Medical education from a succession perspective: what can the apprenticeship model bring to competency-based...

Area of Science:

• Medical Education
• Workplace Training
• Competency-Based Education

Background:

• Workplace-based training in medical education can be viewed as a succession concept.
• Modern competency-based medical education can benefit from integrating traditional apprenticeship models.
• Medical competence is conceptualized in three layers: canonical, contextual, and personalized.

Purpose of the Study:

• To explore the integration of traditional apprenticeship benefits with modern competency-based medical education.
• To focus on contextual competence, defined as the ability to work effectively within a patient care setting.
• To examine the role of entrustment in workplace-based training and assessment.

Main Methods:

• Framing workplace-based training as a succession concept.
• Broadening the construct of medical competence into canonical, contextual, and personalized layers.
• Focusing on workplace-based assessment and professional judgment for contextual competence.

Main Results:

• Contextual competence requires workplace-based assessment and professional judgment.
• The aim of training is to achieve readiness for entrustment with healthcare tasks.
• Entrustment with units of practice (entrustable professional activities) involves granting autonomy and requires a prospective focus.

Conclusions:

• An apprenticeship model with a prospective aim requires a rotational structure for sufficient trainee acquaintance to enable entrustment.
• Learners contributing to care by taking over supervisor tasks represents a return on investment and enhances motivation.
• Successful implementation of entrustment-based workplace training necessitates curricular transformation.