Competency-based training
in the Netherlands
Professor Gerrit Glas MD PhD
Liesbeth Vleugel MD
[email protected]
[email protected]
Het opleidingsplan: de theorie
Competency-based training in the Netherlands
EH
Overview
• Introduction: why competency-based
learning ?
• What is competency-based learning?
• ‘Building’ a training programma.
Competency-based learning: competence as a concept
Competency-based training in the Netherlands: why ?
• Government initiatives
– Rearrangement of the landscape of professions
– Emphasis on demand-side instead of supply side
– Shortening length of medical specialist training
• Science of teaching
– Approaches of the initial professional education (MD)
applied to medical specialist training (problem oriented
teaching; homework assignments; discussion;
reflection on learning process)
• Transfer of responsibility
– Trainee is responsible for his/her own learning process
– Preparation for ‘life-long learning’ (education
“Competence is the habitual and judicious use of
communication, knowledge, technical skills,
clinical reasoning, emotions, values, and
reflection in daily practice for the benefit of the
individual and community being served.”
R.M. Epstein & E.M. Hundert, JAMA, Vol 287 (2002), 226-235.
Competency-based learning: competence as a concept
‘Mindful practice’
Het opleidingsplan: de theorie
EH
Het opleidingsplan: de theorie
• Knowledge and skills of the profession • Patient, family and professionals
• Evidence-based medicine; teaching; informing the public; participation in research
• Colleagues and health providers within and outside the hospital/clinic
• Appropriate working with others; optimization of health logistics
• Prevention; knowledge / application of legislation; risk management; dealing with adverse events • Ethics; reflection; knowledge of own limitations
Competencies of the medical specialist
Based on CanMEDS: 7 competency areas, each with 4 specified competencies
• Medical • Communication • Scholarly attributes • Collaboration • Organisational knowledge • Health advocacy • Professional behaviour
Competency area relates to:
Het opleidingsplan: de theorie
Some examples of general competencies
Medical
the specialist has state of the art knowledge and
skills
Communication
the specialist creates effective diagnostic and
treatment relations with patients
Collaboration
the specialist refers/transfers adequately
Organisation
the specialist works effectively and efficiently
within a health care organisation
Health advocate
the specialist works according to the relevant
legislation
Scholarly attributes
the specialist contemplates medical information
critically, encourages expertise development of
students, colleagues, etc.
Professional
the specialist shows awareness of his/her own
competencies and limitations
EH
Het opleidingsplan: de praktijk
Het opleidingsplan: de theorie
Het opleidingsplan: de theorie
The Training Programme: Legislation
Legislation
Competencies of the
specialist
Profile of the specialism
Het opleidingsplan: de theorie
The Training Programme: Profile of the Specialism and Competencies
Profile of the specialism
Het opleidingsplan: de theorie
The Training Programme: the Foundation
The competencies of the specialist
The capacity to perform, in an adequate way, a professional activity in a specific, authentic context through integration of knowledge, skills and attitude
Global picture of the profession and its position in health care, now and in the years to come
Het opleidingsplan: de theorie
The Training Programme: Themes, Operationalised competencies, Assessment
Themes Operationalisedcompetencies Assessment Competencies of the specialist
Profile of the specialism
Themes: • Activities which belong together/ recognizable parts of the training
• Arrangement of the training programme on the basis of the work of the medical specialist
Het opleidingsplan: de theorie
The Training Programme: the Work as Point of Departure
Operationalised competencies
Assessment
• Competencies made explicit within the context of the training programme
• Knowledge, skills and attitudes which the trainee attains in the course of the training
• Description of a vision and the starting points of a programme of assessment
• Assessment methods
Het opleidingsplan: de theorie
The Training Programme: Themes: general view versus details
Vision of the training programme on assessment
• Why do you want to assess? • What do you want to assess?
• How much do you want to assess? • When do you want to assess?
• Who does the assessment?
• Which instruments do you want to use?
Het opleidingsplan: de theorie
The Training Programme: Assessment
Developmental focus: formative Selection focus: summative Why assessment?
Het opleidingsplan: de theorie
The Training Programme: Assessment Philosophy
Wat toetsen? Knowledge, skills, attitude, competencies When assessment? Dependent on objectives and content:
before, during, after completed training, before, during, after practical work
Who does the assessment
Dependent on objectives and content; trainee, fellow trainee, director of training, supervisor, nurse, patiënt…..
What has to be assessed?
Het opleidingsplan: de theorie
The Training Programme: Training Method, Activities and Material
Training method Training activities Training material
Themes Operationalisedcompetencies Assessment Competencies of the specialist
Profile of the specialism
Legislation
Training method Philosophy about training: how do we want to train? Principles of training of professionals and of
competency-based training
Het opleidingsplan: de theorie
The Training Programme: Training Method, Activities and Material
Training activities
Training material
Learning clinical medicine in workplaces/courses/self
What material do we need for training activities to be effective?
• Stimulating work and learning climate
• Experience-based learning: competency development on the basis of previous experiences
• Rolmodelling and coaching (feedback)
• Reflection on and insight in own competencies • Increasing responsibility and independence
• Individual adaptation of the training scheme on the basis of portfolio • Opportunities to study and train with e.g. modern media (e-learning,
virtual reality, skillslab, training courses) According to the principles of
learning by professionals
Het opleidingsplan: de theorie
Training activities:
patient reporting journal clubs teaching round out patient clinic patient round consultations
mortality/morbidity review multidisplinary conferences
structured series of conferences OR
teaching ……….
Het opleidingsplan: de theorie
The Training Programme: the Training Activities
Het opleidingsplan: de theorie
The Training Programme: Quality control
Training method Training activities Training material
Themes Operationalisedcompetencies Assessment Competencies of the specialist
Profile of the specialism
Legislation Quality control: • Training process • Check on legislation • Professionalizing trainers and trainees • Research of education
• visitation • internal audit
• professionalizing trainers and trainees • (participation) in research of education • ………
Quality control
Het opleidingsplan: de theorie
The Training Programme: Quality control
Profile of the specialism
The competencies of the specialist Themes Operationalised competencies Assessment philosophy methods programme Educational method Educational activities Educational material Quality control educational process legislation check
professionalizing trainees and trainers research of educational process
Checklist training programme:
Het opleidingsplan: de theorie
The Training Programme: in Practice
Training method Training activities Training materialThemes Operationalisedcompetencies Assessment Competencies of the specialist
Profile of the specialism
Legislation Quality control: • Training process • Check on legislation • Professionalizing trainers and trainees • Research of education
