While physicians have more expertise in what it means to be a competent physician than the trainees they are teaching, the emergence of competency based curricula may shift this divergence, as trainees may take on a larger role in determining their own needs to achieve a set of competencies.
The transformative potential of competency based education lies in more than any one product or application.
The advances of competency based education have been well described in the literature [ 33- 38].
This group developed a set of ten competency based, basic modules for training provincial and district supervisors and staff at health centre level (Appendix 1).
To improve this situation, the Institute of Medicine (IOM) has recommended that education in environmental health become an integral component of medical education and has produced a set of competency-based learning objectives in environmental health (IOM 1995).
To guide the development of curricula and the training of fellows, the Fellowship Oversight Committee developed a set of competency-based training objectives in PEH (Etzel et al. 2003).
Through the Integrative Family Medicine program, a six site pilot program of a four year residency training model combining integrative medicine and family medicine training, we have developed and tested a set of competency-based evaluation tools to assess residents' skills in integrative medicine history-taking and treatment planning.
It is relevant to note that Edmonstone [ 58] and other authors [ 59] have criticized the set of assumptions that underlie competency based frameworks, such as in management and leadership development programs in the NHS.
"What you look for is a wider set of attributes and abilities and if the grading is more broad rather than competency based then I think there is some merit in exploring it".
I thought I was in for a long afternoon of painstaking reading and careful consideration of "person specification and competency based criteria" set against "evidence of experience and accomplishments" blah, blah, blah.
The practical aspects of implementing this competency based curriculum on QI have been previously described [ 15].
