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Competency-based Medical Education Aligning Curriculum, and Assessment with Objectives . Competency-Based Medical Education. The International CMBE Collaborators 2009.
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Competency-based Medical EducationAligning Curriculum, and Assessment with Objectives
Competency-Based Medical Education The International CMBE Collaborators 2009 is an outcomes-based approach to the design, implementation, assessment and evaluation of a medical education program using an organizing framework of competencies
ACGME General Competencies • Medical knowledge • Patient care and procedural skills • Professionalism • Interpersonal and communication skills • Practice-based learning and improvement • Systems-based practice
The Outcome? Evidence of Competence in Each of the ACGME General Competencies
Competency • An observable ability of a health professional, integrating multiple components such as knowledge, skills, values, and attitudes. The International CMBE Collaborators 2009
Competent The International CBME Collaborators, 2009 Possessing the required abilities in all domains in a certain context at a defined stage of medical education or practice.
Competence ten Cate, Med Teach, 2010 Competence entails more than the possession of knowledge, skills and attitudes; it requires you … to apply these [abilities] in the clinical environment to achieve optimal results.
The CBME Basics Outcome Data Assessment Curriculum
The CBME Basics Outcome (Attest they have competence (evaluation) – Narratives or high level ACGME Milestones) Data (Collected evidence they are competent - Portfolios) (EPA focused assessment strategies and other) Assessment Curriculum (milestones and learning venues)
Implications - A new paradigm You must know the trainee has demonstrated competence and is ready to progress to the next stage of their training or career: • Requires clear definition of expected outcomes or competencies • Requires assessment and evaluation systems capable of demonstrating that these things are done consistently and within the contextual needs of the clinical environment
Assessment vs Evaluation • Assessment -The process of generating data (regarding competent vs not competent) Competent - Possessing the required abilitiesin all domains in a certain context at a defined stage of medical education or practice.
Assessment vs Evaluation • Evaluation - The process of making a judgment or attestation of competence based upon assessment data. Competence - entails more than the possession of knowledge, skills and attitudes; it requires you apply these [abilities] in the clinical environment to achieve optimal results.
Fully Competent A B C Finish PGY3 Start PGY1 Milestones and Trajectories A’ Lucey and Boote Milestones
The Importance of Life-long Learning Medical School Professional Career Residency Fellowship
Reality in Training • Programs are having trouble moving from structure/process to competency/outcomes • Variable understanding of competencies by faculty • Paucity of evidence that CBME is better • Difficulty assessing and evaluating competency
ACGME Milestones Initiative • All specialties to develop milestones and recommend assessments to advance CBME. • Define developmental milestones and reliable, valid assessment tools for all training programs by 2012!
The NAS - 2014 • Trainee performance data will be reported every six months using agreed upon milestones (developmentally based, specialty specific achievements that residents are expected to demonstrate at established intervals as they progress through training) • While specialties can develop their own milestones, ACGME has also developed a generic set of milestones in professionalism, IPCS, SBP, and IPCS
Dr Williams will review the specific milestones work of the Cardiology Community