Related Experiment Video
Updated: Feb 12, 2026
Design and Implementation of an fMRI Study Examining Thought Suppression in Young Women with, and At-risk, for Depression
Published on: May 19, 2015
Re-examining claims about competence by design (CBD) implementation success in Canadian postgraduate medical
Jonathan Chainey1,2, Ayelet Kuper2,3,4, Ryan Brydges2,3,5
1Division of Neurosurgery, Department of Surgery, University of Montreal, Montreal, Canada.
Introduction:
Competency-Based Medical Education (CBME) has transformed postgraduate medical education worldwide. In 2017, Canada adopted the Competence by Design (CBD) model. While widely promoted as a successful large-scale curricular reform, emerging critiques suggest limited empirical evidence and unintended consequences. We critically examined a recent article promoting CBD's success via citation analysis and evidence appraisal.
Methods:
We analyzed the article's 169 references, categorizing each by type and empirical relevance. We synthesized Canadian-situated empirical studies on Entrustable Professional Activities (EPAs) and their role in feedback within CBD systems. Additionally, we consulted the Royal College of Physicians and Surgeons of Canada's (RCPSC) 2024 CBD Adaptations Plan to contextualize recent developments.
Results:
Empirical studies accounted for 49.2% of the citations, and only 59.4% of those directly addressed CBME. We observed many (25.3%) self-citations, suggesting limited diversity of perspectives. Synthesized studies revealed mixed outcomes: although EPAs aimed to enhance feedback, trainees reported increased stress, administrative burden, and inconsistent feedback quality. These challenges were largely unacknowledged in the analyzed article but were recognized in the 2024 CBD Adaptations Plan's proposed reforms.
Discussion:
Our findings challenge the narrative of CBD's unequivocal success in Canada. We highlight the need for context-sensitive empirical research to guide future reforms.
More Related Videos
Related Concept Videos
02:17Ecological Succession
01:11Testing a Claim about Mean: Known Population SD
Estimating a population mean requires the samples to be distributed normally. The data should be collected from the randomly selected samples having no sampling bias. The sample size needed to be higher than 30, and most importantly, the population standard deviation should be already known.
In most realistic situations, the population standard deviation is often unknown, but in rare circumstances, when it...
01:24Testing a Claim about Population Proportion
There are two methods of testing a claim about a population proportion: (1) Using the sample proportion from the data where a binomial distribution is approximated to the normal distribution and (2) Using the binomial probabilities calculated from the data.
The first method uses normal distribution as an approximation to the binomial distribution. The requirements are as follows: sample size is large...
01:19Testing a Claim about Standard Deviation
The hypothesis testing for the claim of population standard deviation (or variance) requires the data and samples to be random and unbiased. The population distribution also must be normal. There is no specific requirement on the sample size as the estimation is based on the chi-square distribution.
As a first step, the hypothesis (null and alternative) concerning the claim about...
01:21Testing a Claim about Mean: Unknown Population SD
Estimating a population mean requires the samples to be approximately normally distributed. The data should be collected from the randomly selected samples having no sampling bias. There is no specific requirement for sample size. But if the sample size is less than 30, and we don't know the population standard deviation, a different approach is used;...
01:15Nursing Implementation
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.