Enough Already with CBME – Not Why but HOW!

Sarita Verma, LLB, MD, CCFP

The past five years have seen a flurry of innovations and changes to medical education across the continuum - in support of personalized learning, new models of learning, and new approaches to assessment of competency. Looking ahead, medical education innovators have their work cut out for them in 2018-19. Some of this work will require them to ask the hard questions such as: Where is the evidence of impact from these changes? Does it make any difference? Is the ‘return on investment’ worth the depletion of resources in my budget? Answering these questions means acknowledging that there’s an elephant in the room. How much change can these processes and our institutions absorb? And are we ready to manage where the next waves of innovation stand to emerge? The CCME in Halifax saw many folks asking about and debating these very issues. In the plenaries and in most of the presentations, poster and oral sessions, the rapid evolution of medical education and the impending fluctuations that will be driven by AI, technology and other advances were well  in discussion.  Although I didn’t take a scientific survey, the mood as measured by taking the pulse in the rooms offered some areas of consensus. Here are five topics I heard being discussed in the CCME corridors:

  1. Link CBME learning to CBME assessment methods. There is a lot of talk about data but really, how will we use the tools for assessment and evaluation of learners and programs?
  2. Be patient. Not all domains in medical education are as rapidly progressive as the PGME programs in CBD. UGME is catching up but CPD is just starting to use competency based education in their programs. As well, the resource implications for the implementation of CBME are not well known.
  3. Stop debating the impact of technology and start teaching how to integrate it in our curriculum. Explicitly set aside time in the programs to prepare our learners for practice in a rapidly evolving world of technology and artificial intelligence. Better yet, engage our learners in teaching their faculty as they are way ahead of us.
  4. Revisit accountability. And then revisit it again. Is your school/program really achieving relevant impact? How do you measure that? Does CBME make a better learner and a better program? More importantly, does it produce a better doctor?
  5. There is always a better way to do things. Look for disruptive changes in education outside your field, and outside your country. Medical education needs to look outward more than inward.

Tell me what you think. Is there more to discuss with the rollout of CBME?

Sarita Verma, LLB, MD, CCFP
Vice President, Education
Association of Faculties of Medicine of Canada

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Vol. 2, Issue 1 June 2018