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 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.

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 Delivering on the promise of competency based medical education – an institutional approach

2019 ◽  
Vol 10 (1) ◽  
pp. e28-38 ◽  
Author(s):  
Damon Dagnone ◽  
Denise Stockley ◽  
Leslie Flynn ◽  
Rylan Egan ◽  
Richard Van Wylick ◽  
...  
Keyword(s):  
Medical Education ◽  
Diffusion Of Innovation ◽  
Training Model ◽  
Residency Education ◽  
Transformative Change ◽  
Competency Based Medical Education ◽  
Professional Activities ◽  
Competency Based ◽  
Institutional Vision ◽  
Proactive Measures

The Royal College of Physicians and Surgeons of Canada (RCPSC) adopted a plan to transform, over a seven-year horizon (2014-2021), residency education across all specialties to competency-based medical education (CBME) curriculum models. The RCPSC plan recommended implementing a more responsive and accountable training model with four discrete stages of training, explicit, specialty specific entrustable professional activities, with associated milestones, and a programmatic approach to assessment across residency education. Embracing this vision, the leadership at Queen’s University (in Kingston, Ontario, Canada) applied for and was granted special permission by the RCPSC to embark on an accelerated institutional path. Over a three-year period, Queen’s took CBME from concept to reality through the development and implementation of acomprehensive strategic plan. This perspective paper describes Queen’s University’s approach of creating a shared institutional vision, outlines the process of developing a centralized CBME executive team and twenty-nine CBME program teams, and summarizes proactive measures to ensure program readiness for launch. In so doing, Queen’s created a community of support and CBME expertise that reinforces shared values including fostering co-production, cultivating responsive leadership, emphasizing diffusion of innovation, and adopting a systems-based approach to transformative change. 

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.

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.

scholarly journals Transitioning to competency-based medical education: impact of educational interventions on resident understanding

2019 ◽  
Vol 10 (4) ◽  
pp. e96-e98
Author(s):  
Vijay J. Daniels ◽  
Jesse Stach ◽  
Gurtej Sandu
Keyword(s):  
Internal Medicine ◽  
Medical Education ◽  
Residency Program ◽  
Educational Interventions ◽  
Internal Medicine Residency ◽  
Internal Medicine Residency Program ◽  
Competency Based Medical Education ◽  
Successful Launch ◽  
Competency Based

In this paper, we describe our efforts to improve resident understanding of Competency-Based Medical Education (CBME) in an Internal Medicine residency program that launched CBME earlier than most of the country's programs. We also share the resources we have developed to address this issue with the intent of helping other programs have a successful launch.

scholarly journals An Entrustable Professional Activity Addressing Racism and Pediatric Health Inequities

PEDIATRICS ◽  
2022 ◽  
Author(s):  
Ndidi I. Unaka ◽  
Ariel Winn ◽  
Adiaha Spinks-Franklin ◽  
Patricia Poitevien ◽  
Franklin Trimm ◽  
...  
Keyword(s):  
Medical Education ◽  
Health Care Systems ◽  
Health Inequities ◽  
Professional Activity ◽  
Competency Based Medical Education ◽  
Pediatric Health ◽  
Professional Activities ◽  
Care Systems ◽  
Competency Based ◽  
Pediatric Populations

Racism and discrimination are the root of many pediatric health inequities and are well described in the literature. Despite the pervasiveness of pediatric health inequities, we have failed to adequately educate and prepare general pediatricians and pediatric subspecialists to address them. Deficiencies within education across the entire continuum and in our health care systems as a whole contribute to health inequities in unacceptable ways. To address these deficiencies, the field of pediatrics, along with other specialties, has been on a journey toward a more competency-based approach to education and assessment, and the framework created for the future is built on entrustable professional activities (EPAs). Competency-based medical education is one approach to addressing the deficiencies within graduate medical education and across the continuum by allowing educators to focus on the desired equitable patient outcomes and then develop an approach to teaching and assessing the tasks, knowledge, skills, and attitudes needed to achieve the goal of optimal, equitable patient care. To that end, we describe the development and content of a revised EPA entitled: Use of Population Health Strategies and Quality Improvement Methods to Promote Health and Address Racism, Discrimination, and Other Contributors to Inequities Among Pediatric Populations. We also highlight the ways in which this EPA can be used to inform curricula, assessments, professional development, organizational systems, and culture change.

scholarly journals Remediation in the Context of the Competencies: A Survey of Pediatrics Residency Program Directors

2013 ◽  
Vol 5 (1) ◽  
pp. 60-63 ◽  
Author(s):  
Meredith P. Riebschleger ◽  
Hilary M. Haftel
Keyword(s):  
Medical Education ◽  
Patient Care ◽  
Graduate Medical Education ◽  
Residency Program ◽  
Online Survey ◽  
Medical Knowledge ◽  
Program Directors ◽  
Graduate Medical ◽  
Competency Based ◽  
Residency Program Directors

Abstract Background The 6 competencies defined by the Accreditation Council for Graduate Medical Education provide the framework of assessment for trainees in the US graduate medical education system, but few studies have investigated their impact on remediation. Methods We obtained data via an anonymous online survey of pediatrics residency program directors. For the purposes of the survey, remediation was defined as “any form of additional training, supervision, or assistance above that required for a typical resident.” Respondents were asked to quantify 3 groups of residents: (1) residents requiring remediation; (2) residents whose training was extended for remediation purposes; and (3) residents whose training was terminated owing to issues related to remediation. For each group, the proportion of residents with deficiencies in each of the 6 competencies was calculated. Results In all 3 groups, deficiencies in medical knowledge and patient care were most common; deficiencies in professionalism and communication were moderately common; and deficiencies in systems-based practice and practice-based learning and improvement were least common. Residents whose training was terminated were more likely to have deficiencies in multiple competencies. Conclusion Although medical knowledge and patient care are reported most frequently, deficiencies in any of the 6 competencies can lead to the need for remediation in pediatrics residents. Residents who are terminated are more likely to have deficits in multiple competencies. It will be critical to develop and refine tools to measure achievement in all 6 competencies as the graduate medical education community may be moving further toward individualized training schedules and competency-based, rather than time-based, training.

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.

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