Competency frameworks: Universal or local

摘要

We read with great enthusiasm the scholarly paper by Morcke et al. (2012) published in the Advances in Health Sciences Education journal entitled "Outcome (competency) based education: an exploration of its origins, theoretical basis, and empirical evidence". The authors of this splendid manuscript provide a comprehensive review of an important concept in medical education, i.e. "competency". It is very important to notice that the outcome based education (OBE) era, despite the widespread discussions and debates which have been present over the issue, still suffers from a scarcity of the evidence to support its impact on learning. Most of the few studies that Morecke et al. found do not actually check for the outcome or output of this approach. While we support most of the ideas presented in the paper, there is one point we do not completely agree with. The authors state that "even, schools with very different styles of curriculum could reach consensus on learning outcomes". They set CanMEDS competency framework as an example and claim that it has been "extensively adopted, not only in Canada, but around the world". This notion implies that a similar set of competencies can be adopted by all medical schools aroqpd the world.