From competency mapping to curriculum development: Identifying gaps in an undergraduate general practice clerkship – a mixed-methods study

Objectives: This study aims to show the process of developing a competency-based medical education (CBME) General Practice (GP) block clerkship at the University of Heidelberg, aligned with frameworks such as CanMEDS, Entrustable Professional Activities (EPAs), and the National Competency-based Learning Objectives Catalogue (NKLM 2.0). Objectives are to identify competencies addressed in the current two-week clerkship, determine additional content needed to cover all required competencies, and assess student perspectives. Methods: A questionnaire completed by 165 students in 2023 evaluated perceived competence in various areas and their interest in GP before and after the clerkship. Data were analysed using a 5-point Likert scale ((1=fully agree to 5=completely disagree), and the curriculum was mapped to NKLM 2.0, CanMEDS, and EPAs to identify represented and missing competencies. Focus group meetings with lecturers and students were held to develop a new concept. Results: The current clerkship received an overall rating of 1.8 (SD: 1.06) but did not significantly increase interest in GP careers. Some competencies were well-covered, but areas like interprofessional skills or leadership and management were lacking. A six-week longitudinal clerkship was proposed to address these gaps, focusing on interprofessional collaboration, leadership, and patient-centred care, and including digital teaching, reflection and simulation training, and shadowing experiences. Conclusion: The proposed CBME curriculum addresses evolving needs in medical education. Successful implementation will require longitudinal integration, interdisciplinary cooperation, trained preceptors, and centralised coordination. This study provides a roadmap for emphasising key competencies, promoting GP career choice, and contributing to high-quality patient care.