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Re-examining claims about competence by design (CBD) implementation success in Canadian postgraduate medical education.

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Title: Re-examining claims about competence by design (CBD) implementation success in Canadian postgraduate medical education.
Authors: Chainey, Jonathan1,2 (AUTHOR) jonathan.chainey@mail.utoronto.ca, Kuper, Ayelet2,3,4 (AUTHOR), Brydges, Ryan2,3,5 (AUTHOR)
Source: Medical Teacher. Jul2026, Vol. 48 Issue 7, p1269-1274. 6p.
Subject Terms: *Medical education, *Educational tests & measurements, *Citation analysis, *Medical students, *College teacher attitudes, *Professional employee training, *Curriculum planning, *Masters programs (Higher education), *Outcome-based education, *National competency-based educational tests, *Continuing education, *Employees' workload, Evaluation of human services programs, Mentoring, Evidence-based medicine, Professional competence
Geographic Terms: Canada
Abstract: Introduction: Competency-Based Medical Education (CBME) has transformed postgraduate medical education worldwide. In 2017, Canada adopted the Competence by Design (CBD) model. While widely promoted as a successful large-scale curricular reform, emerging critiques suggest limited empirical evidence and unintended consequences. We critically examined a recent article promoting CBD's success via citation analysis and evidence appraisal. Methods: We analyzed the article's 169 references, categorizing each by type and empirical relevance. We synthesized Canadian-situated empirical studies on Entrustable Professional Activities (EPAs) and their role in feedback within CBD systems. Additionally, we consulted the Royal College of Physicians and Surgeons of Canada's (RCPSC) 2024 CBD Adaptations Plan to contextualize recent developments. Results: Empirical studies accounted for 49.2% of the citations, and only 59.4% of those directly addressed CBME. We observed many (25.3%) self-citations, suggesting limited diversity of perspectives. Synthesized studies revealed mixed outcomes: although EPAs aimed to enhance feedback, trainees reported increased stress, administrative burden, and inconsistent feedback quality. These challenges were largely unacknowledged in the analyzed article but were recognized in the 2024 CBD Adaptations Plan's proposed reforms. Discussion: Our findings challenge the narrative of CBD's unequivocal success in Canada. We highlight the need for context-sensitive empirical research to guide future reforms. [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.)
Database: Education Research Complete
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  Data: Re-examining claims about competence by design (CBD) implementation success in Canadian postgraduate medical education.
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  Data: <searchLink fieldCode="AR" term="%22Chainey%2C+Jonathan%22">Chainey, Jonathan</searchLink><relatesTo>1,2</relatesTo> (AUTHOR)<i> jonathan.chainey@mail.utoronto.ca</i><br /><searchLink fieldCode="AR" term="%22Kuper%2C+Ayelet%22">Kuper, Ayelet</searchLink><relatesTo>2,3,4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Brydges%2C+Ryan%22">Brydges, Ryan</searchLink><relatesTo>2,3,5</relatesTo> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Medical+Teacher%22">Medical Teacher</searchLink>. Jul2026, Vol. 48 Issue 7, p1269-1274. 6p.
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  Data: *<searchLink fieldCode="DE" term="%22Medical+education%22">Medical education</searchLink><br />*<searchLink fieldCode="DE" term="%22Educational+tests+%26+measurements%22">Educational tests & measurements</searchLink><br />*<searchLink fieldCode="DE" term="%22Citation+analysis%22">Citation analysis</searchLink><br />*<searchLink fieldCode="DE" term="%22Medical+students%22">Medical students</searchLink><br />*<searchLink fieldCode="DE" term="%22College+teacher+attitudes%22">College teacher attitudes</searchLink><br />*<searchLink fieldCode="DE" term="%22Professional+employee+training%22">Professional employee training</searchLink><br />*<searchLink fieldCode="DE" term="%22Curriculum+planning%22">Curriculum planning</searchLink><br />*<searchLink fieldCode="DE" term="%22Masters+programs+%28Higher+education%29%22">Masters programs (Higher education)</searchLink><br />*<searchLink fieldCode="DE" term="%22Outcome-based+education%22">Outcome-based education</searchLink><br />*<searchLink fieldCode="DE" term="%22National+competency-based+educational+tests%22">National competency-based educational tests</searchLink><br />*<searchLink fieldCode="DE" term="%22Continuing+education%22">Continuing education</searchLink><br />*<searchLink fieldCode="DE" term="%22Employees'+workload%22">Employees' workload</searchLink><br /><searchLink fieldCode="DE" term="%22Evaluation+of+human+services+programs%22">Evaluation of human services programs</searchLink><br /><searchLink fieldCode="DE" term="%22Mentoring%22">Mentoring</searchLink><br /><searchLink fieldCode="DE" term="%22Evidence-based+medicine%22">Evidence-based medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Professional+competence%22">Professional competence</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Canada%22">Canada</searchLink>
– Name: Abstract
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  Data: Introduction: Competency-Based Medical Education (CBME) has transformed postgraduate medical education worldwide. In 2017, Canada adopted the Competence by Design (CBD) model. While widely promoted as a successful large-scale curricular reform, emerging critiques suggest limited empirical evidence and unintended consequences. We critically examined a recent article promoting CBD's success via citation analysis and evidence appraisal. Methods: We analyzed the article's 169 references, categorizing each by type and empirical relevance. We synthesized Canadian-situated empirical studies on Entrustable Professional Activities (EPAs) and their role in feedback within CBD systems. Additionally, we consulted the Royal College of Physicians and Surgeons of Canada's (RCPSC) 2024 CBD Adaptations Plan to contextualize recent developments. Results: Empirical studies accounted for 49.2% of the citations, and only 59.4% of those directly addressed CBME. We observed many (25.3%) self-citations, suggesting limited diversity of perspectives. Synthesized studies revealed mixed outcomes: although EPAs aimed to enhance feedback, trainees reported increased stress, administrative burden, and inconsistent feedback quality. These challenges were largely unacknowledged in the analyzed article but were recognized in the 2024 CBD Adaptations Plan's proposed reforms. Discussion: Our findings challenge the narrative of CBD's unequivocal success in Canada. We highlight the need for context-sensitive empirical research to guide future reforms. [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.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=ehh&AN=194783050
RecordInfo BibRecord:
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    Identifiers:
      – Type: doi
        Value: 10.1080/0142159X.2026.2628089
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      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 6
        StartPage: 1269
    Subjects:
      – SubjectFull: Medical education
        Type: general
      – SubjectFull: Educational tests & measurements
        Type: general
      – SubjectFull: Citation analysis
        Type: general
      – SubjectFull: Medical students
        Type: general
      – SubjectFull: College teacher attitudes
        Type: general
      – SubjectFull: Professional employee training
        Type: general
      – SubjectFull: Curriculum planning
        Type: general
      – SubjectFull: Masters programs (Higher education)
        Type: general
      – SubjectFull: Outcome-based education
        Type: general
      – SubjectFull: National competency-based educational tests
        Type: general
      – SubjectFull: Continuing education
        Type: general
      – SubjectFull: Employees' workload
        Type: general
      – SubjectFull: Evaluation of human services programs
        Type: general
      – SubjectFull: Mentoring
        Type: general
      – SubjectFull: Evidence-based medicine
        Type: general
      – SubjectFull: Professional competence
        Type: general
      – SubjectFull: Canada
        Type: general
    Titles:
      – TitleFull: Re-examining claims about competence by design (CBD) implementation success in Canadian postgraduate medical education.
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            NameFull: Chainey, Jonathan
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            NameFull: Kuper, Ayelet
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            – D: 01
              M: 07
              Text: Jul2026
              Type: published
              Y: 2026
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