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  • Title: Impact of a competency-based curriculum on medical student advancement: a ten-year analysis.
    Author: Brokaw JJ, Torbeck LJ, Bell MA, Deal DW.
    Journal: Teach Learn Med; 2011; 23(3):207-14. PubMed ID: 21745054.
    Abstract:
    BACKGROUND: In 1999, the Indiana University School of Medicine implemented a new curriculum based on the attainment of core competencies beyond medical knowledge. PURPOSE: The objective was to document how the Student Promotions Committee (SPC) has adjudicated students' competency-related deficiencies over the past decade. METHODS: Using SPC records, the authors determined the frequency of competency-related deficiencies reported to the SPC over time, the nature of those deficiencies, and how the deficiencies were remediated. For the purposes of this study, traditional knowledge-related deficiencies like course failures were excluded from analysis. RESULTS: From 1999 to 2009, 191 students (138 male, 53 female) were referred to the SPC for competency-related deficiencies in 8 performance domains involving communication, basic clinical skills, lifelong learning, self-awareness, social context, ethics, problem solving, and professionalism. By comparison, 1,090 students were referred to the SPC for knowledge-related deficiencies during this time. Collectively, the 191 students were cited for 317 separate competency-related deficiencies (M ± SD = 1.7 ± 1.3; range = 1-10). Of these 317 deficiencies, the most prevalent were in the competencies of professionalism (29.3%), basic clinical skills (28.4%), and self-awareness (17.7%). Each of the remaining competencies constituted less than 10% of the total. Successful remediation utilized 12 methods ranging from a simple warning letter to repeating the year under close monitoring. Remediation was unsuccessful for 17 students (8.9%) who were dismissed from medical school primarily due to unprofessional behaviors and poor self-awareness. CONCLUSIONS: Competency-related deficiencies can be identified and remediated in most cases, but deficiencies in professionalism and self-awareness are especially challenging.
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