scholarly journals Outcomes in the age of competency-based medical education: Recommendations for emergency medicine training in Canada from the 2019 symposium of academic emergency physicians

CJEM ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. 204-214 ◽  
Author(s):  
Teresa M. Chan ◽  
Quinten S. Paterson ◽  
Andrew K. Hall ◽  
Fareen Zaver ◽  
Robert A. Woods ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
Clinical Outcomes ◽  
Online Survey ◽  
Emergency Physicians ◽  
Competency Based Medical Education ◽  
Canadian Association ◽  
National Implementation ◽  
Competency Based ◽  
The Impact

ABSTRACTObjectivesThe national implementation of competency-based medical education (CBME) has prompted an increased interest in identifying and tracking clinical and educational outcomes for emergency medicine training programs. For the 2019 Canadian Association of Emergency Physicians (CAEP) Academic Symposium, we developed recommendations for measuring outcomes in emergency medicine training in the context of CBME to assist educational leaders and systems designers in program evaluation.MethodsWe conducted a three-phase study to generate educational and clinical outcomes for emergency medicine (EM) education in Canada. First, we elicited expert and community perspectives on the best educational and clinical outcomes through a structured consultation process using a targeted online survey. We then qualitatively analyzed these responses to generate a list of suggested outcomes. Last, we presented these outcomes to a diverse assembly of educators, trainees, and clinicians at the CAEP Academic Symposium for feedback and endorsement through a voting process.ConclusionAcademic Symposium attendees endorsed the measurement and linkage of CBME educational and clinical outcomes. Twenty-five outcomes (15 educational, 10 clinical) were derived from the qualitative analysis of the survey results and the most important short- and long-term outcomes (both educational and clinical) were identified. These outcomes can be used to help measure the impact of CBME on the practice of Emergency Medicine in Canada to ensure that it meets both trainee and patient needs.

Faculty development in the age of competency-based medical education: A needs assessment of Canadian emergency medicine faculty and senior trainees

CJEM ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. 527-534 ◽  
Author(s):  
Alexandra Stefan ◽  
Justin N. Hall ◽  
Jonathan Sherbino ◽  
Teresa M. Chan
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
Faculty Development ◽  
Patient Care ◽  
Needs Assessment ◽  
Direct Observation ◽  
Senior Resident ◽  
Cross Sectional ◽  
Competency Based Medical Education ◽  
Competency Based

ABSTRACTObjectivesThe Royal College of Physicians and Surgeons of Canada (RCPSC) emergency medicine (EM) programs transitioned to the Competence by Design training framework in July 2018. Prior to this transition, a nation-wide survey was conducted to gain a better understanding of EM faculty and senior resident attitudes towards the implementation of this new program of assessment.MethodsA multi-site, cross-sectional needs assessment survey was conducted. We aimed to document perceptions about competency-based medical education, attitudes towards implementation, perceived/prompted/unperceived faculty development needs. EM faculty and senior residents were nominated by program directors across RCPSC EM programs. Simple descriptive statistics were used to analyse the data.ResultsBetween February and April 2018, 47 participants completed the survey (58.8% response rate). Most respondents (89.4%) thought learners should receive feedback during every shift; 55.3% felt that they provided adequate feedback. Many respondents (78.7%) felt that the ED would allow for direct observation, and most (91.5%) participants were confident that they could incorporate workplace-based assessments (WBAs). Although a fair number of respondents (44.7%) felt that Competence by Design would not impact patient care, some (17.0%) were worried that it may negatively impact it. Perceived faculty development priorities included feedback delivery, completing WBAs, and resident promotion decisions.ConclusionsRCPSC EM faculty have positive attitudes towards competency-based medical education-relevant concepts such as feedback and opportunities for direct observation via WBAs. Perceived threats to Competence by Design implementation included concerns that patient care and trainee education might be negatively impacted. Faculty development should concentrate on further developing supervisors’ teaching skills, focusing on feedback using WBAs.

scholarly journals Assessment of emergency medicine residents: a systematic review

2017 ◽  
Vol 8 (1) ◽  
pp. e106-122 ◽  
Author(s):  
Isabelle N Colmers-Gray ◽  
Kieran Walsh ◽  
Teresa M Chan
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
Direct Observation ◽  
Full Text ◽  
Assessment Tools ◽  
Competency Based Medical Education ◽  
Mesh Terms ◽  
Competency Based ◽  
Resident Assessment ◽  
Assessment Frequency

Background: Competency-based medical education is becoming the new standard for residency programs, including Emergency Medicine (EM). To inform programmatic restructuring, guide resources and identify gaps in publication, we reviewed the published literature on types and frequency of resident assessment.Methods: We searched MEDLINE, EMBASE, PsycInfo and ERIC from Jan 2005 - June 2014. MeSH terms included “assessment,” “residency,” and “emergency medicine.” We included studies on EM residents reporting either of two primary outcomes: 1) assessment type and 2) assessment frequency per resident. Two reviewers screened abstracts, reviewed full text studies, and abstracted data. Reporting of assessment-related costs was a secondary outcome.Results: The search returned 879 articles; 137 articles were full-text reviewed; 73 met inclusion criteria. Half of the studies (54.8%) were pilot projects and one-quarter (26.0%) described fully implemented assessment tools/programs. Assessment tools (n=111) comprised 12 categories, most commonly: simulation-based assessments (28.8%), written exams (28.8%), and direct observation (26.0%). Median assessment frequency (n=39 studies) was twice per month/rotation (range: daily to once in residency). No studies thoroughly reported costs.Conclusion: EM resident assessment commonly uses simulation or direct observation, done once-per-rotation. Implemented assessment systems and assessment-associated costs are poorly reported. Moving forward, routine publication will facilitate transitioning to competency-based medical education.

The competency-based medical education evolution of Canadian emergency medicine specialist training

CJEM ◽  
2019 ◽  
Vol 22 (1) ◽  
pp. 95-102 ◽  
Author(s):  
Jonathan Sherbino ◽  
Glen Bandiera ◽  
Ken Doyle ◽  
Jason R. Frank ◽  
Brian R. Holroyd ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
Residency Education ◽  
Multiple Sources ◽  
High Stakes ◽  
Competency Based Medical Education ◽  
Professional Activities ◽  
Local Resources ◽  
Education Design ◽  
Competency Based

ABSTRACTCanadian specialist emergency medicine (EM) residency training is undergoing the most significant transformation in its history. This article describes the rationale, process, and redesign of EM competency-based medical education. The rationale for this evolution in residency education includes 1) improved public trust by increasing transparency of the quality and rigour of residency education, 2) improved fiscal accountability to government and institutions regarding specialist EM training, 3) improved assessment systems to replace poor functioning end-of-rotation assessment reports and overemphasis on high-stakes, end-of-training examinations, and 4) and tailored learning for residents to address individualized needs. A working group with geographic and stakeholder representation convened over a 2-year period. A consensus process for decision-making was used. Four key design features of the new residency education design include 1) specialty EM-specific outcomes to be achieved in residency; 2) designation of four progressive stages of training, linked to required learning experiences and entrustable professional activities to be achieved at each stage; 3) tailored learning that provides residency programs and learner flexibility to adapt to local resources and learner needs; and 4) programmatic assessment that emphasizes systematic, longitudinal assessments from multiple sources, and sampling sentinel abilities. Required future study includes a program evaluation of this complex education intervention to ensure that intended outcomes are achieved and unintended outcomes are identified.

scholarly journals Knowledge gaps in the diagnosis and management of patients with tropical diseases presenting to Canadian emergency departments: are the gaps being met?

CJEM ◽  
2014 ◽  
Vol 16 (06) ◽  
pp. 458-466 ◽  
Author(s):  
Nazanin Meshkat ◽  
Shikha Misra ◽  
Cheryl Hunchak ◽  
Paula Cleiman ◽  
Yasmin Khan ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Online Survey ◽  
Comfort Level ◽  
Tropical Diseases ◽  
Emergency Physicians ◽  
Further Training ◽  
Knowledge Gaps ◽  
Perceived Need ◽  
Canadian Association ◽  
Case Vignettes

ABSTRACTObjective:We conducted a needs assessment to identify knowledge gaps in the management of tropical diseases by Canadian emergency physicians and identify available, related continuing medical education (CME) resources.Methods:A literature review was conducted to summarize challenges in the management of commonly encountered tropical diseases. An anonymous online survey was administered to Canadian emergency physicians using the Canadian Association of Emergency Physicians survey deployment service in July and August 2012. The survey identified self-reported gaps in knowledge and assessed knowledge using case-based vignettes. A list of CME resources was generated from a review of major academic emergency medicine journals, online cases, and conference topics from emergency medicine associations during 2010– 2011. Two independent reviewers assessed the relevance of the resources; differences were resolved by consensus.Results:From 635 citations, 47 articles were selected for full review; the majority (66%) were retrospective chart reviews, few (10.6%) had an emergency medicine focus, and fewer still were Canadian (8.5%). In total, 1,128 surveys were distributed, and 296 (27%) participants were included in the study. Most respondents reported ‘‘no’’ (52.4%) or ‘‘some’’ (45.9%) training in tropical medicine. Most (69.9%) rated their comfort in managing patients with tropical diseases as ‘‘low.’’ Few (11.1%) respondents reported a tropical disease being misdiagnosed or mismanaged; 44.1% indicated malaria. The perceived need for further training was high (76.7%). Conference workshops were the most highly requested CME modality, followed by case studies and podcasts. Correct answers to case vignettes ranged from 30.7 to 58.4%. Although 2,038 CME titles were extracted from extensive searches, only 6 were deemed relevant.Conclusions:Most Canadian emergency physicians have had minimal training in tropical diseases, reported a low comfort level in their management, and identified a high need for CME opportunities, which are lacking.

scholarly journals The Impact of a National Competency-Based Medical Education Initiative in Family Medicine

2018 ◽  
Vol 93 (12) ◽  
pp. 1850-1857 ◽  
Author(s):  
Rachel H. Ellaway ◽  
Maria Palacios Mackay ◽  
Sonya Lee ◽  
Marianna Hofmeister ◽  
Greg Malin ◽  
...  
Keyword(s):  
Medical Education ◽  
Family Medicine ◽  
Competency Based Medical Education ◽  
Competency Based ◽  
The Impact ◽  
Education Initiative

scholarly journals Competency based medical education in gastrointestinal motility

2016 ◽  
Vol 28 (10) ◽  
pp. 1460-1464 ◽  
Author(s):  
R. Yadlapati ◽  
R. N. Keswani ◽  
J. E. Pandolfino
Keyword(s):  
Medical Education ◽  
Gastrointestinal Motility ◽  
Competency Based Medical Education ◽  
Competency Based

scholarly journals P026: Need for training in medical education: staff emergency physician perspectives

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S86
Author(s):  
J. Bryan ◽  
F. Al Rawi ◽  
T. Bhandari ◽  
J. Chu ◽  
S. Hansen ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
Adult Education ◽  
Family Medicine ◽  
Graduate Training ◽  
Formal Training ◽  
Emergency Physicians ◽  
Allied Health Professionals ◽  
Evaluation Time ◽  
Post Graduate Training

Introduction: Emergency medicine physicians in our urban/suburban area have a range of training in medical education; some have no formal training in medical education, whereas others have completed Master’s level training in adult education. Not all staff have a university appointment; of those who are affiliated with our university, 87 have appointments through the Department of Medicine, 21 through the Department of Pediatrics, and 117 through the Department of Family Medicine. Emergency physicians in our area are a diverse group of physicians in terms of both formal training in adult education and in the variety of settings in which we work. The purpose of this study was to gauge interest in formal training in adult education among emergency medicine physicians. Methods: With research ethics board approval, we created and sent a 10-item electronic questionnaire to emergency medicine staff in our area. The questionnaire included items on demographics, experience in emergency medicine, additional post-graduate training, current teaching activities and interest in short (30-60 minute) adult education sessions. Results: Of a potential 360 active emergency physicians in our area, 120 responded to the questionnaire (33.3%), representing 12 area hospitals. Nearly half of respondents had been in practice over 10 years (48.44%). Respondents were mainly FRCP (50%) or CCFP-EM (47.50%) trained. 33.3% of respondents had masters degrees, of which 15% were MEd. Most physicians were involved in teaching medical students (98.33%), FRCP residents (80%) and family medicine residents (88.3%), though many were also teaching off-service residents, and allied health professionals. More than half of respondents (60%) were interested in attending short sessions to improve their skills as adult educators. The topics of most interest were feedback and evaluation, time-efficient teaching, the learner in difficulty, case-based teaching and bedside teaching. Conclusion: Emergency physicians in our area have a wide variety of experience and training in medical education. They are involved in teaching learners from a range of training levels and backgrounds. Physicians who responded to our survey expressed an interest in additional formal teaching on adult education topics geared toward emergency medicine.

Competency on Call: Resident Driven Learning Objectives for Competency-Based Medical Education

2020 ◽  
Vol 44 (6) ◽  
pp. 812-813 ◽  
Author(s):  
Bruce Fage ◽  
Tracy Alldred ◽  
Sarah Levitt ◽  
Amanda Abate ◽  
Mark Fefergrad
Keyword(s):  
Medical Education ◽  
Learning Objectives ◽  
Competency Based Medical Education ◽  
Competency Based

Implementing competency-based medical education: Moving forward

2017 ◽  
Vol 39 (6) ◽  
pp. 568-573 ◽  
Author(s):  
Jason R. Frank ◽  
Linda Snell ◽  
Robert Englander ◽  
Eric S. Holmboe ◽  
Keyword(s):  
Medical Education ◽  
Competency Based Medical Education ◽  
Competency Based
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