title: Otolaryngology residency education: a scoping review on the shift towards competency-based medical education.
abstract: BACKGROUND
  Residency training programmes worldwide are experiencing a shift from the traditional time-based curriculum to competency-based medical education (CBME), due to changes in the healthcare system that have impacted clinical learning opportunities. Otolaryngology-Head and Neck Surgery (OTL-HNS) programmes are one of the first North American surgical specialties to adopt the new CBME curriculum.
  
  
  OBJECTIVE
  The purpose of this scoping review is to examine the literature pertaining to CBME in OTL-HNS programmes worldwide, to identify the tools that have been developed and identify potential barriers to the implementation of CBME.
  
  
  METHODS
  Four online databases, OVID MEDLINE (R) from 1946 to 5 August 2015, EMBASE 1974 to 5 August 2015, Cochrane and CINAHL databases up to 5 August 2015, were searched using key words related to OTL-HNS and CBME.
  
  
  METHODS
  Two researchers independently reviewed the literature in a systematic manner and met to discuss and address any discrepancies at each step of the review process.
  
  
  RESULTS
  Of the 207 publications identified in the initial search, 31 were included in this scoping review. Two key themes emerged from the literature: first, OTL-HNS programmes reported a need for new assessment tools that assess competency and also provide the learner with formative feedback. Second, although varieties of tools assessing both technical and non-technical skills have been developed, implementation of such tools has been met with some challenges. These challenges include a lack of faculty support, inadequate administrative support and a lack of knowledge on how to start the transition to CBME.
  
  
  CONCLUSIONS
  This scoping review suggests that task-specific checklists, entrustment scales, evaluation portfolios from multiple assessments and faculty training sessions are key aspects to incorporate as OTL-HNS training programmes shift towards a CBME curriculum.
authors.affiliation: Department of Surgery, McMaster University, Hamilton, ON, Canada.
authors.forename: N
authors.initials: N
authors.lastname: Wagner
authors.affiliation: Department of Surgery, McMaster University, Hamilton, ON, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Fahim
authors.affiliation: Department of Surgery, McMaster University, Hamilton, ON, Canada.
authors.forename: K
authors.initials: K
authors.lastname: Dunn
authors.affiliation: Department of Surgery, McMaster University, Hamilton, ON, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Reid
authors.affiliation: Department of Surgery, McMaster University, Hamilton, ON, Canada.
authors.forename: R R
authors.initials: RR
authors.lastname: Sonnadara
mesh_terms: D002983:Clinical Competence; D003162:Competency-Based Education / Q000458:organization & administration*; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000458:organization & administration*; D006801:Humans; D007396:Internship and Residency; D010036:Otolaryngology / Q000193:education*