Postgraduate Medical Education, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
Department of Medicine, University of California, San Francisco, CA, USA.
Med Teach. 2023 Aug;45(8):802-815. doi: 10.1080/0142159X.2023.2168525. Epub 2023 Jan 20.
Competency-based medical education (CBME) received increased attention in the early 2000s by educators, clinicians, and policy makers as a way to address concerns about physician preparedness and patient safety in a rapidly changing healthcare environment. Opinions and perspectives around this shift in medical education vary and, to date, a systematic search and synthesis of the literature has yet to be undertaken. The aim of this scoping review is to present a comprehensive map of the literary conversations surrounding CBME.
Twelve different databases were searched from database inception up until 29 April 2020. Literary conversations were extracted into the following categories: perceived advantages, perceived disadvantages, challenges/uncertainties/skepticism, and recommendations related to CBME.
Of the 5757 identified records, 387 were included in this review. Through thematic analysis, eight themes were identified in the literary conversations about CBME: credibility, application, community influence, learner impact, assessment, educational developments, organizational structures, and societal impacts of CBME. Content analysis supported the development of a heat map that provides a visual illustration of the frequency of these literary conversations over time.
This review serves two purposes for the medical education research community. First, this review acts as a comprehensive historical record of the shifting perceptions of CBME as the construct was introduced and adopted by many groups in the medical education global community over time. Second, this review consolidates the many literary conversations about CBME that followed the initial proposal for this approach. These findings can facilitate understanding of CBME for multiple audiences both within and outside of the medical education research community.
在 21 世纪初，教育工作者、临床医生和政策制定者将基于能力的医学教育（CBME）作为解决在快速变化的医疗保健环境中医生准备情况和患者安全问题的一种方式，引起了人们的关注。围绕这种医学教育转变的观点和看法各不相同，迄今为止，尚未对文献进行系统的搜索和综合。本次范围综述的目的是展示围绕 CBME 的文学对话的全面图谱。
从数据库建立之初到 2020 年 4 月 29 日，共检索了 12 个不同的数据库。将文学对话提取到以下类别中：感知优势、感知劣势、挑战/不确定性/怀疑和与 CBME 相关的建议。
在 5757 条已识别记录中，有 387 条被纳入本次综述。通过主题分析，确定了 8 个主题，即 CBME 的文学对话：可信度、应用、社区影响、学习者影响、评估、教育发展、组织结构和 CBME 的社会影响。内容分析支持开发一张热点图，该图提供了这些文学对话随时间变化的频率的直观说明。
本次综述对医学教育研究界有两个作用。首先，本次综述作为 CBME 观念转变的全面历史记录，因为该观念随着时间的推移被医学教育全球社区中的许多群体引入和采用。其次，本次综述整合了 CBME 提出后围绕该方法展开的许多文学对话。这些发现可以促进医学教育研究界内外的多个受众对 CBME 的理解。
