Enabling Implementation of Competency Based Medical Education through an Outcomes-Focused Accreditation System.

Area of Science:

• Medical Education
• Accreditation Systems
• Competency-Based Medical Education (CBME)

Background:

• Competency-based medical education (CBME) adoption is increasing globally.
• Accreditation is a key enabler for CBME implementation, yet its design's role is under-researched.
• Canada's transition to an outcomes-based accreditation system alongside CBME provides a relevant case study.

Purpose of the Study:

• To characterize features of accreditation systems that facilitate CBME implementation.
• To analyze the Canadian postgraduate medical education accreditation system as an example.
• To identify how accreditation design can both enable and hinder CBME adoption.

Main Methods:

• Qualitative analysis of the Canadian postgraduate medical education accreditation system.
• Characterization of four key features of accreditation systems facilitating CBME: theoretical underpinning, quality focus, standards, and processes.
• Examination of how these features align with CBME principles.

Main Results:

• Alignment between accreditation's theoretical basis and CBME drives consistent change.
• A quality improvement focus, rather than solely quality assurance, fosters educational development.
• Flexible yet detailed accreditation standards and non-punitive processes support high-fidelity CBME implementation and innovation.

Conclusions:

• Accreditation system design significantly impacts CBME implementation success.
• Key features include theoretical alignment, quality improvement orientation, balanced standards, and supportive processes.
• Attention to accreditation's role is vital for medical education bodies adopting CBME worldwide.