The Competency-Based Mandate for Emergency Bedside Sonography Training and a Tale of Two Residency Programs

2012 ◽  
Vol 31 (4) ◽  
pp. 515-521 ◽  
Author(s):  
Timothy B. Jang ◽  
Wendy C. Coates ◽  
Yiju T. Liu
Keyword(s):  
Residency Programs ◽  
Competency Based

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

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.

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

2020 ◽  
Author(s):  
Jeffery Damon Dagnone ◽  
Laura McEwen ◽  
David Taylor ◽  
Amy Acker ◽  
Mary Bouchard ◽  
...  
Keyword(s):  
Medical Education ◽  
Change Management ◽  
Educational Outcomes ◽  
Management Theory ◽  
Competency Based Medical Education ◽  
Residency Programs ◽  
Program Leaders ◽  
Short Summary ◽  
Collective Experience ◽  
Competency Based

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.

scholarly journals Competency-based education in general surgery: Are Canadian residents ready?

2021 ◽  
Vol 64 (5) ◽  
pp. E473-E475
Author(s):  
Gabrielle Gauvin ◽  
Kathryn Hay ◽  
Wilma Hopman ◽  
Scott Hurton ◽  
Stephanie Lim ◽  
...  
Keyword(s):  
Medical Education ◽  
Royal College ◽  
General Surgery ◽  
Implementation Process ◽  
Web Based ◽  
Training Opportunity ◽  
Residency Programs ◽  
Competency Based Education ◽  
Work Hour ◽  
Competency Based

Competency-based education (CBE) is currently being implemented by the Royal College of Physicians and Surgeons of Canada across all residency programs. This shift away from time-based residency is proposed to be the answer to maximize training opportunity in the era of work hour restrictions and growing concerns regarding accountability in medical education. A Web-based survey was conducted to obtain feedback from Canadian general surgery residents on their experience and perception of competence within core procedures, as well as attitudes toward CBE. A total of 244 residents completed the survey. For most procedures, more than 50% of residents felt they could perform the procedure with no guidance after completing 11–30 cases. Generally, residents were welcoming of CBE; however, medium-sized programs reported some concerns regarding inadequate exposure to cases and risk of training less well-rounded surgeons. This is valuable resident feedback for programs to consider during the implementation process.

scholarly journals Competency Assessment in Family Medicine Residency: Observations, Knowledge-Based Examinations, and Advancement

2017 ◽  
Vol 9 (6) ◽  
pp. 730-734 ◽  
Author(s):  
Arch G. Mainous ◽  
Bo Fang ◽  
Lars E. Peterson
Keyword(s):  
Family Medicine ◽  
Medical Knowledge ◽  
National Sample ◽  
Competency Assessment ◽  
Residency Programs ◽  
Knowledge Based ◽  
Competency Based ◽  
Key Dimensions ◽  
Relationship Of ◽  
The Relationship

ABSTRACT Background  The Family Medicine (FM) Milestones are competency-based assessments of residents in key dimensions relevant to practice in the specialty. Residency programs use the milestones in semiannual reviews of resident performance from the time of entry into the program to graduation. Objective  Using a national sample, we investigated the relationship of FM competency-based assessments to resident progress and the complementarity of milestones with knowledge-based assessments in FM residencies. Methods  We used midyear and end-of-year milestone ratings for all FM residents in Accreditation Council for Graduate Medical Education–accredited programs during academic years 2014–2015 and 2015–2016. The milestones contain 22 items across 6 competencies. We created a summative index across the milestones. The American Board of Family Medicine database provided resident demographics and in-training examination (ITE) scores. We linked information to the milestone data. Results  The sample encompassed 6630 FM residents. The summative milestone index increased, on average, for each cohort (postgraduate year 1 [PGY-1] to PGY-2 and PGY-2 to PGY-3) at each assessment. The correlation between the milestone index that excluded the medical knowledge milestone and ITE scores was r = .195 (P < .001) for PGY-1 to PGY-2 cohort and r = .254 (P < .001) for PGY-2 to PGY-3 cohort. For both cohorts, ITE scores and composite milestone assessments were higher for residents who advanced than for those who did not. Conclusions  Competency-based assessment using the milestones for FM residents seems to be a viable multidimensional tool to assess the successful progression of residents.

scholarly journals Development of a Competency-based Training in Obstetrics and Gynecology Ultrasound for Undergraduate and Graduate Medical Education

2014 ◽  
Vol 8 (1) ◽  
pp. 83-86
Author(s):  
Hoi Ho ◽  
Jorge Sarmiento ◽  
Dolgor Baatar ◽  
Jesus Peinado
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Obstetrics And Gynecology ◽  
Residency Programs ◽  
Graduate Medical ◽  
Practice Of Medicine ◽  
Competency Based ◽  
Medical Educators ◽  
And Training ◽  
The Continuum

ABSTRACT Advances in technology have made ultrasonography a rapidly evolving concept in the practice of medicine and a valuable component of the competency-based education. American Medical Association (AMA) recently affirms that ‘ultrasound imaging is a safe, effective and efficient tool when utilized by, or under the direction of appropriately trained physicians.’ AMA also supports the educational efforts and widespread integration of ultrasound throughout the continuum of medical education. Training in ultrasonography is rapidly expanding to numerous residency programs of graduate medical education but discrepancies in ultrasound curriculum and criteria for proficiency exist among programs within the same discipline, despite clearly defined objectives recommended by the governing bodies. There is a trend to integrate ultrasonography into the curriculum of undergraduate medical education. However, funding, availability of ultrasound-trained faculty and student time are barriers to the implementation. Ultrasonography is a natural fit for competency-based training and should be introduced early in medical education. We expect that the LCME will soon mandate the integration of ultrasound into the 4-year curriculum. The imminent question that medical educators ask is not when ultrasound will become a required component of the curriculum but how to effectively integrate the teaching and training of ultrasound into the continuum of medical education. How to cite this article Baatar D, Peinado J, Sarmiento J, Ho H. Development of a Competency-based Training in Obstetrics and Gynecology Ultrasound for Undergraduate and Graduate Medical Education. Donald School J Ultrasound Obstet Gynecol 2014;8(1):83-86.

scholarly journals P101: The development of entrustable professional activity reference cards to support the implementation of Competence by Design in emergency medicine

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S100
Author(s):  
E. Stoneham ◽  
L. Witt ◽  
Q. Paterson ◽  
L. Martin ◽  
B. Thoma
Keyword(s):  
Emergency Medicine ◽  
Low Cost ◽  
Intervention Mapping ◽  
Assessment System ◽  
Professional Activity ◽  
Residency Programs ◽  
Professional Activities ◽  
Competency Based ◽  
Curriculum Map ◽  
User Friendly

Innovation Concept: Competence by Design (CBD) was implemented nationally for Emergency Medicine (EM) residents beginning training in 2018. One challenge is the need to introduce residents to Entrustable Professional Activities (EPAs) that are assessed across numerous clinical rotations. The Royal College's resources detail these requirements, but do not map them to specific rotations or present them in a succinct format. This is problematic as trainees are less likely to succeed when expectations are unclear. We identified a need to create practical resources that residents can use at the bedside. Methods: We followed an intervention mapping framework to design two practical, user-friendly, low-cost, aesthetically pleasing resources that could be used by residents and observers at the bedside to facilitate competency-based assessment. Curriculum, Tool or Material: First, we designed a set of rotation- and stage-specific EPA reference cards for the use of residents and observers at the bedside. These cards list EPAs and clinical presentations likely to be encountered during various stages of training and on certain rotations. Second, we developed a curriculum board to organize the EPA reference cards by stage based upon our program's curriculum map. The curriculum board allows residents to view the program's curriculum map and the EPAs associated with each clinical rotation at a glance. It also contains hooks to hang and store extra cards in an organized manner. Conclusion: We believe that these practical and inexpensive tools facilitated our residency program's transition to competency-based EPA assessments. Anecdotally, the residents are using the cards and completing the suggested rotation-specific EPAs. We hope that the reference cards and curriculum board will be successfully incorporated into other residency programs to facilitate the introduction of their EPA-based CBD assessment system.

scholarly journals Stages of Milestones Implementation: A Template Analysis of 16 Programs Across 4 Specialties

2021 ◽  
Vol 13 (2s) ◽  
pp. 14-44
Author(s):  
Nicholas A. Yaghmour ◽  
Lauren J. Poulin ◽  
Elizabeth C. Bernabeo ◽  
Andem Ekpenyong ◽  
Su-Ting T. Li ◽  
...  
Keyword(s):  
Stakeholder Engagement ◽  
Early Stage ◽  
Implementation Strategies ◽  
Fine Tuning ◽  
Residency Programs ◽  
Program Leaders ◽  
Process Implementation ◽  
Template Analysis ◽  
Competency Based ◽  
Clinical Competency Committee

ABSTRACT Background Since 2013, US residency programs have used the competency-based framework of the Milestones to report resident progress and to provide feedback to residents. The implementation of Milestones-based assessments, clinical competency committee (CCC) meetings, and processes for providing feedback varies among programs and warrants systematic examination across specialties. Objective We sought to determine how varying assessment, CCC, and feedback implementation strategies result in different outcomes in resource expenditure and stakeholder engagement, and to explore the contextual forces that moderate these outcomes. Methods From 2017 to 2018, interviews were conducted of program directors, CCC chairs, and residents in emergency medicine (EM), internal medicine (IM), pediatrics, and family medicine (FM), querying their experiences with Milestone processes in their respective programs. Interview transcripts were coded using template analysis, with the initial template derived from previous research. The research team conducted iterative consensus meetings to ensure that the evolving template accurately represented phenomena described by interviewees. Results Forty-four individuals were interviewed across 16 programs (5 EM, 4 IM, 5 pediatrics, 3 FM). We identified 3 stages of Milestone-process implementation, including a resource-intensive early stage, an increasingly efficient transition stage, and a final stage for fine-tuning. Conclusions Residency program leaders can use these findings to place their programs along an implementation continuum and gain an understanding of the strategies that have enabled their peers to progress to improved efficiency and increased resident and faculty engagement.

Microsurgery Training Resource Variation among US Integrated Plastic Surgery Residency Programs

2018 ◽  
Vol 35 (03) ◽  
pp. 176-181 ◽  
Author(s):  
Melissa Mueller ◽  
Navid Pourtaheri ◽  
Gregory Evans
Keyword(s):  
Plastic Surgery ◽  
Statistical Significance ◽  
High Volume ◽  
Training Curriculum ◽  
Formal Curriculum ◽  
Residency Programs ◽  
Large Program ◽  
Chi Squared ◽  
Competency Based ◽  
Survey Responses

Background Given emerging focus on competency-based surgical training and work-hour limitations, surgical skills laboratories play an increasingly important role in resident education. This study was designed to investigate educational opportunities in microsurgery across integrated residency programs. Methods Senior residents (PGY 4–6) at integrated plastic surgery programs were surveyed during the 2016 to 2017 academic year to determine each program's access to: training microscopes and anastomosis models, video-based skills assessment, pre-requisite skills exams, flap courses, or a formal microsurgical training curriculum. Programs were stratified based on large size (>18 residents) and presence of microsurgery fellows. Chi-squared analysis was performed with p < 0.05 to assess statistical significance. Results Survey responses were collected from 32 of 60 eligible programs (53% response rate). Sixty-nine percent provide access to one to two training microscopes, 25% provide three or more, and 6% provide none. Sixty-nine percent of programs train anastomosis with nonliving prosthetics, 66% with living biologics, and 50% with nonliving biologics. Large program size or having microsurgical fellows was not associated with increased access to training microscopes or specific anastomosis models. Programs without microsurgery fellows reported more often that a formal microsurgery curriculum would be helpful (90 vs. 58% of programs with fellows, p = 0.0003). Respondents who indicated that creating a formal curriculum would not be helpful elaborated that their program already has a formal curriculum or a high volume of microsurgery cases. Conclusion This study demonstrates the current variation in microsurgery training at integrated plastic surgery residency programs. A formal microsurgical training curriculum is commonly viewed as being helpful, particularly at programs without microsurgery fellows.

Assessments of Otolaryngology Resident Operative Experiences Using Mobile Technology: A Pilot Study

2019 ◽  
Vol 161 (6) ◽  
pp. 939-945 ◽  
Author(s):  
Jenny X. Chen ◽  
Elliott Kozin ◽  
Jordan Bohnen ◽  
Brian George ◽  
Daniel G. Deschler ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Smartphone Application ◽  
Multicenter Studies ◽  
Median Response ◽  
Residency Programs ◽  
Key Indicator ◽  
Median Response Rate ◽  
Competency Based ◽  
Self Assessments ◽  
Standardized Curriculum

Objectives Surgical education has shifted from the Halstedian model of “see one, do one, teach one” to a competency-based model of training. Otolaryngology residency programs can benefit from a fast and simple system to assess residents’ surgical skills. In this quality initiative, we hypothesize that a novel smartphone application called System for Improving and Measuring Procedural Learning (SIMPL) could be applied in an otolaryngology residency to facilitate the assessment of resident operative experiences. Methods The Plan Do Study Act method of quality improvement was used. After researching tools of surgical assessment and trialing SIMPL in a resident-attending pair, we piloted SIMPL across an otolaryngology residency program. Faculty and residents were trained to use SIMPL to rate resident operative performance and autonomy with a previously validated Zwisch Scale. Results Residents (n = 23) and faculty (n = 17) were trained to use SIMPL using a standardized curriculum. A total of 833 assessments were completed from December 1, 2017, to June 30, 2018. Attendings completed a median 20 assessments, and residents completed a median 14 self-assessments. All evaluations were resident initiated, and attendings had a 78% median response rate. Evaluations took residents a median 22 seconds to complete; 126 unique procedures were logged, representing all 14 key indicator cases for otolaryngology. Discussion This is the first residency-wide application of a mobile platform to track the operative experiences of otolaryngology residents. Implications for Practice We adapted and implemented a novel assessment tool in a large otolaryngology program. Future multicenter studies will benchmark resident operative experiences nationwide.

scholarly journals LO097: A novel curriculum for assessing competency in resuscitation at the foundations of discipline level of training

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S63-S63
Author(s):  
T. Chaplin ◽  
L. McMurray ◽  
A.K. Hall
Keyword(s):  
Assessment Tool ◽  
Professional Activity ◽  
First Year ◽  
Residency Programs ◽  
Modified Delphi ◽  
Simulation Based ◽  
Level Of Consciousness ◽  
Objective Structured Clinical Exam ◽  
Competency Based ◽  
Level Of Training

Introduction / Innovation Concept: Junior residents are often the first physicians who attend to the acutely unwell floor patient, especially at night and on weekends. The ‘Nightmares Course’ at Queen’s University was designed to address an Entrustable Professional Activity (EPA) relevant to several residency programs at the ‘Foundations of Discipline’ level of training: “to manage the acutely unwell floor patient for the first 5-10 minutes until help arrives”. In keeping with competency based medical education principles, this course offers longitudinal and repetitive practice and assessment. We have also designed a summative objective structured clinical exam (OSCE) in order to identify trainees who require additional remedial practice of this EPA. Methods: We developed simulated cases that reflect common but “scary” calls to the floor. We then, using a modified Delphi process with experts in resuscitation, defined relevant milestones applicable to the Foundations of Discipline level of training in order to inform our formative assessment. We also modified the Queen’s Simulated Assessment Tool (QSAT) to adopt CBME terminology and this will be used to provide a summative assessment during a four-scenario OSCE in the spring. Residents with QSAT scores below the competency threshold will be enrolled in a remediation course. Curriculum, Tool, or Material: Weekly sessions were led by staff physicians and were offered to first-year residents from internal medicine, core surgery, obstetrics and gynecology, and anesthesiology over the academic year. Each resident participated in one session every 4-week block. Sessions were organized into themes such as “shortness of breath” or “decreased level of consciousness” and involved three high-fidelity simulated cases with a structured debrief following each case. Formative feedback was given following each case. Conclusion: The Nightmares Course is a novel simulation-based, multidisciplinary curriculum in resuscitation medicine. It includes longitudinal practice and repetitive assessment, as well as summative testing and remediation of an EPA common to several residency programs.

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