The Spanish Society for Medical Education

Inside the framework of the European Area for Higher Education created by the Bologna Agreements, the Spanish faculties of medicine have initiated a new process of syllabus reform. One of the key points in this process is the need to structure syllabuses according to competencies, and medicine faculties have been quick to respond.

As part of the quality control of the training process, the skills to be learnt in the syllabus must first be defined. To discuss ways of doing so, a meeting was held on 23 - 24 September 2004 during the Mahon Lazaretto Public Health Summer School (Menorca). The meeting, entitled How are the professional competencies of undergraduate degrees evaluated?, was organized by the Spanish Association for Medical Education (SEDEM) in conjunction with the University of Barcelona and under the auspices of the Carlos III Health Institute*.

The meeting took the form of a workshop led by two experts in the processes of evaluation of professional competencies in the health professions. The National Conference of Deans of the Spanish Faculties of Medicine, the University of Barcelona, the Carlos III Health Institute and the SEDEM also participated.

At the end of the sessions, agreement was reached on a series of important points which were then gathered together to form the Declaration of the Mahon Lazaretto. These points are presented below. The Spanish Association for Medical Education accepts and supports them, and urges all those involved in Medical Education and, especially, all those involved in syllabus reform, to uphold the terms expressed in the following statements:

Declaration of the Mahón Lazaretto

1. Faculties of medicine shall explicitly define the competencies that graduates must acquire. They shall also draw up a Faculty-Student contract based on the competencies to be taught and learnt.

2. Faculties of medicine must work on a process of syllabus reform leading to the design of study programs based on a set of previously defined competencies. To this end, faculties shall devise a long-term strategy which sets out the participation process through which those involved will define the competencies to be learnt, the development and implementation of the learning strategies needed to ensure that they are acquired, and procedures for the evaluation of the said competencies.

3. All those involved, both internal (faculty and students) and external (professional associations, administration, health service providers, scientific associations) shall participate actively in the process.

4. In order to promote the involvement of teaching staff, faculties shall encourage the participation of medical education experts able to provide training and advice for teaching staff in the processes of defining and evaluating professional competencies.

5. The process of competencies evaluation, like any other evaluation process, must be valid, reliable and feasible. The design should aim to ensure its acceptability and educational impact among both students and teachers.

6. It is to be hoped that, when new study programs are introduced, faculties will already have experience in competencies evaluation.

7. The process of competencies evaluation must be initiated as soon as possible, and shall be implemented in all areas of the curriculum. Evaluation and learning must complement each other at all times. Pilot schemes should be devised for the evaluation of the quality of training and study programs and to respond to the growing needs of evaluation agencies.

8. The process of evaluation of learning and professional competencies is favoured by the existence of skills laboratories where students acquire new abilities. Faculties should promote the creation of skills laboratories of this kind, increasing the range of facilities they provide and improving the performance.

9. In addition to the strategy of continued implementation of learning and competencies evaluation throughout the degree, it is necessary to establish a formal, academically acknowledged evaluation of the competencies acquired at the conclusion of the degree. Together with other assessments, this final evaluation of the competencies acquired should be accepted both by professional associations and by post-graduate training programs.

Lazareto de Mahón, Menorca
24th September 2004