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Faculty development in the age of competency-based medical education: A needs assessment of Canadian emergency medicine faculty and senior trainees

  • Alexandra Stefan (a1), Justin N. Hall (a1), Jonathan Sherbino (a2) and Teresa M. Chan (a2)

Abstract

Objectives

The Royal College of Physicians and Surgeons of Canada (RCPSC) emergency medicine (EM) programs transitioned to the Competence by Design training framework in July 2018. Prior to this transition, a nation-wide survey was conducted to gain a better understanding of EM faculty and senior resident attitudes towards the implementation of this new program of assessment.

Methods

A multi-site, cross-sectional needs assessment survey was conducted. We aimed to document perceptions about competency-based medical education, attitudes towards implementation, perceived/prompted/unperceived faculty development needs. EM faculty and senior residents were nominated by program directors across RCPSC EM programs. Simple descriptive statistics were used to analyse the data.

Results

Between February and April 2018, 47 participants completed the survey (58.8% response rate). Most respondents (89.4%) thought learners should receive feedback during every shift; 55.3% felt that they provided adequate feedback. Many respondents (78.7%) felt that the ED would allow for direct observation, and most (91.5%) participants were confident that they could incorporate workplace-based assessments (WBAs). Although a fair number of respondents (44.7%) felt that Competence by Design would not impact patient care, some (17.0%) were worried that it may negatively impact it. Perceived faculty development priorities included feedback delivery, completing WBAs, and resident promotion decisions.

Conclusions

RCPSC EM faculty have positive attitudes towards competency-based medical education-relevant concepts such as feedback and opportunities for direct observation via WBAs. Perceived threats to Competence by Design implementation included concerns that patient care and trainee education might be negatively impacted. Faculty development should concentrate on further developing supervisors’ teaching skills, focusing on feedback using WBAs.

Introduction

Les programmes de médecine d'urgence (MU) du Collège royal des médecins et chirurgiens du Canada sont passés, en juillet 2018, à un nouveau modèle de formation appelé Compétence par conception. Avant ce passage, une enquête avait été menée à l’échelle nationale pour dégager une meilleure compréhension des attitudes du personnel enseignant et des résidents séniors en MU à l’égard de la mise en œuvre du nouveau programme d’évaluation.

Méthode

Il s'agit d'une enquête transversale et multicentrique sur l’évaluation des besoins. Elle visait à recueillir des renseignements sur les perceptions des personnes concernées sur la formation médicale axée sur les compétences, sur leurs attitudes à l’égard de la mise en application du programme ainsi que sur les besoins perçus, suscités ou inaperçus du personnel en matière de perfectionnement. Les membres du personnel enseignant en MU et les résidents séniors ont été désignés par les directeurs de tous les programmes de MU du Collège royal. Les données ont été analysées à l'aide de simples statistiques descriptives.

Résultats

Au total, 47 participants ont rempli le questionnaire d'enquête (taux de réponse : 58,8%) entre février et avril 2018. La plupart des répondants (89,4%) ont indiqué que les apprenants devraient recevoir de la rétroaction à tous les postes de travail, et 55,3% avaient l'impression de donner une rétroaction adéquate. Bon nombre de répondants (78,7%) étaient également d'avis que les services des urgences se prêtaient bien à l'observation directe, et la plupart des participants (91,5%) avaient bon espoir d'intégrer les évaluations en milieu de travail (EMT). Par ailleurs, si un assez bon nombre de répondants (44,7%) croyaient que la formation axée sur la Compétence par conception n'aurait aucune incidence sur les soins aux patients, d'autres (17,0%) s'en inquiétaient. Enfin, les priorités perçues en matière de perfectionnement du personnel comprenaient la communication des rétroactions, la réalisation des EMT et les décisions relatives à la promotion des résidents.

Conclusion

Le personnel enseignant en MU du Collège royal a des attitudes favorables à l’égard de certains concepts liés à la formation médicale axée sur les compétences, tels que les rétroactions et les possibilités d'observation directe au moyen des EMT. Par contre, la mise en œuvre du programme de Compétence par conception suscite également des craintes, comme une incidence défavorable sur les soins aux patients et la formation des stagiaires. Le perfectionnement du personnel enseignant devrait donc porter davantage sur les aptitudes à enseigner des superviseurs, notamment sur la communication des rétroactions à l'aide des EMT.

Copyright

Corresponding author

Correspondence to: Dr. Teresa Chan, 2nd Floor, McMaster Clinics, 237 Barton St. E., Hamilton, ON L8L 2X2; Email: teresa.chan@medportal.ca; Twitter: @TChanMD

References

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1.Sherbino, J, Snell, L, Dath, D, et al. A national clinician-educator program: a model of an effective community of practice. Med Educ Online 2010;15:18.
2.Frank, JR, Snell, LS, Cate O Ten, , et al. Competency-based medical education: theory to practice. Med Teach 2010;32(8):63845.
3.Snell, LS, Frank, JR. Competencies, the tea bag model, and the end of time. Med Teach 2010;32(8):629–30.
4.Carraccio, CL, Englander, R. From Flexner to competencies: reflections on a decade and the journey ahead. Acad Med 2013;88(8):1067–73.
5.Ferguson, PC, Caverzagie, KJ, Nousiainen, MT, Snell, L. Changing the culture of medical training: an important step toward the implementation of competency-based medical education. Med Teach 2017;39(6):599602.
6.Holmboe, ES, Sherbino, J, Englander, R, et al. A call to action: the controversy of and rationale for competency-based medical education. Med Teach 2017;39(6):574–81.
7.Caverzagie, KJ, Nousiainen, MT, Ferguson, PC, et al. Overarching challenges to the implementation of competency-based medical education. Med Teach 2017;39(6):588–93.
8.Frank, JR, Snell, L, Englander, R, Holmboe, ES. Implementing competency-based medical education: moving forward. Med Teach 2017;39(6):568–73.
9.Lockyer, J, Carraccio, C, Chan, MK, et al. Core principles of assessment in competency-based medical education. Med Teach 2017;39(6):609–16.
10.Hodges, BD. A tea-steeping or i-Doc model for medical education? Academic Medicine. 2010;85(9):S3444.
11.Carraccio, C, Englander, R, Melle, E Van, et al. Advancing competency-based medical. 2016;91(5):645–9.
12.Cooney, R, Chan, TM, Gottlieb, M, et al. Academic Primer Series: key papers about competency-based medical education. West J Emerg Med 2017;18(4):713–20.
14.Royal College of Physicians and Surgeons of Canada. Competence by Design (CBD); 2014. Available at: http://www.royalcollege.ca/portal/page/portal/rc/common/documents/canmeds/cbd/what_is_cbd_e.pdf (accessed April 8, 2019).
15.Future of Medical Education in Canada. Postgraduate Project; 2010. Available at: http://www.afmc.ca/future-of-medical-education-in-canada/postgraduate-project/pdf/FMEC_PG_Public_Report-FINAL_EN.pdf.
16.Royal College of Physicians and Surgeons of Canada. Competency by Design; 2015. Available at: http://www.royalcollege.ca/portal/page/portal/rc/common/documents/canmeds/cbd/what_is_cbd_e.pdf (accessed February 28, 2016).
17.Bandiera, G, Lendrum, D. Dispatches from the front: emergency medicine teachers’ perceptions of competency-based education. CJEM 2011;13(3):155–61.
18.Frank, JR, Snell, L, Sherbino, J. The draft CanMEDS 2015 physician competency framework–series IV. Ottawa: The Royal College of Physicians and Surgeons of Canada; 2014.
19.Bandiera, G, Lendrum, D. Daily encounter cards facilitate competency-based feedback while leniency bias persists. CJEM 2008;10(1):4450.
20.Sherbino, J, Kulasegaram, K, Worster, A, Norman, GR. The reliability of encounter cards to assess the CanMEDS roles. Adv Heal Sci Educ 2013;18(5):987–96.
21.Chan, TM, Jo, D, Shih, AW, et al. The Massive Online Needs Assessment (MONA) to inform the development of an emergency haematology educational blog series. Perspect Med Educ 2018;7(3):219–23.
22.Tseng, EK, Jo, D, Shih, AW, et al. Window to the unknown: using storytelling to identify learning needs for the intrinsic competencies within an online needs assessment. AEM Educ Train 2019;3:179–87.
23.Dilman, DA. Mail and Internet surveys: the tailored design method. New York, NY: Wiley; 2000.
24.Bandiera, G. How do I improve the quality of in-training assessment of learners? CJEM 2011;13(4):267–72.
25.Brown, GM, Lang, E, Patel, K, et al. A National Faculty Development Needs Assessment in Emergency Medicine. CJEM 2016;18(3):161–82.
26.Thurgur, L, Bandiera, G, Lee, S, Tiberius, R. What do emergency medicine learners want from their teachers? A multicenter focus group analysis. Acad Emerg Med 2005;12(9):856–61.
27.Bandiera, G, Lee, S, Tiberius, R. Creating effective learning in today's emergency departments: how accomplished teachers get it done. Ann Emerg Med 2005;45(3):253–61, doi:10.1016/j.annemergmed.2004.08.007.
28.Chan, TM, Dewark, K Van, Sherbino, J, et al. Failure to flow: an exploration of learning and teaching in busy, multi-patient environments using an interpretive description method. Perspect Med Educ 2017;6(6):380–7.
29.Li, S, Sherbino, J, Chan, TM. McMaster Modular Assessment Program (McMAP) through the years: residents’ experience with an evolving feedback culture over a 3-year period. AEM Educ Train 2017;1(1):514.
30.Dayal, A, O'Connor, DM, Qadri, U, Arora, VM. Comparison of male vs female resident milestone evaluations by faculty during emergency medicine residency training. JAMA Intern Med 2017;177(5):651.
31.Chan, T, Sherbino, J. The McMaster Modular Assessment Program (McMAP). Acad Med 2015;90(7):900–5.
32.Sebok-Syer, SS, Klinger, DA, Sherbino, J, Chan, TM. Mixed messages or miscommunication? Investigating the relationship between assessors? Workplace-based assessment scores and written comments. Acad Med 2017;92(12):1774–9.
33.McConnell, M, Sherbino, J, Chan, TM. Mind the gap: the prospects of missing data. J Grad Med Educ 2016;8(5):708–12.
34.Chan, TM, Sherbino, J, Mercuri, M. Nuance and noise: lessons learned from longitudinal aggregated assessment data. J Grad Med Educ 2017;9(6):724–9.
35.Hall, AK, Rich, J, Dagnone, J, et al. P061: implementing in emergency medicine: lessons learned from the first 6 months of transition at Queen's University A. CJEM 2018;20(S1):S78.
36.Dweck, CS. Mindset. 1st ed. New York: Penguin Random House LLC; 2003.

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Faculty development in the age of competency-based medical education: A needs assessment of Canadian emergency medicine faculty and senior trainees

  • Alexandra Stefan (a1), Justin N. Hall (a1), Jonathan Sherbino (a2) and Teresa M. Chan (a2)

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