Resident perceptions of Competency-Based Medical Education

Abstract

Background: Residency training programs in Canada are undergoing a mandated transition to competency-based medical education (CBME). There is limited literature regarding resident perspectives on CBME. As upper year residents act as mentors and assessors for incoming cohorts, and are themselves key stakeholders in this educational transition, it is important to understand how they view CBME. We examined how residents who are not currently enrolled in a competency-based program view that method of training, and what they perceive as potential advantages, disadvantages, and considerations regarding its implementation.
 Methods: Sixteen residents volunteered to participate in individual semi-structured interviews, with questions focussing on participants’ knowledge of CBME and its implementation. We used a grounded theory approach to develop explanations of how residents perceive CBME.
 Results: Residents anticipated improved assessment and feedback, earlier identification of residents experiencing difficulties in training, and greater flexibility to pursue self-identified educational needs. Disadvantages included logistical issues surrounding CBME implementation, ability of attending physicians to deliver CBME-appropriate feedback, and the possibility of assessment fatigue. Clear, detailed communication and channels for resident feedback were key considerations regarding implementation.
 Conclusions: Resident views align with educational experts regarding the practical challenges of implementation. Expectations of improved assessment and feedback highlight the need for both residents and attending physicians to be equipped in these domains. Consequently, faculty development and clear communication will be crucial aspects of successful transitioning to CBME.

Overcoming The Barriers To Implementation Of Competence-Based Medical Education: A Narrative Literature Review

“…There were surveys looking at perceptions of faculty and residents 11 , faculty needs assessment 12 , and program preparedness 13 . Two studies used qualitative interviews to explore perceptions of residents 14 and both residents and faculty 15 . Finally, there were two case studies of a single program, one in the emergency department 16 and one in anesthesiology 17 .…”

“…Another frequently raised concern was commitment and engagement from the faculty and residents directly impacted by CBME 14,15,17 . Dagnone et al 9 promoted the need for centralized institutional governance and support for CBME, with the appropriate allocation of nancial support, time, and educational resources.…”

Perceptions on Competence by Design in urology

“…These findings correlate well with previous qualitative studies. 6,7 However, when discussing this benefit, Boet et al cautions us that one must also note and understand the ambiguity surrounding definitions of 'competence'. 6…”

“…6 Similar findings were demonstrated by Mann et al in a preliminary study of residents on their perceptions of CBD. 7 In the United States, members of the Residency Review Committee for Urology 8 highlighted the paucity of effective evaluation tools and lack of evidence that these changes will ultimately improve the training of residents. Despite these uncertainties, all urology residency training programs will be making the transition to CBD.…”

Analyzing the Administrative Burden of Competency Based Medical Education

“…4 The competency-based model defines clear sequential stages for specialty training as well as stage-specific objectives for learning progression. 4 The assessment framework integrates multiple assessments of resident performance for specific competencies with both direct and indirect observation in clinical settings. 5 A variety of faculty participate in the assessment process, allowing for diverse perspectives on performance.…”