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A Call for Mixed Methods in Competency-Based Medical Education: How We Can Prevent the Overfitting of Curriculum and
1N.S. Hoang is research associate and specialty investigator in simulation and curriculum development, Stanford School of Medicine, Stanford, California. J.N. Lau is clinical professor, Department of General Surgery, and director, Goodman Surgical Education Center, Stanford School of Medicine, Stanford, California.
Summary
Competency-based medical education (CBME) faces challenges like reductionism. Implementing flexible competency definitions and mixed-methods assessment, including qualitative approaches, can improve authenticity and trainee skill representation.
Area of Science:
- Medical Education
- Curriculum Development
- Assessment Methods
Background:
- Competency-based medical education (CBME) is widely adopted despite significant challenges.
- Key issues include reductionism and loss of authenticity in curricula and assessments.
- Existing problems with CBME remain largely unsolved.
Purpose of the Study:
- To address reductionism and loss of authenticity in CBME.
- To propose solutions for developing more robust competency definitions and assessment tools.
- To advocate for the integration of mixed methods in medical education assessment.
Main Methods:
- Analysis of reductionism in competency definitions, drawing parallels with data science overfitting.
- Proposal of conceptual and concrete solutions to mitigate reductionist tendencies.
- Advocacy for the reintroduction of qualitative assessment methods alongside quantitative ones.
Main Results:
- Mixed-methods assessment with multiple assessors in diverse contexts offers a more accurate trainee evaluation.
- This approach can deter the loss of authenticity in assessments.
- Increased willingness among medical educators to adopt feasible CBME models is anticipated.
Conclusions:
- Flexible competency definitions and mixed-methods assessment are crucial for effective CBME.
- Integrating qualitative tools with quantitative methods enhances authenticity and accuracy.
- Dedicated faculty assessors and physician coaches can support a mixed-methods approach, reducing faculty burden.
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