Plenary Abstracts

1. Competency Achieving Medical Education – Challenges & Solutions
     G. (Niv) Patil (The University of Hong Kong, Hong Kong)

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Traditional medical curriculum is based on premise that student is ‘Able to achieve’. Current initiative towards ‘Outcome based curriculum’, though synonymous to ‘Competency Based Curriculum’, denotes ‘Able to show’ than ‘Able to do/perform’. With spectacular increase in number of medical schools and students across the world, there is a perception that medical schools are in danger of producing ‘fit to pass exams’ graduates than ‘Fit to practice’. Medical profession need to revolutionize curriculum to articulate role of medical schools by providing ‘Competency Achieving Syllabus’ which should clearly demonstrate practical approach in creation of undifferentiated doctors, tomorrow’s specialists with generic skills; and graduates who can perform well during internship. Author will highlight examples of competency achieving syllabus.

2. Learning Driving Assessment
     Cees Van der Vleuten (Maastricht University, Netherlands)

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To better prepare learners for the needs of health care, education is rapidly moving towards outcomes and competencies, including an emphasis on self-directed learning as a basis for life-long learning. To be successful in making this transition, assessment strategies need to change. These changes include the assessment of behavioural skills, the focus on feedback, the use of narrative assessment information, more longitudinal assessment and monitoring, and supporting learners in their self-directed learning. Curriculum wide assessment strategies such as programmatic assessment will gain popularity. The general intent is to make assessment more meaningful for supporting learning. The old credo of “assessment driving learning” needs replacement by “learning driving assessment”.

3. Developing and Assessing Entrustable Professional Activities as the Basis for Assessment of Patient Safety Competencies
    Paul Barach (Wayne State University School of Medicine, USA)

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Determining when residents are independently prepared to perform clinical care tasks safely is not easy or understood. Educators have struggled to identify robust ways to evaluate trainees and their preparedness to treat patients while unsupervised. However, efforts to implement competency-based medical education have been stymied by practical challenges and assessment questions. Competency-based assessment tools, while potentially psychometrically strong, can prompt narrow focus on aspects of individual competencies  and improper implementation of assessment tools with inadequate faculty training limits the information gained. Entrustable professional activities (EPAs) are a novel method of operationalizing competencies and milestones in the context of actual clinical work.  An EPA reflects relevant competencies and milestones; requires skills, knowledge, and attitudes; addresses a professional task with a recognizable output; and can be observed and judged by an expert. Trust allows the trainee to experience increasing levels of participation and responsibility in the workplace in a way that builds competence for future practice. The breadth of knowledge and skills required to become a competent and safe physician, coupled with the busy workload confound this challenge. Notably, a technically proficient trainee may not have the clinical judgment to treat patients without supervision. This talk will review patient safety Milestones (discipline-specific developmental achievements toward competence), and their assessment, that ideally facilitates meaningful workplace-based assessment over time. We will review the factors affecting why and when supervisors trust residents to proceed without supervision.

4. ‘Educating tomorrow’s doctors’ – accreditation and quality assurance of medical education
      Stephanie Hering (Swiss Agency of Accreditation and Quality Assurance AAQ, Switzerland)

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The World Federation for Medical Education (WFME) has published international standards for the quality improvement of medical education since 1997. International norms need to be adjusted to respective regional, national and institutional contexts or specific health care needs.

This contribution will present a case-study from Switzerland as a model of how to negotiate global demands and local requirements in order to educate the next generation of doctors. For the mandatory accreditation of basic and postgraduate medical education programmes quality standards and processes had to be designed. The ministries of education and public health were involved as well as many other stakeholders. The result is a set of robust standards for medical education that successfully integrate multiple dimensions.

5. Excellence in Assessment – If It Ain’t Broke, Make it Better!
     Debra Klamen (Southern Illinois University School of Medicine, USA)

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There is an axiom that goes, “If it Ain’t Broke, Don’t Fix it.”  For a long time in medical education, that meant that we used time-worn assessment measures and didn’t worry too much about it.  MCQs, checklists, and ‘observation’ were (and still are) standard assessments.  We have progressed beyond this rubric.  Now the literature is full of competencies, milestones, and EPAs.  However, how we measure these falls immediately back into old paradigms.  What we need is a system of global judgment with some structure, a different (and better?) model of assessment.  This talk will outline what that new model of assessment might look like.

6. A contemporary view of the role of assessment in continuing professional development for health professionals.
     Elizabeth Farmer (Medical Board Australia, Australia)

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There is increased regulatory activity in revalidation and recertification worldwide. This has sharpened the focus on the role and value of continuing professional development. This plenary presentation will explore where assessment fits in contemporary thinking about how best to ensure that doctors and other health professionals remain fit to practise throughout their entire professional careers.