4.5 Article

The critical role of infrastructure and organizational culture in implementing competency-based education and individualized pathways in undergraduate medical education

Journal

MEDICAL TEACHER
Volume 43, Issue -, Pages S7-S16

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/0142159X.2021.1924364

Keywords

Undergraduate medical education; competency-based medical education; UME; CBME; master adaptive learner; coaching; learning environment

Funding

  1. American Medical Association

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Competency-based medical education (CBME) is a developmental approach that ensures each trainee is prepared to progress through different stages of training and continue to grow in unsupervised practice to meet current and future healthcare challenges. Implementing CBME requires a fundamental shift in organizational culture and investment in appropriate infrastructure.
In 2010, several key works in medical education predicted the changes necessary to train modern physicians to meet current and future challenges in health care, including the standardization of learning outcomes paired with individualized learning processes. The reframing of a medical expert as a flexible, adaptive team member and change agent, effective within a larger system and responsive to the community's needs, requires a new approach to education: competency-based medical education (CBME). CBME is an outcomes-based developmental approach to ensuring each trainee's readiness to advance through stages of training and continue to grow in unsupervised practice. Implementation of CBME with fidelity is a complex and challenging endeavor, demanding a fundamental shift in organizational culture and investment in appropriate infrastructure. This paper outlines how member schools of the American Medical Association Accelerating Change in Medical Education Consortium developed and implemented CBME, including common challenges and successes. Critical supporting factors include adoption of the master adaptive learner construct, longitudinal views of learner development, coaching, and a supportive learning environment.

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