Competency-based training for rehabilitation medicine visiting trainees: current status and recommendations for a localized competency framework_West China Medical Journal

Authors：

ZHOU Lijun ^1,2,3 ,  LIU Sijia ^1,2

1. Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China;
2. Key Laboratory of Rehabilitation Medicine in Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIU Sijia, Email: 137595879@qq.com

Keywords：

Rehabilitation medicine; visiting trainees; competency framework; competency-based medical education

DOI：

10.7507/1002-0179.202512145

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Focusing on the core issues of competency-based training for rehabilitation medicine visiting trainees in China, this article systematically reviewed the current development status and main problems of rehabilitation training, and analyzed its applicability in the training of rehabilitation trainees based on the relevant theories of competency-based medical education and international practical experience. At the same time, combined with the training mode of typical rehabilitation medical centers in China, this article explored the key competency components and evaluation focuses of job competency for rehabilitation trainees, and proposes a framework construction idea for job competency of rehabilitation trainees that conforms to the actual situation of rehabilitation clinical practice in China, with the aim of providing a reference for the standardization and competency-oriented transformation of rehabilitation medicine trainee training.

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2.	萧敦武, 王玉帛, 李晨, 等. 康复治疗人员职业分类与核心胜任力研究. 中国康复理论与实践, 2024, 30(10): 1160-1171.
3.	国家卫生健康委, 国家发展改革委, 教育部, 等. 关于印发加快推进康复医疗工作发展意见的通知. 中华人民共和国国家卫生健康委员会公报, 2021(6): 4-8.
4.	李博杨, 吴惠群, 卢守四, 等. 我国康复机构人才培养现状调查与分析. 中国医院, 2021, 25(8): 12-13.
5.	董春璇, 姚兴璋, 寄婧, 等. 基于岗位胜任力的迷你临床演练测评在康复医生培训中的应用效果. 中国康复医学杂志, 2024, 39(8): 1202-1204.
6.	Sultan MA, Miller E, Tikkanen RS, et al. Competency-based education and training for community health workers: a scoping review. BMC Health Serv Res, 2025, 25(1): 263.
7.	Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA, 2002, 287(2): 226-235.
8.	Frank JR, Snell LS, Cate OT, et al. Competency-based medical education: theory to practice. Med Teach, 2010, 32(8): 638-645.
9.	Royal College of Physicians and Surgeons of Canada. The CanMEDS 2005 physician competency framework. Ottawa: RCPSC, 2005: 1-25.
10.	Frank JR, Snell L, Sherbino J. CanMEDS 2015 physician competency framework. Ottawa: Royal College of Physicians and Surgeons of Canada, 2015: 19-30.
11.	Wentzell DD, Chung H, Hanson C, et al. Competency-based medical education in ophthalmology residency training: a review. Can J Ophthalmol, 2020, 55(1): 12-19.
12.	Lee AG, Oetting T, Beaver HA. The ACGME outcome project in ophthalmology: practical recommendations for overcoming the barriers to local implementation of the national mandate. Surv Ophthalmol, 2009, 54(4): 507-517.
13.	Lee AG, Arnold AC. The ACGME milestone project in ophthalmology. Surv Ophthalmol, 2013, 58(4): 359-369.
14.	Lee AG, Arnold AC. The next accreditation system in ophthalmology. Surv Ophthalmol, 2015, 60(1): 82-85.
15.	World Health Organization. Rehabilitation competency framework. Geneva: World Health Organization, 2021: 1-52.
16.	Singh R, Küçükdeveci AA, Grabljevec K, et al. The role of interdisciplinary teams in physical and rehabilitation medicine. J Rehabil Med, 2018, 50(8): 673-678.
17.	Frank JR, Danoff D. The CanMEDS initiative: implementing an outcomes-based framework of physician competencies. Med Teach, 2007, 29(7): 642-647.
18.	Karpinski J, Stewart J, Oswald A, et al. Competency-based medical education at scale: a road map for transforming national systems of postgraduate medical education. Perspect Med Educ, 2024, 13(1): 24-32.
19.	Ten Cate O, Gruppen LD, Kogan JR, et al. Time-variable training in medicine: theoretical considerations. Acad Med, 2018, 93(Suppl 3): S6-S11.
20.	Nasca TJ, Philibert I, Brigham T, et al. The next GME accreditation system--rationale and benefits. N Engl J Med, 2012, 366(11):1051-1056.
21.	Torralba KD, Jose D, Katz JD. Competency-based medical education for the clinician-educator: the coming of milestones version 2. Clin Rheumatol, 2020, 39(6): 1719-1723.
22.	Gruppen LD, Mangrulkar RS, Kolars JC. The promise of competency-based education in the health professions for improving global health. Hum Resour Health, 2012, 10: 43.
23.	Iobst WF, Sherbino J, Cate OT, et al. Competency-based medical education in postgraduate medical education. Med Teach, 2010, 32(8): 651-656.
24.	Denney M, Johnstone A. Can general practice trainees engage with leadership activities during their GP training placements? - An evaluation of an intervention in South East Scotland. Educ Prim Care, 2019, 30(2): 102-109.
25.	Rimmer A. Switching specialties must be made easier, says GMC. BMJ, 2017, 357: j1699.
26.	陈心航, 李海潮, 吴红斌. 我国毕业后医学教育研究特点与发展趋势分析. 中国毕业后医学教育, 2021, 5(2): 98-103.
27.	Chen Q, Li M, Wu N, et al. A survey of resident physicians’ perceptions of competency-based education in standardized resident training in China: a preliminary study. BMC Med Educ, 2022, 22(1): 801.
28.	黄卫, 邓婉君, 夏欧东. 基于岗位胜任力的医学教育改革中外比较. 医学与社会, 2018, 31(6): 83-86.
29.	中国住院医师培训精英教学医院联盟. 中国住院医师培训精英教学医院联盟住院医师核心胜任力框架共识. 协和医学杂志, 2022, 13(1): 17-23.
30.	董海瑛, 万学红, 吴敏. 医学毕业生胜任特征模型的构建. 中国循证医学杂志, 2007(5): 348-354.
31.	余杨, 李夏西, 夏欧东, 等. 广东地区临床医学本科生胜任力特征模型的构建. 中华医学教育探索杂志, 2017, 16(4): 351-355.
32.	王贤吉, 张新平. 全科医师胜任力模型及其应用. 中国卫生事业管理, 2007, 23(11): 727-728.
33.	邱卓英, 郭键勋, 孙宏伟, 等. 世界卫生组织康复胜任力架构及其在康复领域的系统应用: 理论架构、方法和应用领域. 中国康复理论与实践, 2022, 28(3): 265-274.
34.	Beamish N, Footer C, Lowe R. Rehabilitation professions’ core competencies for entry-level professionals: a thematic analysis. J Interprof Care, 2024, 38(1): 32-41.
35.	Lockyer J, Carraccio C, Chan MK, et al. Core principles of assessment in competency-based medical education. Med Teach, 2017, 39(6): 609-616.
36.	Lörwald AC, Lahner FM, Nouns ZM, et al. The educational impact of mini-clinical evaluation exercise (Mini-CEX) and direct observation of procedural skills (DOPS) and its association with implementation: a systematic review and meta-analysis. PLos One, 2018, 13(6): e0198009.
37.	张芳芳. 康复治疗师岗位胜任力模型构建与应用研究. 石家庄: 河北医科大学, 2023.
38.	王静, 郑璐, 王小飞, 等. 基于康复胜任力架构的康复治疗师岗位胜任力模型构建与实证研究. 中华医学教育杂志, 2024, 44(4): 251-256.
39.	Benè KL, Bergus G. When learners become teachers: a review of peer teaching in medical student education. Fam Med, 2014, 46(10): 783-787.
40.	Frank JR, Mungroo R, Ahmad Y, et al. Toward a definition of competency-based education in medicine: a systematic review of published definitions. Med Teach, 2010, 32(8): 631-637.
41.	Holmboe ES, Sherbino J, Long DM, et al. The role of assessment in competency-based medical education. Med Teach, 2010, 32(8): 676-682.
42.	王烁珊, 杨贤盛, 颜梅, 等. 强化内隐胜任力教学在全科医师规范化培训中的实践效果. 中华全科医学, 2025, 23(8): 1399-1403.

1. Cieza A, Causey K, Kamenov K, et al. Global estimates of the need for rehabilitation based on the global burden of disease study 2019: a systematic analysis for the global burden of disease study 2019. Lancet, 2019, 396(10267): 2006-2017.
2. 萧敦武, 王玉帛, 李晨, 等. 康复治疗人员职业分类与核心胜任力研究. 中国康复理论与实践, 2024, 30(10): 1160-1171.
3. 国家卫生健康委, 国家发展改革委, 教育部, 等. 关于印发加快推进康复医疗工作发展意见的通知. 中华人民共和国国家卫生健康委员会公报, 2021(6): 4-8.
4. 李博杨, 吴惠群, 卢守四, 等. 我国康复机构人才培养现状调查与分析. 中国医院, 2021, 25(8): 12-13.
5. 董春璇, 姚兴璋, 寄婧, 等. 基于岗位胜任力的迷你临床演练测评在康复医生培训中的应用效果. 中国康复医学杂志, 2024, 39(8): 1202-1204.
6. Sultan MA, Miller E, Tikkanen RS, et al. Competency-based education and training for community health workers: a scoping review. BMC Health Serv Res, 2025, 25(1): 263.
7. Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA, 2002, 287(2): 226-235.
8. Frank JR, Snell LS, Cate OT, et al. Competency-based medical education: theory to practice. Med Teach, 2010, 32(8): 638-645.
9. Royal College of Physicians and Surgeons of Canada. The CanMEDS 2005 physician competency framework. Ottawa: RCPSC, 2005: 1-25.
10. Frank JR, Snell L, Sherbino J. CanMEDS 2015 physician competency framework. Ottawa: Royal College of Physicians and Surgeons of Canada, 2015: 19-30.
11. Wentzell DD, Chung H, Hanson C, et al. Competency-based medical education in ophthalmology residency training: a review. Can J Ophthalmol, 2020, 55(1): 12-19.
12. Lee AG, Oetting T, Beaver HA. The ACGME outcome project in ophthalmology: practical recommendations for overcoming the barriers to local implementation of the national mandate. Surv Ophthalmol, 2009, 54(4): 507-517.
13. Lee AG, Arnold AC. The ACGME milestone project in ophthalmology. Surv Ophthalmol, 2013, 58(4): 359-369.
14. Lee AG, Arnold AC. The next accreditation system in ophthalmology. Surv Ophthalmol, 2015, 60(1): 82-85.
15. World Health Organization. Rehabilitation competency framework. Geneva: World Health Organization, 2021: 1-52.
16. Singh R, Küçükdeveci AA, Grabljevec K, et al. The role of interdisciplinary teams in physical and rehabilitation medicine. J Rehabil Med, 2018, 50(8): 673-678.
17. Frank JR, Danoff D. The CanMEDS initiative: implementing an outcomes-based framework of physician competencies. Med Teach, 2007, 29(7): 642-647.
18. Karpinski J, Stewart J, Oswald A, et al. Competency-based medical education at scale: a road map for transforming national systems of postgraduate medical education. Perspect Med Educ, 2024, 13(1): 24-32.
19. Ten Cate O, Gruppen LD, Kogan JR, et al. Time-variable training in medicine: theoretical considerations. Acad Med, 2018, 93(Suppl 3): S6-S11.
20. Nasca TJ, Philibert I, Brigham T, et al. The next GME accreditation system--rationale and benefits. N Engl J Med, 2012, 366(11):1051-1056.
21. Torralba KD, Jose D, Katz JD. Competency-based medical education for the clinician-educator: the coming of milestones version 2. Clin Rheumatol, 2020, 39(6): 1719-1723.
22. Gruppen LD, Mangrulkar RS, Kolars JC. The promise of competency-based education in the health professions for improving global health. Hum Resour Health, 2012, 10: 43.
23. Iobst WF, Sherbino J, Cate OT, et al. Competency-based medical education in postgraduate medical education. Med Teach, 2010, 32(8): 651-656.
24. Denney M, Johnstone A. Can general practice trainees engage with leadership activities during their GP training placements? - An evaluation of an intervention in South East Scotland. Educ Prim Care, 2019, 30(2): 102-109.
25. Rimmer A. Switching specialties must be made easier, says GMC. BMJ, 2017, 357: j1699.
26. 陈心航, 李海潮, 吴红斌. 我国毕业后医学教育研究特点与发展趋势分析. 中国毕业后医学教育, 2021, 5(2): 98-103.
27. Chen Q, Li M, Wu N, et al. A survey of resident physicians’ perceptions of competency-based education in standardized resident training in China: a preliminary study. BMC Med Educ, 2022, 22(1): 801.
28. 黄卫, 邓婉君, 夏欧东. 基于岗位胜任力的医学教育改革中外比较. 医学与社会, 2018, 31(6): 83-86.
29. 中国住院医师培训精英教学医院联盟. 中国住院医师培训精英教学医院联盟住院医师核心胜任力框架共识. 协和医学杂志, 2022, 13(1): 17-23.
30. 董海瑛, 万学红, 吴敏. 医学毕业生胜任特征模型的构建. 中国循证医学杂志, 2007(5): 348-354.
31. 余杨, 李夏西, 夏欧东, 等. 广东地区临床医学本科生胜任力特征模型的构建. 中华医学教育探索杂志, 2017, 16(4): 351-355.
32. 王贤吉, 张新平. 全科医师胜任力模型及其应用. 中国卫生事业管理, 2007, 23(11): 727-728.
33. 邱卓英, 郭键勋, 孙宏伟, 等. 世界卫生组织康复胜任力架构及其在康复领域的系统应用: 理论架构、方法和应用领域. 中国康复理论与实践, 2022, 28(3): 265-274.
34. Beamish N, Footer C, Lowe R. Rehabilitation professions’ core competencies for entry-level professionals: a thematic analysis. J Interprof Care, 2024, 38(1): 32-41.
35. Lockyer J, Carraccio C, Chan MK, et al. Core principles of assessment in competency-based medical education. Med Teach, 2017, 39(6): 609-616.
36. Lörwald AC, Lahner FM, Nouns ZM, et al. The educational impact of mini-clinical evaluation exercise (Mini-CEX) and direct observation of procedural skills (DOPS) and its association with implementation: a systematic review and meta-analysis. PLos One, 2018, 13(6): e0198009.
37. 张芳芳. 康复治疗师岗位胜任力模型构建与应用研究. 石家庄: 河北医科大学, 2023.
38. 王静, 郑璐, 王小飞, 等. 基于康复胜任力架构的康复治疗师岗位胜任力模型构建与实证研究. 中华医学教育杂志, 2024, 44(4): 251-256.
39. Benè KL, Bergus G. When learners become teachers: a review of peer teaching in medical student education. Fam Med, 2014, 46(10): 783-787.
40. Frank JR, Mungroo R, Ahmad Y, et al. Toward a definition of competency-based education in medicine: a systematic review of published definitions. Med Teach, 2010, 32(8): 631-637.
41. Holmboe ES, Sherbino J, Long DM, et al. The role of assessment in competency-based medical education. Med Teach, 2010, 32(8): 676-682.
42. 王烁珊, 杨贤盛, 颜梅, 等. 强化内隐胜任力教学在全科医师规范化培训中的实践效果. 中华全科医学, 2025, 23(8): 1399-1403.

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