Competency and Its Many Meanings

AIFM-ed Curriculum Framework for Postgraduate Family Medicine Education on Artificial Intelligence: Mixed Methods Study

BACKGROUND

As health care moves to a more digital environment, there is a growing need to train future family doctors on the clinical uses of artificial intelligence (AI). However, family medicine training in AI has often been inconsistent or lacking.

OBJECTIVE

The aim of the study is to develop a curriculum framework for family medicine postgraduate education on AI called "Artificial Intelligence Training in Postgraduate Family Medicine Education" (AIFM-ed).

METHODS

First, we conducted a comprehensive scoping review on existing AI education frameworks guided by the methodological framework developed by Arksey and O'Malley and Joanna Briggs Institute methodological framework for scoping reviews. We adhered to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist for reporting the results. Next, 2 national expert panels were conducted. Panelists included family medicine educators and residents knowledgeable in AI from family medicine residency programs across Canada. Participants were purposively sampled, and panels were held via Zoom, recorded, and transcribed. Data were analyzed using content analysis. We followed the Standards for Reporting Qualitative Research for panels.

RESULTS

An integration of the scoping review results and 2 panel discussions of 14 participants led to the development of the AIFM-ed curriculum framework for AI training in postgraduate family medicine education with five key elements: (1) need and purpose of the curriculum, (2) learning objectives, (3) curriculum content, (4) organization of curriculum content, and (5) implementation aspects of the curriculum.

CONCLUSIONS

Using the results of this study, we developed the AIFM-ed curriculum framework for AI training in postgraduate family medicine education. This framework serves as a structured guide for integrating AI competencies into medical education, ensuring that future family physicians are equipped with the necessary skills to use AI effectively in their clinical practice. Future research should focus on the validation and implementation of the AIFM-ed framework within family medicine education. Institutions also are encouraged to consider adapting the AIFM-ed framework within their own programs, tailoring it to meet the specific needs of their trainees and health care environments.

Re-Envisioning Global Health Competencies for the African Region Aligned with Local Health Needs and Resources

Background:

While many Global Health programs aim to address health inequalities within and between HICs and low- and middle-income countries (LMICs) there is a need to establish new Global Health academic programs within the growing trend towards ‘internationalization of higher education’.

Objective:

This study was undertaken to re-envision Global Health competencies for the African region context with respect to the local health needs and availability of resources.

Methods:

This study was undertaken over a period of four years from 2017 till 2020. A three-pronged strategy was undertaken to scan, scope, distil and develop a set of Global Health domains and competencies for the African region. Strategy 1 encompassed an environmental scan of Global Health competencies (2017–2019), and a literature review (2017–2020); strategy 2 comprised a scoping of education programs in Global Health (2018–2019); and strategy 3 involved an interest-group discussion in a face-to-face conference.

Findings:

Seven core and four cross-cutting global health competency statements were developed for the African region. The core competency statements included following domains: global health systems and international relations; global evidence ecosystem; role of international organizations; universal health issues; intellectual property rights; responses to issues affecting different at-risk groups; local, national, and international policy and economic context affecting global health. The four cross-cutting competency statements included following domains: digital and academic literacies; quantitative and qualitative research; policy and funding allocation resources; ethical conduct of global health practice and research global health.

Conclusion:

There is a need to enable higher education institutions (HEIs) from the Global South to offer global health qualifications with a set of competencies that better approximate solutions to contextualised problems – not only to students from the Global South but also from the Global North. The global health competencies developed in this research study will enable African HEIs to offer global health education in a more pragmatic manner.

Validity evidence for summative performance evaluations in postgraduate community pharmacy education

INTRODUCTION

Workplace-based assessment of competencies is complex. In this study, the validity of summative performance evaluations (SPEs) made by supervisors in a two-year longitudinal supervisor-trainee relationship was investigated in a postgraduate community pharmacy specialization program in the Netherlands. The construct of competence was based on an adapted version of the 2005 Canadian Medical Education Directive for Specialists (CanMEDS) framework.

METHODS

The study had a case study design. Both quantitative and qualitative data were collected. The year 1 and year 2 SPE scores of 342 trainees were analyzed using confirmatory factor analysis and generalizability theory. Semi-structured interviews were held with 15 supervisors and the program director to analyze the inferences they made and the impact of SPE scores on the decision-making process.

RESULTS

A good model fit was found for the adapted CanMEDS based seven-factor construct. The reliability/precision of the SPE measurements could not be completely isolated, as every trainee was trained in one pharmacy and evaluated by one supervisor. Qualitative analysis revealed that supervisors varied in their standards for scoring competencies. Some supervisors were reluctant to fail trainees. The competency scores had little impact on the high-stakes decision made by the program director.

CONCLUSIONS

The adapted CanMEDS competency framework provided a valid structure to measure competence. The reliability/precision of SPE measurements could not be established and the SPE measurements provided limited input for the decision-making process. Indications of a shadow assessment system in the pharmacies need further investigation.

Rethinking Competence: A Nexus of Educational Models in the Context of Lifelong Learning

Competency-based education (CBE) “derives a curriculum from an analysis of a prospective or actual role in modern society and attempts to certify students’ progress on the basis of demonstrated performance in some or all aspects of that role”. This paper summarizes pertinent aspects of existing CBE models in health professions education; pharmacy education presented as an example. It presents a synthesis of these models to propose a new diagrammatic representation. A conceptual model for competency-based health professions education with a focus on learning and assessment is discussed. It is argued that various elements of CBE converge to holistically portray competency-based learning and assessment as essential in initial education and relevant to practitioners’ continuing professional development, especially in the context and importance of pursing lifelong learning practices.

Competency (and Beyond): Think Patient. Collaborate. Develop. Evaluate. Improve. Repeat

The global workforce needs to be competent, flexible, adaptable, sustainable, and patient-focused. A competency approach towards education, development, and professional practice strengthens services and increases better health outcomes. This paper will provide a global perspective on competency approaches from different health care professions. It will focus on two case reports, describing the use of competency methodologies at an undergraduate and postgraduate level, as well as supporting the internship and/or pre-registration training. Challenges and opportunities will be highlighted by addressing some of the key questions posed for this special edition.