A three-tiered laddered CBME training model for breast surgery: L1 basic skills, L2 minor procedures, L3 advanced surgery¶

Design · All designs
Evidence · 3 claims (3 for) · 1 study (1 causal), q3 · 0 of 1 report an effect size · 3 claims rest on one study

Description¶

The article introduces a stepwise, competency-based training model that categorizes breast surgery training into three sequential levels: L1 basic skills (ultrasound-guided biopsy, 1 month), L2 minor procedures (venous access port implantation, 2 months), and L3 advanced surgery (breast-conserving surgery, 3 months). Progression to each subsequent level requires completion of predefined objectives and competency requirements of the preceding stage. The model reorganizes case-driven clinical exposure into sequential, competency-based practice without extending the 6-month rotation period. Ultrasound serves as a bridging technology across all three tiers.

Design Implications¶

Context¶

Requirements¶

Completion of predefined objectives and competency requirements of the preceding stage before progression
A fixed 6-month rotation period within which training time is redistributed rather than expanded
Ultrasound as a bridging technology across diagnostic and procedural milestones

Constraints¶

Implemented within a single tertiary hospital setting
A 6-month training period inadequate for longitudinal competency assessment
Absence of individualized adaptation strategies for residents with varying baseline abilities

Target Learners¶

Second- and third-year breast surgery residents in standardized training

Learning Goals¶

Ultrasound-guided biopsy competency
Venous access port implantation competency
Breast-conserving surgery competency
Clinical decision-making and patient management

Claims¶

Examples¶

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Key Sources¶

Xu Kailun, Jiang Lingting, Zhang Yun, Du Yushen, Shen Yong, Chen Yiding, Shao Yingkuan. (2026). A laddered training model for breast surgery specialists: development and validation of a CBME-based precision education framework. BMC Medical Education. https://doi.org/10.1186/s12909-026-09688-5

Page metadata

Field	Value
`type`	`design`
`id`	`laddered-cbme-breast-surgery-model`
`title`	`A three-tiered laddered CBME training model for breast surgery: L1 basic skills, L2 minor procedures, L3 advanced surgery`
`description`	`The article introduces a stepwise, competency-based training model that categorizes breast surgery training into three sequential levels: L1 basic skills (ultrasound-guided biopsy, 1 month), L2 minor procedures (venou...`
`status`	`review`
`generated`	by `process:settle-candidates` on `2026-11-04`
`trust`	unverified — no one has confirmed this page's content
`sources`	1 — `xu-kailun-2026`

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