JOGC

Competency-Based Medical Education and Assessment of Training: Review of Selected National Obstetrics and Gynaecology Curricula

  • Milena Garofalo
    Correspondence
    Corresponding Author: Dr. Milena Garofalo, Department of Obstetrics and Gynaecology, Faculty of Medicine, McGill University, Montréal, QC
    Affiliations
    Department of Obstetrics and Gynaecology, Faculty of Medicine, McGill University, Montréal, QC

    Department of Surgery, Faculty of Medicine, McGill University, Montréal, QC
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  • Rajesh Aggarwal
    Affiliations
    Department of Surgery, Faculty of Medicine, McGill University, Montréal, QC

    Steinberg Centre for Simulation and Interactive Learning, Faculty of Medicine, McGill University, Montréal, QC
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      Abstract

      There are global variations in obstetrics and gynaecology (OBGYN) training curricula, both in length and in their structure and content. The ultimate goal for all residency programs is to ensure a skilled, competent physician, capable of independent practice by the end of his or her training. An online search was used for nationally recognized OBGYN training curricula. The curricula of Australia, Canada, the Netherlands, the United Kingdom, and the United States were individually reviewed and evaluated for their use of competency-based medical education and methods of assessment, including simulation. These were also compared to the World Federation for Medical Education’s Global Standards for postgraduate medical education. Comparing the OBGYN curricula of these five countries led to quite similar results. Even though curricula reviewed have or will be integrating competency-based medical education into their residency program, there is a need to develop adequate assessment tools, including simulation, to train competent physicians capable of independent practice. Standardization of curricula leads to a decrease in the variability and an increase in the quality of training and allows for measurements and comparisons across centres. Ultimately, modifications to the curricula or even consensus for an international standard, including a standardized national simulation curriculum, may potentially increase the quality and efficiency of training, which could have a direct impact on patient safety and quality of care.

      Résumé

      La formation en obstétrique-gynécologie varie dans le monde, autant dans sa durée que dans sa structure et son contenu. Tous les programmes de résidence ont le même objectif ultime : former des médecins compétents et qualifiés, capables de pratiquer seuls à la fin de leur formation. Nous avons effectué une recherche en ligne pour repérer les programmes nationaux reconnus de formation en obstétrique-gynécologie. Nous avons ensuite examiné et évalué ceux de l’Australie, du Canada, des Pays-Bas, du Royaume-Uni et des États-Unis en ce qui a trait à l’utilisation de l’apprentissage par compétences et aux méthodes d’évaluation, notamment la simulation. Les programmes ont aussi été comparés aux normes internationales relatives aux études postdoctorales en médecine de la Fédération mondiale pour l’éducation médicale. L’évaluation a montré que la formation dans les cinq pays était similaire. Bien que les programmes de résidence utilisent ou utiliseront l’apprentissage par compétences, il faudra élaborer des outils d’évaluation adéquats, y compris des exercices de simulation, pour former des médecins compétents pouvant travailler de façon autonome. L’uniformisation des programmes limite la variabilité et fait augmenter la qualité de la formation, en plus de permettre la collecte de données et d’assurer la comparabilité d’un centre à l’autre. Au final, modifier les programmes, voire arriver à un consensus sur une norme internationale de formation – prévoyant un programme de simulation national –, pourrait rehausser la qualité et l’efficacité de la formation, et ainsi avoir une incidence directe sur la sécurité des patients et la qualité des soins.

      Key Words

      Abbreviations:

      ACGME ( Accreditation Council for Graduate Medical Education), BOEG ( Better Education for Obstetrics and Gynecology), CBD ( Competence by Design), CBME ( competency-based medical education), EPA ( entrustable professional activity), GMC ( General Medical Council), GMP ( Good Medical Practice), OBGYN ( obstetrics and gynaecology), PME ( postgraduate medical education), RANZCOG ( Royal Australian and New Zealand College of Obstetricians and Gynaecologists), STAR ( statement of awarded responsibility), WFME ( World Federation for Medical Education)
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