Rationale
Competency‐based education (CBE) is currently being implemented across Canadian postgraduate medical education programmes through Competence by Design (CBD).1 Queen's University received ...permission to initiate CBE in all programmes simultaneously starting in 2017; an institutional initiative termed Competency‐based medical education (CBME).2 We describe our initial experiences to highlight perceptions and barriers and facilitate implementation at other centers.
Methods
Anonymous online surveys were administered to faculty and residents transitioning to CBE (138 respondents) including (a) Queen's programme leaders (Programme Directors and CBME Leads) n = 27, (b) Queen's residents n = 102, and (c) Canadian neurology programme directors n = 9 and were analysed using descriptive and inferential statistical techniques.
Results
Perceptions were favourable (x = 3.55/5, SD = 0.71) and 81.6% perceived CBE enhanced training; however, perceptions were more favourable among faculty. Queen's programme leaders indicated that CBE did not improve their ability to provide negative feedback. Queen's residents did not perceive improved quality of feedback. National Canadian neurology programme directors did not perceive that their institutions had adequately prepared them. There was variability in barriers perceived across groups. Queen's programme leaders were concerned about resident initiative. Queen's residents felt that assessment selection and faculty responsiveness to feedback were barriers. Canadian neurology programme directors were concerned about access to information technology.
Recommendations
Our results indicate that faculty were concerned about the reluctance of residents to actively participate in CBE, while residents were hesitant to assume such a role because of lack of familiarity and perceived benefit. This discrepancy indicates attention should be devoted to (a) institutional administrative/educational supports, (b) faculty development around feedback/assessment, and (c) resident development to foster ownership of their learning and familiarity with CBE.
In this article, we present a new model of teachers' assessment competence. The model is based on the educational competence concept, thus defining competences to be context-specific, learnable ...cognitive dispositions that are needed to successfully cope with specific situations. Integrating research on assessment processes, practices, and products, we specify the range of situations our model applies to, and discuss how its elements may become involved and measurable in a variable assessment process. The model aims to inspire future integrative research on the description, explanation, prediction, and promotion of teachers' assessments in various situations.
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•A new conceptual model on teachers' assessment competence is introduced.•Competence, as its base, is a learnable situation-specific cognitive disposition.•The model integrates research on assessment processes, practices, and products.•We discuss how its elements become measurable in a variable assessment process.•The model aims to inspire integrative research on assessment.
Across the United States, court orders for competence to stand trial (CST) evaluations and competence restoration services have been increasing much more rapidly than states can provide these ...services, prompting what has been called a national "competency crisis." The challenge in providing timely competence restoration services has, in several jurisdictions, prompted a change in competence evaluations. Evaluators are more often required to address broader clinical issues-such as recommending placement or addressing the urgency of hospitalization-rather than addressing only CST. This marks an evolving practice in forensic evaluation, which moves evaluators beyond the very narrow forensic question of competence and into more traditionally clinical recommendations. We describe several state examples of changing practice in order to highlight the initial barriers, and potential benefits, to addressing additional clinical issues in competence evaluations, amid a national competence crisis.
Since the turn of the twenty-first century, competency-based medical education (CBME) has become a dominant approach to postgraduate medical education in many countries. CBME has a history dating ...back half a century and is rooted in general educational approaches such as outcome-based education and mastery learning. Despite controversies around the terminology and the CBME approach, important national medical regulatory bodies in Canada, the United States, and other countries have embraced CBME. CBME can be characterized as having two distinct features: a focus on specific domains of competence, and a relative independence of time in training, making it an individualized approach that is particularly applicable in workplace training. It is not the length of training that determines a person's readiness for unsupervised practice, but the attained competence or competencies. This shift in focus makes CBME different from traditional training. In this contribution, definitions of CBME and related concepts are detailed.
This research examined the relationships between motivation, support, and intercultural communicative competence (ICC) among students involved in a university project in Malaysia, called Crossroads ...of Culture. We evaluated the impact on ICC of intrinsic and extrinsic motivation types,
and of autonomy, competence, and relatedness support. Data collected via a questionnaire from a diverse group of 273 participants were processed using descriptive and correlation analysis. The findings underscore that in Malaysia's multilingual society, students participating in intercultural
communicative activities had higher intrinsic than extrinsic motivation. Furthermore, extrinsic motivators, such as the desire to improve language skills, obtain credits or certificates, or achieve career benefits, did not exhibit a significant correlation with ICC. Additionally, the availability
of mentor support and the establishment of meaningful relationships among participants were identified as pivotal elements in molding their levels of satisfaction, which profoundly impacted their ICC. Implications of the findings are discussed.
Increasing the cultural competence of physicians is one means of responding to demographic changes in the USA, as well as reducing health disparities. However, in spite of the development and ...implementation of cultural competence training programs, little is known about the ways cultural competence manifests itself in medical encounters. This paper will present a model of culturally competent communication that offers a framework of studying cultural competence ‘in action.’ First, we describe four critical elements of culturally competent communication in the medical encounter – communication repertoire, situational awareness, adaptability, and knowledge about core cultural issues. We present a model of culturally competent physician communication that integrates existing frameworks for cultural competence in patient care with models of effective patient-centered communication. The culturally competent communication model includes five communication skills that are depicted as elements of a set in which acquisition of more skills corresponds to increasing complexity and culturally competent communication. The culturally competent communication model utilizes each of the four critical elements to fully develop each skill and apply increasingly sophisticated, contextually appropriate communication behaviors to engage with culturally different patients in complex interactions. It is designed to foster maximum physician sensitivity to cultural variation in patients as the foundation of physician-communication competence in interacting with patients.
This paper analyzes the extent to which sustainability is present in the curricula of the 16 Education Degree programs belonging to the EDINSOST project: 6 Early Childhood Education Degrees, 7 ...Primary Education Degrees, 2 Pedagogy Degrees and 1 Social Education Degree. The results obtained suggest that sustainability is present in all Degrees, but not uniformly so. A great disparity is observed in the number of subjects that develop sustainability, with an average of 22.63 subjects per Degree. The competency most present is the 'Application of ethical principles related to the values of sustainability in personal and professional behaviors,' while the least present is 'Sustainable use of resources and prevention of negative impacts on the natural and social environment.' Sustainability is not developed uniformly in the different universities either. Three universities (UAM, UCA and UIC) develop sustainability competencies at 100%, while others such as the USAL do so at only 50%.
Clinical supervision is acknowledged as a distinct professional competence that requires specific education and training. However, it is all too often an inadequately addressed or an entirely missing ...ingredient in psychology curricula and clinical research, including, for example, clinical trial protocols and evidence-based treatment implementation. It is proposed that clinical supervision training follow the shift to the competence movement that has occurred in psychology education, training, and regulation generally and embrace a systematic and intentional competence model. Groundwork for such a competence model for supervision has been laid in the supervision guidelines from the American Psychological Association and the Association of State and Provincial Psychology Boards, defining parameters for clinical supervision and the requisite supervisor competencies. This article discusses these inadequately addressed or missing ingredients, the insufficiently organized approach to supervision as a distinct competency at the present time, and the assumptions that are obstacles to progress. Strategies are proposed to overcome these obstacles; for example, methods of infusing supervision into existing curricula, the hidden curriculum, and transformational leadership that would guide its implementation. Knowledge, skills, and attitudes would be systematically developed as a critical component of self-reflective competency-based education, a portal to lifelong learning, and an essential part of research and implementation.
Beyond Dichotomies Blömeke, Sigrid; Gustafsson, Jan-Eric; Shavelson, Richard J.
Zeitschrift für Psychologie,
2015, Letnik:
223, Številka:
1
Journal Article
Recenzirano
Odprti dostop
In this paper, the state of research on the assessment of competencies in higher education is reviewed.
Fundamental conceptual and methodological issues are clarified by showing that current ...controversies are built
on misleading dichotomies. By systematically sketching conceptual controversies, competing competence
definitions are unpacked (analytic/trait vs. holistic/real-world performance) and commonplaces
are identified. Disagreements are also highlighted. Similarly, competing statistical approaches to assessing
competencies, namely item-response theory (latent trait) versus generalizability theory (sampling error
variance), are unpacked. The resulting framework moves beyond dichotomies and shows how the different
approaches complement each other. Competence is viewed along a continuum from traits that underlie perception,
interpretation, and decision-making skills, which in turn give rise to observed behavior in real-world
situations. Statistical approaches are also viewed along a continuum from linear to nonlinear models that
serve different purposes. Item response theory (IRT) models may be used for scaling item responses and
modeling structural relations, and generalizability theory (GT) models pinpoint sources of measurement error
variance, thereby enabling the design of reliable measurements. The proposed framework suggests multiple new
research studies and may serve as a "grand" structural model.
Competency-based education in the health care professions has become a prominent approach to postgraduate training in Canada, the Netherlands, the United Kingdom, the United States, and many other ...countries. Competency frameworks devised at national and international levels have been well received, and in many cases mandated, by governing bodies. However, the teaching and assessment of competencies pose questions of practicality, validity, and reliability. In this article we propose that competence and competencies be approached in the context of the particular clinical environment, such that the assessment of competence is tied to a trainee's performance of essential clinical activities that define the profession. Competence is implicit in the eventual entrustment of trainees to perform these professional activities. Competencies and "entrustable professional activities" (EPAs) relate to each other as two dimensions of a grid in which each EPA can be mapped back to a number of competencies. This backward visioning from EPAs to competencies is proposed as a guide to curriculum planning and assessment. The authors discuss experiences with this conceptual model in research, curriculum development and learner assessment.
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