a Division of General Internal Medicine, Department of Internal Medicine, University of Nebraska Medical Center , Omaha , NE , USA.
b Division of Orthopaedic Surgery, Department of Surgery, University of Toronto , Toronto , Canada.
Med Teach. 2017 Jun;39(6):588-593. doi: 10.1080/0142159X.2017.1315075.
Medical education is under increasing pressure to more effectively prepare physicians to meet the needs of patients and populations. With its emphasis on individual, programmatic, and institutional outcomes, competency-based medical education (CBME) has the potential to realign medical education with this societal expectation. Implementing CBME, however, comes with significant challenges. This manuscript describes four overarching challenges that must be confronted by medical educators worldwide in the implementation of CBME: (1) the need to align all regulatory stakeholders in order to facilitate the optimization of training programs and learning environments so that they support competency-based progression; (2) the purposeful integration of efforts to redesign both medical education and the delivery of clinical care; (3) the need to establish expected outcomes for individuals, programs, training institutions, and health care systems so that performance can be measured; and (4) the need to establish a culture of mutual accountability for the achievement of these defined outcomes. In overcoming these challenges, medical educators, leaders, and policy-makers will need to seek collaborative approaches to common problems and to learn from innovators who have already successfully made the transition to CBME.
医学教育面临着越来越大的压力，需要更有效地培养医生，以满足患者和人群的需求。以个体、项目和机构成果为重点的基于能力的医学教育（CBME）有可能使医学教育与这种社会期望重新保持一致。然而，实施 CBME 面临着重大挑战。本文描述了全球医学教育者在实施 CBME 时必须面对的四个总体挑战：（1）需要协调所有监管利益相关者，以优化培训计划和学习环境，从而支持基于能力的进展；（2）有目的地整合医学教育和临床护理提供方式的重新设计；（3）需要为个人、项目、培训机构和医疗保健系统确定预期成果，以便衡量绩效；（4）需要建立对实现这些既定成果的相互问责文化。在克服这些挑战的过程中，医学教育者、领导者和决策者将需要寻求共同解决问题的合作方法，并向已经成功过渡到 CBME 的创新者学习。
