{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T11:58:58Z","timestamp":1785239938631,"version":"3.55.0"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Research competency is increasingly recognized as essential for medical graduates, yet rigorous evaluation of educational interventions remains uncommon. Outcome-based education (OBE) aligns teaching activities with predefined competencies, but its application to research competency development in specialized clinical rotations is underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This methodological reflection draws on a feasibility pilot evaluating an OBE research-integrated teaching model in nephrology. A mixed-methods quasi-experimental design was employed, combining quantitative outcome data with qualitative feedback within a within-instructor counterbalanced framework. Eight instructors taught 126 fifth-year medical students across two consecutive 4-week blocks, with model crossover and no washout period. The primary outcome was a comprehensive examination (100-point scale); secondary outcomes included self-rated research competency, capstone proposal ratings, and platform usability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Near-transfer assessment scores were higher in the OBE condition (mean difference 5.6 points, 95% CI 3.1\u20138.1,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.001). Sensitivity analysis excluding the research design subscale (which directly overlapped with OBE micro-projects) attenuated the effect by 32% (mean difference 3.8 points, 95% BCa CI 1.2\u20136.4,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.005). Self-rated competency gains and capstone scores favored the OBE group, but all assessments lacked far-transfer tasks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>\n                      The statistically significant differences reflect near-transfer performance on examination tasks structurally aligned with training activities, not generalizable competency acquisition. The design failed to deliver credible evidence due to four fatal flaws: (1) assessment-task alignment between the research design subscale and OBE micro-projects; (2) absence of graduated transfer assessment; (3) insufficient instructor sample (\n                      <jats:italic>n<\/jats:italic>\n                      = 8) to detect instructor-by-model interactions; and (4) lack of a washout period introducing cross-contamination. The control condition (passive didactic teaching) conflated OBE-specific effects with generic active learning benefits. This article provides no evidence that the OBE model improves research competency; its sole contribution is to identify and warn against assessment alignment bias as a common validity threat. We propose a graduated transfer assessment framework and methodological checklist for future studies.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1893135","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T11:10:21Z","timestamp":1785237021000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["When assessment alignment masks generalizability: a methodological cautionary tale from an OBE pilot in nephrology"],"prefix":"10.3389","volume":"13","author":[{"given":"Qi-shun","family":"Wu","sequence":"first","affiliation":[{"name":"Second Affiliated Hospital of Wannan Medical University","place":["Wuhu, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Wang","sequence":"additional","affiliation":[{"name":"Affiliated Fourth Hospital of Jiangsu University","place":["Zhenjiang, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gui-rui","family":"Sang","sequence":"additional","affiliation":[{"name":"Second Affiliated Hospital of Wannan Medical University","place":["Wuhu, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"81625","DOI":"10.2215\/CJN.0000000000000133","article-title":"Reimagining nephrology fellowship education to meet the future needs of nephrology: a report of the American Society of Nephrology Task Force on the Future of Nephrology","volume":"18","author":"Rosenberg","year":"2023","journal-title":"Clin J Am Soc Nephrol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"10S","DOI":"10.1681\/ASN.2025ry9erbx6","article-title":"Enhancing health literacy in CKD: quality improvement initiative comparing artificial intelligence (AI)-generated content and expert nephrologist insights","volume":"36","author":"Zapata","year":"2025","journal-title":"J Am Soc Nephrol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1080\/01421590701729930","article-title":"Outcome-based education: the future is today","volume":"29","author":"Harden","year":"2007","journal-title":"Med Teach"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2026.05.048","article-title":"How to evaluate the robustness of causal findings in observational studies: application of E-values and bounding factors","author":"Mafiz","year":"2026","journal-title":"Clin Microbiol Infect"},{"key":"B5","doi-asserted-by":"publisher","first-page":"361","DOI":"10.2105\/AJPH.94.3.361","article-title":"Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: The TREND statement","volume":"94","year":"2004","journal-title":"Am J Public Health."},{"key":"B6","author":"Biggs","year":"2011","journal-title":"Teaching For Quality Learning At University"},{"key":"B7","volume-title":"Visible Learning: A Synthesis Of Over 800 Meta-Analyses Relating To Achievement","author":"Hattie","year":"2009"},{"key":"B8","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1037\/0033-2909.128.4.612","article-title":"When and where do we apply what we learn? 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