Medical Educator Minute: What is Competency Based Medical Education (CBME)?
You may have heard the term Competency Based Medical Education (CBME) before, but what does it mean? CBME is an outcomes-based approach to medical education and assessment that starts with the end in mind: patient care. The goal of CBME is to ensure that trainees achieve patient-centered outcomes during their training. Starting with the desired end result of excellent patient care, each specialty breaks down learning into components that are needed to achieve competence in providing quality care for that specialty. These components may be described as observable behaviors like Milestones, or as a more global picture of what it means to provide competent care, like Entrustable Professional Activities (EPAs).
Instead of focusing on what content to teach, CBME focuses on what should be achieved (i.e., what does competence look like, and what knowledge and skills does each trainee need to reach that level of competence.)
CBME also acknowledges that trainees learn and develop at different rates and uses continuous assessment to shape that learning. A trainee may excel in one area, such as procedural skills, but still has potential for growth in another, such as communication skills. In this way, CBME is rooted in a growth mindset, understanding that all trainees are on their own path to competence and may need different educational opportunities to move along that path at their own pace. This framework can give faculty language to deliver individualized and productive feedback and can help trainees understand their own individualized learning plan.
The Value of CBME
The CBME approach better prepares trainees for the activities they will need in practice because:
- It is comprehensive and thorough, focusing on the ability of a trainee to meet patient needs, requiring more than medical knowledge and/or surgical technique
- CBME assessment occurs in the workplace where trainees are working directly with patients
- Future learning for trainees can be individualized and flexible, based on their unique needs
- CBME can help programs define and address curricular gaps in helping trainees achieve competence
