Competency-based Curriculum

Competency-based Curriculum – a neat idea but likely hard bought buy-in

This past week I looked at competency-based curriculum from a system’s perspective. I had to remind myself that as an instructional designer I am pragmatist while reviewing some of the literature. As a pragmatist I can say that “it might work if…” or “it might work but…” and I can design as I am asked to design with the theoretical framework given but when I feel that it doesn’t quite work then I can bring in some other idea and try make it work. I don’t have to look through just one lens – which is all good. Instructional design is, after all, not a predictable process, because over time we have come to realize that people are not predictable (like behaviorists wanted to have it), but learning is more of a situated process adapted to fit the moment and the learner in focus.

Competency-based curriculum allows students to learn skills but also to apply their learning in real-life like ways – within context (RSA, n.d.). The curriculum has been used to quite some extent within medical school such as when preparing students become ready for their physician residency, and within nursing, but also in psychiatry, and economics. Albanese, Mejicano, Anderson, and Gruppen (2010) note that it “requires careful planning, preparation, and a long-term commitment from everyone involved in the educational process.” This sounds time-consuming and it is. Buy-in is expected from everyone and I think most of us know how hard that can be. Even just one faculty teaching with lower expectations or with leaner grading can jeopardize the entire program the curriculum is implemented in.

In competency-based curriculum the idea is that learners shall make connections and apply learning as per constructivist means, having the curriculum building blocks guide the process as they build on existing knowledge. Faculty functions as facilitators in the process but within medical school, Albanese et al. (2010) note that it is hard for faculty to find the time to supervise and assess learners in the real as they are heavily burdened themselves being practitioners. The application part is a must because without it, how can physicians become competent physicians? In Albanese et al.’s study the competency-based curriculum helps learners prepare for their residency rather than preparing them as physicians. i.e. it provides them the basics of what they need to know – levels them to a competency level set as an entry goal to residency. Learners have to demonstrate that they achieved competency at all levels along the way.

This all sounds good, so what is the hatch? Albanese et al. (2010) note that there is a large challenge in slicing the curriculum so that it becomes manageable. Once this is done the students competence, with each chunks or levels, needs somehow to be assessed. Who decides how it is to be assessed? How is it going to be assessed? Is it a pass/fail concept? Can it be measured on a scale? What should the scale look like? Who determines that the learner has reached competence? What is competence anyway? How do learners pace through the curriculum? Are there time limits to how long they can try for competence? What happens if they fail? Since we already determined that humans are not predictable, can more than one instructor determine if someone passes or fails? What if life happens and a learner has personal problems, illness, etc. and is unable to self-pace? Will someone take note and consult? What implications does it have on facilitators, the program, the school, the greater environment of the community if someone fails or gets a pass grade without having passed the competencies?

With so many questions noted why would anyone want to implement competency-based curriculum? Albanese et al. (2010) take a humoristic approach as they say “If student growth does not make you ecstatic, there is not much else to get excited about because a competency-based curriculum is really more of a quality control mechanism that functions by giving students greater control over their education. Quality control and relinquishing control are not things most faculty get ecstatic about.”

How does this fantastic environment look like as a system? Well, let’s take Albanese et al.’s (2010) physicians as an example. There is the learner in the center given control through the designed curriculum. Learners should pass through the curriculum but also be able to – at least ideally – test out if they bring with them vast amount of applicable practical and theoretical knowledge. There are the instructors assigned as facilitators, mentors, guides, assessors. Everyone has to teach to the curriculum so assessment is fair and the competency is equally measured. To achieve this everyone who teaches and assesses the learners need continuous training to stay on the same level and use the same principles. This training, and indeed the entire program, needs a strong support from administration and funds made available from the school. As students reach proficiency the school and community needs to make available residency positions for the learners. In a national perspective we are in dire need of these physicians and practitioners that have chosen to become part of a profession that according to Albanese et al. is facing a serious shortfall.

As I started off, there really is no ideal way of designing curriculum. So much has to be considered: the learner, the teacher, the cognitive levels, the situation, the goals by the individual learner as well as the program, the institution, the community, and the nation. All pieces are interconnected and should be seen as such. It should not be about the individual going through the motions in a program striving for some letters to place in front of their name – it should be about learning, change, understanding, building a better world for those coming after us. Not everyone sees it as such. There are too many students that get passing grades that do not deserve them and I see it is not just the fault of the instructors – it is part of a system failure where goals and outcomes for programs and institutions require instructors to pass even the weak because sometimes the students we get are not the ones with a passion to learn but those that are weak. Here is where I see the competency-based curriculum as dangerous: When there is no whole-hearted system buy-in – When students become numbers of graduates in reports submitted upward to the bigger system rather than really competent graduates leaving a program contributing to our and our children’s shared future.

Feel free to disagree – the comment box is there for this very purpose.

Albanese, M. A., Mejicano, G., Anderson, W. M., & Gruppen, L. (2010). Building a competency-based curriculum: The agony and the ecstasy.
RSA. (n.d.). Opening Minds. Retrieved from http://www.rsaopeningminds.org.uk/about-rsa-openingminds/

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2 responses to “Competency-based Curriculum

  1. Jenny,

    Jenny,

    First of all, I agree with you that, from a practical point of view, there really is no ideal way of designing curriculum; because as you stated, so much has to be considered: the learner, the teacher, the cognitive levels, the situation, the goals by the individual learner as well as the program, the institution, the community, and the nation.

    Furthermore, I agree with you that instructional design is not a predictable process, because people are not predictable. Learning is more of a situated process, adapted to fit the moment and the learner. It should not be about the individual going through the motions in a program striving for some letters to place behind their name – it should be about learning, change, understanding, and building a better world for those coming after us.

    In your discussion of a competency-based curriculum, you noted that the methods of instruction not only allow students to learn skills, but also encourages them to apply their learning in real-life like ways – within context (RSA, n.d.). The idea is that learners shall make connections and apply learning as per constructivist means, having the curriculum building blocks guide the process as they build on existing knowledge.

    Albanese, Mejicano, Anderson, and Gruppen (2010), note that competency-based medical school curricula helped learners prepare for their residency rather than preparing them as physicians. Such an approach provides them the basics of what they need to know as residents, thereby bringing them to a competency level established as an entry-level goal to the practice of medicine. Learners must demonstrate that they achieved competency at all levels along the way. Albanese et al. (2010) further emphasize that this “requires careful planning, preparation, and a long-term commitment from everyone involved in the educational process,” while also observing that it is hard for faculty to find the time to supervise and assess learners in real-time as they are themselves heavily burdened as medical practitioners.
    Jenny, you ask some difficult questions in coming to terms with evaluating the complete competency-based curriculum development process…
    • What if life happens and a learner has personal problems, illness, etc. and is unable to self-pace? Will someone take note and consult?
    • What implications does it have on facilitators, the program, the school, the greater environment of the community if someone fails or gets a pass grade without having passed the competencies?
    • Who decides how it is to be assessed? How is it going to be assessed? Is it a pass/fail concept? Can it be measured on a scale? What should the scale look like?
    • Who determines that the learner has reached competence? What is competence anyway?
    • How do learners pace through the curriculum? Are there time limits to how long they can try for competence? What happens if they fail?
    Finally, you conclude that competency-based curriculum is dangerous when there is no whole-hearted system buy-in, or when students simply become numbers of graduates in reports submitted upward to the bigger system, rather than becoming really competent graduates who leave a program with the necessary knowledge and skills to become contributing assets towards our shared future.
    When the overwhelming reality of the task becomes apparent, I see the only possible solution arising from the deep personal recognition of our shared humanity and ultimate common destiny as learner and teacher. By recognizing the dignity and worth of the individual as the basic premise of a practical application of spirituality in the workplace, a competency-based curriculum becomes a much more humanistic approach for both the learner and the teacher.

  2. HI

    Great and in depth piece on CBE. I agree that there is ” no ideal way of designing curriculum”, but we at Brandman have tried to put together a challenging and efficient CBE program. Anyways, thanks for sharing this article you put together.

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