How to Implement Competency-Based Learning in Your Healthcare Classrooms 

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Competency-based learning is redefining healthcare education by shifting the focus from hours spent in the classroom to a more holistic, blended approach.  

By blending traditional lectures with an emphasis on mastery of practical skills, competency-based education is tailored to individual learning needs, allowing learners to progress as they demonstrate readiness rather than strictly adhering to time-based milestones. 

However, the potential of competency-based learning to enhance educational outcomes, broaden access, and even reduce the time it takes to graduate depends on successful implementation.  

Today, we’re discussing how to implement competency-based learning in healthcare. But first, a quick refresher on what competency-based learning is. 

What is Competency-Based Learning?

Competency-based learning (CBL) is an approach to education in which students progress based on their demonstrated mastery of specific competencies.  

Unlike traditional education based on time spent in the classroom and rubric-based milestones, CBL is focused on learning outcomes. Instead, students learn at their own pace, only moving on from one competency when they have successfully demonstrated their proficiency. 

Competency-based learning is also quite effective.  

Not only has CBL been shown to result in higher post-test scores — including when students believed the traditional classroom experience to be better — it’s often quicker. In a pilot by the University of Toronto’s orthopedic residency program, students enrolled in the CBL track graduated earlier than those enrolled in the standard five-year program. 

Securing Buy-In from Curriculum Managers to Incorporate CBL

While CBL has many benefits for learners, educators, and the broader healthcare system, its success depends on its implementation.  

Getting buy-in from faculty and curriculum managers to incorporate competency-based education is a must, making it essential that you: 

  • Gather evidence of its effectiveness to build a strong case for competency-based learning. A growing body of research supports the use of CBL in healthcare education. Be sure to share this research with curriculum managers and explain how CBL can benefit their students. 
  • Be prepared to answer questions and address concerns. Curriculum managers may be concerned about the feasibility of implementing CBL or its impact on their students. Faculty members who are used to how things are now may seek out flaws in past executions of CBL to make the case against it. And so on. You might consider drafting up talking points addressing likely concerns. 
  • Be patient and make every effort to understand where objections are coming from. Faculty may need time to warm up to a new approach, and change is often slow in higher ed. Be patient but persistent. Listen carefully and consider where objections are coming from. Is it fear of change? Complacency? Concern about outcomes? Knowing that will help you to tailor your message. 

In the next few sections, we’ll examine the mechanics of competency-based education more closely, ensuring you’re well-prepared to address common questions and objections you may encounter. 

How Competencies Are Assessed in Healthcare Training Settings

One common concern among holdouts is that CBL is more loosely defined and, therefore, somehow less rigorous. That couldn’t be any further from the truth. With CBL, it’s not enough to be able to answer questions on a test; students must be able to show that they can safely apply that knowledge in practice. 

Unlike traditional classrooms, in which standardized tests are the norm, competencies are typically assessed through a variety of methods, including: 

  • Direct Observation and Simulation: Students are observed performing tasks in clinical or simulation settings to ensure they can apply skills in realistic scenarios. Medical manikins and other patient simulators enable students to practice and refine their skills in a safe, controlled environment. 
  • Patient Encounters: Students interact with actual patients under a preceptor’s supervision, testing clinical and interpersonal skills crucial for patient care. 
  • Objective Structured Clinical Examinations (OSCEs): These tests involve a series of clinical stations where students must demonstrate their ability to perform specific tasks within time constraints, ensuring competency in high-pressure situations. 

Further expanding on traditional methods, CBL can also involve innovative assessment techniques for students, educators, and curriculum developers, such as: 

  • Workplace-Based Assessments (WBAs): Used extensively in postgraduate medical education, these assessments involve tools like mini-CEX (clinical evaluation exercises), direct observation of procedural skills (DOPS), and multisource feedback, providing a comprehensive evaluation of a trainee’s performance from multiple perspectives, including peers, patients, and supervisors. 
  • Simulation-Based Summative Assessment: Beyond training, simulation is used for high-stakes testing, assessing decision-making and procedural skills in critical scenarios to confirm students’ abilities to apply their knowledge effectively. 
  • The Delphi Method for Competency Validation: The Delphi model engages experts to reach a consensus on essential competencies, ensuring the relevancy and rigorous assessment of skills before they are implemented in educational programs. 
  • Competency Frameworks Development: This methodical approach identifies necessary competencies within specific practice contexts, starting broadly and refining through ongoing expert consultation. 

5 Effective Strategies for Teaching Competencies In Healthcare Education

Healthcare instructors can effectively implement competency-based learning by integrating a mix of interactive and practical teaching methods tailored to developing specific skills and knowledge areas.  

Here’s are five ways instructors can teach to competencies: 

  1. Problem-Based Learning (PBL): Engage students with real-world problems that require them to apply their knowledge to develop viable solutions collaboratively. This method encourages critical thinking and problem-solving skills. 
  1. Case-Based Learning: Utilize detailed case studies that reflect actual patient scenarios. Instructors can guide discussions and decision-making processes, helping students to connect theoretical knowledge with clinical reasoning and patient care. 
  1. Clinical Simulation: Implement state-of-the-art simulations using manikins and patient simulators to mimic clinical situations. This hands-on approach allows students to practice and hone their skills in a controlled but realistic environment. 
  1. Real Patient Interactions: Provide structured clinical experiences where students interact with patients under close supervision. This direct exposure is crucial for developing patient communication, assessment, and management competencies. 
  1. Continuous Skill Development: Provide instructors with ongoing opportunities to enhance their teaching skills. This can include professional development through workshops, webinars, and conferences focused on the latest educational strategies and technologies. 

Supporting Instructor Transition to CBL

Transitioning to competency-based education requires thoughtful planning and support for instructors. Institutions should provide clear guidelines on competency frameworks and assessment criteria. Regular training sessions can help instructors adjust their teaching strategies and assessment methods to align with competency-based objectives. 

Examples of How to Implement Competency-Based Teaching and Learning in a classroom or Simulation Setting

In a classroom Setting

To successfully implement CBL in a classroom setting, educators should: 

  • Develop Clear Learning Objectives: Start by defining clear, competency-aligned learning objectives that detail the skills and knowledge students must acquire. 
  • Include Diverse Teaching Methods: Employ a mix of teaching methods such as lectures, group discussions, and interactive activities to cater to various learning styles and reinforce the practical application of theoretical knowledge. 
  • Regularly Assess Learner Progress: Use formative assessments to monitor student progress and provide timely feedback regularly. This helps ensure students master each competency before moving on to the next. 

In a Simulation Setting

Simulation settings offer unique opportunities for applying CBL in ways that closely mimic real-world healthcare scenarios: 

  • Scenario-Based Learning: Create detailed scenarios that reflect real-life challenges and conditions students will face in their healthcare careers, ensuring these scenarios are directly tied to the competencies being taught. 
  • Practice in a Controlled Environment: Allow students to practice their skills in a safe, controlled environment where they can make mistakes and learn from them without the risk of harming actual patients. 
  • Feedback and Reflection: Provide immediate, constructive feedback during and after simulation exercises. Encourage students to reflect on their performance and understand what they did well and what they need to improve. 

Improving Educational Outcomes with Competency-Based Learning in Healthcare

The transition to competency-based learning can be challenging and will not happen overnight, but the end result will be worth the effort.  

Successful implementation requires careful consideration, research, and planning. It also entails choosing tools that will support competency-based healthcare education. 

Education Management Solutions (EMS) offers a robust suite of tools designed to provide educators and learners alike the best possible CBL experience, including advanced tools for tracking and managing clinical competencies to ensure learners meet all necessary educational standards. 

Contact us today to find out how EMS can help you implement competency-based learning, take your clinical simulations to the next level, and more. 

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