Competency-based medical education: the discourse of infallibility

• DOI: 10.1111/medu.13467
• Publication Date: 2017-10-27T06:32:38Z
• Authors: Victoria A Boyd; Cynthia R Whitehead; Patricia Thille; Shiphra Ginsburg; Ryan Brydges; Ayelet Kuper
• Keywords: Infallibility

Background Over the last two decades, competency-based frameworks have been internationally adopted as primary educational approach in medicine. Yet medical education (CBME) remains contested academic literature. We look broadly at nature of this debate to explore how it may shape scholars' understanding CBME, and its implications for research practice. In doing so, we deconstruct unarticulated discourses assumptions embedded CBME Methods assembled an archive literature focused on CBME. The dates from 1996, publication year first CanMEDS Physician Competency Framework. then conducted a Foucauldian critical discourse analysis (CDA) delineate dominant underpinning CDA examines intersections language, social practices, knowledge power relations highlight entrenched ways thinking influence what can or cannot be said about topic. Findings Detractors advanced array conceptual critiques. Proponents often responded with recurring discursive strategy that minimises these critiques deflects attention underlying concept approach. As part process, concerns are reframed practical problems: implementation interpretation. assertion construct's was unsupported by empirical evidence. These practices contribute infallibility Discussion uncovering infallibility, silence voices hinder rigorous examination strengthen constructing infallible propose re-approaching dialogue surrounding starting point investigation, driven aim broaden design, development education.