a Department of Learning Health Sciences , University of Michigan Medical School , Ann Arbor , MI , USA.
b Royal College of Physicians and Surgeons of Canada , Ottawa , Canada.
Med Teach. 2017 Jun;39(6):623-630. doi: 10.1080/0142159X.2017.1315065.
Competency-based medical education (CBME) is both an educational philosophy and an approach to educational design. CBME has already had a broad impact on medical schools, residency programs, and continuing professional development in health professions around the world. As the CBME movement evolves and CBME programs are implemented, a wide range of emerging research questions will warrant scholarly examination. In this paper, we describe a proposed CBME research agenda developed by the International CBME Collaborators. The resulting framework includes questions about the meaning of key concepts of CBME and their implications for learners, faculty members, and institutional structures. Other research questions relate to the learning process, the meaning of entrustment decisions, fundamental measurement issues, and the nature and definition of standards. The exploration of these questions will help to solidify the theoretical foundation of CBME, but many issues related to implementation also need to be addressed. These pertain to, among other things, nurturing independent learning, assembling and using assessment results to make decisions about competence, structuring feedback, supporting remediation, and how best to evaluate the longer-term outcomes of CBME. High-quality research on these questions will require rigorous outcome measures with strong validity evidence. The complexity of CBME necessitates theoretical and methodological diversity. It also requires multi-institutional studies that examine effects at multiple levels, from the learner to the team, the institution, and the health care system. Such a framework of research questions can guide and facilitate scholarly discourse on the theoretical and practical body of knowledge related to competency-based health professions education.
基于能力的医学教育（CBME）既是一种教育理念，也是一种教育设计方法。CBME 已经对世界各地的医学院校、住院医师培训计划和医疗保健专业人员的继续教育产生了广泛的影响。随着 CBME 运动的发展和 CBME 计划的实施，将涌现出一系列需要学术研究的新问题。在本文中，我们描述了由国际 CBME 合作者提出的拟议的 CBME 研究议程。该框架包括有关 CBME 关键概念的含义及其对学习者、教师和机构结构的影响的问题。其他研究问题涉及学习过程、委托决策的含义、基本测量问题以及标准的性质和定义。对这些问题的探索将有助于巩固 CBME 的理论基础，但也需要解决与实施相关的许多问题。其中包括培养自主学习能力、收集和使用评估结果来做出能力决策、构建反馈、支持补救以及如何最好地评估 CBME 的长期结果等。关于这些问题的高质量研究需要具有强大有效性证据的严格结果测量。CBME 的复杂性需要理论和方法的多样性。它还需要多机构研究，从学习者到团队、机构和医疗保健系统等多个层面考察效果。这样的研究问题框架可以指导和促进与基于能力的健康专业教育相关的理论和实践知识库的学术讨论。
