Defining and Assessing the 21st-Century Physician in Training

Excerpt

We are experiencing a paradigm shift in medical education. Education has moved away from using “time” as a determinant of learner readiness to advance to the next stage and ultimately onto independent practice, to the current competency-based paradigm that focuses on a learner’s mastery of specific professional activities as a measure of their fitness for unsupervised practice. This approach creates opportunities for more individualized, developmental-based learning, and how we define competency will drive curriculum development and assessment. For example, defining the specific competencies needed to provide high-quality care may identify gaps in existing curricula. Competency-based education lends itself to “assessment for learning” in which learners utilize regular feedback from multiple sources to improve performance in a set of defined skills and behaviors along a developmental continuum.1 Structures that support this model include clearly described competencies that link entrustable professional activities (EPAs) (which represent the work that competent physicians perform when synthesizing and contextualizing knowledge and information to care for patients) to learning experiences that occur in authentic clinical environments with opportunities for individualized assessment coupled with meaningful real-time feedback.2 …