A Systematic Review on Insights to Community Medicine and Clinical Research: Competency Training in Medical and Dental Education
DOI:
https://doi.org/10.36283/ziun-pjmd14-2/068Keywords:
Competency-Based Education, Community Medicine, Clinical Research Trials, Medical Education, Dental Education, Patient-Centered CareAbstract
Background: Competency based training in medical and dental education has become important to train healthcare professionals to tackle clinical, cultural, and social aspects of healthcare. The innovations and developments in these training programs enabled a better understanding of healthcare and treatment planning. The purpose of this systematic review was to assess the implications of competency training in medical and dental curricula; more specifically, the incorporation of competency-based trainings with community medicine and research trials.
Methods: Using PRISMA criteria, the literature search was done in Google Scholar, ScienceDirect, and PubMed in articles published between 2020 and 2024. This review focused on competency-based education in medical and dental education, especially the intersection of competency-based education and community medicine and clinical research trials. Articles that were published in English and within the last five years were considered. Cross-referencing was done against other databases that ensured high-quality and comprehensive data. Studies that were related to non-healthcare students, without empirical evidence, or that were out of the scope were eliminated. The studies were evaluated by two independent reviewers, and the inter-rater reliability was calculated using Cohen’s kappa coefficient. These reviewers screened the titles and abstracts of studies and then reviewed the full texts of studies for eligibility. Duplicate studies were removed using EndNote X9, and risk of bias was assessed using the Cochrane risk of bias tool.
Results: Out of 94 articles, 15 were selected because they described training designs, outcomes, or difficulties in fulfilling the goals. The total number of participants was 4978 across medical and dental education. Competency training programs illustrated better results on healthcare competencies that included improved communication skills, enhanced cultural competence, and increased patient satisfaction. Hands-on training programs and the use of multimedia tools showed better outcomes as compared to the traditional methods. Challenges that were faced included differences in implementation, constraints in resources, and a lack of standardized assessments. The certainty of evidence showed moderate results for communication skills and patient satisfaction, and low to moderate results for the readiness in clinical trials and cultural competence due to variability in study design.
Discussion: Effective competency training curricula substantially enhanced the functioning of healthcare systems and results for patients. Variations in the implementation of competency training programs and the assessment methods used were the main reasons for heterogeneity. Inaccuracy was seen due to limitations in sample sizes in some studies and a lack of long-term follow-up in others, hence constraining the generalizability of the results. There should be improved structure and specification so that such techniques would be applied in routine across a wide range of establishments to create more systematically planned and effectively delivered training in diverse and complex settings.
References
La Chimea T, Kanji Z, Schmitz S. Assessment of clinical competence in competency-based education. Can J Dent Hyg. 2020 Jun;54(2):83. doi: not available
Lee GB, Chiu AM. Assessment and feedback methods in competency-based medical education. Ann Allergy Asthma Immunol. 2022 Mar;128(3):256-62. doi: 10.1016/j.anai.2021.12.010
Holmboe E. The transformational path ahead: competency-based medical education in family medicine. Fam Med. 2021 Feb;53(7):583-9. doi: 10.22454/FamMed.2021.296914
Chaney KP, Hodgson JL. Using the five core components of competency-based medical education to support the implementation of CBVE. Front Vet Sci. 2021 Jul;8:689356. doi:10.3389/fvets.2021.689356.
Hall AK, Schumacher DJ, Thoma B, Caretta-Weyer H, Kinnear B, Gruppen L, et al. Outcomes of competency-based medical education: a taxonomy for shared language. Med Teach. 2021 Jul ;43(7):788-793. doi:10.1080/0142159X.2021.1925643
Lomis KD, Mejicano GC, Caverzagie KJ, Monrad SU, Pusic M, Hauer KE. The critical role of infrastructure and organizational culture in implementing competency-based education and individualized pathways in undergraduate medical education. Med Teach. 2021 Apr;43(2):S7-S16. doi: 10.1080/0142159X.2021.1924364
Ho D, Quake SR, McCabe ER, Chng WJ, Chow EK, Ding X, et al. Enabling technologies for personalized and precision medicine. Trends Biotechnol. 2020 May;38(5):497-518. doi:10.1016/j.tibtech.2019.12.021
Kilag OK, Malbas MH, Miñoza JR, Ledesma MM, Vestal AB, Sasan JM. The views of the faculty on the effectiveness of teacher education programs in developing lifelong learning competence. J High Educ Acad Adv. 2024 Jan;1(2):92-102. doi:10.1186/s40594-018-0125-4
Santen SA, Ginzburg SB, Pusic MV, Richardson J, Banks E, George KE, et al. The Association of Master Adaptive Learning with Less Burnout and More Resilience in Obstetrics and Gynecology Residents. Acad Med. 2023 Oct;1(1):10-97. doi:10.1097/ACM.0000000000005733
Zipkin DA, Ramani S, Stankiewicz CA, Lo MC, Chisty A, Alexandraki I, et al. Clinician-educator training and its impact on career success: a mixed methods study. J Gen Intern Med. 2020 Dec;35(1):3492-3500. doi:10.1007/s11606-020-06049-w.
Faizin C. Readiness of Interprofessional Education In Community Medicine: Medical And Dentistry Students. Al-Iqra Med J. 2023 Mar;6(1):1-6. Doi: not available
Lu PY, Tsai JC, Green A, Hsu AS. Assessing Asian medical students’ readiness for diversity: localizing measures of cross-cultural care competence. Teach Learn Med. 2021 May 27;33(3):220-34. doi:10.1080/10401334.2020.1830097.
Lee JY, Lensing SV, Botello-Harbaum MT, Medina R, Zozus M. Assessing clinical investigators’ perceptions of relevance and competency of clinical trials skills: An international AIDS Malignancy Consortium (AMC) study. J Clin Transl Sci. 2021 Jan;5(1):e28. doi:10.1017/cts.2020.520.
Sulena S, Kulkarni A, Mathur M, Jyoti N, Sidhu TK, Badyal D, Guha R. Challenges in Implementing Competency-based Medical Education in India–Stakeholders’ Perspective: A Mixed-method Analysis. Int J Appl Basic Med Res. 2024 Oct;14(4):225-232. doi:10.4103/ijabmr.ijabmr_268_24.
Febbraro M, Kazemi G, Juergens R, Pond GR. Trainee evaluations of preparedness for clinical trials in medical oncology—A national questionnaire. Curr Oncol. 2023 Aug;30(8):7627-7637. DOI:10.3390/curroncol30080553.
Kn Hs, Palappallil Ds, Panattil P. Clinical trials: Perspectives of medical community. Clin Trials. 2020;13(9):228. doi:10.22159/ajpcr.2020.v13i9.38228
Hsiao YT, Liu HY, Hsiao CC. Development of a novel interactive multimedia e-learning model to enhance clinical competency training and quality of care among medical students. InHealthcare. 2020 Nov;8(4):500. doi:10.3390/healthcare8040500.
Dieck-Assad G, González Peña OI, Rodríguez-Delgado JM. Evaluation of emergency first response’s competency in undergraduate college students: Enhancing sustainable medical education in the community for work occupational safety. Int J Environ Res Public Health. 2021 Jul;18(15):7814. doi:10.3390/ijerph18157814.
Shukla S, Acharya S, Acharya N, Singh S, Dolas P. Inculcating research methodology related skills and aptitude amongst medical undergraduates-An interventional study. J Fam Med Prim Care. 2022 Jul;11(7):3648-3653. doi:10.4103/jfmpc.jfmpc_1812_21.
Sng TJ, Yong CW, Wong RC. Cross sectional study on the competence and confidence of dental students and graduates in the management of medically compromised patients and acute medical emergencies. PLoS One. 2023 Feb;18(2):e0281801. doi:10.1371/journal.pone.0281801
Mills DA, Bernstein J. A community of practice in dental education: a phenomenon of newcomers becoming oldtimers. J Dent Educ. 2021 Jul;85(7):1259-1266. doi:10.1002/jdd.12582
Khan R, Khan S. Quality of dental education among students after graduation: a perspective study. Pak J Med Dent. 2021 Aug;10(4):98-103. doi:10.21815/JDE.019.094.
Jawade P, Reche A, Chhabra KG, Madhu PP, Kitey V, Hiware G. Knowledge, attitude and practice of research opportunities among medical and dental interns in Central India. J Pharm Res Int. 2021 Nov;33(47):146-149. doi:10.9734/JPRI/2021/v33i47B33105
Suwanchatchai C, Khuancharee K, Rattanamongkolgul S. Community-based interprofessional education for medical and health promotion students. BMC Med Educ. 2024 Jan;24(1):93. doi:10.1186/s12909-024-05066-1
Yarhere IE, Ogundipe O, Williams A. Scaling up numbers and competency of graduating medical and dental students in Nigeria. Niger J Clin Pract. 2023 Sep;26(9):1377-1382. doi:10.4103/njcp.njcp_246_23.
Grover A, Howley LD. Competency-based medical education—a journey or destination?. JAMA Netw Open. 2023 Apr;6(4):e237395. doi:10.1001/jamanetworkopen.2023.7395.
Deeter C, Hannah D, Reyes C. Professional development for clinical research professionals. J Res Adm. 2020;51(2):15-40. doi:not available
Rhoney DH, Chen AM, Churchwell MD. The need for competency-based education. Am J Pharm Educ. 2024 May;88(5):100706. doi:10.1016/j.ajpe.2024.100706.
Gebremickael A, Mulu A. National competency-based medical curriculum in Ethiopia: opportunities and challenges. BMC Med Educ. 2024 Jul;24(1):799. doi:10.1186/s12909-024-05796-2.
Sharma K, Sharma A, Neemawat K. Competency-based training for dental interns in Jaipur. CHRISMED J Health Res. 2020 Apr;7(2):110-114. doi:10.4103/cjhr.cjhr_60_19
Skivington K, Matthews L, Simpson SA. Framework for developing and evaluating complex interventions. BMJ. 2021 Sep;374:n2061. doi:10.1016/j.ijnurstu.2024.104705.
Witt CM, Balneaves LG, Carlson LE, et al. Education competencies for integrative oncology. J Cancer Educ. 2022 Jun;37(3):499-507. doi:10.1007/s13187-020-01829-8.
Dragan IF, Yildiz LF, Dunn K. Integrating remote proctoring in dental education. J Dent Educ. 2020 Jul;85(7):1071-1073. doi:10.1002/jdd.12307.
Mohile SG, Epstein RM, Hurria A. Communication with older patients using geriatric assessment. JAMA Oncol. 2020 Feb;6(2):196-204. doi:10.1001/jamaoncol.2019.4728.
Batt AM, Tavares W, Williams B. Development of competency frameworks in healthcare professions. Adv Health Sci Educ. 2020 Oct;25(5):913-987. doi:10.1007/s10459-019-09946-w.
Dagnone JD, Chan MK, Meschino D. Bridging competency-based medical education theory to practice in Canada. Acad Med. 2020 Nov;95(11):1643-1646. doi:10.1097/ACM.0000000000003216.
Deliz JR, Fears FF, Jones KE. Cultural competency interventions during medical school: a review. J Gen Intern Med. 2020 Feb;35(2):568-577. doi:10.1007/s11606-019-05417-5.
Shuyi AT, Zikki LY, Qi AM. Effectiveness of interprofessional education for medical and nursing professionals. Nurse Educ Pract. 2024 Jan;74:103864. doi:10.1016/j.nepr.2023.103864.
Schuwirth LW, van der Vleuten CP. History of assessment in medical education. Adv Health Sci Educ. 2020 Dec;25(5):1045-1056. doi:10.1007/s10459-020-10003-0.
Gopalakrishnan S, Catherine AP, Kandasamy S. Implementation of competency-based medical education in India. J Educ Health Promot. 2022 Jan;11(1):206. doi:10.4103/jehp.jehp_1130_21.
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