The Impact of a National Competency-Based Medical Education Initiative in Family Medicine

Ellaway, Rachel; Mackay, Maria Palacios; Lee, Sonya; Hofmeister, Marianna; Malin, Greg; Archibald, Douglas; Lawrence, Katherine; Dogba, Joyce; Côté, Luc; Ross, Shelley

doi:10.1097/acm.0000000000002387

Cited by 24 publications

(42 citation statements)

References 13 publications

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“…Family medicine was one of the earliest adopters of CBME framework in Canada and the United States with its programs being implemented into residency training on a nationwide scale. 12,16,22,25,26 The challenge is that the studies that have focused on examining competency-based assessment tools (eg, identifying challenges, providing criteria, basic principles, and guidance for good assessment), 4,6,11,[27][28][29][30] have not paid sufficient attention to the overall implementation of assessment practices, particularly in family medicine. In other words, there are no studies that have thematically and systematically synthesized the current family medicine literature pertaining to the overall CBME assessment implementation and identified gaps in existing knowledge.…”

Section: Discussionmentioning

confidence: 99%

Implementing Competency-Based Medical Education in Family Medicine: A Narrative Review of Current Trends in Assessment

Danilovich

Kitto

Price

et al. 2021

Fam Med

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Background and Objectives: The implementation of effective competency-based medical education (CBME) relies on building a coherent and integrated system of assessment across the continuum of training to practice. As such, the developmental progression of competencies must be assessed at all stages of the learning process, including continuing professional development (CPD). Yet, much of the recent discussion revolves mostly around residency programs. The purpose of this review is to synthesize the findings of studies spanning the last 2 decades that examined competency-based assessment methods used in family medicine residency and CPD, and to identify gaps in their current practices. Methods: We adopted a modified form of narrative review and searched five online databases and the gray literature for articles published between 2000 and 2020. Data analysis involved mixed methods including quantitative frequency analysis and qualitative thematic analysis. Results: Thirty-seven studies met inclusion criteria. Fourteen were formal evaluation studies that focused on the outcome and impact evaluation of assessment methods. Articles that focused on formative assessment were prevalent. The most common levels of educational outcomes were performance and competence. There were few studies on CBME assessment among practicing family physicians. Thematic analysis of the literature identified several challenges the family medicine educational community faces with CBME assessment. Conclusions: We recommend that those involved in health education systematically evaluate and publish their CBME activities, including assessment-related content and evaluations. The highlighted themes may offer insights into ways in which current CBME assessment practices might be improved to align with efforts to improve health care.’

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Section: Discussionmentioning

confidence: 99%

Implementing Competency-Based Medical Education in Family Medicine: A Narrative Review of Current Trends in Assessment

Danilovich

Kitto

Price

et al. 2021

Fam Med

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show abstract

“…Authors in other contexts have also reported that educational innovations have resulted in an underappreciated increased administrative requirement necessitating additional time and effort from educational leaders. 14,15 We think this increased education-based administration, with its adverse impact on educational supervisors, deserves greater recognition in the design and implementation of future educational innovations in the workplace. Within our participants' context, we think ANZCA ought to advocate for increased time and administrative support for Supervisors of Training while seeking to simplify the administrative requirements where possible.…”

Section: Discussionmentioning

confidence: 99%

A balancing act: The Supervisor of Training role in anaesthesia education

Castanelli

Weller

Chander

et al. 2019

Anaesth Intensive Care

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In this qualitative study, we report how Supervisors of Training, educational supervisors overseeing the learning of anaesthesia trainees, experience their role in practice. Using purposive sampling, we interviewed Supervisors of Training from across Australia and New Zealand. The interviews began by asking ‘what do you see as your role as a Supervisor of Training?’ then explored the response in detail. Following the technique of thematic analysis, inductive analysis occurred as data were collected until we generated a thematic structure sufficient to address our research question after 19 interviews. In the first three of the four identified themes, Supervisors of Training perceived themselves as the fulcrum of the learning environment, ‘the something in between’. These three themes were: guiding and assessing trainees; identifying, supporting, and adjudicating trainee underperformance; and mediating trainees’ relationship with the hospital. Participants perceived themselves as a broker between trainees, their colleagues, their hospital, the Australian and New Zealand College of Anaesthetists and the community to varying degrees at different times. Negotiating these competing responsibilities required Supervisors of Training to manage multiple different relationships and entailed significant emotional work. Our fourth theme, scarcity, described the imbalance between these demands and the time and resources available. The complexity of the Supervisor of Training role and the tensions between these competing demands is underappreciated. Our findings would support strategies to mitigate the administrative load and share the decision-making burden of the role and to enhance the capability of Supervisors of Training by requiring formal training for the role.

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“…This led to some inconsistencies across programs. 13 As our experience with CBME deepens, we observe that competence, while necessary, may be insufficient on its own to ensure preparedness and uptake of comprehensive practice. What else is required?…”

Section: Lessons Learned?mentioning

confidence: 96%

“…This cultivated a sense of ownership, professional identity, purpose, and enthusiasm within the family medicine teaching community and spawned a generation of educational leaders. 13 Despite these important accomplishments, CBME does not appear to have moved the needle on our social accountability goals. Rural, indigenous, and inner-city populations are still underserved, with a maldistribution of family physicians and the scopes of practice and practice intentions of our graduates continuing to narrow.…”

Section: What Is Our Story?mentioning

confidence: 99%

The Evolution of Residency Training in Family Medicine: A Canadian Perspective

Fowler

Lemire

Oandasan

et al. 2021

Fam Med

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The Impact of a National Competency-Based Medical Education Initiative in Family Medicine

Abstract: Triple C has been successfully implemented across Canada but in differing ways and with different impacts.

Cited by 24 publications

References 13 publications

Implementing Competency-Based Medical Education in Family Medicine: A Narrative Review of Current Trends in Assessment

Implementing Competency-Based Medical Education in Family Medicine: A Narrative Review of Current Trends in Assessment

A balancing act: The Supervisor of Training role in anaesthesia education

The Evolution of Residency Training in Family Medicine: A Canadian Perspective

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