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Conceptualization of Competency-Based Medical Education Terminology in Family Medicine Postgraduate Medical Education
Heather Lochnan1, Simon Kitto, Natalia Danilovich
1H. Lochnan is assistant dean of continuing professional development, Education Programming, Faculty of Medicine, an endocrinologist, and professor, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada. S. Kitto is director of research, Office of Continuing Professional Development, and professor, Department of Innovation in Medical Education, University of Ottawa, Ottawa, Ontario, Canada. N. Danilovich is a research associate, Office of Continuing Professional Development, Department of Innovation in Medical Education, University of Ottawa, Ottawa, Ontario, Canada. G. Viner is director of evaluation in postgraduate program and associate professor, Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada. A. Walsh is professor emeritus, Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada. I.F. Oandasan is director, Education/directrice, Éducation, College of Family Physicians of Canada, Mississauga, Ontario, Canada. P. Hendry is vice dean of continuing professional development and professor of surgery, Faculty of Medicine, University of Ottawa, and a cardiac surgeon, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Purpose:
To examine the extent, range, and nature of how competency-based medical education (CBME) implementation terminology is used (i.e., the conceptualization of CBME-related terms) within the family medicine postgraduate medical education (PGME) and continuing professional development (CPD) literature.
Method:
This scoping review's methodology was based on Arksey and O'Malley's framework and subsequent recommendations by Tricco and colleagues. The authors searched 5 databases and the gray literature for U.S. and Canadian publications between January 2000 and April 2017. Full-text English-language articles on CBME implementation that focused exclusively on family medicine PGME and/or CPD programs were eligible for inclusion. A standardized data extraction form was used to collect article demographic data and coding concepts data. Data analysis used mixed methods, including quantitative frequency analysis and qualitative thematic analysis.
Results:
Of 470 unique articles identified, 80 (17%) met the inclusion criteria and were selected for inclusion in the review. Only 12 (15%) of the 80 articles provided a referenced definition of the coding concepts (i.e., referred to an article/organization as the definition's source), resulting in 19 highly variable-and 12 unique- referenced definitions of key terms used in CBME implementation (competence, competency, competency-based medical education). Thematic analysis of the referenced definitions identified 15 dominant themes, among which the most common were (1) a multidimensional and dynamic concept that encompasses a variety of skill components and (2) being able to use communication, knowledge, technical skills, clinical reasoning, judgment, emotions, attitudes, personal values, and reflection in practice.
Conclusions:
The construction and dissemination of shared definitions is essential to CBME's successful implementation. The low number of referenced definitions and lack of consensus on such definitions suggest more attention needs to be paid to conceptual rigor. The authors recommend those involved in family medicine education work with colleagues across medical specialties to develop a common taxonomy.
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