Impact of a Competency-Based Curriculum on Medical Student Advancement

Abstract

BACKGROUND In 1999, the Indiana University School of Medicine implemented a new curriculum based on 9 core competencies. We sought to document how the Student Promotions Committee (SPC) has adjudicated students’ competency-related deficiencies in the past decade. METHODS Using SPC records, we determined the frequency of competency-related deficiencies reported to the SPC over time, the nature of those deficiencies, and how the deficiencies were remediated. RESULTS From 1999-2009, 191 students (138 males, 53 females) were referred to the SPC for one or more competency-related deficiencies in 8 performance domains: effective communication; basic clinical skills; lifelong learning; self-awareness, self-care, and personal growth; social and community contexts of health care; moral reasoning and ethical judgment; problem solving; and professionalism and role recognition. For the purposes of this study, students with traditional academic performance issues like course failures were excluded from analysis. Collectively, the 191 students were cited for 317 separate competency-related deficiencies (1.66 per student). Of these 317 deficiencies, the most prevalent were in the competencies of professionalism (29.3%), basic clinical skills (28.4%), and self-awareness (17.7%). Each of the remaining competencies constituted less than 10% of the total. Successful remediation utilized 12 methods ranging from a simple warning letter to being required to repeat the year under close monitoring. Remediation was unsuccessful for 17 students (8.9%) who were dismissed from medical school. CONCLUSIONS Based on our School’s experience, we believe that unprofessional behaviors and other competency-related deficiencies can be identified and remediated in most cases.