scholarly journals Identifying leadership in medical trainees: valuation of a competency-based approach

BMJ Leader ◽  
2021 ◽  
pp. leader-2020-000402
Author(s):  
Samantha K. Jones ◽  
Ka Hong Chan ◽  
Joshua S. Bourdage ◽  
Aleem Bharwani
Keyword(s):  
Clinical Performance ◽  
Medical Professional ◽  
Assessment Tools ◽  
Performance Evaluations ◽  
Positive Leadership ◽  
Medical Trainees ◽  
Long Form ◽  
Competency Based ◽  
Perceptions Of Leadership ◽  
Negative Leadership

BackgroundAs medical professional roles diversify, it is essential to understand what makes effective medical leaders. This study develops and validates a medical leadership competency framework that can be used to develop and evaluate leaders across all levels of medical organisations.MethodIn Phase One, the authors derived desired leadership traits and behaviours in the medical context from a panel of subject matter experts (SMEs). Traits and behaviours were then combined into multifaceted competencies which were ranked and further refined through evaluation with additional SMEs. In Phase Two, the final seven competencies were evaluated with 181 medical trainees and 167 supervisors between 2017 and 2018 to determine the validity of rapid-form and long-form leadership assessments of medical trainees. Self and supervisor reports of the seven competencies were compared with validated trait and leadership behaviour measures as well as clinical performance evaluations.ResultsThe final seven leadership competencies were: Ethical and Social Responsibility, Civility, Self-Leadership, Team Management, Vision and Strategy, Creativity and Innovation, and Communication and Interpersonal Influence. Results demonstrate initial validity for rapid-form and long-form leadership evaluations; however, perceptions of good leadership may differ between trainees and supervisors. Further, negative leadership behaviours (eg, incivility) are generally not punished by supervisors and some positive leadership behaviours (eg, ethical leadership) were associated with poor leadership and clinical performance evaluations by supervisors. Supervisor perceptions of leadership were significantly driven by trainee scores on social boldness (a facet of extraversion).ConclusionsA multicompetency framework effectively evaluates leadership in medicine. To more effectively reinforcepositive leadership behaviours and discourage negative leadership behaviours in medical students and resident physicians, we recommend that medical educators:: (1) Use validated frameworks to build leadership curriculum and evaluations. (2) Use short-term and long-term assessment tools. (3) Teach assessors how to evaluate leaders and encourage positive leadership behaviours early in training.

Competency-Based Education in Minimally Invasive and Robotic Colorectal Surgery

2021 ◽  
Vol 34 (03) ◽  
pp. 155-162
Author(s):  
Marisa Louridas ◽  
Sandra de Montbrun
Keyword(s):  
Minimally Invasive ◽  
Technical Skill ◽  
Assessment Tools ◽  
Independent Practice ◽  
Competency Based Education ◽  
The Past ◽  
Robotic Colorectal Surgery ◽  
Competency Based ◽  
Colorectal Surgeons ◽  
Educational Paradigm

AbstractMinimally invasive and robotic techniques have become increasingly implemented into surgical practice and are now an essential part of the foundational skills of training colorectal surgeons. Over the past 5 years there has been a shift in the surgical educational paradigm toward competency-based education (CBE). CBE recognizes that trainees learn at different rates but regardless, are required to meet a competent threshold of performance prior to independent practice. Thus, CBE attempts to replace the traditional “time” endpoint of training with “performance.” Although conceptually sensible, implementing CBE has proven challenging. This article will define competence, outline appropriate assessment tools to assess technical skill, and review the literature on the number of cases required to achieve competence in colorectal procedures while outlining the barriers to implementing CBE.

scholarly journals An assessment of the Armenian national midwifery curriculum as per international standards

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Aslanyan ◽  
S Sahakyan ◽  
V Petrosyan
Keyword(s):  
Poor Quality ◽  
International Standards ◽  
Assessment Tools ◽  
Global Competency ◽  
Midwifery Education ◽  
Study Team ◽  
Competency Based ◽  
Document Review ◽  
Provision Of Care

Abstract Background Literature suggests increasing evidence that incompetent midwifery education results in poor quality of care. The study compared and evaluated the level of compliance of the Armenian national criterion on midwifery with the global competency standards and developed recommendations for improvement. Methods The study team conducted a document review using a standardized checklist, which was adapted from the International Confederation of Midwives (ICM) core assessment tools. The document review explored if the main knowledge and skills/ability related elements of each ICM competency were separately covered by different modules of the national criterion using a scoring system with categories: not met, partially met, fully met and unspecified. Results Although the national criterion did not have specifically defined competencies, most of the elements required by the ICM were present as specific learning outcomes under different modules of the criterion. Midwifery program curriculum was described as intensive with unnecessarily heavy workload. Additionally, the document review reviled that most of the learning outcome defined in modules of the national criterion focused more on theoretical knowledge rather than practical skills and abilities. Overall, the ICM required competency in provision of care during pregnancy was the most comprehensively covered one in the national criterion, while the competency in facilitation of abortion related care was the lowest covered. National criterion did not highlight the importance of topics such as women's rights and health, principles of epidemiology, statistical methods of research, cultural, local and ethical beliefs. Conclusions The systematic comparison of the national criterion with internationally recognized essential competencies demonstrates significant gaps. The study team recommends revisions to the national criterion to make it competency based. Key messages Midwifery education criteria in Armenia did not reflect internationally accepted midwifery competency’s fundamental philosophy and values. Given the shortcomings of the current national midwifery education criterion, a comprehensive revision of the competencies of midwives in Armenia should be considered.

Perceptions of the feedback process: a case study of veterinary residents and supervisors

2020 ◽  
Vol 187 (11) ◽  
pp. 449-449
Author(s):  
Karen Lisette Perry ◽  
Molly Frendo Londgren ◽  
Claire Vinten
Keyword(s):  
Clinical Performance ◽  
Good News ◽  
Study Cohort ◽  
Feedback Process ◽  
Semistructured Interviews ◽  
Residency Programme ◽  
Competency Based ◽  
Culture Development ◽  
Feedback Delivery

BackgroundAppraisal of resident clinical performance is critical during training. The most common method for this is feedback to residents based on impressions of supervising clinicians. How effective these practices are for veterinary residents remains unknown. This study focused on establishing perceptions of veterinary residents and supervisors regarding the feedback process.MethodsA qualitative case study format was chosen to investigate the perceptions and experiences within a well-developed residency programme. The study cohort consisted of veterinary residents and supervisors from the same specialties. Qualitative data were collected through individual semistructured interviews continuing iteratively until theoretical saturation was reached (14 in total).ResultsMismatches in resident and supervisor perceptions were evident regarding positive feedback delivery and the importance of dialogue. The nature of the resident/supervisor relationship and the efficacy of feedback were closely interlinked. The development of a feedback-friendly culture would be beneficial. Residents perceived that feedback on teaching was lacking. Milestones were perceived to be lacking.ConclusionThe results highlight a need for change away from the ‘no news is good news’ culture. Development of training workshops, formation of closer relationships between supervisors and residents, and a transition to competency-based education may be necessary.

scholarly journals Preparing for CBME: How often are faculty observing residents?

2020 ◽  
Author(s):  
Sheenagh J K George ◽  
Sarah Manos ◽  
Kenny K Wong
Keyword(s):  
Direct Observation ◽  
Assessment Tools ◽  
Inpatient Setting ◽  
Institutional Research ◽  
Professional Activities ◽  
Inpatient Settings ◽  
Competency Based ◽  
Resident Assessment ◽  
Outpatient Settings ◽  
Common Barriers

Abstract Background The Royal College of Physicians and Surgeons of Canada officially launched ‘Competence by Design’ in July 2017, moving from time-based to outcomes-based training. Transitioning to competency-based medical education (CBME) necessitates change in resident assessment. A greater frequency of resident observation will likely be required to adequately assess whether entrustable professional activities have been achieved. Purpose Characterize faculty and resident experiences of direct observation in a single paediatric residency program, pre-CBME implementation. Qualitatively describe participants’ perceived barriers and incentives to participating in direct observation. Methods Surveys were sent to paediatric residents and faculty asking for demographics, the frequency of resident observation during an average 4-week rotation, perceived ideal frequency of observation, and factors influencing observation frequency. Descriptive data were analyzed. Institutional research ethics board approval was received. Results The response rate was 54% (34/68 faculty and 16/25 residents). When asked the MAXIMUM frequency FACULTY observed a resident take a history, perform a physical examination, or deliver a plan, the median faculty reply was 1, 2, and 3, for outpatient settings and 0, 1, and 2, for inpatient settings. The median RESIDENT reply was 2, 4, and 10 for outpatient settings and 1, 2, and 20 for inpatient settings. When asked the MINIMUM frequency for each domain, the median FACULTY and RESIDENT reply was 0, except for delivering a plan in the inpatient setting. Faculty reported observing seniors delivering the plan more frequently than junior residents. Faculty and resident median replies for how frequently residents should be observed for each domain were the same, three to four, three to four, and five to six times. Four per cent of faculty reported regularly scheduling observations, and 77% of residents regularly ask to be observed. The most common barriers to observation were too many patients to see and both faculty and residents were seeing patients at the same time. Most faculty and resident responders felt that observation frequency could be improved if scheduled at the start of the rotation; faculty were provided a better tool for assessment; and if residents asked to be observed. Conclusions This study provides baseline data on how infrequent faculty observation is occurring and at a frequency lower than what faculty and residents feel is necessary. The time needed for observation competes with clinical service demands, but better scheduling strategies and assessment tools may help.

Assessment of Clinical Performance during Simulated Crises Using Both Technical and Behavioral Ratings 

1998 ◽  
Vol 89 (1) ◽  
pp. 8-18 ◽  
Author(s):  
David M. Gaba ◽  
Steven K. Howard ◽  
Brendan Flanagan ◽  
Brian E. Smith ◽  
Kevin J. Fish ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Crisis Management ◽  
Clinical Performance ◽  
Assessment Tools ◽  
Rating System ◽  
Ordinal Scale ◽  
Behavioral Ratings ◽  
Technical Performance ◽  
Interrater Variability ◽  
Management Behaviors

Background Techniques are needed to assess anesthesiologists' performance when responding to critical events. Patient simulators allow presentation of similar crisis situations to different clinicians. This study evaluated ratings of performance, and the interrater variability of the ratings, made by multiple independent observers viewing videotapes of simulated crises. Methods Raters scored the videotapes of 14 different teams that were managing two scenarios: malignant hyperthermia (MH) and cardiac arrest. Technical performance and crisis management behaviors were rated. Technical ratings could range from 0.0 to 1.0 based on scenario-specific checklists of appropriate actions. Ratings of 12 crisis management behaviors were made using a five-point ordinal scale. Several statistical assessments of interrater variability were applied. Results Technical ratings were high for most teams in both scenarios (0.78 +/- 0.08 for MH, 0.83 +/- 0.06 for cardiac arrest). Ratings of crisis management behavior varied, with some teams rated as minimally acceptable or poor (28% for MH, 14% for cardiac arrest). The agreement between raters was fair to excellent, depending on the item rated and the statistical test used. Conclusions Both technical and behavioral performance can be assessed from videotapes of simulations. The behavioral rating system can be improved; one particular difficulty was aggregating a single rating for a behavior that fluctuated over time. These performance assessment tools might be useful for educational research or for tracking a resident's progress. The rating system needs more refinement before it can be used to assess clinical competence for residency graduation or board certification.

scholarly journals Pedagogical Design of Digital Coursewith the use of LMS Moodle Tools

2021 ◽  
pp. 51-61
Author(s):  
Mykola A. Semenov ◽  
◽  
Vladyslav D. Krotkykh ◽  
Keyword(s):  
Learning Outcomes ◽  
Time Use ◽  
Assessment Tools ◽  
Digital Learning ◽  
Second Stage ◽  
Pedagogical Design ◽  
Competency Based ◽  
Support Methods ◽  
Research Show

Introduction. The introduction of a competency-based approach in Ukrainian higher education made it possible to update educational standards that define a set of general and professional competencies and learning outcomes, as well as introduce new pedagogical technologies and systems for monitoring the quality of education. Changes in the organization of digital learning largely depend on a competency-based approach. LMS Moodle is a platform that provides standard tools for implementing a competency-based approach. Purpose. To research the possibilities of LMS Moodle for the pedagogical design of the digital course and implementation of a competency-based approach in digital learning. Results. At the first stage, the summary of pedagogical design of a specific digital course built upon flip peddles on sequence is provided and a scheme is formed in which competencies, learning outcomes, and forms of assessment are defined. At the second stage, the process of designing a digital course based on the methodology of pedagogical design and tuning is researched, there an attempt is made to implement the course based on the competence approach using LMS Moodle tools of version 2.7 and version 3.3. As a result, a developed curriculum and framework are added to it, which allows observing the implementation of the learning outcomes in a convenient format. Conclusion. The results of the research show that in order to implement a competency-based approach with the use of LMS Moodle, the following requirements are essential: the scheme with linked competencies, learning outcomes, learning activities, and assessment tools. each activity has clearly indicated form, result, support methods, and estimated time. use of rubrics with all criteria aligned to learning outcomes. According to the results of the study, there are differences between LMS Moodle 2.7 and 3.3. In versions of Moodle later than 3.1, it is more convenient to analyze the achievement of learning outcomes for multiple digital courses by creating a hierarchy of competencies and learning outcomes; it is easier to conduct monitoring of the progress made towards the achievement of learning outcomes.

Interventional Pulmonology: The Role of Simulation Training and Competency-Based Evaluation

2018 ◽  
Vol 39 (06) ◽  
pp. 747-754 ◽  
Author(s):  
Mihir Parikh ◽  
Hans Lee ◽  
Neeraj Desai
Keyword(s):  
Medical Education ◽  
Learning Curves ◽  
Assessment Tools ◽  
Interventional Pulmonology ◽  
Training Outcomes ◽  
Training Models ◽  
Medical Education And Training ◽  
Competency Based ◽  
The Cost ◽  
And Training

AbstractMedical education and training are becoming more complex endeavors as technological and research advancements lead to new tools and methods to care for patients. In recent years, there has been a paradigm shift in medical education to competency-based assessments. Another important recent development in medical education has been the increasing use of simulation-based learning for procedural training. Interventional pulmonology (IP) is a relatively young and rapidly evolving procedural-based subspecialty. There are several well-validated competency-based assessment tools available to measure training adequacy in many of the most commonly performed procedures in IP. These tools have been shown to improve learning curves and training outcomes. The extent of how widely these tools are being used in clinical and educational spheres, however, remains unclear. Moreover, several commonly performed procedures in IP have no or limited validation tools currently available. Standardized training using simulation has also been shown to lead to positive training outcomes as compared with more traditional training models. However, widespread adoption of simulators has been limited due to the cost and availability.

scholarly journals Giving effective feedback to psychiatric trainees

2009 ◽  
Vol 15 (2) ◽  
pp. 123-128 ◽  
Author(s):  
Nick Brown ◽  
Louise Cooke
Keyword(s):  
Clinical Performance ◽  
Daily Practice ◽  
Educational Process ◽  
Effective Feedback ◽  
Assessment Feedback ◽  
Workplace Based Assessment ◽  
Competency Based ◽  
Process Feedback ◽  
The Uk

SummaryFeedback is an essential part of the learning process. Feedback can be positive or negative, constructive or destructive, minimal or in depth. It must always occur and should never be ignored. The role of effective feedback is critical in the modern postgraduate medical educational process in the UK, with its emphasis on competency-based curricula and workplace-based assessment. Feedback is not new in medical education and has been shown in research to be effective in bringing about change, particularly improvement in clinical performance. There are clear principles and features of good and bad feedback and these are highlighted, along with descriptions of models for use in daily practice.

scholarly journals Assessing competence in emergency medicine trainees: an overview of effective methodologies

CJEM ◽  
2008 ◽  
Vol 10 (04) ◽  
pp. 365-371 ◽  
Author(s):  
Jonathan Sherbino ◽  
Glen Bandiera ◽  
Jason R. Frank
Keyword(s):  
Emergency Medicine ◽  
Core Competencies ◽  
Assessment Tools ◽  
Competency Based Education ◽  
Physician Competence ◽  
Competency Based

ABSTRACTHow do we define competence in emergency medicine (EM), and how do we know when a resident has achieved it? In recent years, the idea of physician competence has become widely recognized as being multidimensional. This has resulted in an emphasis on competency-based education and assessment. We describe an up-to-date model to assess competence in EM. An overview of appropriate EM assessment tools is provided, along with their significant strengths and limitations. Sample behaviours representative of core competencies commonly assessed in EM training are matched to appropriate assessment tools. This review may serve as an introductory resource for EM clinicians, teachers and educators involved in EM trainee assessment.

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