Competency-based education in human medicine moves away from the idea that competence is related to time on a rotation. The fundamental premise is the Day 1 test. On Day 1, what can students do with no supervision?
This is an outcomes-based approach to the design, implementation, assessment and evaluation of an education program using competencies. It asks:
- What are the abilities needed of grads?
- How can we sequence from novice to expert?
- How can we enhance teacher-trainee interaction?
- What learning activities are really needed?
- How can we use best practices in assessment?
Competency-based principles include:
- A focus on outcomes: graduate abilities
- Ensuring progression of competence
- Viewing time as a resource, not a framework
- Promoting leaner centerdness
- Demanding greater transparency and utility in the program/curriculum
A new Competency-Based Veterinary Education (CBVE) framework unveiled Saturday at the 2018 conference of the Association of American Veterinary Medical Colleges (AAVMC) represents three years of intensive work and lays the framework for schools to develop a competency-based curriculum.
It is probably the most significant work of the organization to date and facilitates the shift from faculty-centered teaching to student-centered learning, said Chief Executive Officer Andy Maccabe. “We don’t consider this product to be a perfect, final product,” he added. Instead, it will be updated and revised as educators implement it, and all schools are invited to adapt the framework.
The framework encompasses 9 Domains of Competence with corresponding competencies. These include:
- Clinical Reasoning and Decision-making
- Individual Animal Care and Management
- Animal Population Care and Management
- Public Health
- Professionalism and Professional Identity
- Financial and Practice Management
In addition, the framework is accompanied by Entrustable Professional Activities (EPAs) or essential tasks that veterinary medical students can be trusted to perform with limited supervision in a given context and with regulatory requirements, once sufficient competence has been demonstrated. The 8 EPAs include:
- Gather a history, perform an examination, and create a prioritized differential diagnosis list
- Develop a diagnostic plan and interpret results
- Develop and implement a management/treatment plan
- Recognize a patient requiring urgent or emergent care and initiate evaluation and management
- Formulate relevant questions and retrieve evidence to advance care
- Perform a common surgical procedure on a stable patient, including pre-operative and post-operative management
- Perform general anesthesia and recovery of a stable patient, including monitoring and support
- Formulate recommendations for preventive healthcare
The EPAs are accompanied by descriptions of activities, relevant domains, and elements within the activity. AAVMC conference attendees from our college look forward to sharing more information upon their return.
CBE (competency-based education) has a “tyranny of utility.” … It has to be highly applicable. All learning activities are connected to “a golden thread” through the curriculum or they are “selective electives.”
– Jason GRank, CanMEDS, Royal College of Physicians and Surgeons of Canada
For the past two years, a group of respected educators from the Association of American Veterinary Medical Colleges member institutions has been working to develop a competency framework for veterinary medicine that aligns with approaches used by other health professions.
The Office of Teaching & Learning became aware of this work when it began and participated in an activity designed to provide feedback to the group working on this project, specifically examining a very early draft of the competencies during a session at the 2016 Veterinary Educators Collaborative.
The finalized framework will be introduced during a plenary session at the 2018 AAVMC annual meeting in March.
Council for Professional Education Chair Tod Drost and OTL Director Melinda Rhodes-DiSalvo will be present at the meeting and are excited to share what they learn with colleagues at CVM and consider how the framework might assist in advancing educational excellence. In essence the framework will respond to the questions “What does the public expect a graduate veterinarian to be able to do?” and “How do you actually assess students’ competencies in these areas?”
According to AAVMC: “The framework will be introduced as a ‘best practices’ model which all member institutions are welcome to adopt or consult as they modify existing curricula or develop new ones. While no action will be taken to adopt the program as an official standard for evaluating educational outcomes, the body of work represents the most substantial effort ever undertaken in this area of academic veterinary medicine and is expected to serve as a valuable tool to guide curricular development, refinement and outcomes assessment.”
The project was led by Associate Deans for Academic Affairs Dr. Jennie Hodgson of the Virginia-Maryland College of Veterinary Medicine and Dr. Laura Molgaard of the University of Minnesota College of Veterinary Medicine.
AAVMC’s website has additional information about the process and working group.