Establishing veterinary graduation competencies and its impact on veterinary medical education in Korea

The paradigm in modern medical education has changed from the traditional teacher-centered education to student-centered learning. The core of this change was the need for clear standards that students should achieve through the curriculum. Achievement standards are defined as observable and assessable competencies, which refer to the ability to encompass a set of elements including knowledge, skills, and attitudes to perform a particular task [1]. Competency-based education is a method of defining and educating students based on the competencies they can use for on-site work immediately after graduation [1, 2] and it is the most widely applied curriculum in current medical education. In the medical fields, it is crucial to define competencies to be achieved by students because the scope of performing independent work is expanded at each stage of education.

The World Organization for Animal Health (WOAH) defined veterinary services as global public goods [3]. The WOAH introduced the international standard graduation competencies and relevant curriculum recommendations that are essential for the smooth provision of veterinary services [4]. In North America, the core competencies that new veterinary graduates must be equipped with have been newly established. The Association of American Veterinary Medical Colleges presented core competencies in the Roadmap for Veterinary Medical Education in the 21st Century to respond to social changes, development in veterinary medicine and its educational environment [5]. The Royal College of Veterinary Surgeons (RCVS) has established Day One Competences, using it in their education [6, 7]. Such cases have led to demands for establishing graduation competencies for veterinary education in Korea so that new veterinarians acquire aptitudes that correspond to global standards.

A total of 10 veterinary colleges function in Korea, with approximately 500 new students selected each year. While modern veterinary education in Korea began in 1908, the greatest change in the curriculum was the reform into the 6-year education system in 1998, which considered that increasing educational length by 2 years could provide sufficient time to secure professional education. Nevertheless, until the early 2000s, there has hardly been any change in the teaching methods and educational environment. Till date, all Korean veterinary colleges operate with a traditional subject-based curriculum. The teaching methods comprise didactic lectures and empirical lab practices. In terms of evaluation, a written exam in the form of relative evaluation is a common assessment method for each course. Furthermore, the practical exam format varies across colleges, and competency-based lab or practical exams for clinical subjects are rarely conducted. This may be due to the fact that colleges have insufficient faculty members, teaching staff, and facilities.

Meanwhile, the absence of learning achievement standards applicable to all veterinary colleges resulted in differences in the educational contents and levels of each university. Ultimately, this led to differences in the students’ learnings and their competencies. Subsequently, it became the fundamental cause of lowering the difficulty level of the Korean veterinary licensing examination, hindering the securing of basic competencies of new graduates. The absence of graduation competencies halts the enhancement of veterinary service quality at the national level and the fostering of veterinarians corresponding to international standards.

Consequently, the Korean Association of Veterinary Medical Colleges (KAVMC) has established the Korean veterinary graduation competencies in 2016, through questionnaires and research studies targeting professors, students, veterinarians, and stakeholders related to veterinary services [8]. The establishment of these competencies has become the starting point for various standards, necessary for veterinary education thereafter. The purpose of this study is to describe the process of establishing graduation competencies and the implied changes in veterinary education.

The establishment of graduation competencies was pursued by a research committee formed by the KAVMC Education Committee in 2016. The research committee members were mainly composed of faculty members representing each veterinary college and veterinary personnel with expertise in veterinary education.

The research committee initially derived graduation competencies that were suitable for the Korean veterinary environment through an analysis of the North American Veterinary Medical Education Consortium (NAVMEC) Core Competencies, Office International des Epizooties (now known as WOAH) Day-1 Competences, RCVS Day One Competences, and the core curriculum and competencies of veterinary colleges in Japan. The initial document consisted of 30 items in 7 domains. A broad range of surveys was conducted regarding the initial document on students, veterinarians, and professors, and about 1,500 counts of returned material were retrieved. Then, a factor analysis was conducted to prepare a draft consisting of 5 domains, 15 core competencies, and 42 achievement standards.

A review of content suitability of the draft was commissioned to the Korean Veterinary Medical Association, the Korean Society of Veterinary Science, the Korean Association of Veterinary Clinical Education, other professional veterinary organizations, and non-governmental organizations. In addition, legal consultation was employed for the legal content related to veterinarians. The final document was reviewed by a scholar of Korean literature to secure the clarity of phrases and named “Veterinary Education Graduation Competencies 2016,” after fixing 5 domains, 13 core competencies, and 39 achievement standards [8].

The structure of the Korean veterinary graduation competencies is similar to that of other countries (Fig. 1). The competency domain denotes broad distinguishable areas of competence that constitute a general descriptive framework for a profession [9]. Core competencies represent the spectrum of knowledge that enables a veterinarian to have the confidence to be productive in their chosen career on the first day after graduation [5]. Achievement standards refer to what students should achieve through education to accomplish core competencies.

Fig. 1
Schematic structure of Korean veterinary graduation competencies.

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The “Veterinary Education Graduation Competencies 2016” consisted of five domains: animal health care and disease management; one health expertise; communication and collaboration; research and learning; and veterinary professionalism. In each domain, core competencies were classified into two to three competencies, and two to four required achievement standards were established. These graduation competencies are goals that should be achieved by each veterinary student in Korea. In addition, efforts from each veterinary college to develop a curriculum that introduces detailed learning outcomes, and outcome assessment standards based thereon, became necessary.

The “Veterinary Education Graduation Competencies 2016” was expected to initiate significant changes in veterinary education upon enactment; however, the reverberation from each college was not as significant as anticipated. The reason was that, among the contents of the document, the domain for animal health care and disease management had been oversimplified and was not easy to utilize. In addition, it was found that some of the contents were declarative rather than competency-related, due to which many restrictions appeared in their direct application to the actual education. Therefore, it was necessary to develop detailed guidelines that could be actually applied.

On comparing the content of the “Veterinary Education Graduation Competencies 2016” with that of the Competency-Based Veterinary Education (CBVE) presented by the American Association of Veterinary Medical Colleges (AAVMC) Working Group in 2018 [10] and the RCVS Day One Competences, we find that CBVE and RCVS Day One Competences has three out of nine and four out of five domains related to clinical practice, respectively. Thus, the proportion of clinical practice in the “Veterinary Education Graduation Competencies 2016” is excessively reduced.

The initial graduation competencies established in 2016 described a broad range of contents in abbreviated sentences, requiring instructors or colleges themselves to further develop specific and detailed guidelines that could be applied in education. As burden steadily grew, the KAVMC Education Committee derived learning outcomes based on instructors’ needs [11]. Veterinary education learning outcomes are composed of three areas, including veterinary concepts and principles, veterinary clinical practice, and professionalism. The learning outcomes describe essential knowledge, skills, and attitudes that should be taught within curriculum. Embodied as such, they become the basis for the development of a competency-based curriculum for universities. Moreover, it is expected that the learning outcomes can also be used as self-evaluation data in the learning process for students.

Meanwhile, additional materials were developed to reinforce the clinical competency of new graduates. A list of 54 clinical skills required to perform basic clinical practice was established [12]. Currently, a guidebook for basic clinical skills describing standard procedures for each clinical skill is being developed. In addition, a list consisting of 61 basic clinical practices was provided based on the terminal learning outcomes in veterinary clinical practice [13]. The development of such guideline materials promotes their actual utilization by instructors and students; thus, they can be used for competency-based education.

In the process of developing these materials, the Education Committee considered that it was inevitable to revise “Veterinary Education Graduation Competencies 2016” to overcome forementioned shortcomings. In particular, the oversimplified clinical competencies needed to be supplemented. Recently, the committee published the “Veterinary Education Graduation Competencies 2020” supplemented by a list of 5 domains, 11 core competencies, and 33 achievement standards. The most important changes were providing 96 sub-competencies under the achievement standards (Appendix 1). Sub-competencies are specific or practical items of performances, skills, or activities that enable achievement standards. The structure is similar to the CBVE presented by AAVMC [10] but lacks a milestone concept.

The research committee conducted a cross-analysis between the “Veterinary Education Graduation Competencies 2020” and AAVMC competency framework and found that the number of domains were different, but the core competencies and achievement standards were quite similar [13].

The “Veterinary Education Graduation Competencies 2016” catalyzed various changes in the Korean veterinary college education landscape. Their establishment is extremely significant in that it systematically classified by domains all the competencies that any student from a veterinary college in Korea must be equipped with at the time of graduation. These competencies have helped clarify education goals for both instructors and students.