This is an interesting discussion and one that I have, from time to time, been involved with at a residency training level as well as with medical students. I would like to throw into the "mix" the concept of milestones or a developmental aspect to competency-based education (e.g. you first have to sit before you stand and stand before you walk) and offer up the Core Entrustable Professional Activities for Entering Residency (EPAs) prepared for the Association of American Medical Colleges (AAMC).

In brief, competency encompasses the what, how, and why of learned material. This necessitates often multi-blended pedgagogies with correspondingly complex curriculum.

Hope this helps,

Matt

Thank you Matthew for your response, but what makes a competency-based curriculum? Is there a definition? What are the key criteria that we can use to define competency-based curriculum? What elements will you look at to be sure that what you are examining is a competency-based curriculum not something else?

A curriculum that emphasizes the complex outcomes of a learning process (i.e. knowledge, skills and attitudes to be applied by learners) rather than mainly focusing on what learners are expected to learn about in terms of traditionally-defined subject content. In principle such a curriculum is learner-centred and adaptive to the changing needs of students, teachers and society. It implies that learning activities and environments are chosen so that learners can acquire and apply the knowledge, skills and attitudes to situations they encounter in everyday life. Competency-based curricula are usually designed around a set of key competences/competencies that can be cross-curricular and/or subject-bound.

Best Regards Samy Azer

By definition, Competency-based learning refers to systems of instruction, assessment, grading, and academic reporting that are based on students demonstrating that they have learned the knowledge and skills they are expected to learn as they progress through their education.

As the definition suggests, the curriculum is the curriculum; it covers the learning goals and objectives reflecting some breadth and balance, while the textbook(s) adopted recommends the teaching approach that explains the objectives and provides activities and assessment tools that are compatible with this approach.

I hope I answered your question.

Dr Osama, thank you and I agree with your response; but it is important in competency-based curriculum to have the learner demonstrate knowledge, skills, and professional behaviour in the same setting, not each on its own or in isolation. This means that the design of the curriculum should enables the use of teaching and learning methods that fulfil this goal. This leads us to the next question, what teaching and learning approaches should we use in a competency-based curriculum? and what type of training do we need to introduce to teaching staff to ensure that what was planned on papers is practiced?

Competency based education is often based to the writings of B.F. Skinner. The student is asked to complete step by step criterion based instruction. When a student who successfully completes a competency based course, the instructor will be sure that they have a working grasp of certain minimum competencies. they may be better, but they will at least be this good. This is often found in prerequisite courses that require specific skills to advance to a higher course or in courses that lead to a specific job certification.

The UNESCO has a definition of competency-based curriculum in this reference:

http://www.ibe.unesco.org/en/glossary-curriculum-terminology/c/competency-based-curriculum

In essence, a competency-based curriculum is one that focuses upon what learners are expected to carry out rather than on what they are expected to know. I think that this approach produces applied scientists rather than mobile encyclopedias. IMHO, this seems to be a more apt approach.

Matthew Kerry comparto su respuesta bien concreta y sustanciosa. Me preocupa cuanto trabajamos en verdad los docentes para que los estudiantes logren alcanzar las competencias declaradas en esos planes de estudio.

En una investigación que hacemos defendemos que la competencia se define como: formas de actuación del sujeto que involucra una configuración compleja integrada por componentes cognitivos, meta-cognitivos, motivacionales y afectivos para abordar con desempeño deseable las soluciones a los problemas y situaciones que se demanden en contextos determinados . Tomando diferentes referentes (Tobón 2010, Barreto, Luis y Sanchez 2010, Gonzalez 2004, García y Perez 2019, Castellanos2003),

THANK YOU LOOURDES. I enclose a Google translation of your response.

"Matthew Kerry shared his very concrete and substantial answer. I am concerned about how much teachers really work for students to achieve the competencies declared in these curricula. In a research that we do, we defend that competence is defined as: ways of acting of the subject that involves a complex configuration composed of cognitive, meta-cognitive, motivational and affective components to approach with desirable performance the solutions to the problems and situations that are demanded in certain contexts. Taking different references (Tobón 2010, Barreto, Luis and Sanchez 2010, Gonzalez 2004, García and Perez 2019, Castellanos2003),"

I found this definition for competency-based curriculum: Competency-based medical education defined by Frank et al. as: “Competency-based education (CBE) is an approach to preparing physicians for practice that is fundamentally oriented to graduate outcome abilities and organized around competencies derived from an analysis of societal and patient needs. It deemphasizes time-based training and promises greater accountability, flexibility, and learner-centredness”

Frank JR, Mungroo R, Ahmad Y, Wang M, De Rossi S, Horsley T. Toward a definition of competency-based education in medicine: a systematic review of published definitions. Med Teach. 2010;32(8):631-637. DOI: 10.3109/0142159X.2010.500898

The manuscript looks interesting, I recommend reading the studies included in the review, however, I do not feel that what Frank et al is stating here covers the full truth about the definition of competency-based medical education.

I would like to open the discussion for critical evaluation of the definition of competency-based curriculum.

Competency based training and curriculum depends on the premise that there are specific measurable outcomes that students/trainees need to demonstrate. It has been most widely used in vocational education and training. It is not without problems largely related to the context in which an outcome is demonstrated. When I was working in the printing industry a competency might be defined as "produce a 4 colour process print job to enterprise standards and tolerances within industry acceptable time." The problem being that different enterprises produce different qualities of print so that the tolerances acceptable in one enterprise on one machine might not be acceptable in another on a different machine. And you may need more skill to achieve acceptable tolerances depending on what machine you are using regardless of the actual outcome, so putting in fixed tolerances doesn't solve the issue. However when trying to establish national consistency it is difficult if not impossible to take all these factors into consideration. So "competent" can mean different things.

Note that "competency" refers to the standard needed to perform a particular task. It doesn't differentiate between different levels of skill beyond that benchmark. This can be seen as either a strength or a limitation of the system. Employers will therefore look beyond a statement of competency to where it was achieved and the type of work done.

Another issue is how many times do you need to demonstrate something to be considered competent. A single time is probably not sufficient. In the Australian printing industry it was decided that at least two different tasks had to be assessed - but some in the industry were pushing for up to five. And competency should not just be about doing the job. The background knowledge that allows you to cope with problems and contingencies is also important. And a third factor is attitude. There is no point in knowing about something and even being able to do it if you don't actually do it. Workplace health and safety procedures is the classic case here.

So a competency based curriculum is one that leads to develop the knowledge, skills and attitude to demonstrate a particular operation to industry standards in several contexts.

It is useful in some contexts like vocational education and training but not necessarily suitable in all contexts.

Thank you Benjamin, you have added important points.

CanMEDS Physician Competency Framework is a useful resource to those in the medical field. I attach a copy.

This is an interesting discussion and one that I have, from time to time, been involved with at a residency training level as well as with medical students. I would like to throw into the "mix" the concept of milestones or a developmental aspect to competency-based education (e.g. you first have to sit before you stand and stand before you walk) and offer up the Core Entrustable Professional Activities for Entering Residency (EPAs) prepared for the Association of American Medical Colleges (AAMC).

Thank you Fredrick for your excellent contribution and the attached document.

Une compétence peut être également pensée dans le cadre de la Théorie Anthropologique du Didactique développée par Yves Chevallard.

On peut alors considérer que" ‘X a atteint la compétence C’ signifie que X sait accomplir certains types de tâches selon les techniques en vigueur dans l’institution dont il est le sujet, ces techniques étant justifiées ou produites par un savoir déterminé" (Artaud, 2016). Dans ce contexte, une même compétence peut évoluer au fil du cursus si de nouveaux types de tâches et de nouvelles techniques sont introduits. Je conçois alors un "competency-based curriculum" comme l'ensemble progressif des types de tâches et techniques qui sont apportés au fil du curriculum, leur organisation sous forme de compétences à atteindre, leur évaluation.

Thank you Thierry for your response. I have used Google Translation to make your response available to everyone in English.

"A skill can also be thought in the context of the Anthropological Theory of Didactic developed by Yves Chevallard. One can then consider that "'X has reached competence C' means that X knows how to perform certain types of tasks according to the techniques in force in the institution of which he is the subject, these techniques being justified or produced by a certain knowledge" ( Artaud, 2016). In this context, the same skill can evolve over the course of the curriculum if new types of tasks and new techniques are introduced. I then conceive a "competency-based curriculum" as the progressive set of types of tasks and techniques that are introduced throughout the curriculum, their organization in the form of skills to be achieved, their evaluation."

Right, thank you Samy !

I agree with you Thierry. As I conceptualize a competency-based curriculum, i place it in the setting of a developmental process similar to how children develop say in the first year of life from gaining head control and then beginning to discern different faces and respond to a smile with a smile then being able to roll over both ways, etc. on and so forth. I apologize for the child development reference, but I am a pediatrician. Thus, competency is both a journey as well as a destination with steps(benchmarks) along the way.

I am trying to trace a distinction made between competence, as a broader demonstration of knowledge, skills and and attitudes, and competency as more specific skills, in the context of curriculum, particularly in higher education. My brief scan of the literature seems to suggest that competencies are more common in professions such as medicine, nursing and even teacher training. However, recent studies appear to use the term competency-based curriculum than competence-based curriculum. In terms of this distinction, and particularly because of the trend to refer to competency-based curriculum, I can neither trace the theoretical basis for the preference for either. Can anyone shed some light?

With the failure of the 8-4-4 Programme, we in Kenya are currently rolling out Competency Based Curriculum up to Primary 3, and the debate is so fiery between the Ministry of Education and Teachers' Union. I keep wondering the difference between the curricula for "the compent" and for "the gifted". Do they both think like geniuses ? Where will others not in that bracket be placed in the education system/s ?

CBC lays emphasis on the practicality of learning, where the central focus is the learner not the teacher being a 'robot' that lectures passive students. As Schulman notes, it is not what the teachers know but how do they deliver what they know to the students? In essence therefore pedagogical content knowledge is not enough. The CBC seeks to put learners interest first.

Fredrick A Mccurdy Thank you for the attached document. A very good reference and a clear track for the medical teachers to understand what is expected of a student' entering residency. Each EPA has a milestones as you mentioned in your comment "sit before u stand" .....who will decide the milestones and the related knowledge, skill and attitude for each EPA and the required assessment strategy...especially at the basic sciences level in an integrated system based curriculum...what will be the contribution of basic medical sciences to the program competency and how will it be incorporated in the EPAs? I mean will it not be more easier if even the milestones in the EPAs are defined by experts reaching down to the year one of medicine? or do we have some thing already available in the literature? Will highly appreciated help and advice in this regard..Thank you

Thank you all for your response and your contribution.

And Thank you Sam for raising the topic and Frederick for the document and everyone for the engaging exchanges. The Nursing Education profession here in Lesotho started implementing the CBC ahead of most higher education professions and some of their challenges are instructive. The main challenge remains how to support curriculum implementers to take up CBC's underlying principles of focusing on what the learner's interests, the learning process and the mastery of knowledge, skills and attitudes are rather than the teacher's knowledge, the contact time spent with the teacher and the coverage of the content. A key indicator of this underlying challenge is that while the curriculum documents are now expressed in terms of outcomes/competencies of learning, the practices and particularly the assessment approaches remain superficial at best.

These challenges are not new in curriculum reform as we experienced the same challenge when the Learner-Centred Curriculum was being introduced in South Africa where teacher's take up was generally in 'form' rather than in 'substance' (Cuban, 1998 in Brodie, Lelliot & Harris, 2002).

Your words are very real, dear, and I completely agree with You. All the curricula focus on learning outcomes or goals. As for the curriculum based on competencies, it focuses on reaching the student to the highest level of experience and competence according to his various capabilities.

Hello

Read this maybe help you

Banerjee, A. (2020). Coaching classes… competency-based curriculum… bed of procrustes… deck chairs on the Titanic. Medical Journal of Dr. DY Patil Vidyapeeth, 13(1), 1.

Ingrid García

First, you would have to differentiate competence as a noun from the competition as an adjective to ask yourself what it is to be competent. Secondly, you must ask yourself if what you want to train are a competitive and individualistic human being or a caring and collaborative human being.

Dear Prof. Samy,

https://unesdoc.unesco.org/ark:/48223/pf0000250431

Thanks Thabiso Nyabanyaba .