Introduction
The Freiburg Questionnaire to Assess Competence in Medicine (FKM) is a 45-item questionnaire that measures self-perceived medical competencies in students and residents. Marianne Giesler, Johannes Forster, Silke Biller and Götz Fabry published it in 2011. Its nine domains align with the CanMEDS roles, and the original study has received more than 50 citations.
The study appeared in GMS Zeitschrift für Medizinische Ausbildung. Medical schools can use the FKM to check whether students reach the learning outcomes set out in the German Medical Licensure Act (ÄAppO). This guide explains its domains, double rating format, reliability evidence and uses in curriculum evaluation.
Key Features of the FKM
Purpose and Use
The developers created the FKM to assess medical competencies in students and residents. Primarily, it evaluates whether medical education achieves the learning outcomes of the German Medical Licensure Act (ÄAppO). To do so, it measures self-perceived competence across domains aligned with the CanMEDS roles.
Consequently, the FKM serves three main purposes: curriculum evaluation, graduate surveys, and screening to identify weaknesses in medical education.
Target Population
The FKM targets medical students, residents and medical graduates. The source studies do not specify the students' mean age, while residents had a mean age of 29.5 years in one study. The developers recommend using the FKM from the clinical years of medical school onward.
Structure
The current version contains 45 items in nine domains. Each domain corresponds to specific CanMEDS roles and includes items on knowledge, skills and attitudes relevant to medical practice:
Medical ExpertiseCommunicative CompetenceTeam CompetenceCompetence in Health Promotion and PreventionManagement CompetenceProfessionalismLearning CompetenceScholarshipPersonal CompetenceScoring Method
Respondents rate each of the 45 items twice. First, they rate their current, or retrospectively assessed, level of competence. Second, they rate the level of competence they consider necessary in their profession.
Group
Rating scale
Endpoints
Students
5-point Likert scale
1 "very low" to 5 "very high"
Residents
5-point Likert scale
1 "not at all" to 5 "very much"
The FKM produces a score for each of the nine domains. Higher scores indicate higher self-perceived competence or higher perceived job demands. Notably, the source does not mention reverse scoring, and it reports no total score range or cut-off values.
Administration Format
The FKM is a self-assessment questionnaire, so students and residents complete it themselves using the 5-point rating scales above.
Applications of the FKM
The FKM supports several uses in medical education:
Curriculum evaluation: checking whether a program achieves the learning outcomes of the German Medical Licensure Act.Graduate surveys: capturing how graduates rate their competencies after training.Screening: identifying weaknesses in medical education.Competency-based education research: studying medical competencies across the nine CanMEDS-aligned domains.Languages and availability
The FKM was developed for German medical education, and the original article is freely available on PubMed Central. A copy of the publication is also available on ResearchGate. Licensing terms are not reported, so contact the first author, Marianne Giesler, at marianne.giesler@klinikum.uni-freiburg.de before using the questionnaire.
Reliability and Validity
The original study found good to excellent internal consistency, with reliability coefficients ranging from .68 to .97. It also provided initial evidence of construct validity in student and resident samples.
Validation studies:
Development of a questionnaire to assess medical competencies: reliability and validity (Giesler et al., 2011): study linkLimitations and Considerations
Users should keep several points in mind:
Further validation needed: additional validation is required, particularly of criterion-related validity.Self-assessment bias: because the FKM relies on self-assessment, interpret results with awareness of potential response biases.Timing: the developers recommend using the FKM from the clinical years onward.Scores: no total score range or cut-off values are reported.Other Versions And Related Questionnaires
The original article describes two versions of the FKM:
Version 1: 36 items in seven domains.Version 2: 45 items in nine domains, the current version at the time of publication.No related or complementary questionnaires are listed for the FKM.
Additional Resources
The full original article on PubMed Central: linkThe publication on ResearchGate: linkFor inquiries, contact Marianne Giesler at marianne.giesler@klinikum.uni-freiburg.de.Browse more medical education resources in the ResRef database.Frequently Asked Questions (FAQ)
Who can use the FKM?The FKM is designed for medical students, residents and medical graduates. The developers recommend using it from the clinical years of medical school onward, and it is completed as a self-assessment.
What does the FKM measure?It measures self-perceived competence in nine domains aligned with the CanMEDS roles, such as Medical Expertise, Communicative Competence, Team Competence and Professionalism, across knowledge, skills and attitudes.
Why is each FKM item rated twice?Respondents first rate their current, or retrospectively assessed, level of competence. Then they rate the level of competence they consider necessary in their profession.
How reliable is the FKM?The original study reported good to excellent internal consistency, with reliability coefficients from .68 to .97, and initial construct validity in student and resident samples. Criterion-related validity still needs further study.
A Word from ResRef About the FKM
The FKM is a comprehensive self-report instrument for assessing medical competencies across nine domains aligned with CanMEDS roles, developed for curriculum evaluation and graduate surveys in German medical education. It demonstrated good to excellent internal consistency and initial construct validity in student and resident samples. The instrument is recommended for use from the clinical years onward; further validation, particularly criterion-related validity, is needed, and self-assessments should be interpreted with awareness of potential response biases.
References
Giesler, M., Forster, J., Biller, S., & Fabry, G. (2011). Entwicklung eines Fragebogens zur Erfassung von Kompetenzen in der Medizin: Ergebnisse zur Reliabilität und Validität. GMS Zeitschrift für Medizinische Ausbildung, 28(2), Doc31. https://doi.org/10.3205/ZMA000743