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Related Experiment Video

Updated: Apr 19, 2026

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Competency-based postgraduate training: can we bridge the gap between theory and clinical practice?

Olle ten Cate1, Fedde Scheele

  • 1Center for Research and Development of Education, University Medical Center, Utrecht, The Netherlands. t.j.tencate@umcutrecht.nl

Academic Medicine : Journal of the Association of American Medical Colleges
|May 26, 2007
PubMed
Summary

Competency-based medical education requires clear terminology. Using entrustable professional activities (EPAs) and observing clinical practice can effectively assess resident competencies and improve training outcomes.

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Area of Science:

  • Medical Education
  • Competency-Based Training
  • Curriculum Development

Background:

  • Global adoption of competency-based postgraduate medical training presents implementation challenges.
  • Confusion surrounding the definition and assessment of 'competency' hinders effective teaching and assessment program design.

Purpose of the Study:

  • To clarify competency terminology in medical education.
  • To propose a framework for translating general competencies into clinical teaching practice.
  • To bridge the gap between competency-based education theory and clinical practice.

Main Methods:

  • Analysis of critical activities in professional medical practice.
  • Relating professional activities to predetermined competencies.
  • Proposing the use of entrustable professional activities (EPAs) and statements of awarded responsibility (STARs).

Main Results:

  • EPAs represent core professional activities, each requiring multiple competencies.
  • Assessing competencies by observing concrete clinical activities and inferring competencies from these observations is proposed.
  • Residents can be awarded responsibility for EPAs, facilitating competency-based progression.

Conclusions:

  • Focusing on EPAs and observed clinical activities offers a practical approach to competency assessment.
  • This method supports competency-based training with flexible duration and outcome-focused evaluation.
  • Clarifying terminology and using EPAs can enhance the implementation of competency-based medical education.