Implementing Competency-Based Medical Education in Family Medicine: A Narrative Review of Current Trends in Assessment

Author:

Danilovich Natalia1,Kitto Simon1,Price David W.2,Campbell Craig3,Hodgson Amanda4,Hendry Paul5

Affiliation:

1. Office of Continuing Professional Development and Department of Innovation in Medical Education, University of Ottawa, Ottawa, Ontario, Canada

2. University of Colorado Anschutz School of Medicine, Aurora, CO

3. Office of Specialty Education at the Royal College of Physicians and Surgeons of Canada, University of Ottawa, Ottawa, ON, Canada

4. University of Ottawa, Ottawa, Ontario, Canada

5. Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada

Abstract

Background and Objectives: The implementation of effective competency-based medical education (CBME) relies on building a coherent and integrated system of assessment across the continuum of training to practice. As such, the developmental progression of competencies must be assessed at all stages of the learning process, including continuing professional development (CPD). Yet, much of the recent discussion revolves mostly around residency programs. The purpose of this review is to synthesize the findings of studies spanning the last 2 decades that examined competency-based assessment methods used in family medicine residency and CPD, and to identify gaps in their current practices. Methods: We adopted a modified form of narrative review and searched five online databases and the gray literature for articles published between 2000 and 2020. Data analysis involved mixed methods including quantitative frequency analysis and qualitative thematic analysis. Results: Thirty-seven studies met inclusion criteria. Fourteen were formal evaluation studies that focused on the outcome and impact evaluation of assessment methods. Articles that focused on formative assessment were prevalent. The most common levels of educational outcomes were performance and competence. There were few studies on CBME assessment among practicing family physicians. Thematic analysis of the literature identified several challenges the family medicine educational community faces with CBME assessment. Conclusions: We recommend that those involved in health education systematically evaluate and publish their CBME activities, including assessment-related content and evaluations. The highlighted themes may offer insights into ways in which current CBME assessment practices might be improved to align with efforts to improve health care.’

Publisher

Society of Teachers of Family Medicine

Subject

Family Practice

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