title: Impact of a competency-based curriculum on medical student advancement: a ten-year analysis.
abstract: BACKGROUND
  In 1999, the Indiana University School of Medicine implemented a new curriculum based on the attainment of core competencies beyond medical knowledge.
  
  
  OBJECTIVE
  The objective was to document how the Student Promotions Committee (SPC) has adjudicated students' competency-related deficiencies over the past decade.
  
  
  METHODS
  Using SPC records, the authors determined the frequency of competency-related deficiencies reported to the SPC over time, the nature of those deficiencies, and how the deficiencies were remediated. For the purposes of this study, traditional knowledge-related deficiencies like course failures were excluded from analysis.
  
  
  RESULTS
  From 1999 to 2009, 191 students (138 male, 53 female) were referred to the SPC for competency-related deficiencies in 8 performance domains involving communication, basic clinical skills, lifelong learning, self-awareness, social context, ethics, problem solving, and professionalism. By comparison, 1,090 students were referred to the SPC for knowledge-related deficiencies during this time. Collectively, the 191 students were cited for 317 separate competency-related deficiencies (M ± SD = 1.7 ± 1.3; range = 1-10). Of these 317 deficiencies, the most prevalent were in the competencies of professionalism (29.3%), basic clinical skills (28.4%), and self-awareness (17.7%). Each of the remaining competencies constituted less than 10% of the total. Successful remediation utilized 12 methods ranging from a simple warning letter to repeating the year under close monitoring. Remediation was unsuccessful for 17 students (8.9%) who were dismissed from medical school primarily due to unprofessional behaviors and poor self-awareness.
  
  
  CONCLUSIONS
  Competency-related deficiencies can be identified and remediated in most cases, but deficiencies in professionalism and self-awareness are especially challenging.
authors: Admissions and Medical Student Affairs, Indiana University School of Medicine, 635 Barnhill Drive, Indianapolis, IN 46202, USA. jbrokaw@iupui.edu
authors: James J
authors: JJ
authors: Brokaw
authors: Laura J
authors: LJ
authors: Torbeck
authors: Mary A
authors: MA
authors: Bell
authors: Dennis W
authors: DW
authors: Deal
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003162:Competency-Based Education / Q000592:standards*; D003479:Curriculum; D005260:Female; D006801:Humans; D007196:Indiana; D008297:Male; D015397:Program Evaluation; D012577:Schools, Medical; D013337:Students, Medical