Updated: 8 July, 2025

Why Competency-Based Medical Education Needs a New Lens

Medical education is undergoing a fundamental shift. Instead of assuming competence based on time spent in training, programs are now expected to prove that students can consistently demonstrate core skills and behaviors. This shift defines the heart of competency-based medical education (CBME), a model increasingly adopted by institutions across the globe.

While CBME emphasizes observable outcomes, it also introduces new challenges. Ensuring reliable, valid assessments across diverse settings isn’t easy. Moreover, students need timely, structured feedback to grow—yet educators are often stretched thin. Here’s where video becomes a game changer.

More than just a tool for documentation, video supports everything from formative self-assessment to high-stakes evaluations. It offers opportunities for reflection, feedback, and learning that fit seamlessly into a competency-based framework. Platforms like Videolab already enable this transformation by allowing secure video recording, annotation, and feedback for real and simulated patient interactions.

What Is Competency-Based Medical Education?

Competency-based medical education shifts the focus from completing a curriculum to demonstrating real-world performance. Instead of assuming that a set number of hours in clinical rotations results in competence, CBME uses defined outcomes that learners must achieve, regardless of how long it takes. Key competency domains typically include communication, professionalism, systems-based practice, and patient care.

In this model, assessment becomes both continuous and holistic. It often includes direct observation, structured clinical exams (like OSCEs), and portfolio-based documentation. Programs use milestones and entrustable professional activities (EPAs) to break down complex competencies into measurable units.

Integrating video into this framework adds precision and transparency. Instead of relying solely on memory or written notes, educators and learners can revisit actual performances. As shown in real-world deployments of Videolab, this approach enhances both feedback quality and learner autonomy. It also supports fairer evaluations by reducing bias and enabling second opinions if outcomes are contested.

For a deeper dive into how video supports core elements of CBME, see our blog on video use in clinical assessments.

Why Video Works in Competency-Based Medical Education

Video enhances the core principles of CBME by making learning visible, traceable, and reflective. In a model where feedback is central and assessment must be both authentic and reliable, recorded video adds essential structure to how skills are demonstrated, reviewed, and improved over time.

One major advantage is how easily video enables self-reflection. Trainees can review their own communication, clinical reasoning, or procedural techniques in context. This aligns directly with metacognitive strategies that boost long-term competence. A study published in Nurse Educator confirmed that video-assisted debriefing significantly improves learner engagement and performance in simulation-based health education.

Additionally, video enables more consistent and data-rich peer and supervisor feedback. With tools like Videolab, students can annotate key moments, compare notes, and receive time-stamped coaching. This layered feedback becomes a dynamic form of assessment, not just a static judgment. In CBME environments, where longitudinal tracking is critical, these recorded interactions also support growth-based decision-making.

Finally, video builds fairness into high-stakes evaluations. When OSCEs or milestone reviews are recorded, transparency increases. Students know what was observed. Review panels can revisit footage. Institutions using Videolab for evaluations, such as Radboud UMC Academy, report improvements in clarity and accountability across the board.

How Video Is Being Used in CBME Today

Across Europe, CBME-aligned video usage is already in full swing. At universities like Maastricht UMC, ErasmusMC, and Amsterdam VUMC, video recordings of simulated patient encounters and real consultations are used for a wide range of training goals—from communication coaching to clinical assessment.

Students use video for self-reflection, peer feedback, and longitudinal portfolios. Instructors provide annotated comments that track growth across time. For OSCEs, video enables structured evaluations and appeals, where decisions can be reviewed with evidence. Feedback can be targeted to exact timecodes, and teaching moments are easier to revisit. In places like ETZ Hospital, video is also used for rare case training where specialists create instructional clips for asynchronous feedback.

In CBME, where performance matters more than attendance, tools like Videolab help institutions operationalize competency tracking in scalable and compliant ways. With privacy built in by design and full GDPR compliance, even real patient interactions can be recorded and analyzed for learning.

Evidence for Impact: What the Research Shows

The use of video in medical education is backed by a growing body of evidence. Numerous studies have demonstrated its value in improving clinical reasoning, communication skills, and reflective practice. In particular, video-supported feedback has been found to enhance learners’ ability to self-assess and apply feedback effectively—two core principles of competency-based medical education.

A well-cited systematic review published in Medical Teacher highlighted that high-fidelity simulations paired with video feedback significantly improve learning outcomes when combined with guided reflection and structured debriefing (Issenberg et al., 2005). Learners exposed to video review tend to perform better in repeated simulations and show deeper retention of communication strategies.

Video also supports faculty. When learners submit recordings of clinical interactions or skill demonstrations, instructors can provide detailed, time-stamped feedback without the pressure of real-time observation. This asynchronous model increases the number of feedback opportunities and improves feedback quality. It also aligns with the need for distributed, longitudinal assessments across multiple settings.

Moreover, video strengthens fairness and transparency in evaluation. A study on milestone-based progression in internal medicine showed that programs using video-supported assessments reported fewer disputes and greater confidence in promotion decisions (Holmboe et al., 2016). In CBME environments, this added clarity is critical.

Implementation Strategies: How to Get Started with Video in CBME

Integrating video into competency-based medical education doesn’t require an overhaul. A phased, strategic approach works best. Start by identifying a few high-impact areas—such as OSCEs, communication training, or clinical handover practice—where recording and feedback can improve outcomes.

Next, select a simple tool that allows for secure recording, playback, and feedback. Whether you’re using mobile devices or fixed setups, the key is to ensure recordings are easy to capture and review. Faculty development is essential. Instructors need brief but targeted training on how to give video-based feedback, how to use rubrics or milestones for assessment, and how to manage privacy considerations.

Finally, engage learners from the beginning. Explain the purpose of video in their development, and offer them control over when and how their recordings are reviewed. This creates a culture of reflection rather than surveillance and builds the habits CBME aims to instill.

Challenges and Considerations

Introducing video into CBME is not without obstacles. Privacy is the most frequently raised concern. Institutions must ensure GDPR or HIPAA compliance, obtain proper consent, and maintain secure storage systems. Without these safeguards, recording clinical interactions—even simulations—can introduce legal risks and reduce learner or patient trust.

Faculty workload is another barrier. Reviewing video takes time, and not all educators are trained to give effective video-based feedback. Without clear frameworks and manageable workflows, even the best-intentioned initiatives can fizzle out. Faculty development and institutional support must go hand in hand to make video sustainable.

Additionally, students may feel exposed or anxious when recorded. This discomfort can lead to altered behavior or performance drop. Mitigating this requires building psychological safety into the learning culture and offering learners control over when and how recordings are used.

Finally, tech reliability matters. Lost recordings, poor audio, or syncing issues can erode trust in the system. Institutions should pilot their approach in small groups first and refine technical workflows before scaling.

Future Trends: What’s Next for Video in CBME

Looking ahead, several trends point toward deeper integration of video in competency-based medical education. Artificial intelligence is beginning to support automated feedback—highlighting facial expressions, speech patterns, or timing during consultations. These tools are still developing, but they promise to reduce faculty workload while offering rich learner insights.

Another emerging area is immersive video, including 360-degree capture and virtual reality. These formats can replicate complex environments and rare cases, allowing learners to demonstrate competencies in a more dynamic setting. As CBME emphasizes context-based assessment, these modalities will likely grow in relevance.

Cross-institutional sharing of video-based training materials and assessments is also on the rise. When supported by proper consent and anonymization, this creates powerful benchmarking and peer learning opportunities that go beyond local silos.

Finally, better integration with learning management systems and portfolios will make video a seamless part of the assessment ecosystem.

Conclusion

Competency-based medical education calls for continuous feedback, observable performance, and learner autonomy. Video fits naturally into this model, helping both faculty and students reach those goals with greater clarity and efficiency.

Institutions starting small—focusing on one course or rotation—can unlock real value without major disruption. The time to explore video in CBME isn’t someday. It’s now.