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Competency Based Medical Education (CBME)



Competency Based Medical Education (CBME) is an outcomes-based approach to medical education that identifies the abilities required of physicians (competencies) and designing a curriculum to support the achievement and assessment of these predefined competencies. It aims to enhance physician training so that doctors have the skills and behaviours they need throughout their career to continuously meet evolving patient needs. 

CBD Logo  

Competence by Design (CBD) is the Canadian version of CBME, designed by the Royal College of Physicians and Surgeons of Canada, to ensure residents are trained to do the things they are going to do have to in practice, and to do those things well. It focuses on outcomes; the outcomes being residents’ acquisition of specifically defined skills expected for their level of training. A resident’s advancement is dependent on their ability to meet those outcomes.

The keys to CBD are Assessment and Feedback. Assessment is of ability rather than just knowledge. By increasing the frequency of observation of a resident performing a clearly defined skill, and providing specific and constructive feedback residents will be more empowered to act on that feedback.

Resident Learning becomes a learner-centered, developmental approach to acquiring competence. Coaching in the moment supports learning through frequent observation and coaching feedback. Coaching over time provides longitudinal relationships to respond to performance patterns and plan individual learning.

“Better Education.  Enhanced Doctors.  Improved Care.” 

Learn more about Competence by Design from the Royal College


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