Competency model for dentists in China: Results of a Delphi study.

OBJECTIVE: With the increasing awareness of the importance of oral health, patients have an increasing need for integrated care from dentists. In China, the dentistry examination consists of two parts: a practical skills examination and a comprehensive medical examination; to date, no assessment methods that are based on specialized dentistry competencies, unlike the United States, Canada, and other countries, have been established. Therefore, the purpose of this study was to construct a competency model for dentists in China in order to guide the development, admission, training and assessment of dentists. METHODS: Using a literature review, focus group interviews and in-depth personal interviews, a dentist competency index was developed with an expert consultation questionnaire. A panel of 20 specialist experts was chosen from ten national medical universities to carry out two rounds of Delphi expert analysis, using the boundary value method to filter the indicators and the Analytic Hierarchy Process to calculate the weights of the primary indicators. RESULTS: Two rounds of Delphi results showed that the expert authority, enthusiasm, and coordination coefficients were high. Constructs of the competency model that included seven primary indicators and 62 secondary indicators determined the weight of each index. The seven primary indicators included the following: clinical skills and medical services, disease prevention and health promotion, interpersonal communication skills, core values and professionalism, medical knowledge and lifelong learning ability, teamwork ability and scientific research ability. CONCLUSION: In conclusion, the use of the Delphi method to construct an initial model of Chinese physician competency is scientific and feasible. The initial competency model conforms to the characteristics and quality requirements of dentists in China and has a strong scientific basis. The dentist competency model should be used in the National Dental Licensing Examination in China.

What Regulatory Requirements and Existing Structures Must Change If Competency-Based, Time-Variable Training Is Introduced Into the Continuum of Medical Education in the United States?

As competency-based medical education is adopted across the training continuum, discussions regarding time-variable medical education have gained momentum, raising important issues that challenge the current regulatory environment and infrastructure of both undergraduate and graduate medical education in the United States. Implementing time-variable medical training will require recognizing, revising, and potentially reworking the multiple existing structures and regulations both internal and external to medical education that are not currently aligned with this type of system. In this article, the authors explore the impact of university financial structures, hospital infrastructures, national accrediting body standards and regulations, licensure and certification requirements, government funding, and clinical workforce models in the United States that are all intimately tied to discussions about flexible training times in undergraduate and graduate medical education. They also explore the implications of time-variable training to learners' transitions between medical school and residency, residency and fellowship, and ultimately graduate training and independent practice. Recommendations to realign existing structures to support and enhance competency-based, time-variable training across the continuum and suggestions for additional experimentation/demonstration projects to explore new training models are provided.

[Competence-based assessment in the national licensing examination in Germany]. / Kompetenzorientiert prüfen im Staatsexamen Medizin.

In Germany, future physicians have to pass a national licensing examination at the end of their medical studies. Passing this examination is the requirement for the license to practice medicine. The Masterplan Medizinstudium 2020 with its 41 measures aims to shift the paradigm in medical education and medical licensing examinations.The main goals of the Masterplan include the development towards competency-based and practical medical education and examination as well as the strengthening of general medicine. The healthcare policy takes into account social developments, which are very important for the medical education and licensing examination.Seven measures of the Masterplan relate to the realignment of the licensing examinations. Their function to drive learning should better support students in achieving the study goal defined in the German Medical Licensure Act: to educate a medical doctor scientifically and practically who is qualified for autonomous and independent professional practice, postgraduate education and continuous training.

Visions and reality: the idea of competence-oriented assessment for German medical students is not yet realised in licensing examinations.

Objective: Competence orientation, often based on the CanMEDS model, has become an important goal for modern curricula in medical education. The National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM) has been adopted in Germany. However, it is currently unknown whether the vision of competence orientation has also reached the licensing examination procedures. Methods: Therefore, a prospective, descriptive, single-centre, exemplary study design was applied to evaluate 4051 questions/tasks (from 28 examiners at 7 two-day licensing oral-practical exams) for undergraduate medical students at the University of Ulm. The oral and practical questions/tasks as well as the real bedside assessment were assigned to specific competence roles (NKLM section I), categories (NKLM section II) and taxonomy levels of learning domains. Results: Numerous questions/tasks were set per candidate (day 1/2: 70±24/86±19 questions) in the licensing oral-practical exam. Competence roles beyond the "medical expert" were scarcely considered. Furthermore, practical and communication skills at the bedside were hardly addressed (less than 3/15 min). Strikingly, there was a significant predominance of questions with a low-level taxonomy. Conclusions: The data indicate a misalignment of competence-oriented frameworks and the "real world" licensing practical-oral medical exam, which needs improvement in both evaluation and education processes.

[Competence-based catalogue of learning objectives for conducting medical consultations]. / Kompetenzbasierter Lernzielkatalog ¼Ärztliche Gesprächsführung« .

ISSUE: In 2012 the German medical licensure regulations (Approbationsordnung) made teaching and assessing the conduction of medical consultations a mandatory part of medical education. A catalogue of learning objectives (LO) based on existing references was developed to assist medical schools in meeting this requirement. METHODS: A body of relevant material was compiled using literature research and surveying experts. Then, in a multiphase Delphi process, this was evaluated and condensed by an interdisciplinary working group in dialogue with external (clinical) experts. Competence levels and examples of clinical application were assigned to enhance implementation. The catalogue was revised by the medical faculties, professional associations and the BVMD. RESULTS: This learning catalogue comprised 116 learning objectives for the specific skills necessary to conducting medical consultations as well as exemplary application contexts. The catalogue proved to be practical in terms of developing curricula and networking at medical schools. DISCUSSION: This catalogue of learning objectives can serve as the basis for developing a sample communication curriculum for use by medical faculties.

Competence-based curricula for the education of speech-language pathologists and audiologists in Brazil.

OBJECTIVE: The aim of this paper is to present the academic requirements for the education of speech-language pathologists (SLPs) and to discuss some of the challenges in providing quality supervised practice and the solutions proposed by some programs in Brazil. METHODS: Brazilian proposals regarding the training of SLPs are reviewed, with guidelines provided by the International Association of Logopedics and Phoniatrics (IALP) and the Comité Permanent de Liaison des Orthophonistes-Logopèdes de l'UE (CPLOL), and descriptions of the specific experience of the oldest Brazilian program are provided. RESULTS: The bachelor's degree is the minimum level required for the independent practice of speech-language pathology and audiology in Brazil, where there are 75 undergraduate programs. In several programs, students are encouraged to enjoy the diversity at their university, enrolling in courses of different areas to broaden their experience. The basic areas of the undergraduate program are mandatory as per recommendation of the Ministry of Education and include competences related to the health system, decision making, communication, leadership and continued education. Since practice training is part of the undergraduate programs, it is incorporated into the pedagogical concept and has a major role in it. CONCLUSION: The structure of the programs allows the dissociation of theory from practice to be attenuated; both educational strategies are used together as part of the pedagogical concept.

The Australian General Practice Training program--reflections on the past decade.

How has general practice vocational training progressed towards the original goals established by the federal government and General Practice Education and Training 10 years ago?

The evolution of general practice training in Australia.

Training for general practice in Australia has undergone a 60-year evolutionary process punctuated by revolutionary events. The discipline of general practice has also evolved significantly over this period. Today's Australian general practice training program strongly resembles its ancestors, with adaptations that better suit its regionalised environment. General practice training has been affected frequently by political and professional forces. Many of these forces were powered by the government's need for general practice training to deliver immediate workforce solutions, and the profession's struggle to respond. Pressure on general practitioners to train increasing numbers of clinical learners is challenging traditional apprenticeship models. The Australian general practice training program needs to continue to evolve if it is to remain successful within its volatile environment.

Making the transition to postsecondary education and training.

A nationally representative sample of youth with disabilities who recently exited high school was studied to determine the participation of the youth in postsecondary educational programs. The results show that youth with disabilities participate in postsecondary programs at only one-quarter the rate attained by their counterparts without disabilities and at only one-third the rate attained by economically disadvantaged youth. The relationship of postsecondary education for youth with disabilities to long-term success in employment is yet to be determined.