Over the past century, medical education has undergone a paradigm shift, edging itself ever closer toward a focus on competency. As such, the evolutionary process of competency-based medical education (CBME) has now blossomed into a movement that has changed the face of both domestic medical education and medical education abroad. This movement, however, has not been without difficulty. In fact, support for modern era CBME has ebbed and flowed, due in large part to the inherent complexity of assessing competency.
Even with fresh new perspectives mounting and growing literary support, the successful implementation of CBME in today's healthcare curricula relies on the use of workable, pragmatic solutions to assess competencies reliably and consistently. Such learner-centered frameworks must be underpinned by an emphasis on ability and a focus on outcomes. In other words, there is a critical need to translate academic prowess into functional skills and be able to measure that process longitudinally.
The solution for practical, learner-centered competency assessments and the key to successful implementation for CBME ultimately lies in the development and adoption of program-specific entrustable professional activities (EPA). EPAs are professional assessable tasks that are learner-centered, focused on outcomes, and serve to emphasize and assess a learner’s ability. Each EPA, requiring a baseline set of competencies, essentially becomes a functional assessment of the performance in the associated domains of competence. With competency-based medical education quickly becoming the new standard, the development of entrustable professional activities will contextualize assessment, fostering the successful development and implementation competency frameworks within current curricula.
The PA profession has embraced the competency movement with an overt emphasis published within accrediting standards. As the profession edges closer to full-on CBME initiatives, PA programs must understand the barriers to the adoption of a competency-based curriculum as encountered by other similarly situated medical professions. Through a thorough understanding of the evolution of CBME, the difficulties met with its passage, and the ultimate acceptance of EPAs as competency assessment tools, our profession can confidently move forward and foster a smooth transition for PA education into the competency era.
Huddleston J. Answering the Call for Competence. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2020; 2(3).
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