For the past 100 years, residency education has been centered around a time based education, focused on participating in a particular number of cases and surgeries to reach an appropriate level of competence and skills. Nowadays medical education is undergoing a substantial change. Due to higher awareness that increasing patient safety requires limiting procedures and exposure, the higher complexity of medical knowledge within each specialty, and the higher demand to demonstrate the development of higher competence standards leads to a change in thinking.

The Royal College of Physicians and Surgeons of Canada (RCPSC) has identified that there is emerging evidence suggesting training methods may be improved and should be changed. RCPSC expressed the outcome of medical training in terms of seven ‘roles’ of a physician and developed competency framework based on these – the Canadian Medical Education Directions for Specialists (CanMEDS)[1] . These roles are: medical expert, communicator, collaborator, leader, health advocate, scholar and professional.

More medical schools follow this way and are changing their way of traditional learning and the time-based learning system toward a competency-based education focusing on accountability, learning outcomes, curriculum organised around competencies and a learner-centered approach. In competency-based medical education observable abilities that integrates knowledge, skills, values, and attitudes are prioritised over the measurement of knowledge alone. Education is focused on patient outcomes, emphasises learner abilities and increases individualised trainee plans for the learner. [2] Specifically this means that physicians will complete their medical education by reaching key milestones regarding their knowledge as a medical expert but also by showing their skills in other domains including communication, collaboration, health advocacy, ethics and practice management.

The shift from time- to competency-based education is challenging. It requires valid and reliable assessment tools, assessment of learners throughout the whole learning process, commitment of the faculty and the determination of competencies which are necessarily complex. The implementation of CBME also requires a process of quality feedback with ongoing program evaluation to provide important feedback loops, accreditation to monitor the resident experience and setting standards for institutions to follow [3].

Within the framework of the European Erasmus project “Professional Profile of the Surgical Trainer: Train-the-Trainer Curricula (SurgTTT) a European requirement profile and curriculum for the pedagogical and didactic training of surgeons to become surgical trainers has been developed and will be tested. Based on the above mentioned seven roles of a pysician the developed curriculum includes the following modules: concept of competency-based medical education, development of human resources, planning of educational programs/events, microteaching, e-Learning, training of modern surgical technologies, feedback and assessment, which are available as e-Learning modules. Each module gives you background information on the topic together with the learning objectives and suggested activities to be carried out in the workplace.

[2] Frank, J.R., Snell, L., ten Cate, O., Holmboe, E.S., Carraccio, C., Swing, S.R., et al. Competency-based medical education: theory to practice. Medical Teacher 2010; 32(8):638-645

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