Current postgraduate medical education is based on a century-old time-based apprentice model: “See one, do one, teach one”. Social, scientific and technological changes as well as public pressure to improve the quality of care have resulted a change in the medical education and implementation to Competency-Based Medical Education (CBME). CBME emphasizes competencies including clinical skills, professionalism, ethics, team-work teaching and life-long learning skills, essential for patient and society needs . It requires medical educators to evaluate interns in their clinical activities, develop performance evaluation measures and strengthen their reflection skills. CBME requires a comprehensive organization change and the support of all parties involved.
Adopting CBME requires innovative approaches unfamiliar to both specialist physicians, trained in traditional systems, form the backbone of medical education. In 2018, the Scientific Council of the Israeli Medical Association introduced CBME for neonatology fellow trainees across Israel. In Israel, specialist physicians’ perceptions of CBME and transition barriers have not been systematically studied.
The research goal was to examine specialist neonatologists’ perceptions of CBME implementation, identifying advantages and challenges. The study used mixed methods, involving 41 specialist neonatologists, half are women, from 13 departments. The participants filled out questionnaires with open and closed questions, and seven of them participated in semi-structured interviews, from which their perceptions were analyzed. The study revealed three CBME-related factors: “Implementation benefits”, “Self-reflection”, and “Challenges”. Physicians who participated in the CBME training gave more feedback to the interns, gender differences were noted in perceived benefits, while smaller hospitals implemented CBME more effectively than big hospitals. The qualitative analysis identified four themes: “Training”, “Implementation and evaluation”, “Implementation challenges and benefits”, and “Resources”. The findings from the statistical analysis of the questionnaire were found to be complete and consistent with the qualitative analysis from the interviews. The study demonstrated CBME benefits in preparing neonatal fellow trainees and highlighted implementation challenges. Both the CBME questionnaire and interview protocol of neontologists’ perceptions are part of the methodological contribution of this study and can be utilized for further research in the a broader and more comprehensive investigation. Understanding the perceptions of the neontologists and medical educators involved, may contribute to and enhance the integration of CBME as a framework for postgraduate medical education and help identifying potential challenges that other postgraduate specialties face as they transition to a CBME teaching method and fully apply it. These processes may contribute to the applicability of the study and facilitate the successful implementation and assessment of CBME in other specialty fellowship programs in Israel and globally.
