The Canadian CME system encourages physicians to manage their own CME by attending a competence programme.
The Canadian Maintenance of Competence Programme (MOCOMP) and a programme appointed by the Royal College of General Practitioners in Britain are the first portfolio-based learning approaches [ 20].
Today's popularity of competence-based programmes does not imply that a competence-based design should be the universal standard.
It is a revised edition of the 35-session Reasoning & Rehabilitation programme [ 35] that was originally developed as a prosocial competence training programme for use in correctional facilities and its feasibility and effectiveness are well supported in this population [ 36, 37].
Data related to curriculum content and process, student performance, self-reported competence and programme effects were collected.
The provider organisation had recently implemented a race equality cultural competence (RECC) programme; which is mandatory for all clinical staff.
With regard to assessing of adults' competences, the Programme for the International Assessment of Adult Competencies (PIAAC 4 measures core competences in literacy, numeracy and problem solving in technology-rich everyday life environments (OECD 2013, p. 4).
We used a standardized questionnaire adapted from the taxonomy of essential competences for programme evaluators [ 16, 17, 24].
The change in the level of competence following these programmes has not been assessed.
The evaluation is planned to cover the development of the organization (health centres, equipment), the students (fulfilment of the programme, competence in family medicine and practical skills, patient-centred approach), teaching methods (use of distance learning and telemedicine), and some patient perspectives (catchment area, doctor's knowledge of the patient, management of major conditions).
