Transcript TF1 - MEDINE2

Tuning (Medicine) 2007
MEDINE Thematic Network
THE TUNING PROJECT
“HARMONISATION OF
LEARNING OUTCOMES FOR
HIGHER EDUCATION”




Funded by European Commission
Learning outcomes/
competences for graduates
Generic and subject-specific
outcomes
Europe-wide survey and
consultation → consensus
The Tuning Project (Medicine) process and methods

Review of existing outcomes / competency
frameworks
Existing institutional or national learning
outcomes/competency frameworks reviewed by
the Project steering group

Development of draft framework
Preliminary draft learning outcomes/competency
framework for Tuning (Medicine) generated by
the Project steering group
The Tuning Project (Medicine) process and methods

Tuning (Medicine) Task Force workshops 




Budapest (April 2005)
Amsterdam (September 2005)
Edinburgh (February 2006)
Prague (May 2006)
[Genoa (September 2006) – mapping workshop]

Members of Tuning (Medicine) Taskforce sequentially
reviewed draft framework and progressively refined it in the
light of expert opinion

Also: presentations at Learning and Teaching Support Network UK
(Nov 2005), Chinese Association for Medical Education (Dec 2005),
European Medical Students Association (July 2006), Rektors of
German Medical Schools (Oct 2006)
The Tuning Project (Medicine) process and methods

Web-Based Opinion Survey

Tuning methodology - include academics, graduates and
employers. Rate learning outcomes for importance for graduates
in the discipline. Ratings combined and outcomes arranged in a
rank order. Informs the formulation of final Tuning report.

Questionnaire based on draft learning outcomes, incorporated
into the Surveymonkey.com on-line survey instrument, translated
into German and French.

Through MEDINE Network, primary contacts identified for each
European member state. Asked to identify respondents under
each heading and circulate the url. In later stages, url sent to all
members of Network to increase number of respondents.

Respondents rated 115 learning outcomes/competences on four
point Likert scale as essential, very important, quite important or
not important for primary medical degree.
The Tuning Project (Medicine) process and methods

First section - 29 generic outcomes for Higher Education degrees, from
previous phases of “parent” Tuning Project”. Minor amendments made to
take account of specific requirements of medical practice.

Second section - 12 discipline-specific Level 1 outcomes which together
describe the competences required of medical graduates.

Third section - for each Level 1 outcome, discipline-specific Level 2
outcomes (74 in total)

Fourth section - 39 knowledge domains and 14 practice settings in which
students might gain experiential learning.

Information regarding respondents - background (academic, graduate,
employer, student or other), country and institution.

Free text comments - qualitative analysis using the NVivo7 software tool.
The Tuning Project (Medicine) process and methods

Ratification of findings by MEDINE Thematic Network.
AGM of MEDINE Thematic Network, Oslo, May 2007.
Informed by the analyses and by agreement of the Task Force
members, low-scoring outcomes may be omitted from the final
Tuning document outcomes framework, or new outcomes added
derived from the free text comments.

Validation of Tuning Outcomes by Expert Panel.
Presentation of final outcomes framework at Sectorial Validation
Conference, Brussels, June 2007. Expert Panel invited by the
European Commission to review the outcomes framework, meet
members of Task Force, leading to a Validation statement for the
discipline. Same process for each health-care Tuning project
(medicine, nursing, physiotherapy, occupational therapy).

Final report to the European Commission. At the conclusion
of MEDINE Thematic Network, October 2007.
TUNING MEDICINE –
SURVEY RESULTS

10th April – 30th October 2006

1302 responses




830 English version
453 German version
19 French version
All EU member states except
Luxembourg, Estonia, Cyprus
Interpreting Survey Results
Not
Important
Quite
Very
Important Important
Essential
Response
Average
ability to
solve problems
1%
(6)
5%
(34)
28%
(178)
66%
(420)
3.59
Ability to design
and manage
projects
18%
(113)
51%
(319)
28%
(175)
3%
(20)
2.16
NI
1
QI
2
VI
E
3
4
↑
NI
1
QI
2
↑
VI
3
E
4
RESPONDENTS BY COUNTRY
Austria
32
Macedonia
0
Belgium
24
Malta
20
Bulgaria
1
Netherlands
17
Croatia
3
Norway
2
Cyprus
0
Poland
22
Czech Republic
1
Portugal
62
Denmark
23
Romania
3
Estonia
0
Serbia
1
Finland
10
Slovakia
84
France
10
Slovenia
19
Germany
353
Spain
68
Sweden
34
Switzerland
9
Turkey
33
UK
164
Greece
3
Hungary
22
Iceland
1
Ireland
9
Italy
5
Latvia
2
Lithuania
10
Luxembourg
0
Ukraine
1
Non-European
7
Nationality un-specified
169
RESPONDENTS BY CATEGORY
Category of Respondent
Totals
Academic
464
Medical Graduate
169
Graduate Employer
19
Current Medical Student
359
Other (e.g. other health professional, PG
student, patient)
43
Category un-specified
248
RESPONDENTS BY INSTITUTION
Type of Institution
Totals
University with Medical School
919
University without Medical School
13
Medical Employing Institution
(e.g. Health Service)
107
Professional Association
20
Other Association
(e.g. Charity)
8
Other (e.g. Other clinical
institution, PG education,
pharmaceutical company)
54
Affiliated institution un-specified
181
Generic Tuning Competences (1)
ability to recognise limits and ask for help
3.63
capacity for applying knowledge in practice
3.61
capacity to learn (including lifelong self-directed learning)
3.58
probity (honesty, maintaining good practice)
3.58
ability to make decisions
3.57
critical and self-critical abilities
3.41
interpersonal skills
3.37
concern for quality
3.35
ability to work in a multidisciplinary team
3.27
empathy
3.23
Generic Tuning Competences (2)
ability to solve problems
3.51
capacity to adapt to new situations
3.22
ethical commitment
3.21
capacity for analysis and synthesis
3.14
ability to work autonomously
3.10
ability to communicate with experts in other fields
3.09
capacity for organisation and planning (including time
management)
2.87
appreciation of diversity and multiculturality
2.70
will to succeed
2.58
ability to teach others
2.54
knowledge of a second language
2.51
Generic Tuning Competences (3)
understanding of cultures and customs of other countries
2.49
ability to lead others
2.45
basic general knowledge outside med
2.45
initiative and entrepreneurial spirit
2.44
research skills
2.33
creativity
2.29
ability to work in an international context
2.24
ability to design and manage projects
2.22
GENERIC COMPETENCY AVERAGE RATING BY
RESPONDENT CATEGORY
med3 ability to recognise limits and ask for help
med4 probity (honesty, maintaining good practice)
imp2 capacity for applying knowledge in practice
imp16m ability to make decisions
imp10m capacity to learn (including lifelong selfdirected learning)
imp15m ability to solve problems
imp12 critical and self-critical abilities
Generic Tuning Competency
imp18 interpersonal skills
imp29 concern for quality
Average Rating
1=not important
2=quite important
3=very important
4=essential
imp28 ethical commitment
imp20m ability to work in a multidisciplinary team
imp13 capacity to adapt to new situations
med1 empathy
imp1 capacity for analysis and synthesis
imp21 ability to communicate with experts in other
fields
Employer
imp25 ability to work autonomously
imp3 capacity for organisation and planning
(including time management)
Academic
imp17 appreciation of diversity and multiculturality
imp30 will to succeed
med2 ability to teach others
Graduate
imp24 understanding of cultures and customs of
other countries
imp4m basic general knowledge outside medicine
Student
imp27 initiative and entrepreneurial spirit
imp19m ability to lead others
imp7 knowledge of a second language
imp9 research skills
imp14m creativity
imp26m ability to design and manage projects
imp23 ability to work in an international context
1
2
3
4
Level 1 Competences/Learning Outcomes for medical
graduates and practice of medicine in Europe
carry out a consultation with a patient (history, examination ...)
3.77
provide immediate care of medical emergencies, including First Aid and
resuscitation
3.66
assess clinical presentations, order investigations, make differential diagnoses, and
negotiate a management plan
3.50
carry out practical procedures (e.g. venepuncture)
3.36
communicate effectively in a medical context
3.31
apply ethical and legal principles in medical practice
3.26
prescribe drugs
3.26
assess psychological and social aspects of a patient's illness
3.17
apply the principles, skills and knowledge of evidence-based medicine
3.02
use information and information technology effectively in a medical context
2.93
apply scientific principles, method and knowledge to medical practice and research
2.89
work effectively in a health care system and engage with population health issues
2.83
ID
Level-1 Specific Competence
Graduates
Employers
Academics
Students
Total combined ranking
01
Abililty to carry out a consultation with a patient
(history, examination ...)
1
2
1
1
1
02
Ability to assess clinical presentations, order
investigations, make differential diagnoses, and
negotiate a management plan
4
3
3
3
3
03
Ability to provide immediate care of medical
emergencies, including First Aid and resuscitation
2
1
2
2
2
04
Ability to prescribe drugs
6
7
7
5
7
05
Ability to communicate effectively in a medical context
3
6
5
6
5
06
Ability to carry out practical procedures (e.g.
venepuncture)
7
5
6
4
4
07
Ability to assess psychological and social aspects of a
patient's illness
8
10
8
7
8
08
Ability to apply scientific principles, method and
knowledge to medical practice and research
11
11
10
12
11
09
Ability to apply the principles, skills and knowledge of
evidence-based medicine
9
9
9
9
9
10
Ability to use information and information techology
effectively in a medical context
10
8
11
10
10
11
Ability to apply ethical and legal principles in medical
practice
5
4
4
8
6
12
Ability to work effectively in a health care system and
engage with population health issues
12
12
12
11
12
LEVEL 2 - LOW RATED OUTCOMES
Ability to analyse and disseminate experimental results
2.17
Ability to apply statistical analysis to data
2.15
Ability to design research experiments
1.81
Ability to carry out practical laboratory research procedures
1.71
Ability to provide evidence to a court of law
2.48
Ability to perform respiratory function tests
2.53
[ Knowledge - The different types of complementary and
alternative medicine and their use in patient care
2.26]
LEVEL 2 COMPETENCES/OUTCOMES
'Ability to carry out a consultation with a patient'
Ability to take a history
3.80
Ability to carry out physical examination
3.78
Ability to make clinical judgements and decisions
3.51
Ability to provide explanation and advice
3.37
Ability to provide reassurance and support
3.30
Ability to assess the patient's mental state
3.22
LEVEL 2 COMPETENCES/OUTCOMES
'Ability to assess clinical presentations, order investigations, make
differential diagnoses, and negotiate a management plan'
Ability to recognise and assess the severity of clinical presentations 3.56
Ability to order appropriate investigations and interpret the results
3.39
Ability to make differential diagnoses
3.46
Ability to negotiate an appropriate management plan with patients
and carers
3.22
LEVEL 2 COMPETENCES/OUTCOMES
'Ability to provide immediate care of medical emergencies,
including First Aid and resuscitation'
Ability to recognise and assess acute medical emergencies
3.77
Ability to provide basic First Aid
3.76
Ability to provide Basic Life Support and Cardio-Pulmonary Resuscitation
according to European guidelines
3.76
Ability to treat acute medical emergencies
3.44
Ability to provide Advanced Life Support according to European
guidelines
3.15
Ability to provide trauma care according to European ATLS guidelines
2.91
LEVEL 2 COMPETENCES/OUTCOMES
'Ability to prescribe drugs'
Ability to prescribe clearly and accurately
3.39
Ability to match appropriate drugs to the clinical context
3.36
Ability to review the appropriateness of medication and
evaluate the potential benefits and risks
3.30
Ability to prescribe drugs to treat pain and distress
3.21
LEVEL 2 COMPETENCES/OUTCOMES
'Ability to communicate effectively in a medical context'
Ability to communicate with patients
3.75
Ability to communicate with colleagues
3.53
Ability to communicate orally
3.49
Ability to communicate in breaking bad news
3.39
Ability to communicate with relatives
3.33
Ability to communicate with disabled people
3.31
Ability to communicate in seeking informed consent
3.29
Ability to communicate in writing (including medical records)
3.24
Ability to communicate in dealing with aggression
3.17
Ability to communicate by telephone
3.08
Ability to communicate with those who require an interpreter
2.96
LEVEL 2 COMPETENCES/OUTCOMES
'Ability to carry out practical procedures (e.g. venepuncture)'
Ability to measure blood pressure
3.62
Ability to carry out venepuncture
3.52
Ability to administer oxygen
3.40
Ability to carry out cannulation of veins
3.37
Ability to carry out subcutaneous and intramuscular injection
3.34
Ability to adminster IV therapy and use infusion devices
3.31
Ability to carry out electrocardiography
3.09
Ability to carry out suturing
3.03
Ability to carry out blood transfusion
3.00
Ability to carry out bladder catheterisation
2.91
Ability to carry out urinalysis
2.78
Ability to move and handle patients
2.73
Ability to carry out respiratory function tests
2.53
LEVEL 2 COMPETENCES/OUTCOMES
'Ability to work effectively in a health care system and engage with
population health issues'
Ability to provide patient care which minimises the risk of harm to patients
3.55
Ability to apply measures to prevent the spread of infection
3.54
Ability to recognise own health needs and ensure own health does not
interfere with professional responsibilities
3.29
Ability to conform with professional regulation and certification to practise
3.22
Ability to receive and provide professional appraisal
3.11
Ability to make informed career choices
2.86
LEVEL 2 COMPETENCES/OUTCOMES
'Ability to apply ethical and legal principles in medical
practice'
Ability to maintain confidentiality
3.74
Ability to apply ethical principles and analysis to clinical care
3.49
Ability to obtain and record informed consent
3.31
Ability to certify death
3.29
Ability to apply national and European law to clinical care
3.04
Ability to request autopsy
2.88
Ability to provide evidence to a court of law
2.48
LEVEL 2 COMPETENCES/OUTCOMES
'Ability to use information and information technology
effectively in a medical context'.
Ability to keep accurate and complete clinical records
3.51
Ability to use computers
3.49
Ability to access information sources
3.44
Ability to store and retrieve information
3.26
LEVEL 2 COMPETENCES/OUTCOMES
'Ability to apply the principles, skills and knowledge of
evidence-based medicine'.
Ability to apply evidence to practice
3.01
Ability to critical appraise published medical literature
3.00
Ability to define and carry out an appropriate literature search
2.95
Ability to generate evidence through clinical audit
2.47
Ability to apply statistical analysis to data
2.15
LEVEL 2 COMPETENCES/OUTCOMES
'Ability to apply scientific principles, method and knowledge to
medical practice and research'
Ability to apply scientific principles to the practice of medicine
3.01
Ability to analyse and disseminate experimental results
2.17
Ability to design research experiments
1.81
Ability to carry out practical laboratory research procedures
1.71
LEVEL 2 COMPETENCES/OUTCOMES
'Ability to assess psychological and social aspects of a
patient's illness'.
Ability to assess psychological factors in presentations and
impact of illness
3.12
Ability to detect alcohol and substance abuse, dependency
3.11
Ability to detect stress in relation to illness
3.03
Ability to assess social factors in presentations and impact of
illness
3.01
The Tuning Project

Not about identity or conformity
(the European Commission values diversity)

Identifying common ground to build on

“Just a little more tuneful”
KNOWLEDGE OUTCOMES
'Basic Sciences'
Normal function (physiology)
3.55
Normal structure (anatomy)
3.35
Normal body metabolism and hormonal function (biochemistry)
3.13
Normal immune function (immunology)
3.07
Normal cell biology
2.61
Normal molecular biology
2.51
Normal human development (embryology)
2.36
KNOWLEDGE OUTCOMES
'Behavioural and social sciences'
Psychology
2.87
Human development (child/adolescent/adult)
2.76
Sociology
2.41
KNOWLEDGE OUTCOMES
'Clinical Sciences'
Abnormal structure and mechanisms of disease (pathology)
3.40
Infection (microbiology)
3.36
Immunity and immunological disease
3.04
Genetics and inherited disease
2.83
KNOWLEDGE OUTCOMES
'Drugs and prescribing'
use of antibiotics and antibiotic resistance
3.42
principles of prescribing
3.30
drug side effects
3.22
drug interactions
3.18
use of blood transfusion and blood products
3.12
drug action and pharmacokinetics
3.08
individual drugs
2.89
the different types of complementary and alternative medicine and
their use in patient care
2.26
KNOWLEDGE OUTCOMES
'Public Health'
disease prevention
3.14
lifestyle, diet and nutrition
2.98
health promotion
2.83
screening for disease and disease surveillance
2.79
disability
2.72
gender issues relevant to health care
2.64
epidemiology
2.61
cultural and ethnic influences on health care
2.55
resource allocation and health economics
2.40
global health and inequality
2.33
KNOWLEDGE OUTCOMES
'Ethical and legal principles in medical practice'
rights of patients
3.30
rights of disabled people
3.16
responsibilities in relation to colleagues
3.11
KNOWLEDGE OUTCOMES
'Role of the doctor in health care systems'
laws relevant to medicine
2.91
systems of professional regulation
2.73
principles of clinical audit
2.59
systems for health care delivery
2.58
PRACTICE SETTINGS
ALL MEDICAL GRADUATES SHOULD HAVE EXPERIENCED CLINICAL WORK IN THESE
AREAS
care of acutely ill patients in Casualty / Accident and Emergency units
3.51
care of general (internal) medical patients in medical admission units
3.48
care of general surgical patients in surgical admission units
3.20
care in the community/family practice/primary care
3.13
care for elderly patients
3.08
care for sick children
3.04
care for the dying, palliative care
2.91
care for mentally ill patients
2.83
obstetric and gynaecological care
2.81
care for critically ill patients in Intensive Care Units
2.71
care of patients with specialised medical conditions (eg haematology, renal medicine)
2.56
anaesthetic care
2.54
rehabilitation medicine
2.40
care of patients with specialised surgical conditions (eg cardiac surgery, urology)
2.39
WORLD FEDERATION FOR MEDICAL EDUCATION TASK FORCE (2000) Defining international
standards in basic medical education. Report of a Working Party, 1999, Medical Education, 34(8), 665-675.
The WFME standards
1.4 EDUCATIONAL OUTCOME
Basic standard:
The medical school must define the competencies that students should exhibit
on graduation in relation to their subsequent training and future roles in the
health system.
Quality development: The linkage of competencies to be acquired by
graduation with that to be acquired in postgraduate training should be specified.
Measures of, and information about, competencies of the graduates should be
used as feedback to programme development.
Annotations: • Educational outcome would be defined in terms of the competencies the
students must acquire before graduation. • Competencies within medicine and medical
practice would include knowledge and understanding of the basic, clinical, behavioural and
social sciences, including public health and population medicine, and medical ethics
relevant to the practice of medicine; attitudes and clinical skills (with respect to
establishment of diagnoses, practical procedures, communication skills, treatment and
prevention of disease, health promotion, rehabilitation, clinical reasoning and problem
solving); and the ability to undertake lifelong learning and professional development.
2.1 CURRICULUM MODELS AND INSTRUCTIONAL METHODS
Basic standard: The medical school must define the curriculum models and instructional methods employed.
Quality development: The curriculum and instructional methods should ensure that students have responsibility for their
learning process and should prepare them for lifelong, self-directed learning.
Annotations: Curriculum models would include models based on discipline, system, problem and community, etc.
Instructional methods encompass teaching and learning methods.
The curriculum and instructional methods should be based on sound learning principles and should foster the ability to
participate in the scientific development of medicine as professionals and future colleagues.
2.2 SCIENTIFIC METHOD
Basic standard: The medical school must teach the principles of scientific method and evidence-based medicine, including
analytical and critical thinking, throughout the curriculum.
Quality development: The curriculum should include elements for training students in scientific thinking and research
methods.
Annotation: Training in scientific thinking and research methods may include the use of elective research projects to be
conducted by medical students.
2.3 BASIC BIOMEDICAL SCIENCES
Basic standard: The medical school must identify and incorporate in the curriculum the contributions of the basic biomedical
sciences to create understanding of the scientific knowledge, concepts and methods fundamental to acquiring and applying
clinical science.
Quality development: The contributions in the curriculum of the biomedical sciences should be adapted to the scientific,
technological and clinical developments as well as to the health needs of society.
Annotation:
The basic biomedical sciences would - depending on local needs, interests and traditions - typically include anatomy,
biochemistry, physiology, biophysics, molecular biology, cell biology, genetics, microbiology, immunology, pharmacology,
pathology, etc.
2.4 BEHAVIOURAL AND SOCIAL SCIENCES AND MEDICAL ETHICS
Basic standard: The medical school must identify and incorporate in the curriculum the contributions of the behavioural
sciences, social sciences, medical ethics and medical jurisprudence that enable effective communication, clinical decision
making and ethical practices.
Quality development: The contributions of the behavioural and social sciences and medical ethics should be adapted to
scientific developments in medicine, to changing demographic and cultural contexts and to health needs of society.
Annotations: Behavioural and social sciences would - depending on local needs, interests and traditions - typically include
medical psychology, medical sociology, biostatistics, epidemiology, hygiene and public health and community medicine etc.
The behavioural and social sciences and medical ethics should provide the knowledge, concepts, methods, skills and
attitudes necessary for understanding socio-economic, demographic and cultural determinants of causes, distribution and
consequences of health problems.
2.5 CLINICAL SCIENCES AND SKILLS
Basic standard: The medical school must ensure that students have patient contact and acquire sufficient clinical knowledge
and skills to assume appropriate clinical responsibility upon graduation.
Quality development: Every student should have early patient contact leading to participation in patient care. The different
components of clinical skills training should be structured according to the stage of the study programme.
Annotations: The clinical sciences would - depending on local needs, interests and traditions - typically include internal
medicine (with subspecialties), surgery (with subspecialties), anaesthesiology, dermatology & venereology, diagnostic
radiology, emergency medicine, general practice/family medicine, geriatrics, gynaecology & obstetrics, laboratory medicine,
neurology, neurosurgery, oncology & radiotherapy, ophthalmology, orthopaedic surgery, oto-rhino-laryngology, paediatrics,
pathological anatomy, physiotherapy & rehabilitation medicine and psychiatry, etc.
Clinical skills include history taking, physical examination, procedures and investigations, emergency practices and
communication and team leadership skills.
Appropriate clinical responsibility would include health promotion, disease prevention and patient care.
Participation in patient care would include relevant community experience and teamwork with other health professions.
The worth of an intellectual construction is
to be found in its value as an ideal…. That
it also has potential for full realization is a
further, but not the exclusive, benefit.
Socrates (as reported in Plato,
The Republic, book 4, 360 BC)
WHAT IS A EUROPEAN MEDICAL
GRADUATE?

“Basic medical training: admission to basic
medical training shall be contingent upon
possession of a diploma or certificate providing
access to universities or equivalent institutes
which provide higher education, and shall
comprise a total of at least six years of study or
5500 hours of theoretical and practical training
provided by, or under the supervision of, a
university.”
http://europa.eu/scadplus/leg/en/cha/c11065.htm
Universal cross-recognition of primary medical
qualifications within Europe
Directive 2005/36/EC of the European Parliament and of the
Council of 7 September 2005
European medical education –
out of tune?





Wide variation in admission standards and
selection procedures
Degree programmes vary from 4 to 7 years
(or longer)
May involve one, two, or three degrees
Graduation may or may not = license to
practise
No agreement on graduating learning
outcomes/competences
?? “a system of easily readable and
comparable degrees”
The Scottish doctor
http://www.scottishdoctor.org
The UK Doctor
Tomorrow’s Doctors
2002
http://www.gmc-uk.org/med_ed/default.htm
The national European doctor

BLOCH, R. & BURGI, H. (2002) The Swiss Catalogue
of Learning Objectives, Medical Teacher 24(2), pp.
144-150.

METZ, J.C.M., STOELINGA, G.B.A. et al. (1994)
Blueprint 1994: Training of Doctors in The
Netherlands, Objectives of Undergraduate Medical
Education (Nijmegen, University Publications Office).

GUAL, A., PALÉS, J., PARDELL, H. & ORIOL-BOSCH, A
(2005).
Doctors in Spain. An old country, old and new
structures, and a new future.
The Clinical Teacher 2 (1), 59-63.
+ many others
The US doctor
The global doctor
The WFME standards
CURRICULUM
CONTENT –
Scientific method
Basic biomedical
science
Behavioural and Social
Sciences and Medical
Ethics
Clinical Sciences and
Skills
LEARNING OUTCOMES FOR
MEDICINE – OUT OF TUNE?
Vary enormously in –
 Overall structure
 Level of detail
 Content
 Application - theory v
practice, accreditation
TUNING TASK FORCE, MEDINE 2
Aims of the Tuning (Medicine) Task Force will be:

To build on the work of the current network, MEDINE.

To consider how the “Dublin Descriptors” and the Bologna 3 cycle model can be
integrated with the new Tuning (Medicine) competency framework. To
investigate how competences for 1st and 3rd cycles might relate to those for
primary medical qualifications.

To apply new systems for mapping other competency frameworks to Tuning.

To develop new systems for categorising competences and defining level
statements.

To promote use of Tuning (medicine) tools within and outside Europe, linking
with the Tuning Project and Tuning Latina America.

To relate the Tuning competences to curriculum design, including a model core
undergraduate medical curriculum which will allow students to achieve the
Tuning competences at the point of graduation.

To generate guidance on best practice in assessing theTuning (medicine)
competences.