April 2020 What I’m Thinking About…

Considering Thresholds in UGME

Drs. Laura Farrell, Bruce Wright and Shavaun MacDonald

Date: April 7, 2020 *CANCELLED*


Threshold concepts, first described in higher education literature, are core ideas within disciplines that are initially difficult to comprehend, but once grasped, irreversibly transform he learner’s perception of the subject. Threshold concepts, by definition, share common characteristics including being transformative, integrative, irreversible, bounded, and troublesome. There has been a growing trend to acknowledge threshold concepts in Health Professionals’ Education, with the suggestion that threshold concepts may offer new perspectives in curricular design, teaching, learner support, and assessment

In this WITA session, we hope to share our understanding of threshold concepts and discuss practical implications of further development of threshold concepts in Health Professionals’ Education. As threshold concepts become further characterized in a scholarly manner, we hope to promote a discussion on how they might add value to curricular design. In addition, we propose that threshold concepts may allow us to enhance our support and assessment of learners within competency based education, including UBC’s Undergraduate Medical Education curriculum with the current curricular mapping to milestones and exit competencies. Integrating threshold concepts into this model may help better support learners as they grapple with troublesome knowledge to acquire a qualitatively different view of subject matter, aiding in their pursuit of mastery.


  1. Describe the theory of threshold concepts using examples from undergraduate medical education
  2. Discuss how to further define and characterize threshold concepts that are encountered in the various Health Professions disciplines
  3. Explore what role Threshold Concepts could play as a value-added theoretical construct in improving assessment

Accredited by UBC CPD



The University of British Columbia Division of Continuing Professional Development (UBC CPD) is fully accredited by the Committee on Accreditation of Continuing Medical Education (CACME) to provide study credits for continuing medical education for physicians. This program meets the certification criteria of the College of Family Physicians of Canada and has been certified by UBC CPD for up to 18 (1.5 per session) Mainpro+ Group Learning credits. Each physician should claim only those credits accrued through participation in the activity.

RCPSC Accreditation

What I’m Thinking About… is a self-approved group learning activity (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada.