Research Progress in Competency-Based Teaching and Assessment Strategies in Standardized Residency Training
Xinzhu Yuan,
Changwei Lin
Background: As healthcare shifts from a biomedical to a biopsychosocial model, Chinese residency
training faces increasing demands to prepare physicians who are not only knowledgeable but also
competent in clinical reasoning, communication, teamwork, professionalism, and systems-based
practice. Competency-based medical education (CBME) has emerged as a key framework to meet these
needs, yet its implementation in China remains variable. Methods: This narrative review synthesizes
the conceptual foundations and frameworks of CBME in residency training, summarizes commonly
used competency-oriented teaching strategies and assessment tools, and analyzes current challenges
and potential strategies for implementation in Chinese residency programs. Relevant international
and domestic literature on CBME, residency education, and assessment was examined. Results:
International frameworks such as the Accreditation Council for Graduate Medical Education (ACGME)
core competencies and the Canadian Medical Education Directives for Specialists (CanMEDS) roles
have informed emerging Chinese competency models. Competency-oriented approaches, including
case- and problem-based learning, flipped and blended learning, simulation and standardized patient
(SP) encounters, and multidisciplinary team-based activities, are used to support core competency
development. Assessment methods such as the Objective Structured Clinical Examination (OSCE),
workplace-based assessments including the mini-Clinical Evaluation Exercise (mini-CEX), Direct
Observation of Procedural Skills (DOPS), 360-degree evaluations, and learning portfolios enable more
multidimensional and longitudinal evaluation. Persistent barriers include incomplete alignment between
frameworks and practice, limited faculty development, heavy service workloads, and underdeveloped
quality assurance systems. Conclusions: Advancing CBME in Chinese residency training will require
contextualizing and operationalizing competency frameworks, strengthening faculty capacity as
educators and coaches, selecting and phasing in assessment tools in a feasible manner, and building
data-informed quality assurance systems supported by information technology. Coordinated efforts at
policy, institutional, and clinical teaching levels are needed to develop a sustainable CBME model that
supports high-quality healthcare delivery.
