scholarly journals Resident perceptions of Competency-Based Medical Education

2020 ◽  
Author(s):  
Steve Mann ◽  
Amber Hastings Truelove ◽  
Theresa Beesley ◽  
Stella Howden ◽  
Rylan Egan
Keyword(s):  
Medical Education ◽  
Theory Approach ◽  
Structured Interviews ◽  
Competency Based Medical Education ◽  
Educational Transition ◽  
Resident Perceptions ◽  
Key Stakeholders ◽  
Competency Based ◽  
Attending Physicians ◽  
Grounded Theory Approach

Background: Residency training programs in Canada are undergoing a mandated transition to competency-based medical education (CBME).  There is limited literature regarding resident perspectives on CBME.  As upper year residents act as mentors and assessors for incoming cohorts, and are themselves key stakeholders in this educational transition, it is important to understand how they view CBME.  We examined how residents who are not currently enrolled in a competency-based program view that method of training, and what they perceive as potential advantages, disadvantages, and considerations regarding its implementation. Methods: Sixteen residents volunteered to participate in individual semi-structured interviews, with questions focussing on participants’ knowledge of CBME and its implementation.  We used a grounded theory approach to develop explanations of how residents perceive CBME. Results: Residents anticipated improved assessment and feedback, earlier identification of residents experiencing difficulties in training, and greater flexibility to pursue self-identified educational needs.  Disadvantages included logistical issues surrounding CBME implementation, ability of attending physicians to deliver CBME-appropriate feedback, and the possibility of assessment fatigue.  Clear, detailed communication and channels for resident feedback were key considerations regarding implementation. Conclusions: Resident views align with educational experts regarding the practical challenges of implementation.  Expectations of improved assessment and feedback highlight the need for both residents and attending physicians to be equipped in these domains.  Consequently, faculty development and clear communication will be crucial aspects of successful transitioning to CBME.

scholarly journals Examining Academic Leader’s work in implementing Competency-based Medical Education using Organizational Learning Theory

2018 ◽  
Author(s):  
Nicolas Fernandez ◽  
Nicole Leduc ◽  
Nathalie Caire Fon ◽  
Louis-Georges Ste-Marie ◽  
Dat Nguyen-Dinh ◽  
...  
Keyword(s):  
Medical Education ◽  
Organizational Learning ◽  
Learning Theory ◽  
Structured Interviews ◽  
Academic Leaders ◽  
Competency Based Medical Education ◽  
Organizational Learning Theory ◽  
Professional Activities ◽  
Competency Based ◽  
Implementation Progress

ContextCompetency-based medical education (CBME) implementation is being carried out in many medical schools worldwide. Academic Leadership is a strategy where selected Faculty act to influence peers to adopt change. The Université de Montréal medical school, has adopted this strategy to implement CBME.PurposeThis paper aims to describe the work of Academic Leaders in the process of CBME implementation and to explore relevance of the Nonaka and Toyama organizational learning theory to map implementation progress.MethodBecause knowledge creation model focuses on the relationships between leaders and social structures, embedded case study was selected. Diverse sampling method was used to select three departments: internal medicine, surgery and psychiatry, based on the number of CBME training activities. Data collection was at two intervals, two years apart. Semi-structured interviews (individual and group) were conducted with Department Heads and Academic Leaders. Thematic analysis was conducted on the 15 interview transcriptions.ResultsAs implementation begins, Leaders critically revisit accepted teaching routines and develop a common conception of CBME. This enables leaders to communicate with a wider audience and work within existing committees and working groups where they “break down” CBME into practical concepts. This practical understanding, disseminated through Entrustable Professional Activities, enables observable change.ConclusionLeaders’ roles evolved from an “expert” that disseminates knowledge about CBME through lectures, to a responsive and pragmatic supporting role by developing and writing practical tools in collaboration with peers and program directors.

Attending emergency physicians’ perceptions of a programmatic workplace-based assessment system: The McMaster Modular Assessment Program (McMAP)

2019 ◽  
Author(s):  
Anita Acai ◽  
Shelly-Anne Li ◽  
Jonathan Sherboni ◽  
Teresa M. Chan
Keyword(s):  
Large Scale ◽  
Assessment System ◽  
Interpretive Description ◽  
Structured Interviews ◽  
Competency Based Medical Education ◽  
Assessment Program ◽  
Workplace Based Assessment ◽  
Competency Based ◽  
Quality Assessments ◽  
Attending Physicians

Construct: The McMaster Modular Assessment Program (McMAP) is a programmatic workplace-based assessment (WBA) system that provides emergency medicine trainees with competency judgments through frequent task-specific and global daily assessments. Background: The longevity of McMAP relative to other programmatic WBA systems affords a unique view that precedes large-scale transitions to competency-based medical education (CBME), particularly in North America. Although prior work has described the perspective of residents using this system, the in-depth experiences of assessors using the system have yet to be explored. This perspective is important for understanding the validity of the competency judgments the system produces. Approach: We conducted a qualitative study that used semi-structured interviews analyzed using interpretive description (Thorne) to explore 16 attending physicians’ experiences using McMAP. Data analysis was completed independently by 2 researchers, who met regularly to discuss codes and resolve any disagreements. Results: Having a structured assessment framework for a range of clinical tasks has helped encourage what attendings perceived to be more frequent and better-quality assessments, with the added advantages of being holistic, flexible, and learner-driven. However, attendings also perceived a number of challenges of McMAP and programmatic WBA more broadly. These included a reluctance to give and to document negative feedback, “gaming” of the system by both attendings and residents, and a variety of logistic and technology-related concerns. Conclusions: Based on our findings, we offer several key recommendations that can help programs maximize the benefits of programmatic WBA as they transition to CBME.

scholarly journals Mind the Gap

2016 ◽  
Vol 07 (04) ◽  
pp. 1069-1087 ◽  
Author(s):  
Terry Fairbanks ◽  
Erica Savage ◽  
Katie Adams ◽  
Michael Wittie ◽  
Edna Boone ◽  
...  
Keyword(s):  
Future Research ◽  
Theory Approach ◽  
Health It ◽  
Structured Interviews ◽  
Clinical Workflow ◽  
Stakeholder Perspectives ◽  
Critical Areas ◽  
Key Stakeholders ◽  
Emerging Themes ◽  
Grounded Theory Approach

SummaryObjective Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders’ perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs.Materials and Methods Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders’ perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment.Results We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical workflow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps.Discussion Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs.Conclusion Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation.Citation: Ratwani R et al.: Review to identify usability and safety challenges and practices during EHR implementation.

scholarly journals Exploring resident perceptions of initial competency based medical education implementation

2021 ◽  
Author(s):  
Shivani Upadhyaya ◽  
Marghalara Rashid ◽  
Andrea Davila Cervantes ◽  
Anna Oswald
Keyword(s):  
Medical Education ◽  
Professional Activity ◽  
Competency Based Medical Education ◽  
Programmatic Assessment ◽  
Resident Perceptions ◽  
Societal Needs ◽  
Core Components ◽  
Competency Based ◽  
Curricular Model ◽  
Outcome Competencies

Background: Competence by design (CBD) is a nationally developed hybrid competency based medical education (CBME) curricular model that focuses on residents’ abilities to promote successful practice and better meet societal needs. CBD is based on a commonly used framework of five core components of CBME: outcome competencies, sequenced progression, tailored learning experiences, competency-focused instruction and programmatic assessment. There is limited literature concerning residents’ perceptions of implementation of CBME. Objective: We explored resident perceptions of this transformation and their views as they relate to the intended framework. Methods: We recruited residents enrolled in current CBME implementation between August 2018 and January 2019. We interviewed residents representing eight disciplines from the initial two CBME implementation cohorts. Inductive thematic analysis was used to analyse the data through iterative consensus building until saturation. Results: We identified five themes: 1) Value of feedback for residents; 2) Resident strategies for successful Entrustable Professional Activity observation completion; 3) Residents experience challenges; 4) Resident concerns regarding CBME; and 5) Resident recommendations to improve existing challenges. We found that while there was clear alignment with residents’ perceptions of the programmatic assessment core CBME component, alignment was not as clear for other components. Conclusions: Residents perceived aspects of this transformation as helpful but overall had mixed perceptions and variable understanding of the intended underlying framework. Understanding and disseminating successes and challenges from the resident lens may assist programs at different stages of CBME implementation.

scholarly journals Ten ways to get a grip on designing and implementing a competency-based medical education training program

2021 ◽  
Author(s):  
Tina Hsu ◽  
Flavia De Angelis ◽  
Sohaib Al-asaaed ◽  
Sanraj K. Basi ◽  
Anna Tomiak ◽  
...  
Keyword(s):  
Medical Education ◽  
Medical Training ◽  
Training System ◽  
Successful Implementation ◽  
Competency Based Medical Education ◽  
Design Elements ◽  
Program Administrator ◽  
Professional Activities ◽  
Key Stakeholders ◽  
Competency Based

Background: Globally there is a move to adopt competency-based medical education (CBME) at all levels of the medical training system. Implementation of a complex intervention such as CBME represents a marked paradigm shift involving multiple stakeholders. Methods: This article aims to share tips, based on review of the available literature and the authors’ experiences, that may help educators implementing CBME to more easily navigate this major undertaking and avoid “black ice” pitfalls that educators may encounter. Results: Careful planning prior to, during and post implementation will help programs transition successfully to CBME. Involvement of key stakeholders, such as trainees, teaching faculty, residency training committee members, and the program administrator, prior to and throughout implementation of CBME is critical. Careful and selective choice of key design elements including Entrustable Professional Activities, assessments and appropriate use of direct observation will enhance successful uptake of CBME. Pilot testing may help engage faculty and learners and identify logistical issues that may hinder implementation. Academic advisors, use of curriculum maps, and identifying and leveraging local resources may help facilitate implementation. Planned evaluation of CBME is important to ensure choices made during the design and implementation of CBME result in the desired outcomes. Conclusion: Although the transition to CBME is challenging, successful implementation can be facilitated by careful design and strategic planning.

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
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