Creating a Competency-Based Medical Education Curriculum for Canadian Diagnostic Radiology Residency (Queen’s Fundamental Innovations in Residency Education)—Part 1: Transition to Discipline and Foundation of Discipline Stages

Kwan, Benjamin Y. M.; Mbanwi, Achire N.; Cofie, Nicholas; Rogoza, Christina; Chung, Andrew D.; Dalgarno, Nancy; Dagnone, Damon; Xi, Wang; Mussari, Ben

doi:10.1177/0846537119894723

Cited by 18 publications

(20 citation statements)

References 26 publications

(26 reference statements)

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“…Concern has been expressed about the increased daily workload for residents and assessors with a disrupted workflow as well as learner receptivity of feedback. [6][7][8][9][10] From an assessor perspective, little is known about the time required to complete an encounter or the characteristics of the narrative comments provided. From a resident perspective, it is unclear whether feedback improves future performance.…”

Section: Discussionmentioning

confidence: 99%

Entrustable Professional Activities: An Analysis of Faculty Time, Trainee Perspectives and Actionability

David

Walsh

Lockyer

et al. 2021

Can Journ Gen Int Med

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The Royal College of Physicians and Surgeons of Canada introduced Competence by Design (CBD) as an educational model along with Entrustable Professional Activities (EPAs) as markers of achievement that could be directly observed on a frequent basis. In 2017, the University of Calgary Internal Medicine (IM) program piloted CBD. The purpose of this study was to (1) assess whether written feedback from EPAs were actionable, valuable, and disruptive to workflow and (2) assess the time required to complete an EPA. MethodsSeven Foundations of Discipline EPAs were used with 31 PGY-1 Calgary IM residents. The study used quantitative and qualitative data. Following a discussion on an EPA and completion of both the quantitative and written feedback, residents were asked to comment on the value of the encounter and the degree of disruption to workflow. Assessors provided time to complete an EPA. Data were anonymized. Trainee comments were coded for value and disruption, and assessor’s written feedback was coded for actionability. ResultsOne hundred and five EPA encounters were submitted. The majority of the comments provided to trainees were not actionable (94.3%, n = 99/105). While most residents did not comment on value (73.3%, n = 77/105) or disruption (44.8%, n = 47/105) of the encounter, those that did generally found the encounters valuable (25.7%, n = 27/105) and nondisruptive (35.2%, n = 37/105). A minority found the process nonvaluable (1%, n = 1/105) and disruptive (20%, n = 21/105). The mean time to complete an EPA form and provide feedback was 8.6 min. ConclusionMost written feedback was not actionable, suggesting a potential role for faculty development to guide assessors and help them coach trainees on EPAs. RÉSUMÉLe Collège royal des médecins et chirurgiens du Canada a introduit la compétence par conception (CPC) comme modèle d’enseignement, ainsi que les activités professionnelles confiables (APC) comme marqueurs de réussite qui pourraient être observés directement et souvent. En 2017, le programme de médecine interne (MI) de l’Université de Calgary a testé la CPC. L’objectif de cette étude était : 1) d’évaluer si la rétroaction écrite des APC était exploitable, utile et perturbatrice pour le déroulement du travail; 2) d’évaluer le temps nécessaire pour mener à bien une APC. MéthodesSept APC d’acquisition des fondements de la discipline ont été utilisées chez 31 résidents de première année en MI de l’Université de Calgary. L’étude a utilisé des données quantitatives et qualitatives. Après avoir discuté d’une APC et terminé la rétroaction quantitative et écrite, les résidents ont été invités à faire des commentaires sur l’utilité de la rencontre et le degré de perturbation du déroulement du travail. Les évaluateurs ont accordé du temps pour compléter une APC. Les données ont été anonymisées. Les commentaires des stagiaires ont été codés en fonction de l’utilité et du degré de perturbation, et la rétroaction écrite des évaluateurs a été codée en fonction de l’exploitabilité. RésultatsAu total, 105 rencontres d’APC ont été soumises. La majorité des commentaires fournis aux stagiaires n’étaient pas exploitables (94,3 %, n = 99/105). Bien que la plupart des résidents n’aient pas fait de commentaires sur l’utilité (73,3 %, n = 77/105) ou la perturbation (44,8 %, n = 47/105) de la rencontre, ceux qui l’ont fait ont généralement trouvé les rencontres très utiles (25,7 %, n = 27/105) et non perturbatrices (35,2 %, n = 37/105). Une minorité a trouvé le processus inutile (1 %, n = 1/105) et perturbateur (20 %, n = 21/105). Le temps moyen pour remplir un formulaire d’APC et fournir une rétroaction était de 8,6 minutes. ConclusionLa plupart des rétroactions écrites n’étaient pas exploitables, ce qui suggère un rôle que pourrait jouer le perfectionnement du corps professoral afin de guider les évaluateurs et de les aider à encadrer les stagiaires qui effectuent les APC.

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Section: Discussionmentioning

confidence: 99%

Entrustable Professional Activities: An Analysis of Faculty Time, Trainee Perspectives and Actionability

David

Walsh

Lockyer

et al. 2021

Can Journ Gen Int Med

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“…This paper is Part 2 in the series on Diagnostic Radiology CBME implementation at Queen's University. 13…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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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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“…The current Diagnostic Radiology Objectives of Training will be replaced by a Competencies document that has a similar purpose and format, but uses the CanMEDS 2015 framework. 1 The overall aim is to meet societal needs and ensure that physicians achieve the competencies needed to provide effective, safe, and high-quality care. 2 Since radiologists primarily work in collaboration with other members of the healthcare team, strong communication and working relationships with referring physicians are integral to supporting optimal patient management and outcomes.…”

Section: Introductionmentioning

confidence: 99%

Which Aspects of the CanMEDS Competencies are Most Valued in Radiologists? Perspectives of Trainees From Other Specialties

et al. 2021

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Purpose: Radiologists work primarily in collaboration with other healthcare professionals. As such, these stakeholder perspectives are of value to the development and assessment of educational outcomes during the transition to competency-based medical education. Our aim in this study was to determine which aspects of the Royal College CanMEDS competencies for diagnostic radiology are considered most important by future referring physicians. Methods: Institutional ethics approval was obtained. After pilot testing, an anonymous online survey was sent to all residents and clinical fellows at our university. Open-ended questions asked respondents to describe the aspects of radiologist service they felt were most important. Thematic analysis of the free-text responses was performed using a grounded theory approach. The resulting themes were mapped to the 2015 CanMEDS Key Competencies. Results: 115 completed surveys were received from residents and fellows from essentially all specialties and years of training (out of 928 invited). Major themes were 1) timeliness and accessibility of service, 2) quality of reporting, and 3) acting as a valued team member. The competencies identified as important by resident physicians were largely consistent with the CanMEDS framework, although not all key competencies were covered in the responses. Conclusions: This study illustrates how CanMEDS roles and competencies may be exemplified in a concrete and specialty-specific manner from the perspective of key stakeholders. Our survey results provide further insight into specific objectives for teaching and assessing these competencies in radiology residency training, with the ultimate goal of improving patient care through strengthened communication and working relationships.

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Creating a Competency-Based Medical Education Curriculum for Canadian Diagnostic Radiology Residency (Queen’s Fundamental Innovations in Residency Education)—Part 1: Transition to Discipline and Foundation of Discipline Stages

Cited by 18 publications

References 26 publications

Entrustable Professional Activities: An Analysis of Faculty Time, Trainee Perspectives and Actionability

Entrustable Professional Activities: An Analysis of Faculty Time, Trainee Perspectives and Actionability

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

Which Aspects of the CanMEDS Competencies are Most Valued in Radiologists? Perspectives of Trainees From Other Specialties

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