Competency-based veterinary education - An integrative approach to learning and assessment in the clinical workplace

When graduating from veterinary school, veterinary professionals must be ready to enter the complex veterinary profession. Therefore, one of the major responsibilities of any veterinary school is to develop training programmes that support students’ competency development on the trajectory from novice student to veterinary professional. The integration of learning and assessment in the clinical workplace to foster this competency development in undergraduate veterinary education is the central topic of this thesis. Competency-based education is an approach to prepare students for clinical practice oriented to outcome abilities and organised around competencies. Based on these competencies performance-related information can be provided to enhance and evaluate students’ learning. A theory-based programmatic assessment model could allow integration of learning and assessment in the clinical workplace. The need to enhance our understanding on how this integrative programmatic approach to learning and assessment interacts with practice leads up to the central research questions of this thesis. First, what overarching competency structure provides a solid foundation for competency-based education in veterinary medicine? Second, how does theory interact with practice when implementing a competency-based assessment programme in undergraduate veterinary education? And third, which underlying mechanisms affect the exchange of performance-relevant information in competency-based workplace learning and assessment? We used a design-based research approach to advance the interaction between theory and educational practice. Within competency-based veterinary education, educational strategies need to be aligned and based on an agreed competency framework. An overarching competency structure for competency-based education in veterinary medicine could be the VetPro-competency framework, that consists of one more technical, specific domain, i.e. Veterinary Expertise, and six more generic non-technical domains, i.e. Communication, Collaboration, Entrepreneurship, Health and Welfare, Scholarship, and Personal Development. To perform adequately in the complex workplace of the veterinary profession the ability to integrate all the competencies described within these domains is essential. The VetPro competency framework seems to provide a firm basis for reflective and developmental activities on all relevant competencies for the veterinary professional. The implementation and evaluation of the competency-based assessment programme, aiming both to support and evaluate students’ competency development, pointed out a number of challenges. These challenges interfered with the two main objectives of the design, namely using formative assessments to maximally enhance student’ competency development and including performance-relevant information from formative assessment instruments in high-stakes assessment procedures. One of the main stumbling blocks turned out to be the provision of high-quality, meaningful feedback on students’ performance within the complex clinical environment. Furthermore, the objective of the theoretical model for programmatic assessment to use formative information in longitudinal high-stakes assessments seemed to corrupt the other main goal of providing and documenting meaningful feedback in order to maximally enhance students’ competency development. Finally, we explored the underlying mechanisms affecting the exchange of performance-relevant information, and identified three main categories of interrelated factors that influenced students’ feedback-seeking behaviour and teachers’ feedback-giving behaviour in the veterinary clinical workplace.