Defining characteristics of educational competencies.
BACKGROUND
Doctor competencies have become an increasing focus of medical education at all levels. However, confusion exists regarding what constitutes a competency versus a goal, objective or outcome.


OBJECTIVE
This article attempts to identify the characteristics that define a competency and proposes criteria that can be applied to distinguish between competencies, goals, objectives and outcomes.


METHODS
We provide a brief overview of the history of competencies and compare competencies identified by international medical education organisations (CanMEDS 2005, Institute for International Medical Education, Dundee Outcome Model, Accreditation Council for Graduate Medical Education/American Board of Medical Specialties). Based upon this review and comparisons, as well as on definitions of competencies from the literature and theoretical and conceptual analyses of the underpinnings of competencies, the authors develop criteria that can serve to distinguish competencies from goals, objectives and outcomes.


RESULTS
We propose 5 criteria which can be used to define a competency: it focuses on the performance of the end-product or goal-state of instruction; it reflects expectations that are external to the immediate instructional programme; it is expressible in terms of measurable behaviour; it uses a standard for judging competence that is not dependent upon the performance of other learners, and it informs learners, as well as other stakeholders, about what is expected of them.


CONCLUSIONS
Competency-based medical education is likely to be here for the foreseeable future. Whether or not these 5 criteria, or some variation of them, become the ultimate defining criteria for what constitutes a competency, they represent an essential step towards clearing the confusion that reigns.
Albanese
Mark A
MA
Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin, USA. maalbane@wisc.edu
Mejicano
George
G
Mullan
Patricia
P
Kokotailo
Patricia
P
Gruppen
Larry
L
D002983:Clinical Competence / Q000592:standards*; D003162:Competency-Based Education / Q000592:standards; D004503:Education, Medical, Graduate / Q000592:standards*; D006040:Goals; D007722:Health Knowledge, Attitudes, Practice; D007391:International Cooperation