Medical School Use of Competency Frameworks in Learning Objectives and Curriculum

Medical schools use diverse language in their learning objectives, including those at the program, course, and event level. Schools may choose to write original learning objectives, use an existing competency frameworks’ language exactly as is, or customized an existing competency frameworks’ language to best fit their school. This study examines the question – which competency frameworks do US allopathic medical schools in their learning objectives, how do they use them, and how does this play out in curriculum? Four frameworks are examined: the Association of American Medical Colleges (AAMC) Physician Competency Reference Set (PCRS), the Accreditation Council on Graduate Medical Education (ACMGE) core competencies, the AAMC Entrustrable Professional Activities (EPAs), and the Royal College of Physicians and Surgeons of Canada CanMeds enabling competencies. When examining Liaison Committee on Medical Education (LCME) accredited, United States-based allopathic medical schools’ curricular data from 2014-2020, results show that a majority of schools (82 unique schools) use one or more of the four frameworks in the language of their program objectives. There is an upward trend over time of schools incorporating language from frameworks into their learning objectives. When examining unique school uses, the most often chosen of the four frameworks is the AAMC PCRS at the program, course, and event objective level. When examining whether schools use a framework’s language exactly as is, or adapt it to add additional characters, the more common approach is to adapt the frameworks’ language for school-specific learning objectives.