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References

  1. Gantwerker E, Allen L, Hay M. Chapter: Future of Health Professions Education Curricula. In: Nestel D, Reedy G, McKenna L, Gough S, editors. Clinical Education for the Health Professions: Theory and Practice. Springer; 2020.
  2. Gin BC, LaForge K, Burk-Rafel J, Boscardin CK. Macy Foundation innovation report part II: from hype to reality: innovators’ visions for navigating AI integration challenges in medical education. Academic Medicine. 2025 Jul 28;10–97. DOI: 10.1097/ACM.0000000000006117
  3. Knopp MI, Warm EJ, Weber D, et al. AI-Enabled Medical Education: Threads of Change, Promising Futures, and Risky Realities Across Four Potential Future Worlds. JMIR Med Educ. 2023;9:e50373. DOI: 10.2196/50373
  4. Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, Fineberg H, Garcia P, Ke Y, Kelley P, Kistnasamy B, Meleis A, Naylor D, Pablos-Mendez A, Reddy S, Scrimshaw S, Sepulveda J, Serwadda D, Zurayk H. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet. 2010 Dec 4;376(9756):1923–1958. DOI: 10.1016/S0140-6736(10)61854-5
  5. Frank JR, Snell LS, ten Cate O, Holmboe ES, Carraccio C, Swing SR, Harris P, Glasgow NJ, Campbell C, Dath D, et al. Competency-based medical education: theory to practice. Med Teach. 2010;32:638–645. DOI: 10.3109/0142159X.2010.501190
  6. Caverzagie KJ, Nousiainen MT, Ferguson PC, ten Cate O, Ross S, Harris KA, Busari J, Bould MD, Bouchard J, Iobst WF, ICBME Collaborators, et al. Overarching challenges to the implementation of competency-based medical education. Med Teach. 2017;39:588–593. DOI: 10.1080/0142159X.2017.1315075
  7. Nousiainen M, Caverzagie K, Ferguson P, Frank JR, International CBME Collaborators. Implementing competency-based medical education: what changes in curricular structure and processes are needed? Med Teach. 2017. DOI: 10.1080/0142159X.2017.1315077
  8. Ott MC, Pack R, Cristancho S, Chin M, Van Koughnett JA, Ott M. “The Most Crushing Thing”: Understanding Resident Assessment Burden in a Competency-Based Curriculum. J Grad Med Educ. 2022;14(5):583–592. DOI: 10.4300/JGME-D-22-00050.1
  9. Anzinger H, Schrewe B. Centered on learning, but is it learner centered?: Paediatric resident perspectives on competency-based medical education. Med Educ. 2026 Jun;60(6):664–675. DOI: 10.1111/medu.70081
  10. Van Melle E, Frank JR, Holmboe ES, Dagnone D, Stockley D, Sherbino J, International Competency-based Medical Education Collaborators. A Core Components Framework for Evaluating Implementation of Competency-Based Medical Education Programs. Acad Med. 2019 Jul;94(7):1002–1009. DOI: 10.1097/ACM.0000000000002743
  11. Chen A, Rhoney D, Goldhamer M, Ekpenyong A, Humphrey-Murto S, Caretta-Weyer H, Snell L, Damodaran A, Englander R, Hall A, Huwendiek S, Molgaard L, Oswald A, Schumacher D, Chou F, Tanaka P, Frank J, for the International Competency-Based Health Professions Education Collaborators. The CBHPE Outcomes Theory of Change: An International Consensus Statement on the Mechanisms and Outcomes of Competency-Based Education in the Health Professions. 2026, Under Review. DOI: 10.5334/pme.2553
  12. Frank JR, Mungroo R, Ahmad Y, Wang M, De Rossi S, Horsley T. Toward a definition of competency-based education in medicine: a systematic review of published definitions. Med Teach. 2010;32:631–637. DOI: 10.3109/0142159X.2010.500898
  13. Harris B, Topps R, Lieberman F, Snell S, and on behalf of the ICBME Collaborators. Evolving concepts of assessment in a competency-based world. Medical Teacher. 2017;39(6):603–608. DOI: 10.1080/0142159X.2017.1315071
  14. Holmboe ES. Competency-Based Medical Education and the Ghost of Kuhn: Reflections on the Messy and Meaningful Work of Transformation. Acad Med. 2018 Mar;93(3):350–353. DOI: 10.1097/ACM.0000000000001866
  15. Cutrer WB, Spickard WA 3rd, Triola MM, Allen BL, Spell, N 3rd, Herrine SK, Dalrymple JL, Gorman PN, Lomis KD. Exploiting the power of information in medical education. Med Teach. 2021 Jul;43(sup2):S17–S24. DOI: 10.1080/0142159X.2021.1925234
  16. Busari JO, Diffey L, Hauer KE, Lomis KD, Amiel JM, Barone MA, … Chan MK. Advancing anti-oppression and social justice in healthcare through competency-based medical education (CBME). Medical Teacher. 2024;46(9):1167–1174. DOI: 10.1080/0142159X.2023.2298763
  17. Caretta-Weyer HA, Smirnova A, Barone MA, Frank JR, Hernandez-Boussard T, Levinson D, Lombarts KMJMH, Lomis KD, Martini A, Schumacher DJ, Turner DA, Schuh A. The Next Era of Assessment: Building a Trustworthy Assessment System. Perspect Med Educ. 205 Jan 22;13(1):12–23. DOI: 10.5334/pme.1110
  18. Pugh CM. The Quantified Surgeon: A Glimpse into the Future of Surgical Metrics and Outcomes. The American Surgeon™. 2023;89(9):3691–3694. DOI: 10.1177/00031348231168315
  19. Sebok-Syer SS, Small WR, Lingard L, Glober NK, George BC, Burk-Rafel J. Leveraging Electronic Health Record Data and Measuring Interdependence in the Era of Precision Education and Assessment. Acad Med. 2024;99(S1):S48–S56. DOI: 10.1097/ACM.0000000000005621
  20. Tscholl DW, Ebensperger M, RahrischRahrisch A, et al. Generative AI in simulation debriefings: an exploratory study using the Team-FIRST framework and qualitative feedback from simulation experts and learners. Adv Simul (Lond). 2026;11(1):14. DOI: 10.1186/s41077-026-00407-0
  21. Sebok-Syer SS, Chahine S, Watling CJ, Goldszmidt M, Cristancho S, Lingard L. Considering the interdependence of clinical performance: implications for assessment and entrustment. Med Educ. 2018 Apr 19;52(9):970–980. DOI: 10.1111/medu.13588
  22. Miller KA, Ilgen JS, de Bruin AB, Pusic MV, Stalmeijer RE. Physician development through interprofessional workplace interactions: a critical review. Medical Education. 2025 May;59(5):484–493. DOI: 10.1111/medu.15564
  23. Ahn E, Sebok-Syer SS, Maniate JM, Endres K, Cheung WJ. Beyond Individualism and Independence: Exploring Collectivism and Interdependence as Paradigms of Healthcare and Health Professions Education. Perspect Med Educ. 2025 Dec 4;14(1):939–955. DOI: 10.5334/pme.2000
  24. Vaughan M, Johnson KA, Bergin CR. Impact of Clerkship Length and Sequence on NBME Subject Exam Performance. Med Sci Educ. 2025 Feb 17;35(3):1313–1322. DOI: 10.1007/s40670-025-02305-y
  25. Chan T, Sebok-Syer S, Thoma B, Wise A, Sherbino J, Pusic M. Learning analytics in medical education assessment: the past, the present, and the future. AEM Education and Training. 2018 Apr;2(2):178–187. DOI: 10.1002/aet2.10087
  26. Triola MM, Burk-Rafel J. Precision Medical Education. Acad Med. 2023 Jul 1;98(7):775–781. DOI: 10.1097/ACM.0000000000005227
  27. Boscardin CK, Gin B, Golde PB, Hauer KE. ChatGPT and generative artificial intelligence for medical education: potential impact and opportunity. Academic Medicine. 2024 Jan;99(1):22–27. DOI: 10.1097/ACM.0000000000005439
  28. Carraccio CL, Benson BJ, Nixon LJ, Derstine PL. From the educational bench to the clinical bedside: translating the Dreyfus developmental model to the learning of clinical skills. Acad Med. 2008 Aug;83(8):761–767. DOI: 10.1097/ACM.0b013e31817eb632
  29. Ten Cate O. When I say … entrustability. Med Educ. 2020 Feb;54(2):103–104. DOI: 10.1111/medu.14005
  30. George BC, Bohned JD, Schuller MC, Fryer JP. Using smartphones for trainee performance assessment: A SIMPL case study.
  31. Marty AP, Linsenmeyer M, George B, Young JQ, Breckwoldt J, ten Cate O. Mobile technologies to support workplace-based assessment for entrustment decisions: Guidelines for programs and educators: AMEE Guide No. 154. Medical Teacher. 2023;45(11):1203–1213. DOI: 10.1080/0142159X.2023.2168527
  32. Ashman B, et al. Competency-Based Training for Orthopedic Surgery: An Evaluation of the Australian Orthopedic Association Training Program 2017–2021. J. Surg. Educ. 2025;82(8):103550 DOI: 10.1016/j.jsurg.2025.103550
  33. Vygotsky LS. Mind in society: The development of higher psychological processes. Harvard University Press; 1978.
  34. Dunphy BC, Dunphy SL. Assisted performance and the zone of proximal development (ZPD); a potential framework for providing surgical education. Australian Journal of Educational & Developmental Psychology. 2003 Jan;3(2003):48–58.
  35. Desai SV, Burk-Rafel J, Lomis KD, Caverzagie K, Richardson J, O’Brien CL, Andrews J, Heckman K, Henderson D, Prober CG, Pugh CM, Stern SD, Triola MM, Santen SA. Precision Education: The Future of Lifelong Learning in Medicine. Acad Med. 2024 Apr 1;99(4S Suppl 1):S14–S20. DOI: 10.1097/ACM.0000000000005601
  36. Hauer K, Damodaran A, Frank J, Huwendiek S, Marty A, Richardson D, Schumacher D, Tanaka P, Turner T, Rhoney D, for the International Competency-Based Health Professions Education Collaborators. Systems Thinking: Identifying Leverage Points for Achieving a Continuum of Competency-Based Health Professions Education. Perspect Med Educ. 2026 Sep 29;15(1): 916–929. DOI: 10.5334/pme.2573
  37. Bloom BS. The 2 sigma problem: the search for methods of group instruction as effective as one-to-one tutoring. Educ Res. 1984;13:4–16. DOI: 10.3102/0013189X013006004
  38. Rossi V. Inclusive Learning Design in Higher Education: A Practical Guide to Creating Equitable Learning Experiences. First edition. Routledge. 2023. DOI: 10.4324/9781003230144
  39. Turner L, Kelleher M, Overla S, Zheng W, Gregath A, Gharib M, Zahn A, Santen SA, Weber DE. Harnessing the Generative Power of AI to Move Closer to Personalized Medical Education. Academic Medicine. 2025 Jul 28;10–97. DOI: 10.1097/ACM.0000000000006185
  40. Drake CB, Heery LM, Burk-Rafel J, Triola MM, Sartori DJ. A Theoretical Foundation to Inform the Implementation of Precision Education and Assessment. Acad Med. April 2024;99(1):S30–S34. DOI: 10.1097/ACM.0000000000005604
  41. Turner T, Karpinski J, Damodaran A, Tanaka P, Chan M, Pinilla S, Richardson D, Goldhamer M, Snell L, Edgar L, for the International Competency-Based Health Professions Education Collaborators. The Faculty Development Paradox: Competency-Based Education Has Transformed Learner Education, but Not How We Develop Faculty. Perspect Med Educ. 2026 Sep 29;15(1):986–1000. DOI: 10.5334/pme.2603
  42. Warm EJ, Englander R, Pereira A, Barach P. Improving Learner Handovers in Medical Education. Acad Med. 2017 Jul;92(7):927–931. DOI: 10.1097/ACM.0000000000001457
  43. Morgan HK, Mejicano GC, Skochelak S, Lomis K, Hawkins R, Tunkel AR, Nelson EA, Henderson D, Shelgikar AV, Santen SA. A Responsible Educational Handover: Improving Communication to Improve Learning. Acad Med. 2020 Feb;95(2):194–199. DOI: 10.1097/ACM.0000000000002915
  44. Schaye V, DiTullio DJ, Sartori DJ, Hauck K, Haller M, Reinstein I, Guzman B, Burk-Rafel J. Artificial intelligence based assessment of clinical reasoning documentation: an observational study of the impact of the clinical learning environment on resident documentation quality. BMC Medical Education. 2025 Apr 22;25(1):59. DOI: 10.1186/s12909-025-07191-x
  45. Schumacher DJ, Holmboe ES, Van Der Vleuten C, Busari JO, Carraccio C. Developing resident-sensitive quality measures: A model from pediatric emergency medicine. Acad Med. 2018;93(7):1071–1078. DOI: 10.1097/ACM.0000000000002093
  46. Burk-Rafel J, Sebok-Syer SS, Santen SA, Jiang J, Caretta-Weyer HA, Iturrate E, Kelleher M, Warm EJ, Schumacher DJ, Kinnear B. TRainee Attributable & Automatable Care Evaluations in Real-time (TRACERs): A Scalable Approach for Linking Education to Patient Care. Perspect Med Educ. 2023 May 17;12(1):149–159. DOI: 10.5334/pme.1013
  47. Torre D, Schuwirth L. Programmatic assessment for learning: A programmatically designed assessment for the purpose of learning: AMEE Guide No. 174. Medical Teacher. 2025;47(6):918–933. DOI: 10.1080/0142159X.2024.2409936
  48. Ryan M, Touchie C, Frank J, Chen C, Kinnear B, for the International Competency-Based Health Professions Education Collaborators. Validity in the era of competency-based health professions education: Tensions and potential solutions. Perspect Med Educ. 2026 Sep 29;15(1):959–969. DOI: 10.5334/pme.2593
  49. Carney PA, Sebok-Syer SS, Pusic MV, Gillespie CC, Westervelt M, Goldhamer ME. Using learning analytics in clinical competency committees: increasing the impact of competency-based medical education. Medical Education Online. 2023 Dec 31;28(1):2178913. DOI: 10.1080/10872981.2023.2178913
  50. Butow P, Hoque, E. Using artificial intelligence to analyse and teach communication in healthcare. Breast. 2020;50: 49–55 DOI: 10.1016/j.breast.2020.01.008
  51. Boscardin CK, Abdulnour RE, Gin BC. Macy Foundation Innovation Report Part I: Current Landscape of Artificial Intelligence in Medical Education. Acad Med. 2025 Sep 1;100(9S Suppl 1):S15–S21. DOI: 10.1097/ACM.0000000000006107
  52. Warm EJ, Mathis BR, Held JD, et al. Entrustment and Mapping of Observable Practice Activities for Resident Assessment. J Gen Intern Med. 2014;29:1177–1182. DOI: 10.1007/s11606-014-2801-5
  53. Vennemeyer S, Zhang T, Warm EJ, Wu DTY. Visual Analytics Opportunities and Usability Assessment of a Resident Clinical Competency Assessment Dashboard. 2024 Workshop on Visual Analytics in Healthcare (VAHC). San Francisco, CA, USA; 2024. pp. 6–9. DOI: 10.1109/VAHC65315.2024.00009
  54. Rodman A, James CA. Effective engagement with AI is the only path forward for clinician-educators. Academic Medicine. 2025 Jul 28;10–97.
  55. Lucey CR, Hauer KE, Boatright D, Fernandez A. Medical education’s wicked problem: achieving equity in assessment for medical learners. Acad Med. 2020;95(12S):S98–S108. DOI: 10.1097/ACM.0000000000003717
  56. Humphrey-Murto S, Makus D, Moore S, Watanabe Duffy K, Maniate J, Scowcroft K, Buba M, Rangel JC. Training physicians and residents for the use of electronic health records—a comparative case study between two hospitals. Medical Education. 2023 Apr;57(4):337–348. DOI: 10.1111/medu.14944
  57. Pusic MV, Birnbaum RJ, Thoma B, Hamstra SJ, Cavalcanti RB, Warm EJ, Janssen A, Shaw T. Frameworks for integrating learning analytics with the electronic health record. Journal of Continuing Education in the Health Professions. 2023 Jan 1;43(1):52–59. DOI: 10.1097/CEH.0000000000000444
  58. Shanafelt TD, Dyrbye LN, Sinsky C, Hasan O, Satele D, Sloan J, West CP. Relationship Between Clerical Burden and Characteristics of the Electronic Environment with Physician Burnout and Professional Satisfaction. Mayo Clin Proc. 2016 Jul;91(7):836–848. DOI: 10.1016/j.mayocp.2016.05.007
  59. Burm S, MacLeod A. Focus on Methodology: A sense of sociomaterialism: How sociomaterial perspectives might illuminate health professions education. Focus On Health Professional Education: A Multi-Professional Journal. 2020;21(1): DOI: 10.11157/fohpe.v21i1.443
  60. Salwei ME, Carayon P. A Sociotechnical Systems Framework for the Application of Artificial Intelligence in Health Care Delivery. J Cogn Eng Decis Mak. 2022 Dec;16(4):194–206. DOI: 10.1177/15553434221097357
  61. Kudina O, van de Poel I. A sociotechnical system perspective on AI. Minds & Machines. 2024;34:21. DOI: 10.1007/s11023-024-09680-2
  62. Goldie J. The formation of professional identity in medical students: considerations for educators. Med Teach. 2012;34(9):e641–e648. DOI: 10.3109/0142159X.2012.687476
  63. Sternszus R, Steinert Y, Razack S, Boudreau JD, Snell L, Cruess RL. Being, becoming, and belonging: reconceptualizing professional identity formation in medicine. Front Med (Lausanne). 2024 Aug 27;11:1438082. DOI: 10.3389/fmed.2024.1438082
  64. Cutrer WB, Miller B, Pusic MV, Mejicano G, Mangrulkar RS, Gruppen LD, Hawkins RE, Skochelak SE, Moore DE Jr. Fostering the Development of Master Adaptive Learners: A Conceptual Model to Guide Skill Acquisition in Medical Education. Acad Med. 2017 Jan;92(1):70–75. DOI: 10.1097/ACM.0000000000001323
  65. Rhoney D, Barone M, Caretta-Weyer H, Edgar L, Schumacher D, Young J, Ladenheim R, Caverzagie K, for the International Competency-Based Health Professions Education Collaborators. No Free Lunch in Competency-Based Health Professions Education: Exploring Trade-Offs, Value, and Shared Investment in Health Professions Education. Perspect Med Educ. 2026 Sep 29;15(1):783–798. DOI: 10.5334/pme.2574
  66. Hauer K, Goldhamer M, Amiel J, Richardson D, Schwartz A, Marty A, Molgaard L, Pinilla S, Breckwoldt J, for the International Competency-Based Health Professions Education Collaborators. The Educational Alliance: Essential to Implement Competency-Based Health Professions Education. Perspect Med Educ. 2026 Sep 29;15(1):799–813. DOI: 10.5334/pme.2607
  67. Ahn E, Caverzagie K, Damodara S, Huwendiek S, Lomis K, Marty A, Turner D, Turner T, Atkinson A, for the International Competency-Based Health Professions Education Collaborators. No Environment, No Education: Honoring the Clinical Learning Environment as the Engine of Competency-based Education – A Call to Action. Perspect Med Educ. 2026 Sep 29;15(1):771–782. DOI: 10.5334/pme.2548
  68. Englander R, Goldhamer M, Chen A, Oswald A, Atkinson A, Caretta-Weyer H, Chan T, Chou F, Dalseg T, Kini R, Ladenheim R, Niemi-Murola L, Turner D, Snell L, Hall A, for the International Competency-Based Health Professions Education Collaborators. Competency-based health professions education in evolution: Challenges and adaptations after implementation. Perspect Med Educ. 2026 Sep 29;15(1):930–945. DOI: 10.5334/pme.2580
  69. Hall A, Andriole D, Chen A, Englander R, Rojas D, Ryan M, Boscardin C, Caretta-Weyer H, Dalseg T, Incoll I, Ladenheim R, Niemi-Murola L, Oswald A, Pinilla S, Turner D, Goldhamer M, for the International Competency-Based Health Professions Education Collaborators. Approaches to the Evaluation of Competency-Based Health Professions Education Implementation from Around the Globe. Perspect Med Educ. 2026 Sep 29;15(1):1001–1016. DOI: 10.5334/pme.2628
  70. Association of American Medical Colleges (AAMC). Principles for the Responsible Use of Artificial Intelligence in and for Medical Education. 2025. https://aamc.org/about-us/mission-areas/medical-education/principles-ai-use. Accessed September 20, 2026.
  71. OECD. Scaling Artificial Intelligence in Health. Paris: OECD Publishing; 2026. https://oecd.org/en/publications/scaling-artificial-intelligence-in-health_a436e12d-en.html. Accessed September 20, 2026.
  72. Reuben JS, Meiri H, Arien-Zakay H. AI’s pivotal impact on redefining stakeholder roles and their interactions in medical education and health care. Frontiers in Digital Health. 2024 Nov 5;6:1458811. DOI: 10.3389/fdgth.2024.1458811
  73. Lomis. The Medical Educator’s Guide to Projects Leveraging Artificial Intelligence and Learning Analytics. American Medical Association. 2025. https://www.ama-assn.org/system/files/ai-educator-guide.pdf. Accessed September 20, 2026.
  74. Chin-Yee B, Upshur R. Clinical judgement in the era of big data and machine learning. Journal of Evaluation in Clinical Practice. 2019;25(5):745–750.
  75. Blease C, Bernstein MH, Gaab J. Digital Health and Medical Education: Promises and Challenges. Journal of Medical Internet Research, 2022;24(3):e32533.
  76. Busari J, Chan M, Schwartz A, Damodaran A, Ledenheim R, Jones B, Turner D, Khajehei M, Zeleke L, Caretta-Weyer H, for the International Competency-Based Health Professions Education Collaborators. CBE and the missing ‘E’: Making competency-based education an equitable framework for a majority-world health professions education. Perspect Med Educ. 2026 Sep 29;15(1):880–893. DOI: 10.5334/pme.2551
  77. Topol E. Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again. Basic Books; 2019.
  78. Fisher R, Allen L, Malhotra AM, Alderwick H. Tackling the inverse care law. London: The Health Foundation; 2022. https://www.health.org.uk/sites/default/files/upload/publications/2022/Tackling%20the%20inverse%20care%20law.pdf. Accessed September 20, 2026.
DOI: https://doi.org/10.5334/pme.2594 | Journal eISSN: 2212-277X
Language: English
Page range: 1095 - 1108
Submitted on: Mar 21, 2026
Accepted on: Jun 15, 2026
Published on: Oct 22, 2026
Published by: Ubiquity Press
In partnership with: Paradigm Publishing Services

© 2026 Kimberly D. Lomis, Martin V. Pusic, Eric Warm, Jamiu O. Busari, Soren Huwendiek, Ian W. Incoll, Lydia Siew Tiang Lau, Christy K. Boscardin, Jonathan H. Chen, Pedro Tanaka, Karen E. Hauer, As members of the International Competency-Based Health Professions Educators Collaborative, published by Ubiquity Press
This work is licensed under the Creative Commons Attribution 4.0 License.