Trainee Perspectives on the Writing and Implementation of Milestones 2.0

Lim, Jonathan; Westerman, Mary E.; Stewart, Nancy H.; Correa, Ricardo; Eno, Celeste

doi:10.4300/jgme-d-20-00859.1

Cited by 5 publications

(3 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the growing appreciation for the importance of self-reflection, CCC structures often have under-developed mechanisms for celebrating and encouraging a dialectic between the resident’s developing skill of self-assessment and the recognized standards set forth by each specialty. 28 , 29 , 76 , 77 Self-regulated learning and professional accountability both depend on recognizing when one needs additional knowledge, enhanced skill, or direct assistance in order to deliver excellent care. Thus, a key prerequisite for independent practice is not only a collection of experience and demonstrated skills but also the ability to recognize gaps and opportunities, especially in regard to continually evolving professional standards.…”

Section: How Do Cccs Fare In Fulfilling These Goals?mentioning

confidence: 99%

“…77 This serves to incorporate the trainee perspective into the CCC and ensures the trainee is aware of the trajectory of competence progression in their chosen specialty. 76 , 77 CCCs will need to have a mechanism in place to address marked discrepancies, which can and should be discussed during the bi-annual program director-trainee meeting and during the process of co-producing the trainee’s ILP. 24 , 62…”

Section: How Do Cccs Fare In Fulfilling These Goals?mentioning

confidence: 99%

See 1 more Smart Citation

Reimagining the Clinical Competency Committee to Enhance Education and Prepare for Competency-Based Time-Variable Advancement

et al. 2022

View full text Add to dashboard Cite

Assessing residents and clinical fellows is a high-stakes activity. Effective assessment is important throughout training so that identified areas of strength and weakness can guide educational planning to optimize outcomes. Assessment has historically been underemphasized although medical education oversight organizations have strengthened requirements in recent years. Growing acceptance of competency-based medical education and its logical extension to competency-based time-variable (CB-TV) graduate medical education (GME) further highlights the importance of implementing effective evidence-based approaches to assessment. The Clinical Competency Committee (CCC) has emerged as a key programmatic structure in graduate medical education. In the context of launching a multi-specialty pilot of CB-TV GME in our health system, we have examined several program’s CCC processes and reviewed the relevant literature to propose enhancements to CCCs. We recommend that all CCCs fulfill three core goals, regularly applied to every GME trainee: (1) discern and describe the resident’s developmental status to individualize education, (2) determine readiness for unsupervised practice, and (3) foster self-assessment ability. We integrate the literature and observations from GME program CCCs in our institutions to evaluate how current CCC processes support or undermine these goals. Obstacles and key enablers are identified. Finally, we recommend ways to achieve the stated goals, including the following: (1) assess and promote the development of competency in all trainees, not just outliers, through a shared model of assessment and competency-based advancement; (2) strengthen CCC assessment processes to determine trainee readiness for independent practice; and (3) promote trainee reflection and informed self-assessment. The importance of coaching for competency, robust workplace-based assessments, feedback, and co-production of individualized learning plans are emphasized. Individual programs and their CCCs must strengthen assessment tools and frameworks to realize the potential of competency-oriented education.

show abstract

Section: How Do Cccs Fare In Fulfilling These Goals?mentioning

confidence: 99%

Section: How Do Cccs Fare In Fulfilling These Goals?mentioning

confidence: 99%

Reimagining the Clinical Competency Committee to Enhance Education and Prepare for Competency-Based Time-Variable Advancement

et al. 2022

View full text Add to dashboard Cite

show abstract

“…In particular, learners must be actively engaged in data gathering, demonstration of acquisition of competencies, and co-producing their learning plans. [18][19][20][21] Furthermore, their active participation in feedback-seeking, self-assessment, and self-reflection is essential to foster self-regulated learning behaviours for future independent practice. 22,23 Failure to do so could undermine the transformation to CBME.…”

Section: Introductionmentioning

confidence: 99%

A qualitative study of Canadian resident experiences with Competency-Based Medical Education

Day

Colbourne

et al. 2022

Can. Med. Ed. J

View full text Add to dashboard Cite

Background: Competency-based medical education (CBME) is an outcomes-based curricular paradigm focused on ensuring that graduates are competent to meet the needs of patients. Although resident engagement is key to CBME’s success, few studies have explored how trainees have experienced CBME implementation. We explored the experiences of residents in Canadian training programs that had implemented CBME. Methods: We conducted semi-structured interviews with 16 residents in seven Canadian postgraduate training programs, exploring their experiences with CBME. Participants were equally divided between family medicine and specialty programs. Themes were identified using principles of constructivist grounded theory. Results: Residents were receptive to the goals of CBME, but in practice, described several drawbacks primarily related to assessment and feedback. For many residents, the significant administrative burden and focus on assessment led to performance anxiety. At times, residents felt that assessments lacked meaning as supervisors focused on “checking-boxes” or provided overly broad, non-specific comments. Furthermore, they commonly expressed frustration with the perceived subjectivity and inconsistency of judgments on assessments, especially if assessments were used to delay progression to greater independence, contributing to attempts to "game the system". Faculty engagement and support improved resident experiences with CBME. Conclusion: Although residents value the potential for CBME to improve the quality of education, assessment and feedback, the current operationalization of CBME may not be consistently achieving these objectives. The authors suggest several initiatives to improve how residents experience assessment and feedback processes in CBME.

show abstract