Procedural skill needs for Canadian paediatricians: A national profile

2020 ◽  
Author(s):  
Jessica White ◽  
Anne Rowan-Legg ◽  
Hilary Writer ◽  
Rahul Chanchlani ◽  
Ronish Gupta
Keyword(s):  
Medical Education ◽  
Response Rate ◽  
Surveillance Program ◽  
Demographic Information ◽  
Competency Based Medical Education ◽  
Post Graduate ◽  
Survey Response Rate ◽  
Wide Variability ◽  
Competency Based ◽  
National Profile

Abstract Background and Objectives Procedural practice by paediatricians in Canada is evolving. Little empirical information is available on the procedural competencies required of general paediatricians. Accordingly, the aim of this study was to conduct a needs assessment of Canadian general paediatricians to identify procedural skills required for practice, with the goal of informing post-graduate and continuing medical education. Methods A survey was sent to paediatricians through the Canadian Paediatric Surveillance Program (CPSP) (www.cpsp.cps.ca/surveillance). In addition to demographic information about practice type and location, participants were asked to indicate the frequency with which they performed each of 32 pre-selected procedures and whether each procedure was considered essential to their practice. Results The survey response rate was 33.2% (938/2,822). Data from participants who primarily practice general paediatrics were analyzed (n=481). Of these, 71.0% reported performing procedures. The most frequently performed procedures were: bag-valve-mask ventilation of an infant, lumbar puncture, and ear curettage, being performed monthly by 40.8%, 34.1%, and 27.7% of paediatricians, respectively. The procedures performed by most paediatricians were also those found most essential to practice, with a few exceptions. Respondents performed infant airway procedures with greater frequency and rated them more essential when compared to the same skill performed on children. We found a negative correlation between procedures being performed and difficulty maintaining proficiency in a skill. Conclusions This report of experiences from Canadian general paediatricians suggests a wide variability in the frequency of procedural performance. It helps establish priorities for post-graduate and continuing professional medical education curricula in the era of competency-based medical education.

scholarly journals Building a Shared Mental Model of Competence Across the Continuum: Trainee Perceptions of Subinternships for Residency Preparation

2021 ◽  
Vol 8 ◽  
pp. 238212052110633
Author(s):  
Johannah M. Scheurer ◽  
Cynthia Davey ◽  
Anne G. Pereira ◽  
Andrew P. J. Olson
Keyword(s):  
Medical Education ◽  
Response Rate ◽  
Professional Activity ◽  
University Of Minnesota ◽  
Competency Based Medical Education ◽  
Chi Squared ◽  
Competency Based ◽  
Kappa Agreement ◽  
Physician Competency ◽  
The Continuum

INTRODUCTION Toward a vision of competency-based medical education (CBME) spanning the undergraduate to graduate medical education (GME) continuum, University of Minnesota Medical School (UMMS) developed the Subinternship in Critical Care (SICC) offered across specialties and sites. Explicit course objectives and assessments focus on internship preparedness, emphasizing direct observation of handovers (Core Entrustable Professional Activity, “EPA,” 8) and cross-cover duties (EPA 10). METHODS To evaluate students’ perceptions of the SICC's and other clerkships’ effectiveness toward internship preparedness, all 2016 and 2017 UMMS graduates in GME training ( n = 440) were surveyed regarding skill development and assessment among Core EPAs 1, 4, 6, 8, 9, 10. Analysis included descriptive statistics plus chi-squared and Kappa agreement tests. RESULTS Respondents ( n = 147, response rate 33%) rated the SICC as a rotation during which they gained most competence among EPAs both more (#4, 57% rated important; #8, 75%; #10, 70%) and less explicit (#6, 53%; #9, 69%) per rotation objectives. Assessments of EPA 8 (80% rated important) and 10 (76%) were frequently perceived as important toward residency preparedness. Agreement between importance of EPA development and assessment was moderate (Kappa = 0.40-0.59, all surveyed EPAs). CONCLUSIONS Graduates’ perceptions support the SICC's educational utility and assessments. Based on this and other insight from the SICC, the authors propose implications toward collectively envisioning the continuum of physician competency.

scholarly journals Competency Based Post Graduate Residency Program at Patan Academy of Health Sciences, Nepal

2021 ◽  
Vol 19 (1) ◽  
pp. 189-195
Author(s):  
Shrijana Shrestha ◽  
Ashis Shrestha ◽  
Jay Narayan Shah ◽  
Rajesh Nath Gongal
Keyword(s):  
Medical Education ◽  
Residency Training ◽  
Residency Program ◽  
Core Competencies ◽  
Health Sciences ◽  
Assessment System ◽  
Competency Based Medical Education ◽  
Post Graduate ◽  
Faculty Readiness ◽  
Competency Based

Competency-based medical education has evolved as an alternative approach in the residency training program. It shows potential to align educational programs with health system priorities through defining the competencies of graduating doctors. Designing and implementing Competency Based Post Graduate (CBPG) training in a resource-limited setting, where most of the trainings are still run in a conventional approach, is a big challenge. Patan Academy of Health Sciences, School of Medicine has taken the competency-based approach in the postgraduate residency training. Defining core competencies and connecting those to teaching methodology and assessment system are important initial steps in implementing the competency-based approach. The institution has implemented Entrustable Professional Activity (EPA), which is a unit of professional practice and helps to measure the trainees’ achievements in the form of milestones. This paper describes the process of piloting and implementing the CBPG program at this school.The school launched the CBPG training in 2018 and so far, three batches of residents have been enrolled in nine different subjects/disciplines. The first batch of trainee, having the PAHS Core competencies and the pre-defined discipline-specific EPAs certified, will be completing their training soon. The program is time and resource consuming. Continuous faculty development, commitment, supportive leadership and faculty readiness to adapt to newer approaches are the key to the program’s successful implementation.Keywords: Competency based medical education; Nepal; patan academy of health sciences; post graduate training; residency program

scholarly journals A Survey on Changes to the Canadian Anatomical Pathology Certification Examination Due to Coronavirus Disease 2019 and Implications for Competency-Based Medical Education

2021 ◽  
Vol 8 ◽  
pp. 237428952110607
Author(s):  
Katherina Baranova ◽  
Emily A. Goebel ◽  
Jason Wasserman ◽  
Allison Osmond
Keyword(s):  
Medical Education ◽  
Royal College ◽  
Response Rate ◽  
Assessment Process ◽  
Competency Based Medical Education ◽  
Feedback Analysis ◽  
Stakeholder Perspectives ◽  
Key Issues ◽  
Competency Based ◽  
Anatomical Pathology

The coronavirus disease 2019 pandemic resulted in a dramatic change in the Royal College of Physicians and Surgeons of Canada assessment process through elimination of the oral and practical components of the 2020 Anatomical Pathology examination. Our study sought to determine stakeholder opinions and experiences on these changes in the context of the 2019 implementation of competency-based medical education. Surveys were designed for residents and practicing pathologists. In total, 57 residents (estimated response rate 29%) and 185 pathologists (estimated response rate 19%) participated across Canada; 67% of pathologists disagreed with the 2020 Royal College examination changes, compared with 30% for residents (P = <.00001). When asked whether the Royal College examination should be eliminated, 95% of pathologists indicated they would be against this, compared to only 34% of residents (P = <.00001). Perceptions on changes to and importance of different components of assessment in competency-based medical education were similar between pathologists and residents, with participants perceiving assessment practices to have changed fairly little since its implementation, with the exception of more frequent feedback. Analysis of narrative comments identified several common themes around assessment, including the need for objectivity and standardization and the problem of failure-to-fail. However, residents identified numerous elements of their performance that can be assessed only through longitudinal evaluation. Pathologists, on the other hand, tended to view these aspects of performance as laden with bias. Our results will hopefully help guide future innovation in assessment by characterizing different stakeholder perspectives on key issues in medical education.

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

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

Postgraduate medical education: The history and development of competency-based training program in Nepal

2021 ◽  
Vol 8 (1) ◽  
pp. 102-112
Author(s):  
Jay Narayan Shah ◽  
Jenifei Shah ◽  
Jesifei Shah ◽  
Ashis Shrestha ◽  
Nabees Man Singh Pradhan
Keyword(s):  
Medical Education ◽  
Healthcare System ◽  
Postgraduate Training ◽  
Core Competencies ◽  
Health Sciences ◽  
Medical Council ◽  
Competency Based Medical Education ◽  
Surgical Workforce ◽  
Competency Based ◽  
Medical Colleges

Nepal is a small, lower-middle-income country; with a population of around 30 million. As per WHO, Nepal has a low doctor-patient ratio (0.7/1000) and even lower specialists (e.g., surgical) workforce (0.003/1000); additionally, data from Nepal Medical Council show the number of postgraduate specialists is 1/3rd of the total registered doctors. The mismatch in the doctor-patient ratio is further aggravated by the overwhelming number of doctors in urban areas; when 80% of the population are in rural Nepal. This inequitable discrepancy in the healthcare system requires: proper training of competent medical graduates, a fair distribution across the country, and effective changes in the healthcare system. Competency-based medical education plays an important role in: standardizing education, training competent doctors, and deploying them where they are needed the most. The Government of Nepal has recently established Medical Education Commission-which plans to oversee the entrance exams; and expand the postgraduate training to be conducted by private hospitals, previously not affiliated with any medical colleges or universities. Historically, Civil Medical School started training compounders and dressers in Nepal in 1934. A big milestone was achieved with the establishment of the Institute of Medicine under Tribhuvan University in 1972, which has continued to train all categories of health manpower needed in the country. In 2006 Nepal Medical Council developed “Regulations for Post-graduate Medical education”. Thereafter, several institutions started providing postgraduate training, for example: the BP Koirala Institute of Health Sciences, Kathmandu University, National Academy of Medical Sciences, and Patan Academy of Health Sciences (PAHS). The PAHS conducts PG programs and post-PG fellowships in line with competency-based medical education. In addition to formative assessments, research thesis, and a publishable article; PAHS requires its trainees to be certified in a pre-set of entrustable professional activities (EPAs) and to master eight Core Competencies domains in: Professionalism, Patient-centered care, Procedural skills, Clinical Reasoning, Communication, Scholarship, Leadership, Community orientation. The number of medical colleges in Nepal has since expanded to 24  (medical 21 and dental colleges 3). Private medical colleges make up about 3/4th of the total medical colleges in Nepal. This makes the inclusion and regulation of more components of the competency-based curriculum in postgraduate training programs, and its monitoring,  somewhat of a challenge.

scholarly journals Competency-based medical education in two Sub-Saharan African medical schools

2014 ◽  
pp. 483 ◽  
Author(s):  
Elsie Kiguli-Malwadde ◽  
Francis Omaswa ◽  
oluwabunmi Olapade-Olaopa ◽  
Sarah Kiguli ◽  
Candice Chen ◽  
...  
Keyword(s):  
Medical Education ◽  
Medical Schools ◽  
Competency Based Medical Education ◽  
Competency Based ◽  
Sub Saharan
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