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DOI: https://doi.org/10.22263/2312-4156.2018.6.112

Karalkova N.K., Bizunkov A.B.
Competency-based approach and quality control of medical education: historical aspect and analysis of the modern state of the problem
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus

Vestnik VGMU. 2018;17(6):112-120.

Abstract.
The purpose of this work was to assess the effectiveness of competency-based model introduced into medical education in the world and post-Soviet countries. The investigation revealed that applying competency-based methodology, as it was originally conceived, was connected with some significant difficulties. The most important of them were: lack of consensus concerning the competency conception, high costs of the method, scarcity of convincing evidence that the new approach is more effective than the previous one. The most common challenge of the competency-based model usage in post-Soviet countries is vagueness of the competency concept and its reduction to conventional methodology of knowledge-abilities-skills estimation. The introduction of the competency-based model is associated with the greatest difficulties when using it for the evaluation of the mastery of a clinical discipline taken separately. The analysis of the existing modern trends in the world higher medical school has shown  that the assessment of a case history, understood not as a final text but as a process of its creation, is much closer to the idea of competency-based education than the mechanical fragmentation of an exam into practical skills and formalized knowledge in the form of computer tests.
Key words: competency-based model, quality control, competencies, higher school pedagogy, education quality.

References

1. Ten Cate O. Competency-based education, entrustable professional activities, and the power of language. J Grad Med Educ. 2013 Mar;5(1):6-7. doi: http://dx.doi.org/10.4300/JGME-D-12-00381.1
2. Ten Cate O. Competency-Based Education and Entrustable Professional Activities (EPAs) in the context of medical skill training. Available from: https://www.uems.eu/__data/assets/pdf_file/0009/56880/ten-Cate-16-feb-2018-UEMS-NASCE-EPAs-and-Skills-training.pdf. [Accessed 3 Dec 2018].
3. Tyler RW. Basic principles of curriculum and instructions. Chicago: Chicago University Press; 2013. 144 p.
4. Bloom BS. Taxonomy of educational objectives: the classification of educational goals. London: Longmans: Green and Co Ltd; 1956. 207 р.
5. McGaghie WC, Sajid AW, Miller GE, Telder TV, Lipson L, et al. Competency-based curriculum development in medical education. Geneva: World Health Organization; 1978. 90 p.
6. Batalden P, Leach D, Swing S, Dreyfus H, Dreyfus S. General competencies and accreditation in graduate medical education. Health Aff (Millwood). 2002 Sep-Oct;21(5):103-11.
7. Shah N, Desai C, Jorwekar G, Badyal D, Singh T. Competency-based medical education: An overview and application in pharmacology. Indian J Pharmacol. 2016 Oct;48(Suppl 1):S5-S9. doi: http://dx.doi.org/10.4103/0253-7613.193312
8. Swing SR. The ACGME outcome project: retrospective and prospective. Med Teach. 2007 Sep;29(7):648-54. doi: http://dx.doi.org/10.1080/01421590701392903
9. General Medical Council. Outcomes for graduates 2018. Available from: https://www.gmc-uk.org/-/media/documents/dc11326-outcomes-for-graduates-2018_pdf-75040796.pdf. [Accessed 28 Nov 2018].
10. Frank JR, Mungroo R, Ahmad Y, Wang M, De Rossi S, Horsley T. Toward a definition of competency-based education in medicine: a systematic review of published definitions. Med Teach. 2010;32(8):631-7. doi: http://dx.doi.org/10.3109/0142159X.2010.500898
11. Huddle TS, Heudebert GR. Taking apart the art: the risk of anatomizing clinical competence. Acad Med. 2007 Jun;82(6):536-41. doi: http://dx.doi.org/10.1097/ACM.0b013e3180555935
12. Lurie SJ, Mooney CJ, Lyness JM. Commentary: pitfalls in assessment of competency-based educational objectives. Acad Med. 2011 Apr;86(4):412-4. doi: http://dx.doi.org/10.1097/ACM.0b013e31820cdb28
13. Jones MD, Rosenberg AA, Gilhooly JT, Carraccio CL. Perspective: Competencies, outcomes, and controversy – linking professional activities to- competencies to improve resident education and practice. Acad Med. 2011 Feb;86(2):161-5. doi: http://dx.doi.org/10.1097/ACM.0b013e31820442e9
14. Harris P, Snell L, Talbot M, Harden RM. Competency-based medical education: implications for undergraduate programs. Med Teach. 2010;32(8):646-50. doi: http://dx.doi.org/10.3109/0142159X.2010.500703
15. Lurie SJ. History and practice of competency-based assessment. Med Educ. 2012 Jan;46(1):49-57. doi: http://dx.doi.org/10.1111/j.1365-2923.2011.04142.x
16. Carraccio C, Englander R, Van Melle E, Ten Cate O, Lockyer J, Chan MK, et al. Advancing Competency-Based Medical Education: A Charter for Clinician-Educators. Acad Med. 2016 May;91(5):645-9. doi: http://dx.doi.org/10.1097/ACM.0000000000001048
17. Whitcomb ME. Transforming Medical Education: Is Competency-Based Medical Education the Right Approach? Acad Med. 2016 May;91(5):618-20. doi: http://dx.doi.org/10.1097/ACM.0000000000001049
18. Mitrokhina TN. Competence approach in Russian higher education: innovation or regression? Vestn Volgogr Gos Un-ta Ser 4 Istoriia. 2013;(1):158-61. (In Russ.)
19. Mitrofanova KA. Concepts of competence and competence in higher medical education in Russia. Nauch Dialog. 2016;(1):285-97. (In Russ.)
20. Zvonnikov VI, Chelyshkova MB. Quality control of training at certification: competence approach: ucheb posobie. Moscow, RF: Logos: Univ kniga; 2009. 271 р. (In Russ.)
21. Pak YuN, Nuguzhinov ZhS, Pak DYu. Problems of modernization of higher education in the format of competence approach. Vyssh Obrazovanie Segodnia. 2017;(10):48-52. (In Russ.)
22. Ibragimov GI, Ibragimova EM. Assessment of competencies: problems and solutions. Vyssh Obrazovanie Rossii. 2016;(1):43-52. (In Russ.)
23. Kon EL, Freyman VI, Yuzhakov AA, Kon EM. Approach to the formation of the component structure of competences. Vyssh Obrazovanie Rossii. 2013;(7):37-41. (In Russ.)
24. Kon EL, Freyman VI, Yuzhakov AA. Development of approaches to the formalized description of the controllable component structure of disciplinary competence. Obrazovanie Nauka. 2015;(4):52-68. (In Russ.)
25. Budenkova EA. Management of learning outcomes in terms of implementation of the competence approach in the system of HPE. Obrazovat Tekhnologii. 2014;(3):47-58. (In Russ.)
26. Blinov VI, Batrova OF, Esenina EYu, Faktorovich AA. Modern approaches to the assessment of qualifications. Vyssh Obrazovanie Rossii. 2013;(5):100-6. (In Russ.)
27. Chuchalin AI, Epikhin AV, Muratova EA. Planning the evaluation of learning outcomes in the design of educational programs. Vyssh Obrazovanie Rossii. 2013;(1):13-20. (In Russ.)
28. Holmboe ES, Sherbino J, Long DM, Swing SR, Frank JR. The role of assessment in competency-based medical education. Med Teach. 2010;32(8):676-82. doi: http://dx.doi.org/10.3109/0142159X.2010.500704
29. Chang A, Bowen JL, Buranosky RA, Frankel RM, Ghosh N, Rosenblum MJ, et al. Transforming primary care training – patient-centered medical home entrustable professional activities for internal medicine residents. J Gen Intern Med. 2013 Jun;28(6):801-9. doi: http://dx.doi.org/10.1007/s11606-012-2193-3

Information about authors:
Karalkova N.K. – Candidate of Medical Sciences, associate professor, acting head of the Chair of Ophthalmology, Vitebsk State Order of Peoples’ Friendship Medical University,
ORCID: https://orcid.org/0000-0002-6172-6767
Bizunkov A.B. – lecturer of the Chair of Otorhinolaryngology, Vitebsk State Order of Peoples’ Friendship Medical University.

Correspondence address: Republic of Belarus, 210009, Vitebsk, 27 Frunze ave., Vitebsk State Order of Peoples’ Friendship Medical University, Chair of Otorhinolaryngology.  E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Alexander B.Bizunkov.

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