Competency-based Framework Research Articles

Predicting Performance in the Physical Medicine and Rehabilitation Part II Certification Oral Examination Based On Milestone Ratings.

The Accreditation Council for Graduate Medical Education (ACGME) introduced the Milestones to document learner development within a competency-based framework. On the other hand, board certifying examinations serve as a summative evaluation of a learner's readiness for independent medical practice. Scores in Part I of the American Board of Physical Medicine and Rehabilitation (ABPMR) examination, which measures medical knowledge, has been shown to correlate only with Milestones ratings in medical knowledge. We hypothesized that combined ratings of various Milestone competencies can predict subsequent performance in related ABPMR Part II certifying examination domains. Milestones data and ABPMR Part II examination scores of trainees in 3-yr PM&R residency programs in the United States from academic years (AY) 2014-2016 who sat for the ABPMR Parts I and II Examinations, immediately after completion of training, were reviewed. Regression analysis showed that Milestone sub-competencies, alone or in combination, did not correlate with Part II domain scaled scores. Medical Knowledge was the only Milestone sub-competency that was correlated with performance in the ABPMR Part I certifying examination. This current study found that no similar association exists between any of the Milestones Competencies and the ABPMR Part II certifying examination, suggesting that the two assessment tools measure different attributes.

A competency framework for simulation facilitation in low-resource settings: a modified Delphi study.

Skilled facilitators are essential to drive effective simulation training in healthcare. Competency-based frameworks support the development of facilitation skills but, to our knowledge, there are no frameworks that specifically address context-sensitive priorities developed with practitioners working in low-resource settings. We aimed to develop a core competency framework for healthcare simulation facilitation in low-resource settings using a modified Delphi process. We drew on the domain expertise of members of the Vital Anaesthesia Simulation Training Community of Practice, with the study guided by a four-member steering group experienced in the conduct of simulation in low-resource settings. In survey round 1, participants (n = 54) were presented with an initial competency set derived from a previous qualitative study and co-created a set of 57 competencies for effective simulation facilitation in low-resource settings. In survey round 2, participants (n = 52) ranked competencies by relevance into three performance categories: techniques; artistry; and values. In survey round 3, participants (n = 50) ranked competencies on their importance. The steering group collated results and presented a draft core competency framework. In survey round 4, participants (n = 50) voted with 98% agreement that this framework represented the most relevant and important competencies for effective facilitation of simulation sessions in low-resource settings. The final 32-item framework encompasses core competencies found in existing standards and includes important new concepts such as demonstration of cultural sensitivity; humility; ability to recognise and respond to potential language barriers; facilitation team collaboration; awareness of logistics; and contingency planning. This competency-based framework highlights specific practices required for effective simulation facilitation in low-resource settings. Further work is required to refine and validate this tool to train simulation facilitators to deliver effective training to improve patient safety.

Nursing faculty perceptions of entry to nursing practice competencies expected at day one of hire: A statewide study

BackgroundNo universal nursing education framework exists aligning competency expectations of new-to-practice nurses graduating from the varying prelicensure academic degree programs. PurposeThis study aimed to identify a set of core competencies expected of all prelicensure nursing programs in Maryland, including associate degree (ADN), entry-level bachelor of science nursing degree (BSN), and master of science entry into nursing (MSN Entry) programs. MethodA mixed-method approach was used to identify necessary competencies, including a survey consisting of 109 outcome statements and a series of focus groups with faculty representatives from the prelicensure degree programs. FindingsUnexpected findings showed few differences between ADN, BSN, and MSN Entry nursing program faculty perceptions regarding their program graduates' ability to meet the expected competencies. Faculty were not surprised that few differences emerged. Barriers like overloaded curricula, the necessity of prioritizing teaching specific components of nursing content for NCLEX, and competing priorities were faculty concerns. ConclusionsA comprehensive examination of all BSN and MSN entry knowledge not included in the NCLEX-RN is suggested for students, nurse residents, and professional nurses, delineating entry-level and ongoing minimal core competencies expected of a competent professional nurse. Results support the development of a competency-based education framework to clearly communicate learning and performance expectations among the varying degree programs.

Newly graduated and nurse resident competencies: Perceptions of nurse faculty and acute care hospital leaders in the state of Maryland

BackgroundThe many educational pathways to obtain a professional nursing degree create confusion among healthcare leaders about new graduate nurses' (NGNs) competency expectations when entering practice. PurposeThis research sought to identify, among Maryland nursing academic and practice leaders, a standard set of NGN competencies after completing their prelicensure program and nurse residency program (NRP) at 12 months. MethodA mixed-method approach was used, including a survey of 109 outcome statements and faculty and practice leader focus groups. ResultsResults suggested that 90 % of the nursing programs could collectively meet 18 of the 109 outcomes by NGN program completion, with few differences in responses from the varying academic programs. Faculty attributed these low results to the heavy focus on preparing students for the NCLEX examination, overloaded curricula, and competing priorities. Practice leaders perceived NGNs only partially met/did not meet most competencies, viewing many as unrealistic. Findings support requirements for NGNs to complete an NRP and the existence of a practice-education gap. ConclusionsResearch findings can help inform the development of a nationally accepted, competency-based educational framework for students, new-to-practice nurse residents, and professional nurses to help align entry-level nursing practice expectations with those of nursing programs and NRPs.

Evaluation of an innovative dementia care competency model among physical and occupational therapy students

ABSTRACT The rising prevalence of dementia calls for a competent workforce capable of delivering quality dementia care. A standard for assessing dementia-care-specific competencies is necessary to guide curriculum development and implementation in a competency-based educational framework during academic training. This study evaluated the psychometric properties of the Dementia Care Competency Model (DCCM) among students enrolled in physical (PT) and occupational therapist (OT) programs. Eighty PT and OT students completed the DCCM by rating the 11 sub-competencies using the National Institute of Health Proficiency Likert Scale. The Exploratory Factor Analysis yielded a Kaiser-Meyer-Olkin of 0.878 and Bartlett’s test significance value of < 0.001, which indicates that the data were very good for factor analysis. The Eigenvalues and scree plot derived two factors with an excellent internal consistency (Cronbach’s alpha = 0.936). When examining the grouping of sub-competencies, the two factors that emerged were patient-centered and interprofessional collaborative care. The DCCM version 2.0 can guide educators in designing learning experiences that target the essential competencies in dementia care, ensuring that PT and OT graduates are well-prepared to work with individuals living with dementia. Future research should refine the model by exploring additional sub-competencies within each domain and expanding the model’s applicability across multiple healthcare disciplines.

Assessing the Effectiveness of Student-generated Scenario-based Questions as a Tool for Active Learning

Background: Active learning is not new as an educational philosophy and its benefits over passive learning modes are well known. In a competency-based framework, active learning is one of the key thrust areas. However, across the globe studies have shown that its implementation is wrought with challenges and limitations. The present study explored the implementation and effectiveness of an innovative technique of active learning where students in small groups of 5–6 construct structured scenario-based questions (SBQs) and learn in the process of making questions. Objectives: The study was done with the objective of assessing the effectiveness and feedback of student-generated SBQs as a method of active learning among medical students. Materials and Methods: Sensitization about the project was done followed by deciding the topics which could be covered with this method. The method was implemented in Physiology for Phase 1 MBBS students. During implementation, two small groups (25 students each) were randomly assigned into a “study group” and two into a “control group.” The students were given trigger topics, learning resources and then asked to make SBQs in sub-groups of 5–6. The questions were then opened to discussion, comments and answering by the peers. Knowledge obtained was compared by a pre-post analysis within-group using paired t-test. Between-group analysis was done using independent sample t-test. Feedback was collected both from faculty and students on a Likert Scale. Results: The study group recorded a statistically significant higher score (11.92 ± 2.2) after the activity as compared to control group (8.04 ± 2.24). Feedback received from participants and faculty was positive with a mean score of more than 4 on a 5-point Likert Scale for all items, except feasibility in which the faculty feedback score was 3.67. Out of 49 participating students, 31 students commented on qualitative feedback that it was engaging. More than half (26) students mentioned they “want more such sessions.” Conclusion: The present study showed that this activity can be implemented in small group teaching hours of the timetable. It retains the benefits of active learning both in terms of learning outcomes and experientially. It can also be used as a means to implement problem-based learning and early clinical exposure.

Competency-Based Framework Development and Implementation: Current and Future Perspectives

A competency-based framework (CBF) is a standardized metric facilitating various HR functions including recruitment, assessment, training, performance evaluation, and career development. This paper aims to investigate the process of developing CBF, the benefits and the challenges associated with its development and implementation. The paper explores some of the key issues encountered and lessons learned from the practical application of competency frameworks within organizational settings. This paper offers recommendations to guide practitioners and researchers in navigating the complexities associated with CBF implementation. It also guides those endeavoring to develop competency-based frameworks, offering a comprehensive step-by-step process. The focus is on fostering stakeholder engagement, aligning frameworks with organizational objectives, and leveraging technological advancements to enhance integration and effectiveness within the evolving landscape of digital transformation and innovation driven by AI. Additionally, future research opportunities are highlighted to assist organizations in navigating the changing dynamics of the digital era.

Evaluation of E-Learning Platforms under the EASTRIP Project: Enhancing Competency-Based Education and Training through Holographic Technology in Dar Es Salaam, Tanzania

This study delved into the use of hologram technology to bridge the practical learning gaps in the Competency-Based Education and Training framework when using E-learning platforms. The study utilized a convergent mixed-method, combining quantitative and qualitative approaches. The study focused on 26 public tertiary learning institutions located in Dar es Salaam. It selected 14 widely used e-learning platforms for a comprehensive analysis, ensuring diverse representation. The study's statistical treatment included descriptive statistics and content analysis. The study concluded that the platforms are crucial in delivering content and in teaching, uploading lecture notes and administering tests. However, the use of technology in final examinations and practical assignments indicates notable gaps that need addressing, requiring advanced technologies such as hologram. Addressing these gaps will require technological advancements and continuous professional development for academic staff to optimize the use of e-learning platforms and ensure they meet the comprehensive needs of modern education. This holistic approach will strengthen the alignment of e-learning practices with the CBET framework, fostering a more effective and inclusive learning environment.

Challenges and Strategies of Developing Certified Anesthetist Nurse Practitioners in the Post-Pandemic Era in Taiwan

&lt;p&gt;臺灣的麻醉護理在專業定位、執業範圍、證照考試和標準化訓練制度等方面面臨著諸多挑戰，尤其2020 年衛生福利部雖將麻醉護理師正式納入專科護理師之制度內，但後續所推行之標準化課程也衍生出更多待解決之難題，如：未導入核心能力架構及評量機制、欠缺思考成人學習理論、龐大的訓練課程時數、麻醉專師之師資量能不足及欠缺系統性師資培育等窘境。本文提出二項教育改革的因應策略，首先是建構以勝任能力導向的麻醉專科護理教育架構並發展麻醉訓練專師之系統性評量工具，即「可信賴專業活動」，未來則需建立共創教學和共享資源文化，以促進教師之間的協作和知識分享，期能提高教學品質，並為教師和學員帶來更豐富、多元化的學習體驗。本文呼籲麻醉專師訓練應即刻進行課程再造，打破傳統以知識和時間為本的教學框架，改以混成授課、自主學習作為課程規劃與執行之原則，積極接軌「勝任能力導向教育」的全球發展趨勢，朝向共創、共享之目標邁進。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;Anesthetist nurse practitioners in Taiwan encountered several challenges, particularly in terms of professional identity, scope of practice, certification, and standardized training programs. In 2020, the Ministry of Health and Welfare in Taiwan recognized anesthetist nurse practitioner as one of the advanced practice nurses and included them under the regulation of the nurse practitioner system. However, the implementation of the nationwide standardized training program had faced some unre-solved issues and challenges including that the lack of alignment with competency frameworks or pro-grammatic assessments, the extensive increase of training courses, neglects of adult learning theories, shortage of nurse anesthetists instructors, and lack of faculty development system for nurse anesthetist instructors. This article proposes two initiatives as responses to educational reform: 1. constructing a competency-based framework and developing programmatic assessments for training Student Reg-istered Nurse Anesthetist Nurse Practitioner (SRNANP) ; 2. establishing a culture of collaborative teaching and resource sharing. The new culture enhances teaching quality and provides a richer, more diverse learning experience for both trainers and trainees. The article emphasizes the need for im-mediate curriculum transformation in SRNANP training. It emphasizes on the removal of traditional knowledge-centric and time-centric teaching frameworks and focused on adopting blended learning and self-directed learning principles. By aligning with the global trend of competency-based educa-tion, we can actively move toward the goal of co-creation and resource sharing&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Exploring new frontiers in nursing education: Assessing the role of generative AI (chat GPT) in aligning family nurse practitioner coursework to AACN’s new essentials

Background and purpose: Integrating Generative Artificial Intelligence (Gen AI) in higher education, specifically within health sciences, is increasingly recognized for its potential to enhance educational outcomes and efficiency. The American Association of Colleges of Nursing (AACN) mandates the alignment of Family Nurse Practitioner (FNP) programs with its 2021 Essentials, a competency-based educational framework encompassing hundreds of specific standards. This study aims to evaluate a novel use of Gen AI: how effectively can a custom-trained gen AI tool (custom GPT from ChatGPT), align FNP course assessments with the AACN’s New Essentials, thereby potentially reducing faculty workload and improving curriculum accuracy.Methods: Through dialogue and uploading of relevant documents, a custom GPT (called Mapper) was trained from one FNP course to the subcompentencies within the 2021 Essentials. The Mapper was then used to align the assessments from one FNP course. The Mapper’s output was then compared to content expert alignments to assess accuracy.Results: Across all 10 domains of the AACN Essentials, the Mapper aligned with expert analysis with moderate to high accuracy. Initial analysis indicated correct alignment rate from 44% to 93% (average 66%), which improved to 70% (p &lt; .05) upon further refinement of the Mapper tool by content expert. Potential novel alignments (average 26%), and misalignments (average 9%), provided by the Mapper were critically reviewed, leading to adjustments to the content expert’s original alignment, which enhanced the overall precision of the alignment. For example, misalignments were reduced to only 5% (p &lt; .05). In post-analysis, Mapper aligned AACN subcompetencies incorrectly on average 4%, while the lead faculty was incorrect on average 6%.Conclusions: Gen AI has the potential to streamline the complex process of aligning curriculum to national standards. The GPT demonstrated a significant capacity to assist in this task with minimal error rates, but expert oversight remained crucial to ensure accuracy and relevance. This synergy between Gen AI and human expertise points to a promising avenue for enhancing curriculum development and alignment processes in nursing education and other disciplines.

Instruments for Evaluating Student Learning Outcomes in Palliative Care: A Literature Review.

Primary palliative care is a core component of nursing practice for which all students must receive formal education. Through competency-based education, nursing students develop the knowledge, attitudes, and skills to deliver quality primary palliative care before they transition to practice. Nurse educators in academic and practice settings should use reliable and valid means to evaluate student learning across cognitive, affective, and psychomotor domains. Expert faculty conducted a literature review to identify published instruments that evaluate primary palliative care student learning outcomes. Selected articles were required to include instrument reliability, validity, or both. The literature search yielded 20 articles that report on the development and testing of 21 instruments. Findings are organized into 3 learning domains that encompass 5 outcomes. Four instruments assess knowledge within the cognitive domain. In the affective domain, 3 instruments assess attitudes about caring for seriously ill or dying patients, 7 assess attitudes about death, and 5 assess self-efficacy. Competence and competency are evaluated in the psychomotor domain with 4 tools. Instrument implementation considerations within each domain are discussed. Faculty are encouraged to use robust evaluation measures such as those identified in the literature review to measure primary palliative care learning outcomes within a competency-based education framework.

OWIED System to Facilitate the Entrustment Decision in EPA Implementation.

Entrustable professional activities (EPAs) are gaining attention as an approach for adequate implementation of a competency-based evaluation framework in nursing education. This study sought to develop an Online Web-assessment Interface for Entrustment Decision (OWIED) to facilitate the entrustment decision in EPA implementation. A participatory qualitative action research design consisting of two phases was used for this study. The exploration phase was conducted in close collaboration with stakeholders. Following the exploration phase, the primary researcher and a team of subject-matter experts in academic and information technology developed the OWIED system according to the exploration phase results. The necessary features that met the expectations of the stakeholders were identified and assisted in developing the OWIED system. OWIED may provide a valid tool to track and validate nursing student acquisition of core competencies and assist in making entrustment decisions as students fulfill their training requirements in their academic program. [J Nurs Educ. 2024;63(6):356-365.].

Development of a Competency-Based Assessment Framework for High School Home Economics

The dual aims of this study were i) to explore the effectiveness of an assessment method that can measure the competencies learned through high school home economics and ii) develop a competency-based assessment framework for high school home economics, including components of competency-based assessment, item development system, and other elements. The study involved the following stages: literature analysis, draft development, concretization, validity verification, and final version. Based on the results of the literature analysis and expert deliberation, a competency-based assessment framework for high school home economics was developed which comprised three dimensions: ‘core idea’ × ‘process’ × ‘context and value’. Based on this, an item analysis table was presented to systematize various activities for the competency-based assessment of high school home economics, following which a holistic rubric suitable for competency assessment tasks was proposed by referring to the newly developed ‘process’ dimension assessment criteria. This study is significant in that it is the first to propose a competency-based assessment framework that systematically presents a variety of assessment activities. These will facilitate the development of assessment standards and tools that teachers can refer to or trust in the changing school environment due to the introduction of the standard-based assessment system based on a high school credit system, and the guarantee of a minimum achievement level.

Multi-modal recommender system for predicting project manager performance within a competency-based framework.

The evaluation of performance using competencies within a structured framework holds significant importance across various professional domains, particularly in roles like project manager. Typically, this assessment process, overseen by senior evaluators, involves scoring competencies based on data gathered from interviews, completed forms, and evaluation programs. However, this task is tedious and time-consuming, and requires the expertise of qualified professionals. Moreover, it is compounded by the inconsistent scoring biases introduced by different evaluators. In this paper, we propose a novel approach to automatically predict competency scores, thereby facilitating the assessment of project managers' performance. Initially, we performed data fusion to compile a comprehensive dataset from various sources and modalities, including demographic data, profile-related data, and historical competency assessments. Subsequently, NLP techniques were used to pre-process text data. Finally, recommender systems were explored to predict competency scores. We compared four different recommender system approaches: content-based filtering, demographic filtering, collaborative filtering, and hybrid filtering. Using assessment data collected from 38 project managers, encompassing scores across 67 different competencies, we evaluated the performance of each approach. Notably, the content-based approach yielded promising results, achieving a precision rate of 81.03%. Furthermore, we addressed the challenge of cold-starting, which in our context involves predicting scores for either a new project manager lacking competency data or a newly introduced competency without historical records. Our analysis revealed that demographic filtering achieved an average precision of 54.05% when dealing with new project managers. In contrast, content-based filtering exhibited remarkable performance, achieving a precision of 85.79% in predicting scores for new competencies. These findings underscore the potential of recommender systems in competency assessment, thereby facilitating more effective performance evaluation process.

Decision-Making Confidence of Clinical Competency Committees for Entrustable Professional Activities

A competency-based assessment framework using entrustable professional activities (EPAs) was endorsed by the American Board of Surgery following a 2-year feasibility pilot study. Pilot study programs' clinical competency committees (CCCs) rated residents on EPA entrustment semiannually using this newly developed assessment tool, but factors associated with their decision-making are not yet known. To identify factors associated with variation in decision-making confidence of CCCs in EPA summative entrustment decisions. This cohort study used deidentified data from the EPA Pilot Study, with participating sites at 28 general surgery residency programs, prospectively collected from July 1, 2018, to June 30, 2020. Data were analyzed from September 27, 2022, to February 15, 2023. Microassessments of resident entrustment for pilot EPAs (gallbladder disease, inguinal hernia, right lower quadrant pain, trauma, and consultation) collected within the course of routine clinical care across four 6-month study cycles. Summative entrustment ratings were then determined by program CCCs for each study cycle. The primary outcome was CCC decision-making confidence rating (high, moderate, slight, or no confidence) for summative entrustment decisions, with a secondary outcome of number of EPA microassessments received per summative entrustment decision. Bivariate tests and mixed-effects regression modeling were used to evaluate factors associated with CCC confidence. Among 565 residents receiving at least 1 EPA microassessment, 1765 summative entrustment decisions were reported. Overall, 72.5% (1279 of 1765) of summative entrustment decisions were made with moderate or high confidence. Confidence ratings increased with increasing mean number of EPA microassessments, with 1.7 (95% CI, 1.4-2.0) at no confidence, 1.9 (95% CI, 1.7-2.1) at slight confidence, 2.9 (95% CI, 2.6-3.2) at moderate confidence, and 4.1 (95% CI, 3.8-4.4) at high confidence. Increasing number of EPA microassessments was associated with increased likelihood of higher CCC confidence for all except 1 EPA phase after controlling for program effects (odds ratio range: 1.21 [95% CI, 1.07-1.37] for intraoperative EPA-4 to 2.93 [95% CI, 1.64-5.85] for postoperative EPA-2); for preoperative EPA-3, there was no association. In this cohort study, the CCC confidence in EPA summative entrustment decisions increased as the number of EPA microassessments increased, and CCCs endorsed moderate to high confidence in most entrustment decisions. These findings provide early validity evidence for this novel assessment framework and may inform program practices as EPAs are implemented nationally.

Barriers to clinical learning skills development among midwifery students and newly qualified midwives in Morocco: A qualitative study.

In Morocco, despite various initiatives to improve the quality of reproductive healthcare, the indicators remain unfavorable. To strengthen the skills of midwives and support the achievement of Millennium Development Goals (MDGs) 4 and 5 by 2030, Morocco has developed and implemented a competency-based training framework. However, there is a lack of information on the successful implementation of this program and its impact on the quality of student midwives' preparation for practice. This study aimed to gain a deeper understanding and explore the barriers affecting the development of clinical learning skills among midwifery students and newly qualified midwives. This study employed a descriptive, exploratory qualitative approach. Data were collected through nine focus group discussions with 30 midwifery students and 24 newly graduated midwives between April and June 2023 from six higher education institutions in northern and central Morocco. Inductive content analysis was used to analyze the transcribed discussions. The barriers varied between locations. Overall, the internship design was inadequate, and the clinical environment was insufficient. Participants highlighted limited opportunities to experience the full range of midwifery skills. However, most midwifery students and new graduates had deficient competencies in managing high-risk situations and emergencies. This work provides an overview of the nature and extent of the challenges faced by many student midwives in Morocco, resulting in newly graduated midwives being poorly prepared for the full range of midwifery practice. These findings can inform various initiatives to strengthen midwifery education at the global, regional, and national levels.

Latching Medical Students onto a Virtual Breastfeeding Elective During the COVID-19 Pandemic.

Objectives: To describe the implementation of a successful two-week virtual breastfeeding elective for medical students during the COVID-19 pandemic and characterize student demographics, objective knowledge, and perspectives on breastfeeding before and after the elective. Study Design: We adapted the Santa Rosa Kaiser Permanente Family Medicine breastfeeding residency curriculum to create a two-week virtual medical student elective using Kern's six steps of curriculum development and a competency-based education framework. Educational components included self-paced modules, shadowing experiences, and group didactics. Objective knowledge was assessed with multiple-choice tests before and after the elective compared using a paired t-test. Reflective writing pieces were qualitatively analyzed using the six phases of thematic analysis developed by Braun and Clarke. Results: From 2020 to 2023, 40 medical students completed the elective. Breastfeeding knowledge increased significantly from the pre-test 72% (95% CI: 52-92%) to post-test 91% (95% CI: 81-100%) (p < 0.001). Over 90% of students felt that learning objectives were met well or very well and agreed or strongly agreed that the elective increased their knowledge and confidence in providing anticipatory guidance to breastfeeding parents. Similar themes were shared across students' reflective writing pieces, with nearly 30% (n = 23) of the student essays addressing socio-cultural and racial differences in beliefs surrounding breastfeeding. Conclusion: A virtual breastfeeding curriculum for medical students is well-received by stakeholders (patients, lactation consultants, students, etc.) and improves breastfeeding knowledge and confidence. A virtual elective is an innovative and effective way to deliver breastfeeding education and can be used even when institutional breastfeeding or lactation support is unavailable.

Assessment in Undergraduate Competency-Based Medical Education: A Systematic Review.

Studies that have methodically compiled the body of research on the competency-based medical education (CBME) assessment procedure and pinpointed knowledge gaps about the structure of the assessment process are few. Thus, the goals of the study were to create a model assessment framework for competency-based medical education that would be applicable in the Indian setting as well as to thoroughly examine the competency-based medical education assessment framework. PubMed, MEDLINE (Ovid), EMBASE (Ovid), Scopus, Web of Science, and Google Scholar were the databases that were searched. The search parameters were restricted to English language publications about competency-based education and assessment methods, which were published between January 2006 and December 2020. A descriptive overview of the included research (in tabular form) served as the foundation for the data synthesis. Databases provided 732 records; out of which 36 fulfilled the inclusion and exclusion criteria. Thirty-six studies comprised a mix of randomized controlled trials, focus group interviews, and questionnaire studies, including cross-sectional studies, qualitative studies (03), mixed-method studies, etc. The papers were published in 10 different journals. The greatest number was published in BMC Medical Education (18). The average quality score for included studies was 62.53% (range: 35.71-83.33%). Most authors are from the UK (07), followed by the USA (05). The included studies were grouped into seven categories based on their dominant focus: moving away from a behavioristic approach to a constructive approach of assessment (01 studies), formative assessment (FA) and feedback (10 studies), the hurdles in the implementation of feedback (04 studies), utilization of computer or online based formative test with automated feedback (05 studies), video feedback (02 studies), e-learning platforms for formative assessment (04 studies), studies related to workplace-based assessment (WBA)/mini-clinical evaluation exercise (mini-CEX)/direct observation of procedural skills (DOPS) (10 studies). Various constructivist techniques, such as concept maps, portfolios, and rubrics, can be used for assessments. Self-regulated learning, peer feedback, online formative assessment, an online computer-based formative test with automated feedback, the use of a computerized web-based objective structured clinical examination (OSCE) evaluation system, and the use of narrative feedback instead of numerical scores in mini-CEX are all ways to increase student involvement in the design and implementation of the formative assessment.

Transformation of Mandatory Physiotherapy Internship into A Structured Competency-Based Program: A Pilot Study.

Health professions education is challenging in terms of developing ways to construct and assess the amalgamation of knowledge, skills and attitudes that result in novice graduates to be self-aware and confident to practice without supervision. Currently, the Physiotherapy internship program in India does not have a comprehensive competency-based framework. With the current batch of interns facing the wrath of the COVID-19 pandemic during their undergraduate training, it is a matter of concern to ensure they have developed the required competencies to handle patients independently. This is a single-group interventional study using convenience sampling. A competency framework inclusive of a comprehensive assessment and training module was developed and introduced to 27 physiotherapy interns. Every intern underwent 10 training sessions along with 8 competency assessments during 6 months of internship training. A pre-post indigenous questionnaire was used to assess their self-perceived competency along with feedback questionnaire taken at the end of the module. Implementation of the competency framework revealed a statistically significant difference in the self-perceived competency (pre=84.36±10.98, post=98.55±8.74, p≤0.000). Having uniformity in assessment techniques among the faculty, being exposed to challenging cases during assessment, having training module at the beginning of the internship were some of the suggestions given by the participants. Competency based education offers to be an effective technique in health professional program. Incorporating a competency-based training would help the learners to understand their strengths and weaknesses that would go a long way to develop competent health-care professionals. Developing such framework in curriculum will emphasize standardization of learning outcomes, thereby resulting in quality education, further enhancing patient care, and improving the health outcomes worldwide.

Indigenizing and co-producing the ACGME anesthesiology milestone in Taiwan: a Delphi study and subgroup analysis.

To implement the ACGME Anesthesiology Milestone Project in a non-North American context, a process of indigenization is essential. In this study, we aim to explore the differences in perspective toward the anesthesiology competencies among residents and junior and senior visiting staff members and co-produce a preliminary framework for the following nation-wide survey in Taiwan. The expert committee translation and Delphi technique were adopted to co-construct an indigenized draft of milestones. Descriptive analysis, chi-square testing, Pearson correlation testing, and repeated-measures analysis of variance in the general linear model were employed to calculate the F values and mean differences (MDs). The translation committee included three experts and the consensus panel recruited 37 participants from four hospitals in Taiwan: 9 residents, 13 junior visiting staff members (JVSs), and 15 senior visiting staff members (SVSs). The consensus on the content of the 285 milestones was achieved after 271 minor and 6 major modifications in 3 rounds of the Delphi survey. Moreover, JVSs were more concerned regarding patient care than were both residents (MD = - 0.095, P < 0.001) and SVSs (MD = 0.075, P < 0.001). Residents were more concerned regarding practice-based learning improvement than were JVSs (MD = 0.081; P < 0.01); they also acknowledged professionalism more than JVSs (MD = 0.072; P < 0.05) and SVSs (MD = 0.12; P < 0.01). Finally, SVSs graded interpersonal and communication skills lower than both residents (MD = 0.068; P < 0.05) and JVSs (MD = 0.065; P < 0.05) did. Most ACGME anesthesiology milestones are applicable and feasible in Taiwan. Incorporating residents' perspectives may bring insight and facilitate shared understanding to a new educational implementation. This study helped Taiwan generate a well-informed and indigenized draft of a competency-based framework for the following nation-wide Delphi survey.