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Competency Committees in Undergraduate Medical Education: Approaching Tensions Using a Polarity Management Framework.

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  • 1S.U. Monrad was director of the foundational basic/clinical science curriculum at the time this work was completed. She currently is assistant dean for assessment, evaluation, and quality improvement and associate professor of internal medicine and learning health sciences, University of Michigan Medical School, Ann Arbor, Michigan. R.S. Mangrulkar is Marguerite S. Roll Professor of Medical Education, associate dean for medical student education, and associate professor of internal medicine and learning health sciences, University of Michigan Medical School, Ann Arbor, Michigan. J.O. Woolliscroft is Lyle C. Roll Professor of Medicine and professor of internal medicine and learning health sciences, University of Michigan Medical School, Ann Arbor, Michigan. M.M. Daniel is assistant dean for curriculum and associate professor of emergency medicine and learning health sciences, University of Michigan Medical School, Ann Arbor, Michigan. S.E. Hartley is associate program director and associate professor of internal medicine, University of Michigan Medical School, Ann Arbor, Michigan. T.L. Gay is assistant dean for student services and associate professor of psychiatry, University of Michigan Medical School, Ann Arbor, Michigan. A. Highet is a fourth-year medical student and Honor Council member, University of Michigan Medical School, Ann Arbor, Michigan. N. Vijayakumar is a fourth-year medical student and Honor Council member, University of Michigan Medical School, Ann Arbor, Michigan. S.A. Santen was assistant dean for educational research and quality improvement and professor of emergency medicine and learning health sciences, University of Michigan Medical School, Ann Arbor, Michigan, at the time this work was completed. She currently is senior associate dean for assessment, evaluation, and scholarship and professor of emergency medicine, Virginia Commonwealth School of Medicine, Richmond, Virginia.

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Summary

Implementing competency-based medical education requires careful management of assessment tensions. A competency committee framework helps navigate these challenges for medical students.

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Area of Science:

  • Medical Education
  • Competency-Based Education
  • Assessment Strategies

Background:

  • Competency-based medical education (CBME) implementation in undergraduate medical education (UME) presents unique challenges.
  • Effective assessment structures are crucial for ensuring medical students achieve competency.
  • Graduate medical education (GME) utilizes clinical competency committees as a key assessment structure.

Purpose of the Study:

  • To describe the University of Michigan Medical School's experience developing and implementing a UME competency committee.
  • To analyze the challenges and tensions encountered during the first year of committee operation.
  • To present the Polarity Management framework as a strategy for navigating these challenges.

Main Methods:

  • Development of a UME competency committee modeled after GME's clinical competency committee.
  • Application of the Polarity Management framework to address inherent tensions in the committee's approach.
  • Analysis of the first year of implementation with a single cohort of medical students.

Main Results:

  • The UME competency committee faced interdependent, opposing tensions (e.g., problem identification vs. developmental approach, membership composition, student cohort structure, data analysis scope, judgment type).
  • These tensions required a "both/and" management approach rather than "either/or" decisions.
  • The Polarity Management framework was applied to navigate these tensions effectively.

Conclusions:

  • The Polarity Management framework offers a valuable strategy for managing tensions in UME competency assessment.
  • This approach can help develop locally relevant and feasible competency assessment systems.
  • Successful implementation requires addressing and balancing competing priorities within the committee structure.