Clinical competency committees in an entrustable professional activity-based curriculum and assessment system

Competency-based education (CBE) in the health professions is grounded in teaching and assessing the requisite competencies to develop professionals prepared to meet the health care needs of the public and provide high-quality and safe patient care. As such, the outcome of education is the demonstrable competence of graduates in patient care. A curriculum and assessment framework based on entrustable professional activities (EPAs) provides excellent scaffolding for ensuring this outcome. The system is dependent, however, on its ability to support grounded, credible, and summative decisions regarding granting or withholding trainee progression through a program and awarding of increased autonomy (i.e., less supervision) in patient care. In this chapter, we begin by defining a clinical competency committee (CCC) and establishing its roles. We then provide a rationale for the group structure of a CCC as best suited to make the grounded, credible, and summative decisions required in an EPA-based curriculum and assessment system. Next, we explore more deeply the central role of a CCC-'what' it does. Then we address the 'how' of running a CCC, that is, the strategies to help CCCs function optimally, including issues of CCC structure and process. Finally, we explore some of the common pitfalls, misconceptions, and limitations regarding CCCs and suggest some mitigating strategies to overcome them.