Competency-based medical education

The spark to ignite healthcare’s escape fire

Bibliographic Data

ID21448784
AuthorsDaniel J Schumacher (0000-0001-5507-8452, Pediatrics, Cincinnati Children’s Hospital Medical Center and, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA, corresponding author), Benjamin Kinnear (0000-0003-0052-4130, Pediatrics and Internal Medicine, Cincinnati Children’s Hospital Medical Center and, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA), Carol Carraccio (0000-0001-5473-8914, Vice President of Competency-Based Medical Education, American Board of Pediatrics, Chapel Hill, North Carolina, USA), Eric S Holmboe (0000-0003-0108-6021, Accreditation Council for Graduate Medical Education), Eric Holmboe (Milestones Development and Evaluation Officer, Accreditation Council for Graduate Medical Education, Chicago, Illinois, USA), Jamiu O Busari (0000-0002-8616-5564, Maastricht University), Cees Van Der Vleuten (0000-0001-6802-3119, Maastricht University), Lorelei Lingard (0000-0002-1524-0723, Department of Medicine, and Center for Education Research & Innovation, Schulich School of Medicine and Dentistry at Western University, London, Ontario, Canada)
Year2024
Volume46
Issue1
Pages140-146
Publication date2024-01-02
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Teacher (JOURNAL)
Journal identifiersISSN: 0142-159X • E-ISSN: 1466-187X
PublisherInforma UK Limited (PUBLISHER • GB)
DOI10.1080/0142159x.2023.2232097
PMID37463405
OpenAlexW4384662924
LanguageEN
Citations received2
References cited57

High-value care is what patients deserve and what healthcare professionals should deliver. However, it is not what happens much of the time. Quality improvement master Dr. Don Berwick argued more than two decades ago that American healthcare needs an escape fire, which is a new way of seeing and acting in a crisis situation. While coined in the U.S. context, the analogy applies in other Western healthcare contexts as well. Therefore, in this paper, the authors revisit Berwick’s analogy, arguing that medical education can, and should, provide the spark for such an escape fire across the globe. They assert that medical education can achieve this by fully embracing competency-based medical education (CBME) as a way to place medicine’s focus on the patient. CBME targets training outcomes that prepare graduates to optimize patient care. The authors use the escape fire analogy to argue that medical educators must drop long-held approaches and tools; treat CBME implementation as an adaptive challenge rather than a technical fix; demand genuine, rich discussions and engagement about the path forward; and, above all, center the patient in all they do

Analogy · Context (archaeology) · Engineering ethics · Epistemology · Globe · Health care · Management · Medical education · Political science · Public relations · Quality (philosophy) · SPARK (programming language) · Clinical Reasoning and Diagnostic Skills · Computer Science · Engineering · Innovations in Medical Education · Interprofessional Education and Collaboration · Law · Medicine · Nursing · Psychology