Il dibattitto sulle competenze nella formazione delle professioni di cura: alcuni spunti di riflessione critica

The debate on competency-based education has gained increasing interest in the medical education literature over the past thirty years. The “competency-based” approach to medical training has been primarily discussed considering its underlying assumptions, implementation methods, and impact on the summative evaluation of medical students and residents. However, a recent scoping review has pointed out weak evidence that this educational approach produces “better” doctors. This paper will analyze some aspects of competency-based education and discuss, from a pedagogical perspective, key related concepts such as the contextual and phronetic nature of competence, the issue of “transversal” (soft) skills, the relationship among competence, performance, and, consequently, summative evaluation. This analysis will pursue an approach to medical education – and, more generally, to training healthcare professionals – that goes beyond competencies understood as isolated knowledge and skills. Instead, it will advocate for an educational perspective integrating competencies with capability, fostering “practical wisdom” in applying knowledge to individual patients.