Managing curriculum reform in the transition to competency-based education using entrustable professional activities

Curriculum reform in health professions education is essential to address evolving societal expectations for healthcare. Competency-based education (CBE), advocated by leaders in healthcare such as the Lancet Commission and the World Health Organization, aims to bridge the gap between traditional training in the health professions and modern healthcare needs. This chapter outlines a comprehensive approach to curriculum reform, emphasizing the integration of change management for the human aspects and project management for the technical aspects, to ensure successful implementation. Drawing from different models, five essential themes to manage curriculum reform emerge: communication, iterative design, leadership, teamwork, evaluation and refinement.

The transition to a CBE program based on entrustable professional activities (EPAs) necessitates a major curriculum reform that can be considered a systemic overhaul. This process involves planning, implementing, and monitoring changes while preparing and supporting stakeholders to embrace and sustain these changes. This chapter utilizes Van Melle’s core components framework of CBE to set the blueprint for an EPA-based curriculum, guiding the development of EPAs as training outcomes creating tailored instruction and learning experiences to foster competency acquisition, and establishing programmatic assessment to inform entrustment progression. By leveraging international experiences and ensuring contextualization and localization, this chapter provides a robust framework to navigate the complexities of transitioning to CBE. The chapter concludes by presenting a practical, step-by-step method for managing curriculum reform through the phases of initiation, implementation, and sustainability. The principles and strategies outlined offer valuable insights for educational leaders, program directors, and policymakers aiming to effectively align education with healthcare practice.