scholarly journals Towards a shared mental model of progressive competence in postgraduate medical education

2018 ◽  
Vol 9 (3) ◽  
pp. e115-118
Author(s):  
Eric Prost
Keyword(s):  
Medical Education ◽  
Mental Model ◽  
Postgraduate Medical Education ◽  
Competency Based Medical Education ◽  
Shared Mental Model ◽  
Competency Based ◽  
The Military ◽  
Postgraduate Medicine

Many professions have hierarchies and a promotion structure. Postgraduate medicine has a tradition of promoting residents based on time spent in a certain specialty. The military, too, may promote its personnel based on factors other than just merit. Both professions have been criticized for divorcing competence from promotion. While Competency-Based Medical Education (CBME) partly solves this problem in medicine, many models of CBME, including the Canadian one, retain distinct stages of training. We urgently need a shared mental model of what a learner in each stage looks like. Some models have been proposed but fall short.

Competency-based medical education in postgraduate medical education

2010 ◽  
Vol 32 (8) ◽  
pp. 651-656 ◽  
Author(s):  
William F. Iobst ◽  
Jonathan Sherbino ◽  
Olle Ten Cate ◽  
Denyse L. Richardson ◽  
Deepak Dath ◽  
...  
Keyword(s):  
Medical Education ◽  
Postgraduate Medical Education ◽  
Competency Based Medical Education ◽  
Competency Based

scholarly journals Analyzing the Administrative Burden of Competency Based Medical Education

2021 ◽  
pp. 084653712110389
Author(s):  
Kevin Cheung ◽  
Christina Rogoza ◽  
Andrew D. Chung ◽  
Benjamin Yin Ming Kwan
Keyword(s):  
Medical Education ◽  
Postgraduate Medical Education ◽  
Assessment Process ◽  
Full Time ◽  
Equal Distribution ◽  
Competency Based Medical Education ◽  
Quantitative Evidence ◽  
Administrative Burden ◽  
Professional Activities ◽  
Competency Based

Purpose: Postgraduate residency programs in Canada are transitioning to a competency-based medical education (CBME) system. Within this system, resident performance is documented through frequent assessments that provide continual feedback and guidance for resident progression. An area of concern is the perception by faculty of added administrative burden imposed by the frequent evaluations. This study investigated the time spent in the documentation and submission of required assessment forms through analysis of quantitative data from the Queen’s University Diagnostic Radiology program. Methods and Materials: Data regarding time taken to complete Entrustable Professional Activities (EPA) assessments was collected from 24 full-time and part-time radiologists over a period of 18 months. This data was analyzed using SPSS to determine mean time of completion by individuals, departments, and by experience with the assessment process. Results: The average time taken to complete an EPA assessment form was 3 minutes and 6 seconds. Assuming 3 completed EPA assessment forms per week for each resident (n = 12) and equal distribution among all staff, this averaged out to an additional 18 minutes of administrative burden per staff member over a 4 week block. Conclusions: This study investigated the perception by faculty of additional administrative burden for assessment in the CBME framework. The data provided quantitative evidence of administrative burden for the documentation and submission of assessments. The data indicated that the added administrative burden may be reasonable given mandate for CBME implementation and the advantages of adoption for postgraduate medical education.

scholarly journals From prescription to guidance: a European framework for generic competencies

2019 ◽  
Vol 25 (1) ◽  
pp. 173-187 ◽  
Author(s):  
Jessica E. van der Aa ◽  
Anna J. M. Aabakke ◽  
Betina Ristorp Andersen ◽  
Annette Settnes ◽  
Peter Hornnes ◽  
...  
Keyword(s):  
Medical Education ◽  
Change Management ◽  
Postgraduate Medical Education ◽  
Competency Framework ◽  
Competency Based Medical Education ◽  
Generic Competencies ◽  
Obstetrics And Gynaecology ◽  
Competency Based ◽  
Hospital Boards ◽  
Management Theories

Abstract In postgraduate medical education, required competencies are described in detail in existing competency frameworks. This study proposes an alternative strategy for competency-based medical education design, which is supported by change management theories. We demonstrate the value of allowing room for re-invention and creative adaptation of innovations. This new strategy was explored for the development of a new generic competency framework for a harmonised European curriculum in Obstetrics and Gynaecology. The generic competency framework was developed through action research. Data were collected by four European stakeholder groups (patients, nurses, midwives and hospital boards), using a variety of methods. Subsequently, the data were analysed further in consensus discussions with European specialists and trainees in Obstetrics and Gynaecology. These discussions ensured that the framework provides guidance, is specialty-specific, and that implementation in all European countries could be feasible. The presented generic competency framework identifies four domains: ‘Patient-centred care’, ‘Teamwork’, ‘System-based practice’ and ‘Personal and professional development’. For each of these four domains, guiding competencies were defined. The new generic competency framework is supported by European specialists and trainees in Obstetrics and Gynaecology, as well as by their European stakeholders. According to change management theories, it seems vital to allow room for re-invention and creative adaptation of the competency framework by medical professionals. Therefore, the generic competency framework offers guidance rather than prescription. The presented strategy for competency framework development offers leads for implementation of competency-based medical education as well as for development of innovations in postgraduate medical education in general.

Resident evaluations in the age of competency-based medical education: faculty perspectives on minimizing burdens

2020 ◽  
pp. 1-6
Author(s):  
Jessica E. Rabski ◽  
Ashirbani Saha ◽  
Michael D. Cusimano
Keyword(s):  
Medical Education ◽  
Mobile Application ◽  
Postgraduate Medical Education ◽  
Professional Activity ◽  
Successful Implementation ◽  
Neurosurgical Training ◽  
Complete Evaluation ◽  
Competency Based Medical Education ◽  
Main Challenge ◽  
Competency Based

OBJECTIVECompetency-based medical education (CBME), an outcomes-based approach to medical education, continues to be implemented across many postgraduate medical education programs worldwide, including a recent introduction into Canadian neurosurgical training programs (July 2019). The success of this educational paradigm shift requires frequent faculty observation and evaluation of residents performing defined tasks of the specialty. A main challenge involves providing residents with frequent performance evaluations and feedback that are feasible for faculty to complete. This study aims to define what is currently happening and what changes are needed to make CBME successful for the certification of neurosurgeons’ competence.METHODSA 55-item questionnaire was emailed nationwide to survey Canadian neurosurgical faculty.RESULTSFifty-two complete responses were received and achieved a distribution highly correlated with the number of faculty neurosurgeons practicing in each Canadian province (Pearson’s r = 0.94). Two-thirds (35/52) of faculty reported currently taking a median of 10 minutes to complete evaluation forms at the end of a resident’s rotation block. Regardless of the faculty’s province of practice (p = 0.50) or years of experience (p = 0.06), they reported 3 minutes (minimum 1 minute, maximum 10 minutes, interquartile range [IQR] 3 minutes) as a feasible amount of time to spend completing an evaluation form following an observation of a resident’s performance of an entrustable professional activity (EPA). If evaluation forms took 3 minutes to complete, 85% of respondents (44/52) would complete EPA evaluations weekly or daily. The faculty recommended 5 minutes as a feasible amount of time to provide oral feedback (minimum 1 minute, maximum 20 minutes, IQR 3.25 minutes), which was significantly higher (p = 0.00099) than their recommended amount of time for completing evaluation forms. The majority of faculty (71%) stated they would prefer to access resident evaluation forms through a mobile application compared to a paper form (12%), an evaluation website (8%), or through a URL link sent via email (10%; p = 0.0032).CONCLUSIONSTo facilitate the successful implementation of CBME into a neurosurgical training curriculum, resident EPA assessment forms should take 3 minutes or less to complete and be accessible through a mobile application.

scholarly journals Black Ice: ways to get a grip on resident co-production within medical education change

2020 ◽  
Author(s):  
Jeffery D. Dagnone ◽  
Samantha Buttemer ◽  
Jena Hall ◽  
Liora Berger ◽  
Kristen Weersink
Keyword(s):  
Medical Education ◽  
Postgraduate Training ◽  
Postgraduate Medical Education ◽  
Change Leadership ◽  
Successful Implementation ◽  
Competency Based Medical Education ◽  
Education Change ◽  
Competency Based ◽  
Queen's University ◽  
National Approach

The Royal College of Physicians and Surgeons of Canada (RCPSC) is transforming its national approach to postgraduate medical education by transitioning all specialty programs to competency based medical education (CBME) curriculums over a seven-year period. Queen’s University, with special permission from the RCPSC, launched CBME curricula for all incoming residents across its 29 specialty programs in July 2017. Resident engagement, empowerment, and co-production through this transition has been instrumental in successful implementation of CBME at Queen’s University. This article aims to use our own experience at Queen’s in the context of current literature and rooted in change leadership theory, to provide a guide for educators, learners, and institutions on how to leverage the interest and enthusiasm of trainees in the transition to CBME in postgraduate training. The following ten tips provides a model for avoiding the “black ice” type pitfalls that can arise with learner involvement, and ensure a smoother transition for other institutions moving forward with CBME implementation.

scholarly journals Implementing changes to a residency program curriculum before competency-based medical education: a survey of Canadian medical oncology program directors

2020 ◽  
Vol 27 (6) ◽  
Author(s):  
R. Arora ◽  
G. Kazemi ◽  
T. Hsu ◽  
O. Levine ◽  
S.K. Basi ◽  
...  
Keyword(s):  
Medical Education ◽  
Residency Program ◽  
Medical Oncology ◽  
Postgraduate Medical Education ◽  
Program Directors ◽  
Assessment Methods ◽  
Faculty Involvement ◽  
Competency Based Medical Education ◽  
Professional Activities ◽  
Competency Based

Background Postgraduate medical education is undergoing a paradigm shift in many universities worldwide, transitioning from a time-based model to competency-based medical education (cbme). Residency programs might have to alter clinical rotations, educational curricula, assessment methods, and faculty involvement in preparation for cbme, a process not yet characterized in the literature. Methods We surveyed Canadian medical oncology program directors on planned or newly implemented residency program changes in preparation for cbme. Results Prior to implementing cbme, all program directors changed at least 1 clinical rotation, most commonly making hematology/oncology (74%) entirely outpatient and eliminating radiation oncology (64%). Introductory rotations were altered to focus on common tumour sites, and later rotations were changed to increase learner autonomy. Most program directors planned to enhance resident learning with electronic teaching modules (79%), new training experiences (71%), and academic half-day changes (50%). Most program directors (64%) planned to change assessment methods to be entirely based on entrustable professional activities. All programs had developed a competence committee to review learner progress, and most (86%) had integrated academic coaches. Conclusions Transitioning to cbme led to major structural and curricular changes within medical oncology train­ing programs. Identifying these commonly implemented changes could help other programs transition to cbme.

scholarly journals 1129. Optimizing Feedback Strategies on the Infectious Diseases Inpatient Service

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S593-S594
Author(s):  
Eva Clark ◽  
Prathit Kulkarni ◽  
Mayar Al Mohajer ◽  
Stacey Rose ◽  
Jose Serpa ◽  
...  
Keyword(s):  
Medical Education ◽  
Infectious Diseases ◽  
Clinical Education ◽  
Mental Model ◽  
Inpatient Service ◽  
Shared Mental Model ◽  
Effective Feedback ◽  
Medical Trainees ◽  
Feedback Strategies ◽  
Giving Feedback

Abstract Background Timely, efficient, and effective feedback strategies are crucial for enhancing faculty-trainee communication and trainee education. Here we describe attitudes, practices, and perceived behaviors regarding giving feedback to medical trainees rotating on Infectious Diseases (ID) inpatient consult services. Methods An anonymous survey on feedback strategies was distributed to our adult ID Section in February 2020 as part of a facilitated discussion on optimizing trainee clinical education. Results Twenty-six ID Section members completed the survey (18 faculty, 8 trainees). Most trainees (62.5%) and faculty (66.7%) felt that trainees are “sometimes” comfortable voicing concerns to faculty; however, no trainees but 11.1% of faculty indicated that trainees are “always” comfortable voicing concerns to faculty. Most trainees (87.5%) felt that conversations about team expectations occur “sometimes” or “often.” In contrast, most faculty (72.2%) felt that these conversations “always” occur. Although most faculty felt that both informal (94.4%) and formal (83.3%) feedback should be given to trainees, 22.2% of faculty responded that they do not explicitly use the term “feedback” when discussing feedback with a trainee. No trainees and 22.2% of faculty indicated that they utilize a feedback tool. Regarding quantity of feedback trainees perceive they receive from faculty, 37.5% of trainees felt they needed more feedback while 50% felt they received adequate feedback. Most faculty (88.9%) responded that they encourage trainees to give feedback to faculty, although most trainees (62.5%) responded “sometimes” regarding how comfortable they feel doing so. Conclusion In summary, we found differences between faculty and trainees regarding two important aspects of medical education: setting expectations and providing feedback. While most faculty feel that conversations regarding these topics occur invariably, trainees do not always share this perception. Trainees felt less comfortable voicing concerns and giving feedback to faculty than faculty perceived them to be. Overall, the data suggest that there is room for improvement to ensure that trainees and faculty are operating from a shared mental model regarding setting team expectations and providing/receiving feedback. Disclosures All Authors: No reported disclosures

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
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