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Shifting paradigms: from Flexner to competencies.

Carol Carraccio1, Susan D Wolfsthal, Robert Englander

  • 1Department of Pediatrics, University of Maryland, Baltimore, 21201, USA. ccarraccio@peds.umaryland.edu

Academic Medicine : Journal of the Association of American Medical Colleges
|May 16, 2002
PubMed
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Medical education is shifting to competency-based training. Successful implementation requires strategic planning, clear competency benchmarks, and robust assessment tools for evaluating physician competence.

Area of Science:

  • Medical Education
  • Competency-Based Education
  • Healthcare Professional Development

Background:

  • Medical education is transitioning from structure- and process-based models to competency-based education.
  • This shift necessitates a focus on measurable outcomes and physician competence.

Purpose of the Study:

  • To review the medical literature and provide practical insights for implementing and evaluating competency-based medical education.
  • To identify lessons learned from past experiences in the adoption of competency-based approaches.

Main Methods:

  • A comprehensive literature search was conducted using Medline and Educational Resource Information Clearinghouse from the 1960s to the present.
  • Titles and abstracts of 469 articles were reviewed, with 68 selected for full review.

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Main Results:

  • Early attention (1970s-1980s) focused on the need for and development of professional competencies.
  • A significant gap existed in defining specific competency benchmarks, attainment pathways, and evaluation strategies.
  • This lack of evaluation strategies contributed to a three-decade lag in widespread adoption.

Conclusions:

  • Strategic planning and stakeholder buy-in are crucial for defining competencies.
  • Clear delineation of competency benchmarks and attainment thresholds is essential.
  • Developing effective assessment tools and studying the impact on physician competence are key challenges for the future.