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.

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 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 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.

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 Qualitative study to identify the perception and challenges faced by the faculty of community medicine in the implementation of competency-based medical education for postgraduate students

2019 ◽  
Vol 7 (1) ◽  
pp. e000043
Author(s):  
Saurabh Rambiharilal Shrivastava ◽  
Prateek Saurabh Shrivastava
Keyword(s):  
Medical Education ◽  
Qualitative Study ◽  
Faculty Members ◽  
Community Medicine ◽  
Competency Based Medical Education ◽  
Postgraduate Students ◽  
Professional Activities ◽  
Competency Based ◽  
Key Aspects ◽  
The Relationship

ObjectivesTo identify perception about the key aspects of competency-based medical education (CBME) among community medicine faculty members and to ascertain the various challenges faced by them during its implementation.MethodsA descriptive qualitative study of 2 months’ duration was conducted among the faculty members of the community medicine department. Non-probability purposive sampling was employed in the study. Free listing was done initially to elicit the views of faculty members to meet the intended objectives. Visual Anthropac software was used to identify the salient variables using Smith’s Salience Score, and then pile sorting was done to identify the association between the salient variables.ResultsThree faculty members participated in the free listing and pile sorting. A total of 20 responses were obtained pertaining to the key aspects of CBME, of which 12 were identified as the salient variables depending on the cut-off value of 0.125 (Smith’s Salience Score) and subjected to pile sorting. Similarly, eight challenges were identified in the implementation of the programme during the free listing, and all were included in the second stage of pile sorting. Cognitive maps were drawn to understand the relationship between the key aspects of CBME and involved challenges separately.ConclusionOn employing the free listing and pile sorting methods, formulation of entrustable professional activities and their assessment using appropriate tools were the identified crucial areas in CBME, while the lack of sensitisation of stakeholders and inadequate planning were identified as the predominant challenges in the implementation of CBME.

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 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 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.

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