Assessment - Royal College

Implementing a Competency-Based Curriculum in a
Pediatric Training Program
Author: Moyez Ladhani
Date: October 25, 2014
I do not have an affiliation (financial or otherwise)
with a pharmaceutical, medical device or
communications organization.
Je n’ai aucune affiliation (financière ou autre)
avec une entreprise pharmaceutique, un fabricant
d’appareils médicaux ou un cabinet de communication.
Author: Lorem ipsum dolor sit
Date: Dolor sit am
CBE| Ladhani
Three Take Home Points
• Many organizations are moving to a competency-based
education model in place of the historical time-based
model
• Competency-based education hopes to develop a
competent holistic physician and makes sense
• Key to success:
» Stepwise approach
» The proper assessment of learners
» The development of the assessors i.e. the faculty
» Involve the key stakeholders
» You have many of the tools already
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
3
CBE| Ladhani
• Dr. Lucy Giglia
• Dr. Moyez Ladhani
• Dr. Julia Frei
• Dr. Andrea Hunter
• Dr. Natasha Johnson
• Dr. Kim Genier
• Dr. Katrin Scheinemann
• Dr. Anne Moffat
• Dr. April Kam
• Dr. Willa Liao
• Dr. Audrey Lim
• Shirley Ferguson
• Dr. Anne Niec
• Adrianna Flaiani
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
4
CBE| Ladhani
Introduction:
• The year 2005
• Congratulations you have been selected as the Pediatric
Program director
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
5
CBE| Ladhani
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
6
CBE| Ladhani
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
7
CBE| Ladhani
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
8
* Apologies for cross posting *
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
9
CBE| Ladhani
Goals:
1. Implement a competency-based curriculum into the
McMaster University, pediatric residency program.
1. Develop a tool, the Mini Milestones Assessment (MiniMAS) to assess intrinsic medical competencies and
progression through milestones using the Dreyfus
Developmental Model.
1. Test the psychometric theories to assess the reliability,
validity, acceptability and feasibility of the Mini-MAS tool.
1. FIRE: Fundamental Innovations in Residency Education.
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
10
CBE| Ladhani
Goals:
1. Implement a competency-based curriculum into the
McMaster University, pediatric residency program.
1. Develop a tool, the Mini Milestones Assessment (Mini-MAS)
to assess intrinsic medical competencies and progression
through milestones using the Dreyfus Developmental Model.
1. Test the psychometric theories to assess the reliability,
validity, acceptability and feasibility of the Mini-MAS tool.
1. FIRE: Fundamental Innovations in Residency Education.
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
11
CBE| Ladhani
CBME
• Competency-based education is an approach to preparing
physicians for practice that is fundamentally oriented to
graduate outcome abilities and organized around
competencies derived from an analysis of societal and
patient needs. It deemphasizes time-based training and
promises greater accountability, flexibility, and learner
centeredness (p636)
•
Frank, J. R., Mungroo, R., Ahmad, Y., Wang, M., De Rossi, S., & Horsley, T. (2010). Toward a
definition of competency-based education in medicine: A systematic review of published
definitions. Medical Teacher, 32(8), 631-637.
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
12
CBE| Ladhani
Tea- Steeping model
• The current model of education is a time-based model.
Hodges describes this as the “tea-steeping model”: “we
put the student (tea) in medical school (hot water) for a
fixed period of time and voila! After a historically
determined interval of time, we assume a competent
practitioner, like a good cup of tea, will result”
•
Hodges, B. D. (2010). A tea-steeping or i-doc model for medical education?. Academic Medicine,
85(9 Suppl), S34-44.
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
13
CBE| Ladhani
The Analogy
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
14
CBE| Ladhani
Ostrich, Peacock and the Beaver
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
17
CBE| Ladhani
What the beaver must do
• Statement of learning outcome
• Communication with staff and students
• Educational strategies
• Learning opportunities
• Course content
• Student progression
• Assessment
• Educational environment
• Student selection
•
Harden, R. M. (2007). Outcome-based education--the ostrich, the peacock and the beaver.
Medical Teacher, 29(7), 666-671.
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
18
CBE| Ladhani
What the beaver must do
• Statement of learning outcome
• Communication with staff and students
• Educational strategies
• Learning opportunities
• Course content
• Student progression
• Assessment
• Educational environment
• Student selection
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
19
CBE| Ladhani
2013-2014
• A two-day retreat was initially held to develop the
curriculum;
• Members of the residency training committee including
general pediatric faculty and resident representatives from
each year were present.
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
20
CBE| Ladhani
2013-2014
• The curriculum was started for only the general pediatric rotations
as a pilot and to limit the number of faculty involved.
• The PGY 1 residents’ General Pediatric experiences ( 22 weeks)
» CTU-4 weeks
» Community Brampton-4 weeks
» Community St. Joseph’s Healthcare-4 weeks
» CTU Waterloo-4 weeks
» Float call at McMaster-6 weeks
• Occurred in the form of competency-based education with learning
outcomes, milestones and assessment.
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
21
CBE| Ladhani
Learning Outcomes
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
22
CBE| Ladhani
Learning Outcomes
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
23
CBE| Ladhani
What the beaver must do
• Statement of learning outcome
• Communication with staff and students
• Educational strategies
• Learning opportunities
• Course content
• Student progression
• Assessment
• Educational environment
• Student selection
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
24
CBE| Ladhani
Educational strategies
• The residents had exposure to a variety of clinical
situations and teaching sessions.
• Clinical Exposure-Total 22 weeks:
» CTU-4 weeks
» Community Brampton-4 weeks
» Community St. Joseph’s Healthcare-4 weeks
» CTU Waterloo-4 weeks
» Float call at McMaster-6 weeks
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
25
CBE| Ladhani
Learning opportunities
»
Academic Half Day including
Clinical Skills Days
Faculty Development Courses
Department Conferences
»
Simulation
»
Longitudinal CanMEDS
Neonatal Resuscitation Program
(NRP)/ Pediatric Advanced Life
Support (PALS) courses
Competencies (LCC)
»
Journal Club
»
Department Grand Rounds
Case Based Teaching Sessions
(self directed)
»
Division of General Pediatrics
Mac at Night Curriculum
Grand Rounds
PREP The Curriculum
»
Morbidity and Mortality Rounds
»
CTU Teaching Sessions
Self Directed Modules: CPSO,
RCPSC, CPS and Pedialink
»
Subspecialty Rounds
Peer and Faculty Mentors
»
Work in Progress
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
26
CBE| Ladhani
Student Progression and Assessment
• Student progression was based on a comprehensive
assessment program.
• The PGY 1 resident had to meet the milestones and
objectives successfully.
• The competency-based medical education (CBME)
curriculum was considered a comprehensive block of 22
weeks and thus they had the full time period to achieve
the stated objectives.
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
27
CBE| Ladhani
Student Progression and Assessment
• Assessments at the end of each rotation block were
formative to allow the resident to reflect on areas of
improvement.
• At the end of their 22 weeks, all assessments were
reviewed to see if the learner had met their objectives and
reached the appropriate milestones.
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
28
CBE| Ladhani
Student Progression and Assessment
• Objective Structured Clinical exam (OSCE) twice a year.
• Multiple Choice Questions (MCQ) and Short Answer
Questions (SAQ) twice a year.
• American Board of Pediatrics (ABP) In Training Exam, an
MCQ exam held annually
• STACER
• Portfolio
• Multi-Source Feedback (MSF)
• Procedure Log Book
• End of Rotation Evaluation
• Mini-MAS
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
29
CBE| Ladhani
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
30
CBE| Ladhani 2 a week, one competency at a time, 6 competencies 40-44
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
31
CBE| Ladhani
Three Take Home Points
• Many organizations are moving to a competency-based
education model in place of the historical time-based
model
• Competency-based education hopes to develop a
competent holistic physician and makes sense
• Key to success:
» Stepwise approach
» The proper assessment of learners
» The development of the assessors i.e. the faculty
» Involve the key stakeholders
» You have many of the tools already
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
32
Questions/Discussion
The International Conference on Residency Education
|
La Conférence internationale sur la formation des résidents
33
Help us improve.
Aidons-nous à nous améliorer.
Your input matters.
Votre opinion compte.
• Download the ICRE App,
• Téléchargez l’application de la CIFR
• Visit the evaluation area in
Pre-function Hall B, near
Registration, or
• Visitez la zone d’évaluation, au
vestibule de la salle B, près du
kiosque d’inscription, ou
• Go to: http://www.royalcollege.ca/
icreevaluations to complete the
session evaluation.
• Visitez le http://www.collegeroyal
.ca/evaluationscifr afin de remplir
une évaluation de la séance.
You could be entered
to win 1 of 3
$100 gift cards.
Vous courrez la chance de gagner
l’un des trois chèques-cadeaux
d’une valeur de 100 $.

Download Report