Investigating the Roles and Impact of Clinical Competency Committees in Graduate Medical Education: A Narrative Review.

Abstract

Background Although Clinical Competency Committees (CCCs) were implemented to facilitate the goals of competency-based medical education, implementation has been variable, and we do not know if and how these committees affected programs and assessment in graduate medical education (GME). Objective To explore the roles CCCs fulfill in GME and their effect on trainees, faculty, and programs. Methods We conducted a narrative review of CCC primary research with the following inclusion criteria: all articles must be research in nature, focused on GME and specifically studying CCCs, and published in English language journals from January 2013 to November 2022. Results The main results are as follows: (1) The primary role of the CCC (decision-making on trainee progress) is mostly described in "snapshots" (ie, focusing on a single aspect of this role at a single point in time); (2) CCCs are taking on secondary roles, some of which were anticipated (eg, remediation, feedback) whereas others were "unanticipated" (eg, use of CCC data to validate trainee self-assessment, predict trainee performance in other settings such as certifying examinations, investigate gender bias in assessment); and (3) Articles briefly mentioned short-term outcomes of CCCs at the level of the trainees, faculty, and programs. However, most studies described interventions to aid CCC work and did not specifically aim at investigating short-term (eg, curriculum changes) or long-term outcomes (eg, improved patient outcomes). Conclusions CCCs fulfill a range of roles in assessment beyond their intended purpose. A more systematic approach is needed to investigate the outcomes of CCC implementation on GME.