Competence by Design: The Role of High-Stakes Examinations in a Competence Based Medical Education System.

Competency based medical education is developed utilizing a program of assessment that ideally supports learners to reflect on their knowledge and skills, allows them to exercise a growth mindset that prepares them for coaching and eventual lifelong learning, and can support important progression and certification decisions. Examinations can serve as an important anchor to that program of assessment, particularly when considering their strength as an independent, third-party assessment with evidence that they can predict future physician performance and patient outcomes. This paper describes the aims of the ("the Royal College") certification examinations, their future role, and how they relate to the Competence by Design model, particularly as the culture of workplace assessment and the evidence for validity evolves.

Moving away from medicines: an overview of chronic pain management.

Chronic pain can be debilitating and affects an increasing number of people in the UK due to an ageing population and the rising prevalence of comorbidities. Chronic pain can be primary, where it is not accounted for by another condition, or secondary, where it results from an underlying condition or injury. The National Institute for Health and Care Excellence has published updated guidance on the assessment and management of chronic pain in adults.