scholarly journals Addressing Transition to Practice: Assessing Perceived Effectiveness of a Competency Based Change to On-Call Responsibilities of Senior Cardiology Residents

2021 ◽  
Author(s):  
Andrew James Caddell ◽  
Edwin Moses Bamwoya ◽  
Andrew Donald Moeller
Keyword(s):  
Internal Medicine ◽  
Training Program ◽  
Senior Resident ◽  
Program Committee ◽  
Gradual Transition ◽  
Transition To Practice ◽  
Call Structure ◽  
Internal Medicine Residents ◽  
Negative Effect ◽  
Competency Based

Abstract Background There has been a paradigm shift in residency training over the last several years wherein Competency by Design (CBD) is being integrated to replace more traditional time-based models of training. The Residency Program Committee (RPC) for the Cardiology training program at Dalhousie University in Halifax, Canada addressed the Transition to Practice stage by approving a trial of adjusting the resident call responsibilities to reflect the transition to CBD curriculum. The goal of this adjustment was three-fold: i. Gradually increase accountability of the senior cardiology resident as they transition to practice; ii. Address a gap in training that allows the senior resident to have a gradual transition to the role of a practicing cardiologist while on call; iii. Allows further evolution of skills and abilities. Methods A survey was administered to the practitioners involved in this competency-based change to the call responsibilities. Surveys were distributed to the final year Cardiology Residents, Staff Cardiologists, and Senior Internal Medicine residents to assess their experience and opinions of the current, competency-based change of the on-call curriculum. The survey consisted of eleven questions, of which, four were assessed on a Likert scale and 3 were yes/no questions. Results Four PGY6 cardiology residents, five senior internal medicine residents and eleven staff cardiologists completed the survey. Amongst those who completed the survey there was agreement that the change to the on-call responsibilities improved cardiology residents’ skills, accountability and preparedness to practice. All groups felt the changes were useful for the cardiology training program. There was mild negative effect of perceived accountability by the internal medicine residents. Conclusion Overall the change in call structure led to improved perceived preparedness to practice amongst the cardiology residents and addressed a gap in the Transition to Practice phase of CBD training. This study provides some evidence to the potential benefit of CBD and specifically in the benefits towards transitioning to practice.

scholarly journals A collective case study of supervision and competence judgments on the inpatient internal medicine ward

2021 ◽  
Author(s):  
Tristen Gilchrist ◽  
Rose Hatala ◽  
Andrea Gingerich
Keyword(s):  
Internal Medicine ◽  
Clinical Supervision ◽  
Clinical Teaching ◽  
Senior Resident ◽  
Structured Interviews ◽  
Collective Case Study ◽  
Teaching Unit ◽  
Competency Based ◽  
Trainee Competence

Abstract Introduction Workplace-based assessment in competency-based medical education employs entrustment-supervision scales to suggest trainee competence. However, clinical supervision involves many factors and entrustment decision-making likely reflects more than trainee competence. We do not fully understand how a supervisor’s impression of trainee competence is reflected in their provision of clinical support. We must better understand this relationship to know whether documenting level of supervision truly reflects trainee competence. Methods We undertook a collective case study of supervisor-trainee dyads consisting of attending internal medicine physicians and senior residents working on clinical teaching unit inpatient wards. We conducted field observations of typical daily activities and semi-structured interviews. Data was analysed within each dyad and compared across dyads to identify supervisory behaviours, what triggered the behaviours, and how they related to judgments of trainee competence. Results Ten attending physician-senior resident dyads participated in the study. We identified eight distinct supervisory behaviours. The behaviours were enacted in response to trainee and non-trainee factors. Supervisory behaviours corresponded with varying assessments of trainee competence, even within a dyad. A change in the attending’s judgment of the resident’s competence did not always correspond with a change in subsequent observable supervisory behaviours. Discussion There was no consistent relationship between a trigger for supervision, the judgment of trainee competence, and subsequent supervisory behaviour. This has direct implications for entrustment assessments tying competence to supervisory behaviours, because supervision is complex. Workplace-based assessments that capture narrative data including the rationale for supervisory behaviours may lead to deeper insights than numeric entrustment ratings.

scholarly journals Creative Solution for Implementation of Experiential, Competency-Based Palliative Care Training for Internal Medicine Residents

2011 ◽  
Vol 26 (3) ◽  
pp. 436-443 ◽  
Author(s):  
Douglas D. Ross ◽  
Deborah W. Shpritz ◽  
Susan D. Wolfsthal ◽  
Ann B. Zimrin ◽  
Timothy J. Keay ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Palliative Care ◽  
Internal Medicine Residents ◽  
Competency Based ◽  
Care Training

scholarly journals The research rotation: competency-based structured and novel approach to research training of internal medicine residents

2006 ◽  
Vol 6 (1) ◽  
Author(s):  
Balavenkatesh Kanna ◽  
Changchun Deng ◽  
Savil N Erickson ◽  
Jose A Valerio ◽  
Vihren Dimitrov ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Research Training ◽  
Novel Approach ◽  
Internal Medicine Residents ◽  
Competency Based ◽  
Research Rotation

scholarly journals Defining Content for a Competency-based (CanMEDS) Postgraduate Curriculum in Ambulatory Care: A Delphi Study

2012 ◽  
Vol 3 (1) ◽  
pp. e21-e32
Author(s):  
René Wong
Keyword(s):  
Internal Medicine ◽  
Ambulatory Care ◽  
Delphi Study ◽  
Delphi Process ◽  
Ambulatory Training ◽  
Societal Needs ◽  
Internal Medicine Residents ◽  
Recent Graduates ◽  
Health Advocate ◽  
Competency Based

Background: Ambulatory training in internal medicine has been noted to be dysfunctional and inadequate. In this study, we developed a set of competency-based outcomes specific to ambulatory care to guide the design, implementation and evaluation of instructional events to ensure that societal needs are addressed. Methods: In 2007 a Delphi technique was used to reach consensus and define the priorities for competency-based training in ambulatory care for internal medicine residents. Four groups of stakeholders in Canada participated: program directors, members of the Canadian Society of Internal Medicine, recent graduates, and residents. Results: Two rounds of the Delphi process were required to reach consensus on a set of sixty competency-based educational objectives in ambulatory care that were classified under the CanMEDS roles. The inclusion of recent graduates in this study resulted in the addition of non-clinical topics that would have otherwise been missed, falling under roles historically viewed as being challenging to teach and evaluate (Manager, Health Advocate). Conclusion: This study is the first time a Delphi-process has been used to define the priorities for ambulatory care training in internal medicine under a competency-based framework. The resulting compendium of competency-based objectives provides a foundation from which educators can design, evaluate and modify existing training experiences.

scholarly journals Internal medicine residents’ achievement goals and efficacy, emotions, and assessments

2018 ◽  
Vol 9 (4) ◽  
pp. e59-68 ◽  
Author(s):  
Lia Daniels ◽  
Vijay Daniels
Keyword(s):  
Internal Medicine ◽  
Self Efficacy ◽  
Achievement Goals ◽  
Postgraduate Medical Education ◽  
Sense Of Self ◽  
Self Report ◽  
Internal Medicine Residents ◽  
Competency Based ◽  
Approach Goals ◽  
Mastery Approach

Background: Achievement goal theory is consistently associated with specific cognitions, emotions, and behaviours that support learning in many domains, but has not been examined in postgraduate medical education. The purpose of this research was to examine internal medicine residents’ achievement goals, and how these relate to their sense of self-efficacy, epistemic emotions, and valuing of formative compared to summative assessments. These outcomes will be important as programs transition more to competency based education that is characterized by ongoing formative assessments.                             Methods: Using a correlational design, we distributed a self-report questionnaire containing 49 items measuring achievement goals, self-efficacy, emotions, and response to assessments to internal medicine residents. We used Pearson correlations to examine associations between all variables.Results: Mastery-approach goals were positively associated with self-efficacy and curiosity and negatively correlated with frustration and anxiety. Mastery-approach goals were associated with a greater value for feedback derived from annual ACP exams, end-of-rotation written exams, and annual OSCEs. Performance-approach goals were only associated with valuing ACP exams.Conclusion: Mastery-approach goals were associated with self-efficacy and epistemic emotions among residents, two constructs that facilitate autonomous learning. Residents with mastery-approach goals also appeared to value a wider range of types of assessment data. This profile will likely be beneficial for learners in a competency-based environment that involves high levels of formative feedback.

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