Is it the right time to promote competency-based European Training Requirements in Ophthalmology? A European Board of Ophthalmology survey

Abstract

Purpose: To report national practices and recent progress in competency-based medical education (CBME) implementation in ophthalmology across European countries.

Methods: A 30-question online survey was emailed to European Union of Medical Specialists (UEMS) ophthalmology section delegates, European Board of Ophthalmology Diploma (EBOD) examiners and presidents of ophthalmology societies affiliated with UEMS/EBO.

Results: A total of 230 ophthalmologists with an average age of 54.7 years [30-77] and from 28 countries completed the survey. Half of them had been involved as medical educators for more than 10 years. The majority (74%) exercised their educational role in a University Hospital. Ninety six percent of them dedicated less than 50% of their activity to teaching. A third dedicated more than a half of their activity to patient care. The teaching of skills reported (medical, surgical, research, attitudinal and theoretical knowledge) was significantly better applied than their assessment. While 91% of the respondents found it necessary to harmonize European Training Requirements (ETR) in ophthalmology, competency-based education concepts were rarely implemented in their country (for instance, 8% for CBME; 6% for entrustable professional activities (EPAs) and 3% for ETR).

Conclusions: Despite considerable diversity in European residency programmes, post-graduate medical education leaders in ophthalmology agree on the need to find a platform for equivalence in the content of the basic training requirements that constitute the professional identity of a practicing ophthalmologist.

Keywords: European Board of Ophthalmology; European Training Requirements; European Union of Medical Specialists; competency‐based medical education; entrustable professional activities; ophthalmology residency curriculum.

FIGURE 1

Responders' qualitative evaluation for skills teaching (« taught ») and assessment (« assessed ») in their workplace including medical, surgical, research, attitudinal (that is medical professionalism) and theoretical skills. Statistical comparisons of these results were made using the Wilcoxon signed‐rank test. Continuous black lines are used for skills taught and dotted lines are for skills assessed. Teaching for one skill was systematically better rated compared to its assessment. Medical, surgical and theoretical knowledge skills seemed better considered than research and attitudinal skills. *Statistically significant after Bonferroni correction (p < 0.001). ¹Legend for theoretical knowledge assessment is as follows: Dark green square = None; light green square = By concluding the programme; orange square = Annually; red square = Both.

FIGURE 2

The proportion of participants who implemented ETRs, CBMEs, EPAs, CanMEDs, ACGMEs and Miller's Pyramid in their centres for each country along with the proportion of participants who think harmonization of ETRs in European countries is necessary. Countries with two or fewer participants are represented in grey rounds. Data for the entire European sample are given in the top right corner of the figure. ⁺Significantly different from hazard according to Z score (χ ²), only applied for countries with more than 10 responders. ACGME, Accreditation Council for Graduate Medical Education; All, Represents all 6 illustrated concepts; CanMEDs, Canadian Medical Education Directions for Specialists; CBME, Competency‐Based Medical Education; Cz Rep, Czech Republic; EPA, Entrustable Professional Activities; ETR, European Training Requirements; Miller's P, Miller's Pyramid; H, harmonization is necessary (for countries with two or fewer participants only); N, number of participants per country.