Clinical workplace-learning today: how competency frameworks inform clinical workplace learning (and how they do not)

The medical profession is changing due to increasing expectations, technological advancements, changing demographics and awareness of the unsustainable healthcare expenditure. In order to better prepare doctors for their future jobs, medical curricula adopt competency-based approaches that define ultimate learning outcomes. This thesis reveals that the promise of competency-based medical education is not readily achieved. Medical training largely takes place at the clinical workplace, that tends to be unruly and reluctant to change. For instance, we found a dominant focus on time-efficiency, that seemed to hamper patient-centeredness. We formulate important pitfalls that need to be addressed, and showcase that a curriculum change in clinical workplace learning might actually require organisational change.