Seven ways to get a grip on implementing Competency-Based Medical Education at the program level

Competency-based medical education (CBME) curricula are becoming increasingly common in graduate medical education. Put simply, CBME is focused on educational outcomes, is independent of methods and time, and is composed of achievable competencies.1 In spite of widespread uptake, there remains much to learn about implementing CBME at the program level. Leveraging the collective experience of program leaders at Queen’s University, where CBME simultaneously launched across 29 specialty programs in 2017, this paper leverages change management theory to provide a short summary of how program leaders can navigate the successful preparation, launch, and initial implementation of CBME within their residency programs.

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Competency-Based Medical Education in Radiology: A Survey of Medical Student Perceptions

Canadian Association of Radiologists Journal ◽

10.1177/0846537119893663 ◽

2020 ◽

pp. 084653711989366

Author(s):

Joseph Yang ◽

Danny Jomaa ◽

Omar Islam ◽

Benedetto Mussari ◽

Corinne Laverty ◽

...

Keyword(s):

Medical Education ◽

Medical Student ◽

Medical Students ◽

Student Perceptions ◽

Diagnostic Radiology ◽

Competency Based Medical Education ◽

Residency Programs ◽

Radiology Residency ◽

Competency Based ◽

Almost All

Purpose: Implementing competency-based medical education in diagnostic radiology residencies will change the paradigm of learning and assessment for residents. The objective of this study is to evaluate medical student perceptions of competency-based medical education in diagnostic radiology programs and how this may affect their decision to pursue a career in diagnostic radiology. Methods: First-, second-, and third-year medical students at a Canadian university were invited to complete a 14-question survey containing a mix of multiple choice, yes/no, Likert scale, and open-ended questions. This aimed to collect information on students’ understanding and perceptions of competency-based medical education and how the transition to competency-based medical education would factor into their decision to enter a career in diagnostic radiology. Results: The survey was distributed to 300 medical students and received 63 responses (21%). Thirty-seven percent of students had an interest in pursuing diagnostic radiology that ranged from interested to committed and 46% reported an understanding of competency-based medical education and its learning approach. The implementation of competency-based medical education in diagnostic radiology programs was reported to be a positive factor by 70% of students and almost all reported that breaking down residency into measurable milestones and required case exposure was beneficial. Conclusions: This study demonstrates that medical students perceive competency-based medical education to be a beneficial change to diagnostic radiology residency programs. The changes accompanying the transition to competency-based medical education were favored by students and factored into their residency decision-making.

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From prescription to guidance: a European framework for generic competencies

Advances in Health Sciences Education ◽

10.1007/s10459-019-09910-8 ◽

2019 ◽

Vol 25 (1) ◽

pp. 173-187 ◽

Cited By ~ 1

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.

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Burn Care and Surgical Exposure amongst Canadian Plastic Surgery Residents: Recommendations for Transitioning to a Competency-Based Medical Education Model

Journal of Burn Care & Research ◽

10.1093/jbcr/irz086 ◽

2019 ◽

Vol 40 (6) ◽

pp. 796-804

Author(s):

Jessica G Shih ◽

Whitney L Quong ◽

Aaron D C Knox ◽

Nick Zhygan ◽

Douglas J Courtemanche ◽

...

Keyword(s):

Medical Education ◽

Plastic Surgery ◽

Competency Based Medical Education ◽

Residency Programs ◽

Personal Competence ◽

Curricular Development ◽

Burn Care ◽

Competency Based ◽

Case Logs ◽

Competency Evaluation

Abstract With the ongoing implementation of a competency-based medical education (CMBE) model for residency programs in North America, emphasis on the duration of training has been refocused onto ability and competence. This study aims to determine the exposure of burn-related core procedural competencies (CPCs) in Canadian Plastic Surgery Residents in order to enhance curricular development and help define its goals. A retrospective review of burn-related resident case logs encompassing all 10 English-speaking plastic surgery residency programs from 2004 to 2014 was performed, including analysis of personal competence scores and resident role by Postgraduate Year (PGY)-year. Case logs of a total of 55 graduating plastic surgery residents were included in the study. Overall, 4033 procedures in burn and burn-related care were logged, accounting for 6.8% of all procedures logged. On average, each resident logged 73 burn procedures, 99% of which were CPCs. The most frequently performed procedure was harvest and application of autograft, allograft, or xenograft, while emergent procedures such as escharotomy and compartment release were performed on average less than one time per resident. Personal competence scores as well as role of the resident (surgical responsibility) increased as PGY-year progressed during residency. Canadian plastic surgery residency programs provide adequate exposure to the majority of the scope of burn care and surgery. However, infrequently encountered but critical procedures such as escharotomy and fasciotomy may require supplementation through dedicated educational opportunities. CMBE should identify these gaps in learning through facilitation of resident competency evaluation. With consideration for the amount of exposure to burn-related CPCs as identified, plastic surgery residency programs can work toward achieving competency in all aspects of burn care and surgery prior to the completion of residency.

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Creating a Competency-Based Medical Education Curriculum for Canadian Diagnostic Radiology Residency (Queen’s Fundamental Innovations in Residency Education)-Part 2: Core of Discipline Stage

Canadian Association of Radiologists Journal ◽

10.1177/0846537121993058 ◽

2021 ◽

pp. 084653712199305

Author(s):

Siddharth Mishra ◽

Andrew Chung ◽

Christina Rogoza ◽

Omar Islam ◽

Benedetto Mussari ◽

...

Keyword(s):

Medical Education ◽

Residency Program ◽

Diagnostic Radiology ◽

Competency Based Medical Education ◽

Residency Programs ◽

The Core ◽

Procedural Volume ◽

Radiology Residency ◽

Competency Based ◽

Queen's University

Purpose: All postgraduate residency programs in Canada are transitioning to a competency-based medical education (CBME) model divided into 4 stages of training. Queen’s University has been the first Canadian institution to mandate transitioning to CBME across all residency programs, including Diagnostic Radiology. This study describes the implementation of CBME with a focus on the third developmental stage, Core of Discipline, in the Diagnostic Radiology residency program at Queen’s University. We describe strategies applied and challenges encountered during the adoption and implementation process in order to inform the development of other CBME residency programs in Diagnostic Radiology. Methods: At Queen’s University, the Core of Discipline stage was developed using the Royal College of Physicians and Surgeons of Canada’s (RCPSC) competence continuum guidelines and the CanMEDS framework to create radiology-specific entrustable professional activities (EPAs) and milestones for assessment. New committees, administrative positions, and assessment strategies were created to develop these assessment guidelines. Currently, 2 cohorts of residents (n = 6) are enrolled in the Core of Discipline stage. Results: EPAs, milestones, and methods of evaluation for the Core of Discipline stage are described. Opportunities during implementation included tracking progress toward educational objectives and increased mentorship. Challenges included difficulty meeting procedural volume requirements, inconsistent procedural tracking, improving feedback mechanisms, and administrative burden. Conclusion: The transition to a competency-based curriculum in an academic Diagnostic Radiology residency program is significantly resource and time intensive. This report describes challenges faced in developing the Core of Discipline stage and potential solutions to facilitate this process.

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Competency based medical education in gastrointestinal motility

Neurogastroenterology & Motility ◽

10.1111/nmo.12835 ◽

2016 ◽

Vol 28 (10) ◽

pp. 1460-1464 ◽

Cited By ~ 14

Author(s):

R. Yadlapati ◽

R. N. Keswani ◽

J. E. Pandolfino

Keyword(s):

Medical Education ◽

Gastrointestinal Motility ◽

Competency Based Medical Education ◽

Competency Based

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Competency on Call: Resident Driven Learning Objectives for Competency-Based Medical Education

Academic Psychiatry ◽

10.1007/s40596-019-01178-9 ◽

2020 ◽

Vol 44 (6) ◽

pp. 812-813 ◽

Cited By ~ 1

Author(s):

Bruce Fage ◽

Tracy Alldred ◽

Sarah Levitt ◽

Amanda Abate ◽

Mark Fefergrad

Keyword(s):

Medical Education ◽

Learning Objectives ◽

Competency Based Medical Education ◽

Competency Based

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Implementing competency-based medical education: Moving forward

Medical Teacher ◽

10.1080/0142159x.2017.1315069 ◽

2017 ◽

Vol 39 (6) ◽

pp. 568-573 ◽

Cited By ~ 49

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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Blueprint for summative theory assessment in pharmacology - A tool to increase the validity as per the new competency based medical education

National Journal of Physiology Pharmacy and Pharmacology ◽

10.5455/njppp.2021.11.06170202107072021 ◽

2021 ◽

pp. 1

Author(s):

Meenu Pichholiya ◽

Arvind Yadav ◽

Sangita Gupta ◽

Sandeep Kamlekar ◽

Sakshi Singh

Keyword(s):

Medical Education ◽

Competency Based Medical Education ◽

Competency Based

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Postgraduate medical education: The history and development of competency-based training program in Nepal

Journal of Patan Academy of Health Sciences ◽

10.3126/jpahs.v8i1.36243 ◽

2021 ◽

Vol 8 (1) ◽

pp. 102-112

Author(s):

Jay Narayan Shah ◽

Jenifei Shah ◽

Jesifei Shah ◽

Ashis Shrestha ◽

Nabees Man Singh Pradhan

Keyword(s):

Medical Education ◽

Healthcare System ◽

Postgraduate Training ◽

Core Competencies ◽

Health Sciences ◽

Medical Council ◽

Competency Based Medical Education ◽

Surgical Workforce ◽

Competency Based ◽

Medical Colleges

Nepal is a small, lower-middle-income country; with a population of around 30 million. As per WHO, Nepal has a low doctor-patient ratio (0.7/1000) and even lower specialists (e.g., surgical) workforce (0.003/1000); additionally, data from Nepal Medical Council show the number of postgraduate specialists is 1/3rd of the total registered doctors. The mismatch in the doctor-patient ratio is further aggravated by the overwhelming number of doctors in urban areas; when 80% of the population are in rural Nepal. This inequitable discrepancy in the healthcare system requires: proper training of competent medical graduates, a fair distribution across the country, and effective changes in the healthcare system. Competency-based medical education plays an important role in: standardizing education, training competent doctors, and deploying them where they are needed the most. The Government of Nepal has recently established Medical Education Commission-which plans to oversee the entrance exams; and expand the postgraduate training to be conducted by private hospitals, previously not affiliated with any medical colleges or universities. Historically, Civil Medical School started training compounders and dressers in Nepal in 1934. A big milestone was achieved with the establishment of the Institute of Medicine under Tribhuvan University in 1972, which has continued to train all categories of health manpower needed in the country. In 2006 Nepal Medical Council developed “Regulations for Post-graduate Medical education”. Thereafter, several institutions started providing postgraduate training, for example: the BP Koirala Institute of Health Sciences, Kathmandu University, National Academy of Medical Sciences, and Patan Academy of Health Sciences (PAHS). The PAHS conducts PG programs and post-PG fellowships in line with competency-based medical education. In addition to formative assessments, research thesis, and a publishable article; PAHS requires its trainees to be certified in a pre-set of entrustable professional activities (EPAs) and to master eight Core Competencies domains in: Professionalism, Patient-centered care, Procedural skills, Clinical Reasoning, Communication, Scholarship, Leadership, Community orientation. The number of medical colleges in Nepal has since expanded to 24 (medical 21 and dental colleges 3). Private medical colleges make up about 3/4th of the total medical colleges in Nepal. This makes the inclusion and regulation of more components of the competency-based curriculum in postgraduate training programs, and its monitoring, somewhat of a challenge.

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