What is it about?
Continuous improvements in competencies-oriented curricula require the careful alignment of course objectives with outcomes metrics. In this study the authors introduced the use of aggregated, student derived confidence estimates reflecting their ability to perform specific tasks as feedback by which faculty might initiate improvements in course work designed to support the development of task-specific competencies. The findings of this six year study reveal that year over year improvements in the students' aggregated confidence estimates were achieved by faculty-mediated efforts to continually improve their students' ability to competently performing the specific tasks addressed by their course work.
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Why is it important?
The attainment of clinical competencies requires evidence. Unfortunately, medical education has yet to develop psychometrically reliable and valid approaches to the assessment of presentation and task-specific competencies. The work described herein provides an interim methodology by which training programs might work towards competencies based improvements in their curricular offerings.
Perspectives
Unfortunately, many in medical education will dismiss the findings in this report because estimates of confidence have long been seen as unreliable if not misleading metrics. We encourage interested readers to suspend any such beliefs and simply consider the CQI challenge articulated by the authors. That is, the implementation, if not the optimization of a competencies curriculum requires presentation and task-specific assessments of competence. Such assessments are logistically difficult to develop. The confidence metrics used in this study represent an effort to move forward with a competencies oriented curriculum despite logistically difficult assessment hurdles.
Frank Papa
University of North Texas Health Science Center
Read the Original
This page is a summary of: Aggregated student confidence estimates support continuous quality improvements in a competencies-oriented curriculum, BMJ Open Quality, March 2019, BMJ,
DOI: 10.1136/bmjoq-2018-000398.
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