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Unveiling the paradoxes of implementing post graduate competency based medical education programs.

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Title: Unveiling the paradoxes of implementing post graduate competency based medical education programs.
Authors: Birman, Noa A.1 noabirman40@gmail.com, Vashdi, Dana R.1, Miller-Mor Atias, Rotem1, Riskin, Arieh2, Zangen, Shmuel3, Litmanovitz, Ita4, Sagi, Doron5
Source: Medical Teacher. Apr2025, Vol. 47 Issue 4, p622-629. 8p.
Subject Terms: *Medical education, *Human services programs, *Qualitative research, *Rating of students, *Health occupations students, *Research methodology, *Outcome-based education, *Masters programs (Higher education), *National competency-based educational tests, Interviewing, Thematic analysis, Organizational change
Abstract: Purpose: Competency-based medical education (CBME) has gained prominence as an innovative model for post-graduate medical education, yet its implementation poses significant challenges, especially with regard to its sustainability. Drawing on paradox theory, we suggest that revealing the paradoxes underlying these challenges may contribute to our understanding of post graduate competency-based medical education (PGCBME) implementation processes and serve as a first-step in enhancing better implementation. Thus, the purpose of the current study is to identify the paradoxes associated with PGCBME implementation. Method: A qualitative study was conducted, as part of a larger action research, using in-depth semi-structured interviews with fellows and educators in eight Neonatal wards. Results: Analysis revealed that the PGCBME program examined in this study involves three different levels of standardization, each serving as one side of paradoxical tensions; (1) a paradox between the need for standardized assessment tools and for free-flow flexible assessment tools, (2) a paradox between the need for a standardized implementation process across all wards and the need for unique implementation protocols in each ward; and 3) a paradox between the need for a standardized meaning of competency proficiency and the need for flexible and personal competency achievement indicators. Conclusions: Implementing PGCBME programs involves many challenges, some of which are paradoxical, i.e. two contradictory challenges in which solving one challenge exacerbates another. Revealing these paradoxes is important in navigating them successfully. [ABSTRACT FROM AUTHOR]
Copyright of Medical Teacher is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Unveiling the paradoxes of implementing post graduate competency based medical education programs.
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  Data: <searchLink fieldCode="AR" term="%22Birman%2C+Noa+A%2E%22">Birman, Noa A.</searchLink><relatesTo>1</relatesTo><i> noabirman40@gmail.com</i><br /><searchLink fieldCode="AR" term="%22Vashdi%2C+Dana+R%2E%22">Vashdi, Dana R.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Miller-Mor+Atias%2C+Rotem%22">Miller-Mor Atias, Rotem</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Riskin%2C+Arieh%22">Riskin, Arieh</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Zangen%2C+Shmuel%22">Zangen, Shmuel</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Litmanovitz%2C+Ita%22">Litmanovitz, Ita</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Sagi%2C+Doron%22">Sagi, Doron</searchLink><relatesTo>5</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22Medical+Teacher%22">Medical Teacher</searchLink>. Apr2025, Vol. 47 Issue 4, p622-629. 8p.
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  Data: Purpose: Competency-based medical education (CBME) has gained prominence as an innovative model for post-graduate medical education, yet its implementation poses significant challenges, especially with regard to its sustainability. Drawing on paradox theory, we suggest that revealing the paradoxes underlying these challenges may contribute to our understanding of post graduate competency-based medical education (PGCBME) implementation processes and serve as a first-step in enhancing better implementation. Thus, the purpose of the current study is to identify the paradoxes associated with PGCBME implementation. Method: A qualitative study was conducted, as part of a larger action research, using in-depth semi-structured interviews with fellows and educators in eight Neonatal wards. Results: Analysis revealed that the PGCBME program examined in this study involves three different levels of standardization, each serving as one side of paradoxical tensions; (1) a paradox between the need for standardized assessment tools and for free-flow flexible assessment tools, (2) a paradox between the need for a standardized implementation process across all wards and the need for unique implementation protocols in each ward; and 3) a paradox between the need for a standardized meaning of competency proficiency and the need for flexible and personal competency achievement indicators. Conclusions: Implementing PGCBME programs involves many challenges, some of which are paradoxical, i.e. two contradictory challenges in which solving one challenge exacerbates another. Revealing these paradoxes is important in navigating them successfully. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Medical Teacher is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1080/0142159X.2024.2356826
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      – SubjectFull: Human services programs
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      – SubjectFull: Qualitative research
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      – SubjectFull: Rating of students
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      – SubjectFull: Health occupations students
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