Targeted Competency Enhancement Program (TCEP): An Institutional Framework for Competency Support and Remediation

Sabeeh Al Mashhadani

Summary:
The Targeted Competency Enhancement Program (TCEP) is an institutional framework designed to transform remediation into a structured, supportive, and competency-based process. Drawing on global models such as the UK’s ARCP, US ILPs, Saudi SCFHS programs, and specialized centers like CPEP, TCEP consolidates fragmented practices into a unified system. Its 4D model—Detect, Diagnose, Develop, Demonstrate—ensures early gap identification, targeted interventions, and validated reassessment. Supported by governance policies, TCEP emphasizes fairness, learner dignity, and measurable outcomes. By integrating IT and AI tools, including adaptive dashboards, and predictive analytics, it provides personalized learning pathways and institutional oversight. TCEP enhances equity, reduces attrition, and strengthens institutional credibility, positioning it as a future-ready solution in medical and professional education.

 Introduction

In recent years, the demand for structured approaches to competency development in medical and professional education has grown worldwide. Various systems have introduced remediation pathways under different names and models. For example, the United States and Canada have implemented Individual Learning Plans (ILPs) and structured remediation programs within residency [1]. The General Medical Council (UK) applies the Annual Review of Competence Progression (ARCP), which includes remediation placements [2]. Australia and New Zealand use mandatory remediation programs for underperforming trainees [3]. The Saudi Commission for Health Specialties (SCFHS) has also introduced structured remediation workshops and competency-based assessments [4].
Beyond these systems, specialized institutions such as the Center for Personalized Education for Professionals (CPEP) in the U.S. deliver individualized physician assessments and tailored educational interventions [5]. The Federation of State Medical Boards (FSMB) maintains a directory of remediation programs, including the Post-Licensure Assessment System (PLAS) [6]. Academic resources like the ACGME Remediation Toolkit [7] and institutional guides such as the SSM Health GME Toolkit [8] are now widely used.
Despite these advances, most initiatives remain fragmented, localized, or discipline-specific. What has been missing is a comprehensive institutional framework that unifies these practices while leveraging digital transformation and artificial intelligence (AI). The Targeted Competency Enhancement Program (TCEP) provides this solution.

Defining TCEP

The Targeted Competency Enhancement Program (TCEP) is a structured, competency-based process that identifies specific performance gaps, prescribes individualized learning interventions, and confirms growth through reassessment. Unlike traditional remediation, TCEP emphasizes development and fairness rather than punitive measures [9].

Guiding Principles

TCEP builds on lessons learned from programs such as CPEP, ARCP, and FSMB initiatives but codifies them into a consistent framework guided by principles of [10]:
1. Targeted – focus only on verified competency gaps.
2. Competency-Based – observable, measurable outcomes.
3. Programmatic – sequenced pathway with checkpoints.
4. Human-Centered – fairness, psychological safety, learner dignity.
5. Evidence-Driven – data-informed decision making.
6. Proportionality – interventions matched to gap severity.
7. Ethical and Equitable – privacy protection, bias monitoring.
8. Continuous Improvement – institutional feedback loops.

The TCEP Framework – The 4D Model

1. Detect – Early identification using OSCEs, exams, workplace-based assessments, dashboards, or predictive analytics [11].
2. Diagnose – Triangulation of data, root cause analysis, and learner reflection.
3. Develop – Individualized Learning Plans (ILPs), targeted workshops, simulation labs, AI-assisted coaching.
4. Demonstrate – Reassessment with standardized tools, OSCE stations, or case-based discussions [12].

Governance and Policy

Building on models like ACGME Milestones [13] and WFME standards [14], TCEP defines clear governance roles:
- TCEP Committee – policy and oversight.
- Program Directors – resource allocation and implementation.
- Coaches/Mentors – structured feedback and learner guidance.
- Assessment Units – analytics, psychometrics, dashboards.
This ensures fairness, transparency, and auditability, unlike some existing remediation programs that remain ad hoc.

Implementation Roadmap

- Phase 1 (Pilot): Select programs, train faculty, test dashboards.
- Phase 2 (Scale-Up): Expand to all departments, integrate portfolios, automate analytics [15].
- Phase 3 (Institutionalization): Embed in bylaws, link to accreditation, publish benchmarking reports. This roadmap mirrors but extends efforts like the Loma Linda longitudinal OSCE-based remediation program [16].

IT and Artificial Intelligence as Enablers

Here TCEP makes its most innovative leap. While traditional remediation relies on human observation and manual processes, TCEP incorporates IT infrastructure and AI-assisted tools [17]:
- AI-Assisted Learner Portals: Personalized dashboards, adaptive recommendations, chatbot-based clinical scenarios [18].
- Smart Mentor Tools: AI scoring rubrics for OSCEs, automated performance analytics, structured feedback templates.
- Institutional Analytics: Predictive dashboards to identify at-risk learners early, real-time program-wide monitoring [19].

Benefits

- For Learners: Reduced stigma, personalized growth, earlier support.
- For Faculty: AI reduces workload while improving feedback quality.
- For Institutions: Improves pass rates, enhances fairness, strengthens reputation.
- For Healthcare Systems: Produces safer, more competent professionals [20].

Conclusion

While many international programs—such as CPEP, ARCP, FSMB registries, and OSCE-based remediation models—demonstrate the value of remediation, they remain fragmented. The Targeted Competency Enhancement Program (TCEP) integrates these lessons into a comprehensive institutional framework supported by IT and AI innovations. This positions TCEP not only as a tool for remediation but as a future-ready model that ensures no learner is left behind, while raising the quality, equity, and accountability of professional education worldwide.

References

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4. Saudi Commission for Health Specialties (SCFHS). Policies and Procedures for Training Programs. Riyadh, 2018.

5. Center for Personalized Education for Professionals (CPEP). Physician Assessment and Remediation Programs. Denver, USA. 2021.

6. Federation of State Medical Boards (FSMB). Directory of Physician Assessment and Remedial Education Programs (PLAS). FSMB, 2019.

7. Accreditation Council for Graduate Medical Education (ACGME). Remediation Toolkit. ACGME, 2023.

8. SSM Health. Graduate Medical Education Remediation Toolkit. 2022.

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13. ACGME. Milestones Project: Competency-based evaluation. ACGME, 2015.

14. World Federation for Medical Education (WFME). Standards for Postgraduate Medical Education. WFME, 2015.

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19. Chen C, et al. How artificial intelligence will change medical training. Medical Education Online. 2020.

20. Frank JR, Snell L, ten Cate O, et al. Competency-based medical education: theory to practice. Medical Teacher. 2010.