Toward Competency-Based Training: To What Extent Are We Competency-Based?

Area of Science:

• Medical Education
• Plastic Surgery Training
• Competency-Based Education

Background:

• Traditional time-based plastic surgery training models result in variable exposure and low graduate confidence.
• Transitioning to competency-based medical education requires understanding existing interventions in plastic surgery literature.
• Identifying gaps in current educational interventions is crucial for developing effective competency assessments.

Purpose of the Study:

• To systematically review and assess the quality of educational interventions in plastic surgery.
• To identify gaps in competency assessment within plastic surgery training programs.
• To guide the development of assessments that ensure trainee competence.

Main Methods:

• Systematic literature search of major medical databases (MEDLINE, Embase, CINAHL, PubMed, Cochrane) up to December 2017.
• Extracted data on intervention design, execution, competency assessment, and alignment with accreditation standards (ACGME, CanMEDS).
• Assessed study quality using Kirkpatrick's levels, validity evidence, and the Medical Education Research Study Quality Instrument (MERSQI).

Main Results:

• 36 interventions met inclusion criteria from over 4300 initial results.
• Most interventions aligned with Accreditation Council for Graduate Medical Education (ACGME) competencies but often lacked outcome-based competency assessment.
• Low levels of learning evaluation and validity evidence were found, with an average MERSQI score of 10.9/18.

Conclusions:

• The quality of reported educational interventions in plastic surgery is generally low.
• There is a significant need for improved assessment strategies to ensure competency acquisition in plastic surgery trainees.
• Further research should focus on developing and validating robust assessment tools for plastic surgery education.