Competency-based medical education and its competency frameworks

Competency-based medical education (CBME) can be defined as education for the medical profession that is targeted at a fixed level of proficiency in one or more medical competencies and medical competency as a learnable, durable and measurable ability to execute a specific, integrative task that is a part of the full range of tasks that constitute the medical profession. It is a generalized ability that may vary somewhat, depending on the context. The individualized and time-independent nature of CBME stems from this definition, as education is finished when a preset level of competence is reached rather than after a fixed number of years. In this sense, a competent medical professional can act but also has an authority or right to act and may be bestowed with a duty to act, implying that unqualified persons would not have this right or duty.

CBME has observed a huge interest since the turn of the century. As competency frameworks became implemented, its strengths and weaknesses became apparent. To respond to conceptual, psychometric and practical problems, new developments within CBME have recently been added, two of which stand out: milestones for the evaluation and monitoring of learners and entrustable professional activities to ground CBME in day-to-day professional practice. This chapter discusses the definition, the historical background, the problems and the possible solutions concerning CBME.

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