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How to Interpret the Competencies Table in CBME

Updated: Apr 9

Have you ever wondered how medical education ensures that students develop the right skills, knowledge, and professional attributes before they graduate? The answer lies in Competency-Based Medical Education (CBME) and its structured competency tables. These tables serve as a roadmap, guiding medical students through a well-defined learning process. By the end of this article, you'll have a clear understanding of how to read and interpret these competency tables, helping you navigate your medical education effectively.

Understanding the CBME Competencies Table

Understanding the Structure of the Competency Table

CBME competency tables are designed to categorize essential learning outcomes across different subjects and domains of medical education. Each competency is labeled with a unique identifier and is assessed based on its relevance, teaching methods, and certification requirements.


Key Components of the Competency Table

To fully grasp the competency table, you need to understand how each column contributes to student evaluation and learning.


1. Competency Number

Each competency has a unique identifier that helps track progress and reference learning objectives. The format typically follows:

  • Subject Code: A short abbreviation representing the subject (e.g., "PY" for Physiology, "IM" for Internal Medicine).

  • Number Sequence: A numbering system indicating the sequence of competencies within that subject (e.g., "1.1").


2. Description of Competency

This column details the specific competency that students are expected to achieve. It typically includes statements such as:

  • "Describe the structure and function of..."

  • "Elicit and document a patient history..."

  • "Interpret diagnostic findings..."


3. Domains of Learning

Each competency falls into one or more learning domains:

  • Knowledge (K): Understanding theoretical concepts.

  • Skills (S): Practical application of learned techniques.

  • Attitudes (A): Professional values such as ethics and empathy.

  • Communication (C): Effective interaction with patients and healthcare teams.


4. Levels of Achievement

Miller’s framework defines different levels of competency:

  • Knows (K): Theoretical understanding.

  • Knows How (KH): Ability to apply knowledge in clinical scenarios.

  • Shows How (SH): Demonstration of skill under supervision.

  • Perform (P): Independent execution of the skill (typically required in later clinical stages).


5. Suggested Teaching Methods

To achieve the competencies, various teaching methodologies are used:

  • Large Group Teaching (LGT): Lectures and theoretical discussions.

  • Small Group Teaching (SGT): Interactive sessions such as case-based learning.

  • Bedside Clinics: Hands-on learning with real patients.

  • DOAP (Demonstration/Observation/Assisted Performance): Practical training with guided supervision.


6. Core vs. Non-Core Competencies

Each competency is classified as:

  • Core (Y): Essential and mandatory for certification.

  • Non-Core (N): Desirable but not compulsory.


7. Suggested Assessment Methods

Assessments ensure that students meet competency standards through various evaluation methods:

  • OSCE (Objective Structured Clinical Examination): Assesses practical and clinical skills.

  • Direct Observation: Faculty supervision of students performing tasks.

  • Written/Viva Exams: Tests theoretical knowledge.


8. Certification Requirements

Some competencies require a specified number of independent performances before certification. For example, a student might need to document a patient history three times under supervision before gaining certification for that skill.


Competency Table in Action: Examples from Different Subjects

To illustrate how these tables work, let’s break down two examples from different subjects.


Physiology (PY1.1)

  • Competency: "Describe the structure and functions of..."

  • Domain: Knowledge (K)

  • Level of Achievement: Knows How (KH)

  • Teaching Methods: Large Group Teaching (LGT), Small Group Teaching (SGT)

  • Assessment: Written test/Viva

  • Certification Requirement: Not explicitly required


Internal Medicine (IM4.10)

  • Competency: "Elicit, document, and present a medical history..."

  • Domain: Skills (S)

  • Level of Achievement: Shows How (SH)

  • Teaching Methods: Bedside Clinics, DOAP

  • Assessment: OSCE, Direct Observation

  • Certification Requirement: Perform competency three times independently for certification


Why Understanding Competency Tables Matters

Medical students and educators alike benefit from a well-structured competency-based approach. The competency table ensures:

  1. Clear Learning Pathways: Students know exactly what is expected at each stage of their education.

  2. Standardized Assessments: Consistent evaluation methods ensure fair assessment across institutions.

  3. Enhanced Skill Development: The shift from passive learning to active skill-building better prepares students for clinical practice.

  4. Efficient Tracking and Certification: Institutions can systematically monitor student progress and ensure readiness for professional practice.

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