In Short
  • Biggest challenges are lack of time, lack of feedback, lack of educational continuity
  • Competence is not visible
  • Competency-based Medical Education including Programmatic assessment and EPAs provide a sound method for competence assessment
Global context
Not only has the pandemic shown how dependent we are on certain specialized fields in medicine but how scarcely some competencies are distributed in the population.
In order to grow those competencies, we need to optimize our ways to train our specialists of tomorrow.
 
Trainees
Trainees in medical education follow a long path which is rarely straight forward. During training, their supervisors are changing constantly and with this a supportive longitudinal educational relationship can hardly be established. Through redundancies, this leads to inefficient and ineffective teaching. Because trainees can’t prove their competence they are being over-protected in some areas and left alone in others. The first situation undermines the trainee’s motivation and the latter can be a threat to patient safety.
 
Supervisors
Supervisors in their role to educate but also provide high-quality medical care, often struggle to find time for proper supervision and meaningful feedback. In addition to the scarce resources they can’t tailor their teaching or supervision to the needs of the trainees because competence of trainees is not visible.
Hospitals and organizations
Quality healthcare delivery in our hospitals is dependent on competent specialists but a big part of the effort to support their training is administrative work. The documentation tools are still quite static and are mostly serving a controlling purpose. Neither are the documented competencies used for real-time entrustment decisions during a patient encounter, nor is the data helping the trainee grow as a professional.
 
Silver lining
Yet, we are on the brink of a new era.
The rise of mobile devices and digital technology offers new precise ways to document and aggregate assessment data in the workplace - real-time.
With CBME there is a world-wide paradigm shift on the way to put competence in the center of attention. An organizing frame and EPAs provide a framework to assess REAL competency in the clinical environment.
Combined, these developments allow us to help trainees grow competence along a clear and visible trajectory with the goal to efficiently reach expertise.
 
Further readings
Dr. Adi Marty
Post by Dr. Adi Marty
September 8, 2022

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