Implementation of Competency-Based Medical Education in a Canadian Medical Oncology Training Program: a First Year Retro
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Implementation of Competency-Based Medical Education in a Canadian Medical Oncology Training Program: a First Year Retrospective Review Anna Tomiak 1 & Geordie Linford 1 & Micheline McDonald 1 & Jane Willms 1 & Nazik Hammad 1 Accepted: 9 October 2020 # American Association for Cancer Education 2020
Abstract As part of a university-wide initiative, competency-based medical education (CBME) was implemented in the Medical Oncology training program at Queen’s University in July 2017. Stages, entrustable professional activities (EPAs), and required training experiences established by the Royal College of Physicians and Surgeons of Canada (RCPSC) national subspecialty committee were adopted. Entrada (Elentra), the electronic portfolio developed at Queen’s University, was used for assessment collection. Between July 2017 and December 2018, participating faculty members completed 157 assessments. Eighty-nine percent were EPA assessments with a median of 16 assessments per faculty member (range 1–40). Ninety-five percent of assessments included written “Comments” or “Next steps” with 56% of all assessments including specific or actionable feedback. Discussions between the program director, residents, program administrator, CBME education consultant, and CBME lead led to the identification of 9 lessons learned during implementation. These centered on (1) faculty and resident development and engagement; (2) sharing the work of CBME; (3) collaboration and communication; (4) global assessment; (5) assessment plan challenges; (6) burden of CBME; (7) limitations of eportfolio; (8) importance of early tracking of resident progress; and (9) culture change. This article describes the experience of the authors and considers strategies that may be helpful to programs implementing CBME in their teaching and learning environment. Keywords Competency-based . CBME . Implementation . Postgraduate
Introduction The call for competency-based medical education (CBME), referred to as Competence by Design (CBD) in Canada, is a new strategy which aims to improve postgraduate medical education (PGME) training outcomes and to emphasize competencies and increasing accountability to regulatory bodies [1, 2]. The transformation to CBME must be accompanied by initiatives to change the prevailing culture of assessment and teaching [3–6]. Lessons learned from successes and failures of early adopters will contribute to building evidence-based knowledge about the adoption, development, and implementation of best practices in various CBME contexts [7]. In July 2017, we implemented CBME in our Medical Oncology training program, with two new postgraduate year (PGY)-4 residents joining 10
* Anna Tomiak [email protected] 1
Department of Oncology, Queen’s University, 25 King Street West, Kingston K7L 5P9, Canada
faculty members. A second cohort of two PGY-4 residents started 1 year later in July 2018. We prepared for the transition to CBME starting 3 years prior to implementation. Elentra™, the integrated teaching and learning electronic platform d
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