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A call to action: The controversy of and rationale for competency-based medical education

机译：呼吁采取行动：基于能力的医学教育的争论和理由

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Although medical education has enjoyed many successes over the last century, there is a recognition that health care is too often unsafe and of poor quality. Errors in diagnosis and treatment, communication breakdowns, poor care coordination, inappropriate use of tests and procedures, and dysfunctional collaboration harm patients and families around the world. These issues reflect on our current model of medical education and raise the question: Are physicians being adequately prepared for twenty-first century practice? Multiple reports have concluded the answer is no. Concurrent with this concern is an increasing interest in competency-based medical education (CBME) as an approach to help reform medical education. The principles of CBME are grounded in providing better and safer care. As interest in CBME has increased, so have criticisms of the movement. This article summarizes and addresses objections and challenges related to CBME. These can provide valuable feedback to improve CBME implementation and avoid pitfalls. We strongly believe medical education reform should not be reduced to an either/or approach, but should blend theories and approaches to suit the needs and resources of the populations served. The incorporation of milestones and entrustable professional activities within existing competency frameworks speaks to the dynamic evolution of CBME, which should not be viewed as a fixed doctrine, but rather as a set of evolving concepts, principles, tools, and approaches that can enable important reforms in medical education that, in turn, enable the best outcomes for patients.
机译：虽然医学教育在上个世纪享有许多成功，但有一种认可，以至于医疗保健经常不安全并且质量差。诊断和治疗中的错误，沟通故障，差的关心协调，测试和程序的不适当使用，以及全球的功能失调的协作患者和家庭。这些问题反映了我们目前的医学教育模式，提出问题：是医生是否充分准备2世纪的实践？多个报告已经结束了答案是没有的。随着这种关切的并发是对基于能力的医学教育（CBME）的兴趣日益增长，作为帮助改革医学教育的方法。 CBME的原则基于提供更好和更安全的护理。由于对CBME的兴趣增加，因此对运动批评。本文概述并解决了与CBME相关的异议和挑战。这些可以提供有价值的反馈，以改善CBME实施，避免陷阱。我们强烈地相信医学教育改革不应减少到任何一种/或方法，而是应该融合理论和方法，以满足所服务的人口的需求和资源。在现有的能力框架内纳入里程碑和委托的专业活动涉及CBME的动态演进，不应被视为固定的教义，而是作为能够实现重要改革的一系列不断发展的概念，原则，工具和方法。在医学教育中，又为患者提供了最佳成果。

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