Competency-Based Medical Education in Emergency Medicine: A Ten-Year Consensus-Driven Research Agenda

In order to optimize learner development, align rigorous assessment with individualized instruction, and ensure graduates can consistently provide trustworthy, excellent patient care, Emergency Medicine has joined a global medical education movement toward competency-based medical education (CBME). This shift focuses less on teaching specific content in a fixed period of time, and more on ensuring graduating physicians can be trusted to perform the essential activities required of their specialty. Emergency medicine collaborators have piloted implementing the five components of CBME: (1) An outcomes competency framework; (2) Developmental sequencing of competencies; (3) Individualized clinical experiences tailored to the competencies; (4) Competency-centered coaching; (5) Programmatic assessment with emphasis on workplace-based assessment. This work has included developing specialty-specific entrustable professional activities (EPAs), mapping EPAs to the ACGME Milestones, defining an ideal individualized learning plan, coaching pilots across multiple institutions, and implementing workplace-based assessment. Through these efforts across diverse residency programs, educators have experienced both the promise of CBME and the challenges to implementation and sustainability. In order to move the field forward, the 2025 Academic Emergency Medicine Consensus Conference aimed to develop a prioritized 10-year research agenda for CBME in Emergency Medicine graduate medical education to guide discovery over the next decade. This paper reports the process and results of the consensus proceedings, and outlines key research priorities for the following aspects of CBME specific to Emergency Medicine graduate medical education: (1) Coaching and individualized learning; (2) Faculty and Learner Development; (3) Assessment; and (4) Implementation and Change Management.