The critical role of infrastructure and organizational culture in implementing competency-based education and individualized pathways in undergraduate medical education

Abstract

In 2010, several key works in medical education predicted the changes necessary to train modern physicians to meet current and future challenges in health care, including the standardization of learning outcomes paired with individualized learning processes. The reframing of a medical expert as a flexible, adaptive team member and change agent, effective within a larger system and responsive to the community's needs, requires a new approach to education: competency-based medical education (CBME). CBME is an outcomes-based developmental approach to ensuring each trainee's readiness to advance through stages of training and continue to grow in unsupervised practice. Implementation of CBME with fidelity is a complex and challenging endeavor, demanding a fundamental shift in organizational culture and investment in appropriate infrastructure. This paper outlines how member schools of the American Medical Association Accelerating Change in Medical Education Consortium developed and implemented CBME, including common challenges and successes. Critical supporting factors include adoption of the master adaptive learner construct, longitudinal views of learner development, coaching, and a supportive learning environment.

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“…Competency-based medical education promotes individualized pathways and requires flexible educational systems regardless of whether programs plan for time-variable advancement. 6 , 97 …”

Effectiveness and student satisfaction with limited face-to-face lab skills at the faculty of medicine Pasundan University in 2022

“…Supporting facilities in higher education facilities will affect the quality and achievement of student competencies (Lomis et al, 2021). The Lancet Commission focuses on three levels of medical education: informative which focuses on developing knowledge and skills; formative that focuses on developing the values of a professional; and transformative that focuses on preparing students to act as agents and leaders of change (Skochelak et al, 2021).…”

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“…This traditional assessment by few examination of theory, practical, and viva voce was probably adequate in older times but it seems no longer adequate now as various methods of teaching and evaluation processes are being experimented on. [15][16][17][18][19][20] However, whatever evaluation process is put in place it should assess -(a) His understanding and knowledge in the area, (b) ability to apply the knowledge within the available resources, (c) ability to improvise when such resources are in short supply, (d) interact and provide leadership where community level health interaction is needed, and (e) generate new knowledge in his area of operation so that this knowledge can be integrated to advance the health care.…”