Developing a clinical competency committee for undergraduate medical education

The implementation of programmatic workplace-based clinical assessments across multiple competencies in undergraduate medical education (UME) improves student learning through continuous feedback and developmental guidance. However, without a unified assessment approach, these evaluations may vary, risking inconsistencies in feedback and unclear progression standards for students. While clinical competency committees (CCC) are a standard feature in postgraduate medical education, particularly within competency-based frameworks, their implementation at the undergraduate level is not yet universal.1 Our institution established an UME CCC to focus on a standardized, competency-based system aligned with national and international standards, ensuring students graduate with the knowledge, skills and attitudes essential for safe patient care, while also guiding programme evaluation, feedback and faculty development. A multidisciplinary committee consisting of year chairs, clerkship directors, clinical faculty, clerkship coordinators and an assessment lead was formed. For those without prior involvement in CCC received training. The committee created an assessment framework that combined direct clinical observations, case presentations, faculty and peer evaluations, and professionalism standards. Assessments were mapped to national and regulatory standards and a structured protocol was established to collect, document and report data for CCC meetings. Before the meeting, assessment data were reviewed and evaluated by committee members. During the meeting, 48 fourth year students were discussed individually, taking 1–1.5 h. The committee chair spent one-third of the time presenting a summary of student data. Two-thirds of the time, the committee reviewed individual students' academic performance, highlighting their developmental trajectory, problem identification or any observed trends in the core competencies. When an area of concern was identified, targeted interventions like faculty mentorship or additional remediation were recommended. A feedback report was sent to each student stating achievements, or areas for improvement, aiming to guide academic growth. The implementation of the CCC highlighted several lessons for programme improvement and faculty development. One significant takeaway is the value of consistent individualized learning plans (ILPs) for students especially when assessments are criterion-referenced. However, developing recommendations for student growth or identifying issues based on a committee's shared goals for ILPs requires time as well as training/development/calibration to lessen subjectivity of clinical ratings. A key insight is the importance of early stakeholder engagement to clearly define the CCC's role and purpose within the programme. Additionally, allowing adequate time, approximately 6 months prior to the launch of the first CCC is crucial for aligning assessments with competencies and ensuring robust data systems for capturing and analysing performance. Running a pilot CCC is an effective strategy to establish a consistent process and meeting structure thereby ensuring a standardized approach for reviewing every student. Because the CCC is comprised of faculty who work closely with students, and to lessen biases, the committee should aim to utilize data to drive decisions and discussion rather than relying on individuals' firsthand knowledge of the students' performance during clerkships. In addition, integrating the CCC with other assessment committees, such as the Board of Examiners can streamline processes and reinforce the credibility of assessment endorsements. This decision must be decided within the programme. Siaw Cheok Liew: Conceptualization; writing—original draft; methodology; validation; writing—review and editing; formal analysis; project administration; data curation; supervision; resources; visualization; investigation. Jeffrey Mayne: Conceptualization; investigation; writing—original draft; methodology; validation; visualization; writing—review and editing; formal analysis; project administration; data curation; supervision; resources. The authors declared no conflict of interest. The CCC was conducted in a normal educational setting to improve educational practices. No ethical approval was required. The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions

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