Research Progress in Competency-Based Teaching and Assessment Strategies in Standardized Residency Training

Background: As healthcare shifts from a biomedical to a biopsychosocial model, Chinese residencytraining faces increasing demands to prepare physicians who are not only knowledgeable but alsocompetent in clinical reasoning, communication, teamwork, professionalism, and systems-basedpractice. Competency-based medical education (CBME) has emerged as a key framework to meet theseneeds, yet its implementation in China remains variable. Methods: This narrative review synthesizesthe conceptual foundations and frameworks of CBME in residency training, summarizes commonlyused competency-oriented teaching strategies and assessment tools, and analyzes current challengesand potential strategies for implementation in Chinese residency programs. Relevant internationaland 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) roleshave informed emerging Chinese competency models. Competency-oriented approaches, includingcase- and problem-based learning, flipped and blended learning, simulation and standardized patient(SP) encounters, and multidisciplinary team-based activities, are used to support core competencydevelopment. Assessment methods such as the Objective Structured Clinical Examination (OSCE),workplace-based assessments including the mini-Clinical Evaluation Exercise (mini-CEX), DirectObservation of Procedural Skills (DOPS), 360-degree evaluations, and learning portfolios enable moremultidimensional and longitudinal evaluation. Persistent barriers include incomplete alignment betweenframeworks and practice, limited faculty development, heavy service workloads, and underdevelopedquality assurance systems. Conclusions: Advancing CBME in Chinese residency training will requirecontextualizing and operationalizing competency frameworks, strengthening faculty capacity aseducators and coaches, selecting and phasing in assessment tools in a feasible manner, and buildingdata-informed quality assurance systems supported by information technology. Coordinated efforts atpolicy, institutional, and clinical teaching levels are needed to develop a sustainable CBME model thatsupports high-quality healthcare delivery.