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Competency-based medical education in ophthalmology residency training: a review

Published:August 09, 2019DOI:https://doi.org/10.1016/j.jcjo.2019.07.004

      Abstract

      Competency-based medical education (CBME) is an outcomes-based training model that has become the new standard of medical education internationally. Regulatory and accrediting bodies have responded by establishing key competencies that residency programs may use to reshape their curricula. Available literature on the implementation of CBME in ophthalmology residency training programs across North America was examined. Ophthalmology-specific residency training objectives and milestones have been proposed within North America in the last 4 years. Curriculum guidelines and implementation blueprints and principles have also been proffered from various sources internationally but have met with some barriers. Assessment tools within ophthalmology have seen the most innovative development within the domain of surgical skills objectives. Competencies outside of the medical expert and patient care roles have proven more challenging to teach and assess. One ophthalmology program in Canada has undergone early implementation of a novel CBME curriculum. There is still considerable work to be done to successfully implement CBME curricula within ophthalmology residency programs in North America. Collaborative efforts to develop customizable curricula, tackle implementation barriers, and create specific assessment modalities will assist programs in meeting the competency mandates of CBME.

      Résumé

      La formation médicale axée sur les compétences (FMAC), qui repose sur les résultats, est devenue le modèle de référence en matière de formation médicale à l’échelle internationale. Les organismes de réglementation et d'accréditation ont donc établi des compétences clés auxquelles les programmes de résidence peuvent recourir pour remanier leur curriculum. On a examiné la documentation existante sur l'implantation de la FMAC dans les programmes de résidence en ophtalmologie en Amérique du Nord, pour se rendre compte que des objectifs et des jalons spécifiques à ces programmes ont été proposés au cours des 4 dernières années. Des lignes directrices régissant le curriculum, de même que des plans et des principes d'implantation provenant de diverses sources à l’échelle internationale, ont également été mis de l'avant, mais se sont heurtés à des obstacles. C'est dans le domaine des objectifs en matière d'aptitudes chirurgicales que les outils d’évaluation en ophtalmologie ont bénéficié des activités de développement les plus innovatrices. Par contre, les compétences s'exerçant à l'extérieur du savoir-faire médical et des soins aux patients se sont révélées plus complexes à enseigner et à évaluer. Au Canada, un seul programme d'ophtalmologie s'est rapidement doté d'un nouveau curriculum de FMAC. C'est donc dire qu'il reste encore beaucoup de chemin à faire pour que tous les programmes de résidence en ophtalmologie en Amérique du Nord implantent avec succès un curriculum de FMAC. La mise en commun des ressources en vue de créer des curriculums adaptables, d'aplanir les obstacles à l'implantation et de concevoir des modalités d’évaluation spécifiques aidera les programmes à répondre aux exigences de la FMAC.
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