Implementation of a Competency Framework in Saudi Undergraduate Medical Education

Abstract

In 2011, a competency-based medical education (CBME) framework called SaudiMEDs was developed in Saudi Arabia to serve the community with medical graduates who can competently fulfil society’s health needs. SaudiMEDs serves as a guide to designing, developing, and evaluating medical school curricula. Despite the widespread implementation of SaudiMEDs, no research has been conducted on how medical education has been shaped as a result of SaudiMEDs. This study’s primary aim is, therefore, to investigate the real-time implementation of SaudiMEDs and its impact on Saudi medical schools. Qualitative case studies with two medical schools across the country were conducted to investigate how SaudiMEDs had been implemented. Documentary analysis of the medical schools’ documents, semi-structured interviews with academic leaders, and focus groups with faculty members and students were carried out for each school. Framework analysis for documents and Reflexive thematic analysis for interviews and focus groups were used to identify patterns and concepts and to conceptualise and construct meaning from the data. Analysis revealed a complex network of mixed perceptions of SaudiMEDs which, based on identified variations in teaching strategies, ways of learning and assessment methods, are considered as a key influence shaping implementation of SaudiMEDs. The perceptions of faculty members and students provide insight into the culture of each medical school and how it mediates implementation. The study also identifies different challenges in the SaudiMEDs implementation, which could provide further explanation for the variation in each medical school context. A key finding was the challenge of translating curriculum innovation developed in and for Western, specifically North American, contexts to the distinct organisational and institutional culture of Saudi Arabia. One consequence of this was that schools in this study approached implementation as a mapping activity and focused on the short-term accreditation standard requirement rather than a longer-term evaluation. This limited the ability of SaudiMEDs to achieve its stated aims. The research helps to identify what needs to be done to enable the fruitful transformation of SaudiMEDs into robust curricula: a) a rigorous review of SaudiMEDs to contextualise community health needs and b) support for CBME implementation through the enactment of the legislation, training, and establishment of appropriate information technology infrastructure to provide authentic experiences for learners.