Related Experiment Video
Updated: Mar 28, 2026

E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
The promise, perils, problems and progress of competency-based medical education
Claire Touchie1,2, Olle ten Cate3
1Medical Council of Canada, Ottawa, Ontario, Canada.
Context:
Competency-based medical education (CBME) is being adopted wholeheartedly by organisations worldwide in the hope of meeting today's expectations for training a competent doctor. But are we, as medical educators, fulfilling this promise?
Methods:
The authors explore, through a personal viewpoint, the problems identified with CBME and the progress made through the development of milestones and entrustable professional activities (EPAs).
Results:
Proponents of CBME have strong reasons to keep developing and supporting this broad movement in medical education. Critics, however, have legitimate reservations. The authors observe that the recent increase in use of milestones and EPAs can strengthen the purpose of CBME and counter some of the concerns voiced, if properly implemented.
Conclusions:
The authors conclude with suggestions for the future and how using EPAs could lead us one step closer to the goals of not only competency-based medical education but also competency-based medical practice.
Related Concept Videos
Methods of Documentation V: CBE
In CBE, healthcare professionals establish predefined standards of practice that define what constitutes...
Methods of Documentation II: POMR
Methods of Documentation VII: EMR
Patient-centered Care
Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
Standards of Care II

