Summary: In his latest blog Professor Harden responds to criticisms of competence-based medical education and discusses the professional doctorates vs PhD debate, the OSCE and postgraduate examinations in surgery, and the topics for AMEE 2017 in Helsinki Description: CBME is more than faith-based medical education
I was surprised and taken aback by the rather emotional tirade against competency-based education by two highly respected colleagues, Cynthia Whitehead and Ayelet Kuper, in Advances in Health Science Education under the heading Faith-based medical education (Whitehead & Kuper, 2016). They write

“CBME appears not to be evidence-based medical education, nor even research-informed medical education–it is faith-based medical education (FBME), replete with its own unopposable truths and its authorized high priests. Leaders of FBME have decreed that we will now conduct our educational practices in a certain way, and so it will be.”

Since the Best Evidence Medical Education (BEME) collaboration was established in 1999, I have always been a strong supporter for evidence-based or evidence-informed education in medicine. Teaching practice is however a complex area. Donald Bligh in his classic text What’s the use of lectures? highlighted that no research study has shown that lectures are superior to other methods and yet lectures have remained perhaps one of the commonest teaching approaches adopted. I cannot see how anyone can object to the three basic principles of outcome- or competency-based education – that the learning outcomes or competencies expected of a student or trainee by the end of a training programme are specified and made known to all the stakeholders, that the curriculum, including the teaching and learning methods, and assessment are authentic and designed so that students achieve the learning outcomes and that teachers take responsibility that students achieve the expected learning outcomes. Of course there are disagreements and different opinions as to how outcome-based education or competency-based education should be introduced. The need to apply the underlying philosophy to the training of the next generation of doctors is a no-brainer. While we might not agree with how it is implemented, we should not throw out the baby with the bath water. Whitehead and Kuper, however, do us a service by making us think about and justify what we do as teachers.

Whitehead, C. & Kuper, A. 2016. Faith-based medical education. Adv in Health Sci Educ. 22. 1-3

Professional doctorates
Doctors having got the basic medical qualification and membership qualification of a college of physicians or other body, sometimes ask me as to whether they should work for a Doctor of Medicine degree or a PhD. Professional doctorates and PhD degrees are discussed by Pat Thomson in her blog of 16th March. Those doing a professional doctorate she argues are encouraged to look up their own practice and context and to draw their research question from it. They are expected to articulate and critically interrogate their own professional knowledge. Some of the early differences between the professional doctorate and the PhD, however, are disappearing.

Thomson, P. 2017. professional doctorates – what are they good for? Patter. Published online 16/3/17. Accessed at: https://patthomson.net/2017/03/16/professional-doctorates-what-are-they-good-for/

The OSCE and postgraduate examinations in surgery
I remember taking part in a pilot OSCE at the Royal College of Surgeons in Edinburgh some years ago. The OSCE was subsequently adopted as a formal part of the MRCS examination. I note that in Surgeons’ News (March 2017) it is reported that 87 candidates sat the OSCE in Kuala Lumpur in January at the Advanced Surgical Skills Centre in the National University of Malaysia .

Topics for AMEE 2017 in Helsinki
All 3552 abstracts submitted for AMEE 2017 in Helsinki have now been assessed, each by three reviewers. Final decisions now need to be taken as to which 28% will be selected for inclusion in the programme and if selected their allocation to a theme. I am always interested in the topics submitted as an indication of the current issues being addressed in medical education. Each year I notice different trends. Themes featuring more prominently in this year’s submissions include the role of patients as partners in the education programme, programmatic assessment, career choice, leadership training, LGBTI, EPAs and clinical reasoning. Selection and interprofessional education featured prominently in the submissions last year and again feature prominently this year. As in previous years I am impressed by the wide range of themes and the work now going on in education in the health sciences.