gms | German Medical Science

Background: Due to the enormous growth and increasing complexity of knowledge, “… educational and professional qualifications can no longer be described according to a rigid canon of knowledge in specific subjects passed on from generation to generation” [1]. Therefore, in the last decade there has been a shift to outcome-based education. This has also been the case for medical education, where several attempts have been made to identify learning outcomes, which represent essential core competencies that all physicians must possess. This research covers the identification of essential medical competencies and the development of a questionnaire to assess these competencies.

Method: A team of experts identified several domains of medical core competencies, most of which were derived from the German Approbationsordnung (ÄAppO), the defining national framework for medical education. Items were identified for each domain and their comprehensibility was tested by students in their final year. The dimensionality and reliability of the resulting questionnaire the “Freiburger Fragebogen zur Erfassung von Kompetenzen in der Medizin” (FKM) was examined on samples of students before and after their final year and on medical residents. Additionally, analyses of variance were conducted.

Results: A first analysis showed satisfactory reliability (Cr-a between .68 and .88) for all seven scales of the first version of FKM. A critical examination led to a revision of the questionnaire: For two scales additional items were formulated and two new domains of competencies were defined. The following analysis also showed satisfactory reliability scores (Cr-a between .67 and .89)for the FKM-scales: clinical skills, communicative competence and soft skills, team-competence, health-system-competence, competencies on management level, competence in medical profession, learning-competence, scientific-competence and personal competence. Furthermore, compared with their male colleagues, female students show higher ratings in communicative competencies and soft skills.

Conclusions: The FKM-Questionnaire was developed in order to evaluate educational outcomes in medical schools. Given the uncertainty of self-assessment further analyses are necessary in order to test the validity of the questionnaire as a measure of actual competence. However, comparing the results of students and graduates from different schools and different cohorts might in any case be helpful to identify so far neglected areas of the curriculum that need special attention. Furthermore, the extended use of the FKM with postgraduates will inform us both on the relevance of the targeted competencies and on the validity of the instrument.