title: Comparability of outcome frameworks in medical education: Implications for framework development.
abstract: BACKGROUND
  Given the increasing mobility of medical students and practitioners, there is a growing need for harmonization of medical education and qualifications. Although several initiatives have sought to compare national outcome frameworks, this task has proven a challenge. Drawing on an analysis of existing outcome frameworks, we identify factors that hinder comparability and suggest ways of facilitating comparability during framework development and revisions.
  
  
  METHODS
  We searched MedLine, EmBase and the Internet for outcome frameworks in medical education published by national or governmental organizations. We analyzed these frameworks for differences and similarities that influence comparability.
  
  
  RESULTS
  Of 1816 search results, 13 outcome frameworks met our inclusion criteria. These frameworks differ in five core features: history and origins, formal structure, medical education system, target audience and key terms. Many frameworks reference other frameworks without acknowledging these differences. Importantly, the level of detail of the outcomes specified differs both within and between frameworks.
  
  
  CONCLUSIONS
  The differences identified explain some of the challenges involved in comparing outcome frameworks and medical qualifications. We propose a two-level model distinguishing between "core" competencies and culture-specific "secondary" competencies. This approach could strike a balance between local specifics and cross-national comparability of outcome frameworks and medical education.
authors.affiliation: a Charité-Universitätsmedizin Berlin , Germany .
authors.forename: Stefanie C
authors.initials: SC
authors.lastname: Hautz
authors.affiliation: a Charité-Universitätsmedizin Berlin , Germany .
authors.forename: Wolf E
authors.initials: WE
authors.lastname: Hautz
authors.affiliation: a Charité-Universitätsmedizin Berlin , Germany .|b Max Planck Institute for Human Development , Germany.
authors.forename: Markus A
authors.initials: MA
authors.lastname: Feufel
authors.affiliation: a Charité-Universitätsmedizin Berlin , Germany .
authors.forename: Claudia D
authors.initials: CD
authors.lastname: Spies
mesh_terms: D004501:Education, Medical / Q000592:standards*; D004521:Educational Measurement; D006801:Humans; D015397:Program Evaluation / Q000379:methods*; D011786:Quality Control