Misbehavior or misalignment? Examining the drift towards bureaucratic box-ticking in Competency-Based Medical Education
2025

Bureaucratic Box-Ticking in Competency-Based Medical Education

Sample size: 43 publication 10 minutes Evidence: moderate

Author Information

Author(s): Alicia C. Strand, Andreas Gingerich, Vijay John Daniels

Primary Institution: University of Alberta

Hypothesis

What leads residents and faculty towards a ‘tick-box’ approach in EPA assessments?

Conclusion

The study found that the drift towards bureaucracy in workplace-based assessments is becoming a predictable pattern.

Supporting Evidence

  • Entrustable Professional Activity assessments are intended to enhance learning and inform promotion decisions.
  • Participants reported that the requirement to complete assessments often felt bureaucratic.
  • Preceptors and residents described their experiences as being influenced by the need to fulfill assessment quotas.

Takeaway

This study looked at how medical residents and their teachers feel about a new way of assessing their skills, which sometimes feels more like filling out forms than actually learning.

Methodology

Qualitative interviews with 16 residents and 27 preceptors were conducted to explore their experiences with EPA assessments.

Potential Biases

Participants may have felt obligated to complete assessments due to program requirements, which could influence their responses.

Limitations

The study only included participants who submitted an EPA assessment, potentially missing contrasting perspectives.

Participant Demographics

Participants included first- and second-year residents and faculty preceptors from the Internal Medicine residency program at the University of Alberta.

Digital Object Identifier (DOI)

10.1371/journal.pone.0313021

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