Lost in translation? How context shapes the implementation of Competence by Design in operative settings.

Background: Given the complexity of the transition to competency-based medical education (CBME) and the diversity of systems and learning contexts, the literature has acknowledged the need for principled yet contextual approaches to implementation. There is a need for research that examines these adaptations and their consequences, both intended and unintended.

Methods: We performed a constructivist grounded theory study to explore how the theory of CBME translated to practice in operative settings in a Canadian approach to CBME: Competence by Design (CBD).

Fixing disconnects: Exploring the emergence of principled adaptations in a competency-based curriculum.

Purpose: Competency-based medical education (CBME) promises to improve medical education through curricular reforms to support learner development. This intention may be at risk in the case of a Canadian approach to CBME called Competence by Design (CBD), since there have been negative impacts on residents. According to Joseph Schwab, teachers, learners and milieu must be included in the process of curriculum-making to prevent misalignments between intended values and practice.

"The Most Crushing Thing": Understanding Resident Assessment Burden in a Competency-Based Curriculum.

Background: Competency-based medical education (CBME) was expected to increase the workload of assessment for graduate training programs to support the development of competence. Learning conditions were anticipated to improve through the provision of tailored learning experiences and more frequent, low-stakes assessments. Canada has adopted an approach to CBME called Competence by Design (CBD).