"Glocalization" in medical education: A framework underlying implementing CBME in a local context

Area of Science:

• Medical Education
• Competency-Based Education
• Health Systems Research

Background:

• Competency-based medical education (CBME) is a socially constructed process influenced by local context.
• The adaptation of global standards to local systems, termed 'glocalization,' is not well understood.

Purpose of the Study:

• To analyze the glocalization process of adapting global competency standards into a local context.
• To identify a framework underlying the adaptation of medical education milestones.

Main Methods:

• Qualitative content analysis of milestone documents from the Accreditation Council for Graduate Medical Education (ACGME) and the Taiwan Society of Emergency Medicine (TSEM).
• Utilized committee work, nominal group technique (NGT), and a modified Delphi method for consensus.
• Examined the evolution of three TSEM versions and the original ACGME milestones.

Main Results:

• Identified 48 differences between ACGME and TSEM milestones.
• The nominal group technique (NGT) contributed the most differences (44), followed by the modified Delphi (3) and committee work (1).
• Two themes and seven sub-themes emerged, explaining the contextualization process.

Conclusions:

• A glocalization framework was identified, integrating local expression and needs into global competency standards.
• This framework facilitates optimal implementation of CBME models in diverse cultural and systemic contexts.
• The study highlights the importance of understanding local factors in adapting international educational standards.