Competency-based Program Research Articles

Cultivating the Desire to Mentor in Dietetic Interns

Editor's Note: This article is part of a series developed by the Nutrition and Dietetic Educators and Preceptors (NDEP) group on emerging topics of interest in dietetics education.The Academy of Nutrition and Dietetics (Academy) 2017 Visioning Report 1 Kicklighter J.R. Dorner B. Hunter A.M. et al. Visioning report 2017: A preferred path forward for the nutrition and dietetics profession. J Acad Nutr Diet. 2017; 117: 110-127 Abstract Full Text Full Text PDF PubMed Scopus (52) Google Scholar identified mentoring new practitioners as part of the career advancement and leadership needed to address future needs and changes within the dietetics profession. The current dietetics education model is based on a competency-based program where interns are trained by preceptor professionals in the field. Effective preceptors display a desire and commitment to mentor and facilitate learning. 2 Sarcona A.E. Burrowes J. Fornari A. Characteristics of an effective preceptor: Dietetics education as a paradigm. J Allied Health. 2015; 44: 229-235 PubMed Google Scholar Likewise, these individuals are necessary to give timely, relevant feedback and identify knowledge deficiencies in the dietetic interns under their supervision. To best support preceptors, ongoing training as well as clearly defined responsibilities are essential. A 2002 survey of Registered Dietitian Nutritionists (RDNs) conducted by Marincic and Francfort showed that 58% received no training for serving as a preceptor. 3 Marincic P.Z. Francfort E.E. Supervised practice preceptors’ perceptions of rewards, benefits, support, and commitment to the preceptor role. J Acad Nutr Diet. 2002; 102: 543-545 Google Scholar A 2008 report highlighted the preceptor shortage that was likely a result of many factors, including lack of training. 4 Phase 2 Future Practice and Education Task Force Report of 2008. www.eatright.org. Accessed October 13, 2017. Google Scholar In 2007, the Commission on Dietetic Registration (CDR) began offering a free online preceptor training program that awards continuing education units to motivate preceptors to get involved and offer an incentive to RDNs for completing quality training. 5 Connor S.J. Preceptors enrich practice, profession. J Acad Nutr Diet. 2015; 115: 337 Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar

Moving a mountain: Practical insights into mastering a major curriculum reform at a large European medical university

Aim: Undergraduate medical education is currently in a fundamental transition towards competency-based programs around the globe. A major curriculum reform implies a dual challenge: the change of the curriculum and the delivering organization. Both are closely interwoven. In this article, we provide practical insights into our approach of managing such a fundamental reform of the large undergraduate medical program at the Charité – Universitätsmedizin Berlin.Methods: Members of the project management team summarized the key features of the process with reference to the literature.Results: Starting point was a traditional, discipline-based curriculum that was reformed into a fully integrated, competency-based program. This change process went through three phases: initiation, curriculum development and implementation, and sustainability. We describe from a change management perspective, their main characteristics, and the approaches that were employed to manage them successfully.Conclusions: Our report is intended to provide practical insights and guidance for those institutions which are yet considering or have already started to undergo a major reform of their undergraduate programs towards competency medical education.

Show and tell: Blending and expanding credit by exam and competency-based credit in sport management

Prior learning assessment has become a common strategy in higher education whereby institutions recognize and legitimize the meaningful learning that takes place outside of the formal educational setting. While institutional prior learning assessment methods vary, credit by exam is one example of a competency-based program that has grown in popularity due in part to its association with student success benefits. In advancing the conventional credit by exam concept, this article describes the Credit By Exam 2.0 program designed to explore alternative pathways in competency-based education. Different from a traditional College-Level Examination Program Test and credit by exam, the unconventional aspect of this program is its expansion beyond the ‘all or nothing’ approach to earning course credit by using a two-phase process that allows a student to test out of portions of course content that he/she can demonstrate as having already mastered. The novel features of this program and its implications will be discussed.

The Effectiveness of a Linguistic Competence-Based Program in Developing the Skills of Some Writing Modes and Reducing Writing Anxiety of the Preparatory Language School Students

The Effectiveness of a Linguistic Competence-Based Program in Developing the Skills of Some Writing Modes and Reducing Writing Anxiety of the Preparatory Language School Students

Мета-профіль освітньої програми підготовки менеджерів освіти: результати фокус-дослідження

The paper highlights the methodology for developing the meta profile of the educational program for the specialty 073 Management training managers at the second level of higher education. Focus group research has been identified as one of the methods for obtaining information from stakeholders, as well as literature and documentary review. A competence-based programme profile has several advantages, as was shown in the article. Starting from a conceptual discussion around commonly used terms, the author emphasis on some of theіr definitions. A meta-profile is a representation of the structure and combination of competences which gives identity to subject areas «Management». It was found that degree profiles ought to follow a road map for Masters Degrees in Education Management; the meta-profile presents an understanding the core elements of the educational program and their description. The author explains the procedure of focus group study organization; defines its stages and content of each step. The first step looked at the Tuning project methodology, which was adapted to the specific context (the labor market and the market of educational services in Ukraine) and subject area (Management). The second step related to the general context of the meta-profile; the aim was identified, the students and stakeholders were motivated being involvedin the group discussion. List of competences that each student should acquire during his study period in any program were proposed. Finally, lists of generic and subject-specific competences were compiled after analysing the results of the stakeholder-consultation process. A number of conclusions can be drawn in this paper. The meta profile will provide an investment for future job opportunities, personal development and preparation to act, innovate and transform in managing activity. A meta profile serves as a meeting point for the institution which offers it, the staff who are responsible for the development of the educational program and results to be reached and learners (Master degrees holders in Education Management) who will share the responsibility for seeing that the generic and specific sets of competences are attained. Finally, it was found that focus group research has certain advantages when studying the demand for educational services among potential educators and employers. The further research will be aimed at studying the Education Management program content.

Variations in assessment and certification in postgraduate anaesthesia training: a European survey

BackgroundPostgraduate specialty training has traditionally been based on a time- and rotation-based model, but competency-based models are emerging. Because anaesthesia training evolves differently across Europe, variations in assessment and certification processes are expected, but the extent of similarities and differences is unknown. The aim of this study was to compare anaesthesia training programmes in Europe, focusing on assessment and certification processes. MethodsWe performed an online survey among national representatives of the Union of European Medical Specialists/European Board of Anaesthesiology. ResultsAll 36 countries participated. Duration of training had a median of 5 yr (range 2.75–7). Mean number of different assessment tools was 7.45 (range 4–13), with more tools being used in competency-based programmes [mean 9.1 (sd 2.97) vs 7.0 (sd 1.97); P=0.03]. Most countries had a nationally uniform certification process. Based on a qualitative analysis of the survey findings, a categorization of countries emerged, reflecting the approach to assessment and certification. We observed two main streams of countries with an underlying knowledge or procedural focus within a time- and rotation-based apprenticeship model. These main streams are evolving, to different extents, towards a third orientation, competency-based training. ConclusionsAssessment and certification processes in European anaesthesia training are diverse. In many countries, a time-based apprenticeship model is evolving towards a competency-based certification process. This diversity precludes comparison of competence of graduating anaesthetists across Europe.

Instructional Insights: Restructuring the Fieldwork Experience: One Clinic's Journey

ABSTRACTAlthough there are standards for occupational therapy education, there are no universal standards for the affiliated fieldwork settings, only guidelines from the educational institutions. As a result, a student learning experience often varies dramatically from facility to facility. Several factors that may affect the clinical experience include the preparedness of a student, the willingness of a clinic to work through potential student challenges, and the theoretical foundation a clinic has built for disseminating occupational therapy practice skills. This article highlights the journey of one clinic through a redesign of the occupational therapy fieldwork program and outlines the steps taken to transform student experiences and improve program success. Starting with a self-directed review of the fieldwork process, and through a combination of program redesign, application of a theoretical foundation, and refocus toward a competency-based program, the student success rate at this acute rehabilitation hospital drastically improved and achieved positive feedback from all involved.

Comparison of Simulation-based Resuscitation Performance Assessments With In-training Evaluation Reports in Emergency Medicine Residents: A Canadian Multicenter Study.

Simulation stands to serve an important role in modern competency-based programs of assessment in postgraduate medical education. Our objective was to compare the performance of individual emergency medicine (EM) residents in a simulation-based resuscitation objective structured clinical examination (OSCE) using the Queen's Simulation Assessment Tool (QSAT), with portfolio assessment of clinical encounters using a modified in-training evaluation report (ITER) to understand in greater detail the inferences that may be drawn from a simulation-based OSCE assessment. A prospective observational study was employed to explore the use of a multicenter simulation-based OSCE for evaluation of resuscitation competence. EM residents from five Canadian academic sites participated in the OSCE. Video-recorded performances were scored by blinded raters using the scenario-specific QSATs with domain-specific anchored scores (primary assessment, diagnostic actions, therapeutic actions, communication) and a global assessment score (GAS). Residents' portfolios were evaluated using a modified ITER subdivided by CanMEDS roles (medical expert, communicator, collaborator, leader, health advocate, scholar, and professional) and a GAS. Correlational and regression analyses were performed comparing components of each of the assessment methods. Portfolio review and ITER scoring was performed for 79 residents participating in the simulation-based OSCE. There was a significant positive correlation between total OSCE and ITER scores (r=0.341). The strongest correlations were found between ITER medical expert score and each of the OSCE GAS (r=0.420), communication (r=0.443), and therapeutic action (r=0.484) domains. ITER medical expert was a significant predictor of OSCE total (p=0.002). OSCE therapeutic action was a significant predictor of ITER total (p=0.02). Simulation-based resuscitation OSCEs and portfolio assessment captured by ITERs appear to measure differing aspects of competence, with weak to moderate correlation between those measures of conceptually similar constructs. In a program of competency-based assessment of EM residents, a simulation-based OSCE using the QSAT shows promise as a tool for assessing medical expert and communicator roles.

Competency-Based Education in Low Resource Settings: Development of a Novel Surgical Training Program

BackgroundThe unmet burden of surgical disease represents a major global health concern, and a lack of trained providers is a critical component of the inadequacy of surgical care worldwide. Competency-based training has been advanced in high-income countries, improving technical skills and decreasing training time, but it is poorly understood how this model might be applied to low- and middle-income countries. We describe the development of a competency-based program to accelerate specialty training of in-country providers in cleft surgery techniques.MethodsThe program was designed and piloted among eight trainees at five international cleft lip and palate surgical mission sites in Latin America and Africa. A competency-based evaluation form, designed for the program, was utilized to grade general technical and procedure-specific competencies, and pre- and post-training scores were analyzed using a paired t test.ResultsTrainees demonstrated improvement in average procedure-specific competency scores for both lip repairs (60.4–71.0%, p < 0.01) and palate (50.6–66.0%, p < 0.01). General technical competency scores also improved (63.6–72.0%, p < 0.01). Among the procedural competencies assessed, surgical markings showed the greatest improvement (19.0 and 22.8% for lip and palate, respectively), followed by nasal floor/mucosal approximation (15.0%) and hard palate dissection (17.1%).ConclusionSurgical delivery models in LMICs are varied, and trade-offs often exist between goals of case throughput, quality and training. Pilot program results show that procedure-specific and general technical competencies can be improved over a relatively short time and demonstrate the feasibility of incorporating such a training program into surgical outreach missions.

Impact of competency-based and target-oriented training on employee performance

Some firms have applied different in-house training models to keep up with new technological innovations in their specific fields. This study investigated how a target-oriented in-house training programme should be developed and how it should be evaluated for effectiveness. The aim of the study was to develop, implement and evaluate a competency-based and target-oriented training programme with the cooperation of both the academic and the automotive industrial sectors. During this process, 124 employees of Bosch Rexroth Company were trained via a specific target-oriented programme. The effectiveness of the training was assessed using pre- and post-tests, a course evaluation survey and peer evaluation performance analyses. At the end of the study, the success rate of the participants, according to the pre- and post-tests, had increased by 54 points on a 100-point scale. Furthermore, in a participant feedback survey, 93% of the respondents said that the programme had contributed positively to their working life. The most important result was that, according to performance analyses, 26% of the participants had improved their performance relative to an untrained cohort. The goals and outcomes proved to be encouraging for future programmes.

Gaps in Competency-Based Training Programs in Acute Care Facilities

Gaps in Competency-Based Training Programs in Acute Care Facilities

Global Health Master’s Students: Demographics and Career Goals

The Master of Science in Global Health (MSGH) at Northwestern University is a new competency-based graduate degree program designed to prepare students for careers in global health. The purpose of our research is to determine the market characteristics for this degree, provide student backgrounds that will guide curricular and programmatic improvements, and determine if these students intend to pursue degrees in global health. This study examines survey responses from students admitted to the MSGH program between 2014 and 2015. Survey data were collected by the Northwestern University School of Professional Studies (SPS) as part of the online admissions application process. During the same period, all active students in the program were invited to complete a separate, online survey asking about their global health experience, skills and career goals. Application responses were analyzed using descriptive statistics. Free-text responses from the survey were hand-coded using 10 categorical variables developed through an inductive process. Fifty-four individuals were admitted to the MSGH program within 12 months of its inception. Of these 78% were female and the average age was 36. Of those who responded to questions about current employment, 57% were working in a health science field, 11% in government or public administration, and less than 10% responded in all other categories. Responses from the online survey revealed that most students had some prior global health experiences primarily in the medicine and mission/volunteer categories, 45% and 50% respectively. Responses regarding career aspirations were spread evenly across categories and nearly all students intended to join the global health workforce. Medicine was identified most frequently as a desired field for future careers (30%), followed by government and policy (25%). The wide variety of disciplines represented in students’ previous work histories underscores and supports the interprofessional nature of the field and the workforce. This diversity extends to both educational backgrounds and prior field experience and necessitates pedagogical techniques that can appeal to a wide array of students, particularly a majority female population. Findings regarding desired future employment suggests that career advising will need to adapt to market demands, prioritizing project and program management related careers.

Remediation in Emergency Medicine: What are the issues?

Residency training programs have the responsibility to ensure that their graduate develop the knowledge, skills and attitude required to practice their specialty independently. It is also important to be able to measure their competency. However, some residents will need remediation, with extra resources, time and effort to meet the set standards. Most residency programs will have some guidelines on remediation, pertaining to the different domains of concern However, are these best strategies? Here, the author shares about the Emergency Medicine residency in Sing health, a health cluster in Singapore, and also shares her views on time and competency-based programs, as well as some suggestions on a hybrid model for remediation. She suggests flexibility, thinking out of the box methods and bearing in mind the inter-individual variations amongst our residents and doctors. Eventually, there is really “no one size fits all “recommendations. It is about customization, flexibility and a deeper understanding of issues which also include adult learning, motivation and self regulation. Keywords: Emergency Medicine; Remediation; Residency; Competency

When should I attempt my centrally administered summative assessments in the RANZCP competency-based training program?

To provide information relevant to decision-making around the timing of attempting the centrally administered summative assessments in the Royal Australian and New Zealand College of Psychiatrists (RANZCP) 2012 Fellowship Program. We consider the new Competency-Based Fellowship Program of the RANZCP and its underlying philosophy, the trainee trajectory within the program and the role of the supervisor. The relationship between workplace-based and external assessments is discussed. The timing of attempting centrally administered summative assessments is considered within the pedagogical framework of medical competencies development. Although successful completion of all the centrally administered summative assessments requires demonstration of a junior consultant standard of competency, the timing at which this standard will most commonly be achieved is likely to vary from assessment to assessment. There are disadvantages attendant upon prematurely attempting assessments, and trainees are advised to carefully consider the requirements of each assessment and match this against their current level of knowledge and skills. Trainees and supervisors need to be clear about the competencies required for each of the external assessments and match this against the trainee's current competencies to assist in decision-making about the timing of assessments and planning for future learning.

Foundations of quality in competency‐based programs: Competencies and assessments

Foundations of quality in competency‐based programs: Competencies and assessments

Developing Competency-Based Advising Practices in Response to Paradigm Shifts in Higher Education

Competency-based programs have gained prominence in recent years for two primary reasons. First, more students are seeking ways to apply nonclassroom learning experiences toward a degree. Second, a paradigm shift in higher education encourages postsecondary curriculum developers to accept nonclassroom experiences as demonstrations of skills and competencies and to adapt curriculum to include these experiences. Educators must realize that the traditional classroom learning necessary to earn credits toward graduation must also apply to life outside academe and must reflect student experiences. Like educators in the classroom, advisors must respond to this change in perspective through inquiry-based practices and democratic relationships with students.

Modular continuing professional development for emergency physicians – the MNSHA masterclass programme

Emergency physician (EP) training in the Netherlands is currently a 3-year competency-based programme. Upon its completion, many Dutch EPs feel that they lack some of the skills and the knowledge necessary to be fully prepared for the challenges of emergency medicine. We perceived a need for new methods to deliver continuing professional development (CPD). A needs analysis survey was conducted to ascertain whether our perceived need for a new CPD programme was genuine. A new course was developed, incorporating innovative learning methods. The results of the needs analysis were incorporated into the programme. Another survey was held among participants of the first two editions of the programme. Modular CPD for Emergency Physicians (Dutch: MNSHA) is a modular programme that aims to deliver CPD to Dutch EPs. It combines innovative educational methods, such as asynchronous learning in a flipped classroom, with web-based mentoring. The aim is for participants to develop effective, individualized and sustainable methods to gain and maintain knowledge and skills as a part of their ongoing professional education. The participant survey showed encouraging results, strongly suggesting an improvement in confidence. A more robust study would be required to better assess the outcomes of our programme.

Collaborative framework for designing a sustainability science programme

Purpose The authors describe the challenges and opportunities associated with developing an interdisciplinary sustainability programme in an emerging economy and illustrate how these are addressed through the approach taken for the development of the first postgraduate programme (MSc and PhD) in sustainability science at the National Autonomous University of Mexico (UNAM). The purpose of this paper is to outline an approach that has a potential for application in other parts of Latin America and perhaps more broadly in other world regions sharing some of the same challenges and opportunities as found in Mexico. Design/methodology/approach The implemented collaborative framework enabled a transformation of disciplinary research and teaching at UNAM into a postgraduate programme designed to generate cutting-edge educational and research capabilities. The approach to curriculum and programme design emphasized the process and methodological framework for curriculum development as much as the outcome itself. It entailed three primary elements: theory on collaborative processes; the curriculum design approach; and a formative and summative evaluation. Findings Several of the challenges faced were related to the nature of the institution (mainly because of the complexity of its organization and the emphasis in maintaining disciplinary boundaries), as well as to the curriculum development and design approach (acceptance of a competency-based programme appropriate for the MSc but considered restrictive for the PhD). The experience the authors relate in this paper exemplifies how to cope with such challenges. The approach enabled the emergence of a shared vision that was appropriated by all the participants. This ultimately empowered them in the presentation of the curriculum to their disciplinary peers. Furthermore, the approach facilitated the creation of a programme that remained salient along the process, while increasingly gained legitimacy and credibility among the academic community. Social implications In Mexico, the number of sustainability practitioners and scientists is still insufficient, and there is a clear lack of capacities in key themes and tools. UNAM combines a strong scientific tradition and a foundational mandate to serve both the country and humanity and is, thus, a natural platform for developing a higher education programme in sustainability science. The approach taken in the development of UNAM’s programme has useful lessons for the development of similar programmes in other developing nations facing similar educational and institutional challenges. Originality/value This model not only resulted in an innovative and novel programme in sustainability education but also, in the process, strengthened the competencies of diverse stakeholders through a systematic collaborative framework that fosters sustainability as a social learning process. Such experience illustrates the advantages of implementing a collaborative approach to enable the emergence of a critical mass capable to handle the diversity presupposed by a curriculum in sustainability science. It also shows how such a collaborative process can be implemented to overcome the limited resources, lack of experience in sustainability education and strong disciplinary focus that hampers the advancement of higher education in institutions similar to UNAM.

Development a Competency-Based Training Program for Elementary Robotics Teachers by using the DACUM Chart

Development a Competency-Based Training Program for Elementary Robotics Teachers by using the DACUM Chart

The Integrated Law School Curriculum

In January 2014, the American Bar Association’s Task Force on the Future of Legal Education stated that “[a]n evolution is taking place in legal practice and legal education needs to evolve with it.” To this end, the Task Force recommended that the law school curriculum “needs to shift still further toward developing the competencies and professionalism required of people who will deliver services to clients.” In fact, the Task Force emphasized that “[a] graduate’s having some set of competencies in the delivery of law and related services, and not just some body of knowledge, is an essential outcome for any program of legal education.” To develop a competency-based program of legal education, legal educators must support “experimentation and innovation,” and recognize that the time for fundamental curricular changes has arrived. Importantly, however, responsible curricular reforms will reflect an evolution, not a revolution, from traditional law school pedagogy, and adopt a careful blueprint for integration, not merely innovation. Responsible integration - and a curriculum in which students acquire core lawyering competencies - requires structural and sequential changes. Regarding structural changes, law schools must re-think the traditional “silo” model of legal education, in which the three pillars of legal education - doctrinal, skills, and clinical courses - are nestled into separate parts of the curriculum, as if one has no relation to the other. For example, traditional doctrinal courses often predominate in the first year of law school, while skills courses emerge in the second year and live-client clinical instruction is emphasized in the third year. To some degree, this makes sense; students must learn foundational legal concepts and be trained to think like lawyers before they can apply the law to a set of facts, draft a legal document, or represent a client. But the mistake most legal educators make is not realizing that this paradigm can remain intact while simultaneously integrating doctrine, skills, and clinics across and throughout the curriculum. Simply put, the structural prerequisite for responsible integration involves collapsing the separation between the three traditional pillars of legal education and a commitment to building a bridge from law school to the legal profession. With respect to sequencing, law schools should adopt a chronological model in which law students draft litigation and transactional documents - and complete real-world simulations - in the order they would in practice. As discussed in detail below, this can be accomplished through a cross-curricular model. Under this approach, students are given a multi-issue fact pattern in the first semester of law school and proceed to litigate a fictional case from beginning to end. In the first semester, students perform a client interview, followed by a retention agreement, research assignment, predictive memorandum, and complaint. In the second semester, students draft a motion to dismiss, answer, discovery, and motion for summary judgment, and in the third semester draft an appellate brief. In so doing, students will understand the context within which law is practiced, gain experience in drafting multiple real-world documents, and acquire practical skills that can be transferred to other contexts. Based on these principles, this article provides a blueprint for a three-year law school curriculum that retains the traditional emphasis on doctrine, skills, and clinics, but makes structural and sequential changes to ensure that the quality of legal education will build upon the past - and prepare students for the future. Part II sets forth the building blocks upon which a truly integrated program of legal education should rest, including competency-driven learning outcomes, the adoption of formative and summative assessments, and a focus on context-based learning and metacognition. Part III includes a proposed three-year curriculum that, among other things, incorporates a cross-curricular model, six-semester required legal writing program, and five-semester clinical program. Ultimately, as the Task Force noted, responsible curricular reforms require “a reorientation of attitudes toward change, including market-driven change, by persons within the law school,” and recognition that “[l]aw schools, whatever their individual differences, have a basic societal role: to prepare individuals to provide legal and related services.” Indeed, “fusing practice with theory and doctrinal instruction will best prepare students for the demands of practice in the twenty-first century.”