COMPETENCY BASED EDUCATION Introduction The Strategy (WHO 2000a) states that the education of nurses and midwives

should be competency-based. In so doing, it is in harmony with a growing and worldwide emphasis on the use of this approach to the education of health care professionals. Definitions of competency Competency is defined as broad composite statement(s), derived from nursing and midwifery practice, which describe a framework of skills reflecting knowledge, attitudes and psycho-motor elements. A recent revision of nursing and midwifery education in the United Kingdom, conducted by the Central Council for Nursing, Midwifery and Health Visiting (UKCC1999) defined competency as: the skills and ability to practise safely and effectively without the need for direct supervision.

Epstein and HundertJAMA,2001 The habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice for the benefit of the individual and the community being served.

Traditional Educational Approaches Lecturing/ Demonstrating Testing Command of Knowledge Experiencing Clinical Apprenticeships

Problems with Traditional Approaches Focus on isolated knowledge bits: students dont see and arent motivated by BIG PICTURE; also, the bits leave much of task for INTEGRATION and APPLICATION to the student Student Engagement to lecture attendance, participation, hyper-focus on exam. Faculty focused on teaching; less emphasis on discerning impact of their efforts on learning Students progress at different paces Faculty arent knowledgeable enough about aggregate results of instruction relative to broad curricular goals little data Employers unhappy with products want more practice-ready graduates

Need for curriculum reformation

Focus has been on modernizing content usually means INCREASE. Driven by contemporary health care environment. Little attention to BASIC competencies.

Competency Based Education Main focus should always be on the outcome of the education, rather than the process.The process is important, but should be planned and carried out with the outcome of competency in mind. Competency-Based Instruction Ability to assess competency at the end of stages of the program to allow promotion, graduation Ability to assess competency development as students learning and assessing the competency and vice versa. Assessment is of fundamental importance because it is central to public accountability . Commitment to competency-based education ushers in the need : To articulate clearly the things needing to be assessed by using new tools.The ability to simulate technology to the rescue. New innovation in education CBE The articulation of competencies that can be measured. The act of measurement. The modification of trainee experience and/or programs based on assessment results. The relationships that evolve during the act of measurement

Criticisms of Competency Based Education Too reductionistic with behaviors measured yes/no with a checklist Doesnt take into context into account More holistic views see competence not as trained behavior but thoughtful capabilities and a developmental process

Potential Advantages of CBE Makes the curriculum to take on a more holistic appearance and coherence be more than a string of beads. Gets whole faculty to address and assume ownership for the basic competencies. Makes clear to students what the expectations are. Improves the system of feedback to students. Gets the learner more engaged and acting responsibly.

Provides data for decisions: about students, about program effectiveness, about value added.

Challenges of CBE Requires College investment: workshops, simulation tools, electronic portfolios. Time challenge: requires faculty to spend time to alter old products and methods. Requires faculty to learn new concepts (assessment methods) and new skills (feedback) may threaten experts.

Elements of Success Learn the basic principles but be creative about adaptation for local circumstances. Focus on integrated core competencies. Start slow; build on strengths. Innovate dont be afraid to try something different. Avoid perfectionism: the perfect is the enemy of the good. Dont reinvent the wheel: collaborate. Involve faculty in conduct of assessments its motivating!

BIBLIOGRAPHY Shumway,J.M, & Harden, R.M. AMEE Guide No. 25: The assessment of learning outcomes for the competent and reflective physician. Medical Teacher, 2003, 25, 569-584). Goldstein et al, AcadMed. 2005;80:423-433 S. Kerka, 1998, Competency Based Education and Training: Myths and Realities, Clearinghouse on Adult, Career,and Vocational Education (ACVE) www.cete.org/acve/docgen.asp?tbl=mr&ID=65 an unpublished paper prepared by Professor Myriam Ovalle of the Spanish General Council of Nursing. <!--NOSEARCHEND--></html> Anderson, H. M., Moore, D. L., Anaya, G.,&Bird, E. (2005). Student learning outcomes assessment: A component of program assessment. American Journal of Pharmaceutical Education, 69(2), 256268. Australian Nursing and Midwifery Council. (2005). National competency standards forthe registered nurse. Retrieved October 15, 2008, from http://www.anmc.org.au/docs