Competency-based teacher training: A systematic revision of a proven programme in medical didactics

Abstract

Objectives: Competency-based medical education (CBME) requires factual knowledge to be practically applied together with skills and attitudes. With the National Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM) representing a strong official demand for competence-orientation, it is generally important to explicitly outline its characteristics and review its realisation in teacher trainings. Further requirements are given by the core competencies for medical teachers (KLM). As an example the MQ programme ("Medizindidaktische Qualifikation") in Baden-Wuerttemberg, a long established and well-accepted training, has been critically revised on this basis, concerning its suitability for the demands of CBME, its needs for adjustment and the efforts to be undertaken for its implementation. Methods: In a systematic quality management process the MQ curriculum and its organisational framing were analysed and further developed in a step-wise comprehensive approach, using the six-step cycle by Kern. The procedures included a thorough needs assessment (e.g. literature research, programme mapping), strategic decisions on structure and content, piloting and evaluation. During the process essential elements of project and change management were considered. Results: The experiences of the MQ example revealed helpful information for key factors to be considered in the pending change process any training provider will be confronted with. Guiding questions were developed related to the process phases. Our analyses showed persistent key points of proven value as stable foundation for change, as well as components needing special consideration to foster competence-oriented aims and transfer into practice: reflection, feedback, application-oriented methods and transparent competence development. These aspects have to be consciously perceived and experienced by participants. Taking this into account, we re-designed the course evidence-based. Besides visualising competencies and their progress, the occasions for reflection and feedback as well as the number of typical, practice-oriented tasks were extended to facilitate self-directed learning, critical self-reflection and individualised solutions. It is shown at what point, in what form and with which purpose these aspects were integrated in the MQ programme. Piloting showed good acceptance by participants, trainers. Preliminary assessment of the outcome is promising. Conclusion: Respecting the high workload, most likely medical teachers will not put CBME concepts into practice without impulses and support. Therefore, in didactical trainings, medical teachers should practice in a competency-based teaching setting and reflect themselves in different professional roles to be able to transfer the experiences to their own educational approach. Trainers and training can serve as models for CBME realisation.

Keywords: CBME; change management; competence development; competence orientation; faculty development; medical education; reflection; teachers training; teaching competencies; teaching skills.

Figures

Table 1. Overview of the change process in the MQ programme

Table 2. Responsibilities in integrating reflection and feedback as key factors for competence development in teacher trainings/practice

Table 3. Exemplified development in teachers’ core competence fields during MQ I. For every core competence a competence component and a learning objective were selected as an example. The development of this specific objective is depicted on its increasing levels throughout the course with exemplified units and tasks (cp. figure 1). The levels of competencies were defined as; 1=knowledge/reproduction, 2=understanding, 3=demonstration in practice (during course), 3*=demonstration in real teaching setting, 4=integration in routine. The units in brackets are named in the following form: block, day, unit (e.g. block 1, day 1, unit 1 → 1.1.1). Topics of MQ I are subsequently deepened at individual choice in the advanced module MQ II.

Figure 1. Competence spiral as a structuring element in the foundation module of the MQ programme. MQ I is organized in 2 attendance phases of 3 day blocks, each followed by a practice phase. The spiral indicates the progress in complexity of content and tasks corresponding to an increasing level of competence. The tasks offer opportunities responding to individual levels and needs.