other sections have varying numbers of left cells and correctly matchable e-tokens vs. scattered e-tokens (16 vs 20 in section 5; 9 vs. 14 in section 6; and 18 vs. 23 in section 7). The game is played by a registered individual by tapping or dragging each e-token from the right repository and dropping it in the appropriate cell of the game board on the left, until completely filled. The game displays the play results after each round and reshuffles the e-tokens for the next rounds. The results can be verified via a dedicated link, and it provides feedback on right and wrong answers after every three wrong trials. Users of this game reported its positive impact on retrieval learning and assessments. This game can be used for improved teaching, assessment, and practical simulation of GI motility by tutors across the globe, irrespective of the structure of the curriculum used in an institution.

Examiner training and calibration are widely recommended to improve scoring consistency and defensibility in simulation-based observed clinical competency assessments (SOCCAs), yet the empirical evidence has not yet been comprehensively explored. This scoping review maps and describes studies evaluating general examiner training and calibration interventions in SOCCAs. A scoping review was conducted of peer-reviewed studies that reported empirical evaluation or descriptive outcomes of examiner training and/or calibration in any SOCCA format (including OSCEs and OSLERs) across health profession disciplines and training stages. Data were charted on intervention characteristics, study design, outcome measures and reported effects. Given study heterogeneity, findings were synthesised descriptively. Twenty studies met inclusion criteria. Seven described general examiner training, although intervention reporting and evaluation were often insufficient to judge effectiveness. Two broad calibration approaches were identified: (i) general calibration aimed at aligning examiners' internal performance standards and (ii) case-orientation calibration tailored to specific stations subsequently assessed. Most calibration interventions used frame-of-reference approaches, commonly involving video-recorded benchmark performances with facilitated discussion. Effects on scoring outcomes were inconsistent: some studies reported modest improvements in scoring reliability or accuracy, whereas others showed minimal change or increased examiner stringency. Only one study assessed outcomes beyond scoring metrics to study examiner behaviours. Despite widespread endorsement, the evidence base for examiner training and calibration in SOCCAs remains limited and inconsistent. Where benefits were observed, they appeared most evident for borderline/uncertain performances, suggesting calibration may be most useful near decision thresholds. Additionally, this review highlights an unresolved tension in calibration aims, whether to promote score convergence, shared reasoning or both. Future work should specify intended mechanisms, address contextual influences on judgement and extend evaluation to impact on assessor behaviour. In the absence of stronger evidence, routine implementation risks being driven by expectation and convention rather than a sufficiently robust empirical rationale.

The effectiveness of project management is largely determined by the quality of human capital and the set of competencies that ensure successful implementation of project tasks. This study aims to analytically identify and structure key characteristics of human resources in order to define priorities for forming project teams and distributing functional workload within project offices Traditional statistical models typically consider competencies in isolation, which limits their applicability in multidimensional and interconnected managerial processes. The methodological basis of the study includes content analysis of labor market requirements presented in job vacancies on the hh.kz platform and a comparative analysis of employers’ practice-oriented expectations and the normative competency model IPMA ICB v4. To analytically interpret the interconnections between the identified competencies, the DEMATEL method is used as a conceptual framework that allows competencies to be viewed as elements of a single system. The study results show that the labor market emphasizes such characteristics as motivation, adaptability, innovative thinking, professional training, and the ability to maintain work–life balance, which form the foundation for effective functioning of project teams. At the same time, competencies related to interaction management, conflict resolution, and stakeholder communication appear mainly as a response to organizational and contextual conditions. The findings highlight the need to apply systemic approaches to competency assessment and development in a project environment. Integrating structured analytical tools into project offic management practice increases the soundness of managerial decisions and the effectiveness of forming project teams.

Acute kidney injury (AKI) is among the most prevalent life-threatening complications in intensive care units (ICUs), with continuous renal replacement therapy (CRRT) being the primary mode of renal support for haemodynamically unstable patients. Despite the technical complexity of CRRT, formal training programmes for ICU nurses remain inconsistent across healthcare settings. This study explored the informal training experiences of critical care nurses managing dialysis-dependent patients in Al-Ahsa, Saudi Arabia. A qualitative descriptive design was employed, guided by reflexive thematic analysis as described by Braun and Clarke. Semi-structured in-depth interviews were conducted with 20 purposively sampled ICU nurses with direct CRRT management responsibilities across healthcare facilities affiliated with King Faisal University, Al-Ahsa. Data were analysed through six iterative phases of thematic analysis. Ethical approval was obtained from the Institutional Review Board of King Faisal University. Four overarching themes were generated: (1) "Figuring It Out on the Floor", nurses described learning CRRT management primarily through observation and immediate bedside practice; (2) "The Colleague Is the Textbook", experienced peers served as informal educators, transmitting practical knowledge through demonstration and narration; (3) "Anxiety Behind the Machine", nurses articulated persistent fear of error that gradually transformed into competence through repeated exposure; and (4) "Gaps the System Does Not See", participants identified a systemic absence of structured CRRT training and called for formalised competency frameworks. Critical care nurses in this setting rely heavily on informal, peer-mediated learning to acquire CRRT competencies in the absence of standardised institutional training. These findings highlight an urgent need for structured simulation-based CRRT education, written protocols, and competency assessment frameworks. Nursing leaders and ICU educators must recognise and address the informal learning burden carried by frontline nurses to safeguard patient safety and support workforce development. Not applicable.

Emergency nursing education demands repeated exposure to high-acuity clinical scenarios that conventional instructional approaches cannot fully provide due to safety, ethical, and resource constraints. Virtual reality (VR) has emerged as an immersive, interactive alternative capable of replicating high-stakes emergencies in a controlled environment; however, specialty-specific evidence on its educational utility in emergency nursing remains limited and fragmented across existing reviews. This scoping review addresses three questions: how VR is currently applied in emergency nursing education; what cognitive, psychomotor, and affective outcomes have been reported; and what factors moderate these outcomes across study designs and immersion levels. Following the Arksey and O'Malley framework and PRISMA-ScR guidelines, a systematic search was conducted across PubMed, Web of Science, CINAHL, Embase, and the Cochrane Library (to November 5, 2025), supplemented by manual reference screening. Two reviewers independently screened records and extracted data using a structured form. Outcomes were categorised across cognitive, psychomotor, and affective learning domains, and findings were interpreted through three complementary theoretical frameworks. Seventeen studies were included: six RCTs, nine quasi‑experimental studies, and two mixed‑methods studies across seven countries. VR was most applied to resuscitation skills, disaster preparedness, and systematic clinical assessment. Most studies reported positive findings, but the magnitude of improvements varied considerably across study designs. RCTs generally showed non‑inferiority or equivalence to traditional training, whereas quasi‑experimental studies reported larger effects. Only six studies used objective assessments; the majority relied on self-reports. Three studies assessed outcomes beyond the immediate post-test at intervals ranging from three weeks to six months; findings were mixed, with one study reporting maintained outcomes at three and six months, and two documenting attenuation of reported gains at follow-up. This scoping review maps VR applications in emergency nursing education across 17 studies, with the majority reporting positive within-group findings across cognitive, psychomotor, and affective domains. In the absence of formal quality appraisal and given the predominance of quasi-experimental designs, small sample sizes, reliance on self-report instruments, and limited longitudinal follow-up, these findings are best regarded as descriptive and directional rather than as evidence of effectiveness. Future research should prioritise adequately powered multi-site RCTs, longitudinal competency assessment, validated emergency nursing-specific outcome instruments, and interprofessional team-based VR training models.

The rapid expansion of telemedicine has increased the relevance of teleconsultations in everyday clinical practice. However, the manner in which teleconsultation competencies are conceptualized, taught, and assessed in undergraduate medical education remains unclear. A narrative review was conducted using a transparent methodology to identify and select studies. Several bibliographic databases were searched using predefined eligibility criteria, focusing on educational interventions that specifically targeted teleconsultation competencies among undergraduate medical students. The selection process emphasized conceptual clarity, curricular intent, and the inclusion of empirically reported educational outcomes. The eligibility criteria were intentionally designed to identify studies that explicitly conceptualized teleconsultation as a distinct undergraduate clinical competency. The search process yielded 199 records. After screening and comprehensive full-text evaluation, only one study explicitly conceptualized teleconsultation as a distinct undergraduate clinical competency and met all predefined eligibility criteria. This study details a structured educational intervention that frames teleconsultation as a distinct clinical competency. The outcomes concerning communication, clinical reasoning in virtual environments, technical aspects of teleconsultation, and components of remote physical examination were reported. The principal finding was the identification of substantial evidence gaps in the conceptualization, assessment, and longitudinal teaching of teleconsultation competencies. Current evidence regarding the instruction of teleconsultation competencies in undergraduate medical education is limited. The prevailing literature addresses telemedicine primarily as a mode of care delivery rather than emphasizing teleconsultation as a distinct clinical skill. These observations highlight a discrepancy between contemporary clinical practice and undergraduate training, emphasizing the need for well-defined educational frameworks that incorporate teleconsultation competencies.

The rapid advancement of Generative Artificial Intelligence (GenAI) is reshaping the landscape of medical simulation education, necessitating the enhancement of faculty competencies to effectively integrate evolving knowledge systems with GenAI for collaborative decision-making. However, current educational technologies face systemic limitations, including fragmented functionality, a disconnect between conventional and GenAI-driven teaching approaches, and a lack of dynamic capability assessment tools. Constructing a standardised capability scale is crucial to overcoming adaptation bottlenecks. Grounded in the integrated Technological Pedagogical Content Knowledge (TPACK) framework, this research proposed a two-round Delphi method to construct a faculty competency assessment scale, with stratified sampling involving 434 participants from clinical medicine, medical technology, and nursing fields. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were used to test model fit (CFI = 0.939, RMSEA = 0.117). This proposed research was not registered as a clinical trial. The resulting 16-item scale exhibited strong psychometric properties, demonstrating excellent internal consistency (Cronbach's α = 0.979), sampling adequacy (KMO = 0.961), and significant sphericity (Bartlett's test, p < 0.001). No factor covariance was detected, and item consensus was high (Kendall's W = 0.761, p < 0.001). The model showed acceptable fit (χ²/df = 6.893). This empirically validated and standardised assessment model provides robust support for integrating GenAI with simulation-based health sciences education. It offers a foundational framework for advancing faculty competency development and fostering adaptive, technology-enhanced teaching practices, while noting that the scale primarily captures ethical awareness rather than comprehensive governance competence. Not applicable. As this research did not involve clinical interventions, trial registration was not required.

This narrative review analyzes 25 studies published between 2018 and 2026 on educational planning and the competency-based approach in secondary education. The findings are organized into six thematic categories: foundations of the competency-based approach, didactic planning, teaching strategies, competency assessment, teaching competencies and pedagogical practice, and curricular management. The results show that planning constitutes a strategic axis for competency development, although challenges persist such as disciplinary fragmentation, insufficient teacher training, and the gap between normative discourse and classroom practice. Active strategies (PBL, collaborative learning, case studies) and formative assessment emerge as key tools. It is concluded that strengthening teacher planning, with institutional support and continuous training, is essential to transition towards quality competency-based education.

The importance of simulation-based training in minimally invasive surgical education has become increasingly important. However, in low-resource settings, reliable intraoperative assessment contrasting simulation-based and conventional laparoscopic training is still limited. This prospective comparative observational study was conducted at tertiary care centre, including 32 senior surgical residents doing laparoscopic cholecystectomy. Residents were classified into traditional training (n = 17) and simulation-trained groups (n = 15). Using the Global Operative Assessment of Laparoscopic Skills (GOALS) score, operative performance was assessed intraoperatively by two blinded consultants. Residents with prior simulation training demonstrated significantly higher total GOALS scores as compared to traditionally trained residents (18.20 ± 1.15 vs. 11.71 ± 1.21; p < 0.001). Significant improvement across all GOALS domains was observed, with shorter operative time in the simulation group (p < 0.001). Most simulation-trained residents reported to have high competence levels. Prior simulation exposure was associated with higher laparoscopic competence, improved technical performance, and shorter operative time, which may support its integration into modern minimally invasive surgical curriculum.

Infection prevention and control (IPC) nursing plays a central role in implementing IPC standards and preventing healthcare-associated infections. However, a unified core competency framework for IPC nursing roles has yet to be clearly defined. This study aimed to identify and synthesise the core competencies required for IPC nurses, including infection control nurses (ICNs) and infection control link nurses (ICLNs). It also examined how these competencies differ according to role responsibilities and explored patterns of association among competency domains. A scoping review with cluster analysis. This scoping review followed a five-stage methodological framework, including identifying the research questions, identifying relevant sources, selecting sources, charting the data and collating, summarising and reporting the results. Based on this process, we conducted high-frequency term analysis and cluster analysis to identify the core competency structure. This review included 18 sources, from which 40 high-frequency terms were extracted and nine core competency domains were identified. Cluster analysis grouped these domains into three clusters: system-supporting and developmental competencies, IPC in clinical practice and microbiology and surveillance. When compared with the World Health Organization framework, these domains showed overall alignment while also revealing additional domains of importance, such as research competence and personal quality. ICNs placed greater emphasis on surveillance, leadership, education and programme management, whereas ICLNs focused more on clinical practice and communication. This study systematically mapped IPC nursing competencies into nine domains and three functional clusters, distinguishing role-specific profiles for ICNs and ICLNs. The findings can inform role-specific competency framework development and more targeted IPC education and workforce preparation. This scoping review synthesised competency evidence for ICNs and ICLNs. Three competency clusters were identified: system-supporting and development, IPC clinical practice and microbiology and surveillance. The findings support the development of role-specific competency frameworks, assessment tools and training programmes for infection control nursing roles. Findings from this study suggest that strengthening analytical, clinical, and system-level IPC competencies may enhance the effectiveness of infection prevention efforts in daily practice. Targeted competency development appears feasible, though further research is needed to design and evaluate integrated interventions. The findings suggest that IPC competencies should be developed with attention to the distinct requirements of analytical, clinical, and system-level work. Healthcare organizations may enhance IPC performance by providing targeted training in surveillance, supporting frontline implementation, and strengthening mechanisms that connect managerial activities with bedside practice. Integrating these strategies may help improve the consistency and impact of infection prevention efforts. PRISMA-ScR.

Introduction . In modern higher education, in particular medical education, there is still uncertainty in the understanding and measurement of competencies. Common theories often reduce competencies to the sum of knowledge, skills and abilities, without taking into account their dynamic characteristics and subject relevance. This approach does not take into account their dynamic, systematic nature and dependence on a specific professional context, which makes it difficult to form and evaluate the competencies necessary for innovation activities. Objective. Testing of the hypothesis that the competencies of innovative activity of medical students are a functional-dynamic system, the manifestations and interrelations of which are transformed depending on the stage and the subject tasks being solved. Materials and methods . The pilot study was conducted on the basis of the Tyumen Medical University as part of an additional educational program. The assessment of competencies was carried out twice (at the beginning and end of the academic year) using a set of methods: standardized tests for assessing thinking, emotional and social intelligence, self-regulation; testing in the TEZAL system; assessment based on the project activity competence model and self-assessment. Correlation, factor analysis, and regression analysis were used to analyze the data. Results . The study involved 26 students. The results showed that the relationships between the evaluated competencies (goal setting, reflection, situation analysis, self-determination, problematization, organization, communication, self-organization) and stable personal characteristics are not static. Different patterns of correlations were identified at different stages of the project work. Regression analysis has demonstrated a realignment of the structural relationships between competencies from the first to the second dimension. For example, at the first stage, connections within the blocks of operational and subject competencies were key, and at the second stage, the role of the "situation analysis" competence was strengthened. Discussion . The results obtained indicate that the competencies of innovation activity show the properties of a flexible, self-organizing functional-dynamic system that adapts to the requirements of the task and the stage of work. This directly indicates the failure of their isolated, static assessment. The practical significance of the study lies in the substantiation of a fundamentally new approach to the assessment and formation of competencies in medical education: it should be context-dependent and procedural. The results open the way for the development of more adequate assessment procedures and educational trajectories that purposefully develop the ability of future doctors to flexibly integrate competencies in real innovative practice.