Competency-based Assessment Research Articles

Surgical Training Pathways in the United Kingdom and the United States: Lessons for Resource-Limited Settings From High-Income Countries.

Background Surgical training is a critical component of healthcare, especially in high-income countries such as the United Kingdom (UK) and the United States (US), which have established distinct, well-organised training frameworks. Comparing these systems provides valuable insights that may enhance global surgical education, particularly in low- and middle-income countries, where training and retaining proficient surgeons are considerable challenges. Methodology This comparative study examines the surgical training systems in the UK and the US, focusing on key aspects, including training structure, competency-based assessments, and work-hour regulations. Data were sourced from regulatory organisations such as the General Medical Council, the Royal College of Surgeons, the Accreditation Council for Graduate Medical Education, and the American Board of Surgery. The analysis explores how elements of these models might be adapted to support sustainable surgical education frameworks in resource-limited environments. Ethical approval was not required due to the use of publicly accessible data and no patient involvement. Results The UK and US surgical training systems differ substantially in their structure, training duration, and specialisation timing. The UK employs a tiered approach, offering generalist experience before specialisation, while the US favours early specialisation directly after medical school. Both systems implement competency-based evaluations, though the US system places a greater emphasis on case volume and procedural exposure. Work-hour regulations also vary, with the UK capping weekly hours at 48 under the European Working Time Directive, compared to an 80-hour maximum in the US, which results in differing levels of trainee satisfaction and burnout rates. Conclusions The competency-based assessments in both the UK and the US offer adaptable frameworks for resource-limited settings. The phased training approach in the UK is well-suited for environments requiring versatile surgeons capable of handling a wide range of cases. By implementing these adaptable elements, along with cost-effective training innovations such as simulation tools, e-learning platforms, and international partnerships, resource-constrained regions can foster a sustainable, skilled surgical workforce. These insights offer pathways to improve healthcare outcomes and equity globally by enhancing surgical capacity in regions with limited resources.

Preparing the future pharmacy workforce: competency-based undergraduate curricula for teaching, learning and assessment with a focus on antimicrobial stewardship

Abstract Introduction Competency-based teaching, learning and assessment underpins the requirements for initial training and education of pharmacists (IETPs) in the UK and is set by the General Pharmaceutical Council (GPhC). This competency-based pedagogic approach is conducive when teaching antimicrobial resistance (AMR) and antimicrobial stewardship (AMS) since it ensures that rather than only reciting and absorbing content, student pharmacists gain the necessary skills and behaviours to apply knowledge effectively in clinical practice. This is particularly relevant since newly graduate pharmacists will need to show competency in independent prescribing at the point of graduation from 2026 and education needs to evolve to incorporate prescribing skills including decision making. Aim The aim of this project was to develop a UK-wide national AMS competency framework specifically tailored for student pharmacists and foundation year trainees. Method A working group of academics and pharmacy practitioners from all four nations and with expertise in AMS was set up in September 2022. Student pharmacists from a national organisation (BPSA) and a professional pharmacy body (RPS) are also members. Development of the consensus indicative curriculum for student pharmacists was adapted from published frameworks including those for UK undergraduate medical students1, and a UK wide set of generic AMS competencies for undergraduate healthcare professional education2. The results of a survey3 conducted across Schools of Pharmacy (SoP) aiming to determine the nature and extent of implementation of the latter generic competencies, also informed this project. To ensure consistency, the group has worked with the British Society for Chemotherapy (BSAC) to align to the Keep Antibiotics Working (KAW) website, that provides resources for pharmacy students and educators, aligned to the curriculum domains. No ethics approval was required for this study since it did not involve any participants. Results The final curriculum consists of six domains: Infection prevention and control, antimicrobials and antimicrobial resistance, antimicrobial prescribing and stewardship, vaccine uptake, person-centred care and interprofessional collaborative practice. Each domain includes a competency statement together with accompanying descriptors (74) clearly outlining the knowledge and application required by the newly qualified pharmacist. To support implementation of the framework, the individual competencies were mapped to the revised GPhC standards for the IETPs together with Royal Pharmaceutical Society Prescribing Competency Framework that link to AMR and AMS. The group has also developed a set of suggested practice-based activities aligned with the framework domains to support pharmacists supervising or assessing students on placement. Discussion/Conclusion This project is timely to support development of future pharmacists as leaders in AMS and ensure a portable workforce, since pharmacists will be independent prescribers at the point of registration from 2026. A limitation of the development is the fact that not all SoP have been involved in the process; however, efforts are being made to communicate curriculum content as widely as possible. Though it is not mandatory to implement this curriculum, it provides a benchmark for embedding the competencies into undergraduate pharmacy curricula and allows identification of topics that may not be adequately covered. It also promotes consistency of approach across schools. (500 words)

Can routine EPA-based assessments predict OSCE performances of undergraduate medical students?

Background Objective structured clinical examination (OSCE) is used worldwide. This study aims to explore potential alternatives to the OSCE by using entrustable professional activities (EPA)-based assessments in the workplace. Methods This study enrolled 265 six-year undergraduate medical students (UGY) from 2021 to 2023. During their rotations, students were assessed using 13 EPAs, with the grading methods modified to facilitate application. Before graduation, they participated in two mock OSCEs and a National OSCE. We used generalized estimating equations to analyze the associations between the EPA assessments and the OSCE scores, adjusting for age and sex, and developed a prediction model. EPA8 and EPA9, which represent advanced abilities that were not significant in the regression models, were removed from the prediction model. Results Most EPAs were significantly correlated with OSCE scores across the three cohorts. The prediction model for forecasting passing in the three OSCEs demonstrated fair predictive capacity (area under curve = 0.82, 0.66, and 0.71 for students graduated in 2021, 2022, and 2023, respectively all p < 0.05). Conclusions The workplace-based assessments (EPA) showed a high correlation with competency-based assessments in simulated settings (OSCE). EPAs may serve as alternative tools to formal OSCE for medical students.

FAKTOR EKSTERNAL PENGHAMBAT PENCAPAIAN STANDAR KECAKAPAN BAHASA INGGRIS PADA MAHASISWA PARIWISATA BERDASARKAN COMMON ASEAN TOURISM CURRICULUM

This study is aimed to investigate external factors that hinder the students' attainment of English proficiency in the Common ASEAN Tourism Curriculum. The study was conducted on tourism students in AKN Lombok Barat. The study used a descriptive qualitative method and the data was gained through competency-based assessment and questionnaire for the students in three subdivisions; Hotel Accommodation, Food Beverages, and Hotel Engineering. The findings showed that several factors hinder the students' achievement of English proficiency standards externally. The external factors comprise the unsupportive college cultural factors; the dominant use of the mother tongue; the lack of English facilities in the college, such as an English listening laboratory to support the learning process; the limited learning hours for English subjects: the lecturers have limited interaction in English, especially outside the classroom; the lecturer has limited strategies in their teaching method, especially in practicing English for specific purposes like in tourism

Where the rubber meets the road: pearls and pitfalls of implementing competency-based assessment.

Where the rubber meets the road: pearls and pitfalls of implementing competency-based assessment.

Unintended consequences – Risk for bias in competency-based assessment

As nursing education transitions to competency-based education, careful attention to the assessment methodology must be considered. As nursing education contends with structural implicit bias and supports social justice, any transition to the education delivery model must consider the underserved and marginalized. Multilingual and marginalized students have long had inequitable experiences when taking standardized assessments influenced by the perspectives and values of the dominant culture. Resourced and under-resourced nurse educators must be empowered to access information to inform the competency-based assessment design. This perspective article aims to uncover the risk of bias in competency-based assessment when not properly implemented and to present strategies to reduce bias in competency-based assessment. Considerations for schools/colleges of nursing as they implement competency-based assessment are explored.

FEASIBILITY OF A COMPETENCY-BASED SKILLS ASSESSMENT BOOK FOR THE SUBJECT OF BIOLOGY IN GRADE VIII JUNIOR HIGH SCHOOL

This study is intended to determine the feasibility and teacher response to competency-based skills assessment book products in Science-Biology subjects in Class VIII Junior High School. The research method used is Research and Development through 7 stages, namely; (1) potential and problems, (2) data collection, (3) product design, (4) product design validation, (5) product design revision, (6) product trial, and (7) product revision. The research instrument was a product feasibility assessment sheet and a response questionnaire in the form of a Likert scale. Product feasibility was assessed by five experts. The data obtained from the validation sheet (feasibility) was analyzed using Aiken's formula. The product trial was conducted on six teachers. The results showed that the feasibility of the product and the response questionnaire assessed by the validators obtained results respectively were 0.97 and 0.99 with high validity and feasible to use. After the trial, the teacher's response to the competency-based skills assessment book was stated to be very good with an average value of 95.00%. It can be concluded that the book product made is feasible to use for competency-based skills assessment with a very good response.

Competency-based assessment tools for engineering higher education: a case study on complex problem-solving

Competency-based assessment tools for engineering higher education: a case study on complex problem-solving

Technical skills of endoscopic sinus surgery for performance assessment using the Delphi methodology.

In surgical residency, competence has traditionally been defined by a specified number of surgical procedures. Modern advances in medical education and surgical fellowships have challenged this approach. It is widely accepted that a definition of a skill set, enabling a systematic, competency-based assessment is mandatory in surgical education. We conducted an international Delphi study with panelists from the European Rhinologic Society, representing 27 countries. Through four rounds, the panel reached consensus on the phrasing of an assessment tool-, for the technical skills of endoscopic sinus surgery (ESS). Thirty panelists participated throughout the study. The median age of the panelists was 54 years (range 31-66 years) with a median experience of 25 years (range 6-40 years). All were experts in the field of endoscopic sinus surgery. Consensus was reached. The final assessment tool consists of 21 items with descriptive anchors. The assessment tool, European Endoscopic Sinus Surgery - Technical Skills Assessment (EE-TSA), enables a competency-based approach to acquiring and maintaining essential elements of endoscopic sinus surgery. The international Delphi panel makes the tool internationally applicable. Further research should gather validity evidence for EE-TSA, enhancing the assessment of ESS by setting a pass/fail-standard ultimately improving surgical outcomes and patient safety.

Enhancing competency-based assessment: Implementing oral boards in nursing education.

Competency-based education, pivotal in nursing programs, emphasizes learning methods over knowledge accumulation, integrating ongoing assessments for performance and outcomes. The American Association College of Nursing introduced competency-based education, urging educators to explore diverse assessment methods. This article explores the implementation of mock oral boards as an assessment method to synchronize performance standards with competencies in nursing education, specifically in preparing nurse practitioner students for clinical rotations.

Enhancing The Excellence of Quality Management System Auditors: A Competency-Based Training Model with Instructional Design Strategic Approaches and Measurable Outcomes

The development and implementation of a competency-based training model for Quality Management System (QMS) auditors are crucial for enhancing audit quality and organizational performance. This study identifies and addresses gaps in current auditor training programs through a structured approach that includes clear instructional goals, effective assessment tools, and robust instructional strategies. The research utilizes Training Needs Analysis (TNA) data and aligns training objectives with industry expectations through Occupational Standards and Competency Standards. Learning outcomes are formulated using the ABCD method (Audience, Behaviour, Condition, Degree) to ensure clarity, measurability, and achievability. The training program employs Outcome-Based Learning and Teaching (OBLT) methodologies, ensuring that the focus remains on achieving specific competencies. Self-assessment based on competency standards encourages reflective learning and self-improvement, while competency-based assessments measure the effectiveness of the training and the skills acquired by participants. The program culminates in the awarding of Micro Credentials and Certificates of Competency, which are traceable to national and international standards, thereby validating the skills and knowledge gained. Through rigorous testing and evaluation involving experts, educators, and participants, the study refines the training model to ensure its effectiveness and relevance. The findings indicate that the competency-based training model significantly improves the skills and performance of QMS auditors, leading to more effective audits and continuous quality improvement within organizations. This research contributes to the field by providing a comprehensive, evidence-based approach to developing high-quality training programs for QMS auditors.

Trends in Case Volume Reported by Musculoskeletal Oncology Fellows in Accreditation Council for Graduate Medical Education-Accredited Training Programs: 2017 to 2022.

Increasingly, national accrediting bodies and professional societies for musculoskeletal oncology recognize the need for more standardized training. This study elucidates recent trends in reported case volume during Accreditation Council for Graduate Medical Education (ACGME)-accredited musculoskeletal oncology fellowship training relative to case minimum requirements. We conducted a retrospective cross-sectional analysis of fellows at ACGME-accredited musculoskeletal oncology fellowships (2017 to 2022). Percentiles in reported case volumes were calculated across ACGME-defined case categories and temporal changes assessed by linear regression. Variability between the highest (90th percentile) and lowest (10th percentile) deciles was calculated as fold differences. Sensitivity analyses were conducted to estimate the number of fellows not meeting ACGME-defined case minimum requirements. Case logs from 95 musculoskeletal oncology fellows were analyzed. From 2017 to 2022, total relevant oncology procedures increased from 191 ± 49 to 228 ± 73 (P = 0.066). Pediatric oncology accounted for a minority of cases (range, 6 to 8%). A mean of 222 total relevant oncology procedures were reported. Most were in management of metastatic disease (21%), soft-tissue resection/reconstruction (20%), and limb salvage (13%). Variability in total relevant oncology procedures was 2.6 and greatest in spine/pelvis (4.6), pediatric oncologic cases (4.4), and surgical management of complications (4.4). No clear trends were observed in case volume variability over the study period (P > 0.05). Analysis of case volume percentiles identified at least 30% of musculoskeletal oncology fellows not achieving minimum requirements for pediatric oncologic cases (n = 29 fellows) and 10% of fellows not achieving minimum requirements for total relevant oncology procedures (n = 10 fellows). Results from this study may help future musculoskeletal oncology fellows and faculty identify potential areas to increase case exposure and reduce variability during fellowship training. More investigation is needed to determine evidence-based case minimum requirements including surgical learning curves and other competency-based assessment tools in musculoskeletal oncology.

Design and Application of an Evaluation Tool to Assess World Organization for Animal Health Competencies for Graduating (Day 1) Veterinarians.

Graduating competent veterinarians with the appropriate knowledge and skills to support and strengthen their country's National Veterinary Services is a key priority for veterinary institutions globally. The World Organisation for Animal Health (WOAH) developed a set of Day 1 Competencies that should be expected of every veterinary graduate. Veterinary schools need to be able to assess the coverage of these competencies in their curriculum and determine the level of proficiency of their graduates. This article describes the iterative design and development process used to create a semi-quantitative, competency-based assessment survey. The Evaluation Tool for WOAH Day 1 Graduating Veterinarian Competencies is used as part of a stepwise process to systematically assess a veterinary curriculum regarding these competencies. This tool was developed and tested at the University of Gondar College of Veterinary Medicine and Animal Sciences in Ethiopia. The Evaluation Tool was successful in systematically collecting, measuring, and analyzing the perceptions of faculty, senior veterinary students, recent graduates, and external stakeholders about the level of proficiency of graduates in all 19 WOAH Day 1 Competencies. It was specifically designed to be used in conjunction with curriculum mapping to provide a full picture of how effectively these competencies were taught and identify gaps that needed to be addressed. This tool, the supporting resources, and the methodology are now globally accessible to all veterinary institutions, enabling them to revise and update their curricula and, ultimately, improve the training of the future veterinary workforce to support veterinary services in their respective countries.

Utilizing Technology to Assess English Learning Outcomes of Students Based on a Competency-based Approach

This study addresses the research gap in the integration of technology in evaluating English language learning outcomes, aiming to improve efficiency, accuracy, and flexibility in competency-based assessments. The research employs a mixed-methods approach, using quantitative data from online assessments. Participants included educators and learners engaged in English language programs across various educational institutions. The findings indicate that adaptive learning technologies significantly enhance accessibility, scalability, and student engagement in English language assessments. However, challenges such as technological limitations, data privacy issues, and the need for comprehensive teacher training are highlighted. This research underscores the potential of technology to transform competency-based English language proficiency examinations while offering practical insights for educational institutions, policymakers, and ed-tech companies to optimize these advancements effectively.

Competency-based assessment instrument editor

Competency-based assessment instrument editor

Development of a competency-based assessment template for oncology nursing: A participatory action research study

AimThe main objective of this study was to collaboratively develop a competency-based assessment template for oncology nurses. BackgroundThe care of oncology patients and their families requires very specific knowledge and skills, as well as that nurses are trained not only in theoretical and practical knowledge but also in competencies. There is a lack of specific tools to assess competencies in oncology and it is important to include students in the learning process. DesignThis study has a Participatory Action Research. MethodsA focus group was conducted for data collection. The process consisted of 4 phases: 1- Identification of the problem; 2- Planning of the change; 3- Realization of the change; 4- Effect of the change and reflection. A purposive sampling where all the students of the master's degree in oncology nursing who wished to participate voluntarily were selected. A total of 23 students participated. The information was recorded and fully transcribed. Triangulation of researchers was used during data analysis. ResultsOne of the most important aspects included in the new tool was the need for a comprehensive approach to people with oncological diseases and their relatives. The students emphasized the need to primarily address the physical, psychological and social dimensions in this approach. ConclusionThis study developed a competency-based assessment template for oncology nurses, which includes the assessment of knowledge, skills and attitudes. The findings could help other oncology nurse educators or professionals to evaluate their training sessions and even their own knowledge in a healthcare setting.

Teachers’ and Pupils’ Understanding of Competency-Based Assessment for Tanzania Primary School Pupils’ Learning in Mpwapwa District

Teachers’ and Pupils’ Understanding of Competency-Based Assessment for Tanzania Primary School Pupils’ Learning in Mpwapwa District

The Need for Competency-Based Orientation Assessment Instruments in the Medical-Surgical Nursing Specialty.

The Need for Competency-Based Orientation Assessment Instruments in the Medical-Surgical Nursing Specialty.

Assessment in community settings: Is there any role for individual competency-based assessment?

Oral forms of assessment remain a common part of competency-based assessment systems, yet their feasibility is being challenged. The focus on individual competence is problematic given the need to prepare health professionals for teamwork. The present study aimed to investigate how the assessment of collective competence compares to individual assessment, and to explore whether there is a need for individual assessment at all in community or population-based practice. A behavioural-based interview assessment was developed and trialled and correlated to performance as a team on placement. Correlation between student performance on individual behavioural-based interview and teamwork artefacts was assessed using Spearman rho. Differences between performance on individual oral assessment and team performance on artefacts at the cohort level was determined using the Mann-Whitney U-test. Bland-Altman analysis was completed to analyse agreement between performance on the individual oral assessment and team performance at the student level. Students were final year nutrition and dietetics students from 2020, 2021 and 2022 years (total sample = 216) from one Australian university. There was a difference in performance between assessment types in each year and as a total cohort (p < 0.001) with students performing better in teamwork. There was no correlation between individual oral interview and team performance across all years. The results of the Bland-Altman analysis showed little agreement between the two assessment tasks. Assessment of teamwork performance as part of a program of assessment is essential. More valid and reliable tools are needed to assess collective competence.

Research and development teacher education: authentic competency-based assessment

This research aims to develop the development process of teachers and educational personnel for Competency-based assessment. The assessment based on the competency data collection used surveys, interviews, inquiries, observations, and quantitative data analysis by distributing frequencies, percentages, and averages. Results found that the current condition of teachers and educational personnel for the actual assessment was based on competencies. Overall, there was a high level. Moreover, the interview found that the management had promoted, supported, and advised teachers in applying concepts and techniques about actual assessment to evaluate learners. There were four processes in the research, and the results of the development process experiment found that the overall average of knowledge after use was higher than before using the process, and evaluating the process showed that the development of teachers was applicable, possible, accurate, and appropriate at a high level.