title: The effect of implementing undergraduate competency-based medical education on students' knowledge acquisition, clinical performance and perceived preparedness for practice: a comparative study.
abstract: BACKGROUND
  Little is known about the gains and losses associated with the implementation of undergraduate competency-based medical education. Therefore, we compared knowledge acquisition, clinical performance and perceived preparedness for practice of students from a competency-based active learning (CBAL) curriculum and a prior active learning (AL) curriculum.
  
  
  METHODS
  We included two cohorts of both the AL curriculum (n=453) and the CBAL curriculum (n=372). Knowledge acquisition was determined by benchmarking each cohort on 24 interuniversity progress tests against parallel cohorts of two other medical schools. Differences in knowledge acquisition were determined comparing the number of times CBAL and AL cohorts scored significantly higher or lower on progress tests. Clinical performance was operationalized as students' mean clerkship grade. Perceived preparedness for practice was assessed using a survey.
  
  
  RESULTS
  The CBAL cohorts demonstrated relatively lower knowledge acquisition than the AL cohorts during the first study years, but not at the end of their studies. We found no significant differences in clinical performance. Concerning perceived preparedness for practice we found no significant differences except that students from the CBAL curriculum felt better prepared for 'putting a patient problem in a broad context of political, sociological, cultural and economic factors' than students from the AL curriculum.
  
  
  CONCLUSIONS
  Our data do not support the assumption that competency-based education results in graduates who are better prepared for medical practice. More research is needed before we can draw generalizable conclusions on the potential of undergraduate competency-based medical education.
authors.affiliation: Center for Research and Innovation in Medical Education, University of Groningen and University Medical Center Groningen, Ant, Deusinglaan 1, FC40, 9713 AV, Groningen, The Netherlands. w.kerdijk@umcg.nl
authors.forename: Wouter
authors.initials: W
authors.lastname: Kerdijk
authors.forename: Jos W
authors.initials: JW
authors.lastname: Snoek
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: van Hell
authors.forename: Janke
authors.initials: J
authors.lastname: Cohen-Schotanus
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003162:Competency-Based Education / Q000379:methods* / Q000592:standards; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods* / Q000592:standards; D004521:Educational Measurement / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male