P. Veale is associate professor, Department of Pediatrics, and assistant dean of undergraduate medical education, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. K. Busche is assistant professor, Department of Clinical Neurosciences, and assistant dean of undergraduate medical education, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. C. Touchie is associate professor, Department of Medicine, University of Ottawa, and chief medical education officer, Medical Council of Canada, Ottawa, Ontario, Canada. S. Coderre is professor, Department of Medicine, and associate dean of undergraduate medical education, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. K. McLaughlin is professor, Department of Medicine, and assistant dean of undergraduate medical education, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Acad Med. 2019 Jan;94(1):25-30. doi: 10.1097/ACM.0000000000002410.
After many years in the making, an increasing number of postgraduate medical education (PGME) training programs in North America are now adopting a competency-based medical education (CBME) framework based on entrustable professional activities (EPAs) that, in turn, encompass a larger number of competencies and training milestones. Following the lead of PGME, CBME is now being incorporated into undergraduate medical education (UME) in an attempt to improve integration across the medical education continuum and to facilitate a smooth transition from clerkship to residency by ensuring that all graduates are ready for indirect supervision of required EPAs on day one of residency training. The Association of Faculties of Medicine of Canada recently finalized its list of 12 EPAs, which closely parallels the list of 13 EPAs published earlier by the Association of American Medical Colleges, and defines the "core" EPAs that are an expectation of all medical school graduates.In this article, the authors focus on important, practical considerations for the transition to CBME that they feel have not been adequately addressed in the existing literature. They suggest that the transition to CBME should not threaten diversity in UME or require a major curricular upheaval. However, each UME program must make important decisions that will define its version of CBME, including which terminology to use when describing the construct being evaluated, which rating tools and raters to include in the assessment program, and how to make promotion decisions based on all of the available data on EPAs.
经过多年的努力，越来越多的北美研究生医学教育 (PGME) 培训计划现在采用基于可委托专业活动 (EPA) 的以能力为基础的医学教育 (CBME) 框架，而 EPA 反过来又包含更多的能力和培训里程碑。在 PGME 的引领下，CBME 现在被纳入本科医学教育 (UME)，以试图在整个医学教育连续体中实现更好的整合，并通过确保所有毕业生在住院医师培训的第一天就能够胜任所需 EPA 的间接监督，从而促进从实习到住院医师的顺利过渡。加拿大医学协会联合会最近敲定了其 12 项 EPA 的清单，这与美国医学院协会早些时候发布的 13 项 EPA 清单密切相关，并定义了所有医学院毕业生的“核心”EPA。在本文中，作者关注了向 CBME 过渡的一些重要的实际考虑因素，他们认为这些因素在现有文献中尚未得到充分讨论。他们认为，向 CBME 的过渡不应威胁 UME 的多样性，也不应要求对课程进行重大改革。然而，每个 UME 计划都必须做出重要决策，以确定其 CBME 的版本，包括在描述评估结构时使用哪些术语，在评估计划中包含哪些评分工具和评分者，以及如何根据 EPA 的所有可用数据做出晋升决定。
