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Jarrett JB, Elmes AT, Keller E, Stowe CD, Daugherty KK. Evaluating the Strengths and Barriers of Competency-Based Education in the Health Professions. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100709. [PMID: 38729616 DOI: 10.1016/j.ajpe.2024.100709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/30/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE This study aimed to define competency-based education (CBE) for pharmacy education and describe how strengths and barriers of CBE can support or hinder implementation. FINDINGS Sixty-five studies were included from a variety of health professions in order to define competency based pharmacy education (CBPE) and identify barriers and benefits from the learner, faculty, institution, and society perspectives. From the 7 identified thematic categories, a CBPE definition was developed: "Competency-based pharmacy education is an outcomes-based curricular model of an organized framework of competencies (knowledge, skills, attitudes) for pharmacists to meet health care and societal needs. This learner-centered curricular model aligns authentic teaching and learning strategies and assessment (emphasizing workplace assessment and quality feedback) while deemphasizing time." SUMMARY This article provides a definition of CBE for its application within pharmacy education. The strengths and barriers for CBE were elucidated from other health professions' education literature. Identified implementation strengths and barriers aid in the discussions on what will support or hinder the implementation of CBE in pharmacy education.
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Affiliation(s)
- Jennie B Jarrett
- University of Illinois Chicago College of Pharmacy, Department of Pharmacy Practice, Chicago, IL, USA
| | - Abigail T Elmes
- University of Illinois Chicago College of Pharmacy, Department of Pharmacy Practice, Chicago, IL, USA
| | - Eden Keller
- University of Illinois Chicago College of Pharmacy, Department of Pharmacy Practice, Chicago, IL, USA
| | - Cindy D Stowe
- University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR, USA
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Daugherty KK, Chen A, Churchwell MD, Jarrett JB, Kleppinger EL, Meyer S, Nawarskas J, Sibicky SL, Stowe CD, Rhoney DH. Competency-based pharmacy education definition: What components need to be defined to implement it? AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100624. [PMID: 37952584 DOI: 10.1016/j.ajpe.2023.100624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVES This study aimed to define the essential elements in the proposed competency-based pharmacy education (CBPE) definition, provide the key defining components of each essential element on the basis of educational theory and evidence, and define how the essential elements meet the identified needs for CBPE. METHODS best-practice integrative review was conducted as part of the work of the American Association of Colleges of Pharmacy CBPE Task Force to define the essential elements in the CBPE definition and how these elements fit with the need for CBPE. The definition was compared with other published competency-based education definitions across K-12, higher education, medical education, and veterinary education. Task Force members then met to develop a consensus on the core components of the 5 essential elements in the definition. Next, the Task Force evaluated the fit of CBPE by matching the identified needs, discussed in detail elsewhere, across each of the stakeholder perspectives with the core components of the 5 essential elements in the derived definition of CBPE. FINDINGS Upon review of the proposed CBPE definition, the Task Force identified 5 essential elements. These elements include the following: meeting health care and societal needs, outcomes-based curricular model, de-emphasized time, learner-centered culture, and authentic teaching and learning strategies aligned to assessments. SUMMARY This article helps to establish a common language for CBPE by defining the essential elements of the core components of the definition, and provides a starting point for further exploration of CBPE.
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Affiliation(s)
- Kimberly K Daugherty
- Sullivan University College of Pharmacy and Health Sciences, Louisville, KY, USA
| | - Aleda Chen
- Cedarville University, School of Pharmacy, Cedarville, OH, USA
| | - Marianne D Churchwell
- University of Toledo, College of Pharmacy and Pharmaceutical Sciences, Toledo, OH, USA
| | - Jennie B Jarrett
- University of Illinois Chicago, College of Pharmacy, Department of Pharmacy Practice, Chicago, IL, USA
| | | | | | - James Nawarskas
- University of New Mexico, College of Pharmacy, Albuquerque, NM, USA
| | - Stephanie L Sibicky
- Northeastern University, School of Pharmacy and Pharmaceutical Sciences, Boston, MA, USA
| | - Cindy D Stowe
- University of Arkansas for Medical Sciences, College of Pharmacy, Little Rock, AR, USA
| | - Denise H Rhoney
- University of North Carolina at Chapel Hill, Eshelman School of Pharmacy, Chapel Hill, NC, USA.
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Martin L, Blissett S, Johnston B, Tsang M, Gauthier S, Ahmed Z, Sibbald M. How workplace-based assessments guide learning in postgraduate education: A scoping review. MEDICAL EDUCATION 2023; 57:394-405. [PMID: 36286100 DOI: 10.1111/medu.14960] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/16/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Competency-based medical education (CBME) led to the widespread adoption of workplace-based assessment (WBA) with the promise of achieving assessment for learning. Despite this, studies have illustrated tensions between the summative and formative role of WBA which undermine learning goals. Models of workplace-based learning (WBL) provide insight, however, these models excluded WBA. This scoping review synthesizes the primary literature addressing the role of WBA to guide learning in postgraduate medical education, with the goal of identifying gaps to address in future studies. METHODS The search was applied to OVID Medline, Web of Science, ERIC and CINAHL databases, articles up to September 2020 were included. Titles and abstracts were screened by two reviewers, followed by a full text review. Two members independently extracted and analysed quantitative and qualitative data using a descriptive-analytic technique rooted in Billett's four premises of WBL. Themes were synthesized and discussed until consensus. RESULTS All 33 papers focused on the perception of learning through WBA. The majority applied qualitative methodology (70%), and 12 studies (36%) made explicit reference to theory. Aligning with Billett's first premise, results reinforce that learning always occurs in the workplace. WBA helped guide learning goals and enhanced feedback frequency and specificity. Billett's remaining premises provided an important lens to understand how tensions that existed in WBL have been exacerbated with frequent WBA. As individuals engage in both work and WBA, they are slowly transforming the workplace. Culture and context frame individual experiences and the perceived authenticity of WBA. Finally, individuals will have different goals, and learn different things, from the same experience. CONCLUSION Analysing WBA literature through the lens of WBL theory allows us to reframe previously described tensions. We propose that future studies attend to learning theory, and demonstrate alignment with philosophical position, to advance our understanding of assessment-for-learning in the workplace.
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Affiliation(s)
- Leslie Martin
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sarah Blissett
- Department of Medicine, Western University, London, Ontario, Canada
| | - Bronte Johnston
- McMaster Education Research, Innovation, and Theory Program, McMaster University, Hamilton, Ontario, Canada
| | - Michael Tsang
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Stephen Gauthier
- Department of Medicine, Queens University, Kingston, Ontario, Canada
| | - Zeeshan Ahmed
- Department of Medicine, Ottawa University, Ottawa, Ontario, Canada
| | - Matthew Sibbald
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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Waheed S, Maursetter L. Evaluation Evolution: Designing Optimal Evaluations to Enhance Learning in Nephrology Fellowship. Adv Chronic Kidney Dis 2022; 29:526-533. [PMID: 36371117 DOI: 10.1053/j.ackd.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/26/2022] [Accepted: 06/28/2022] [Indexed: 11/10/2022]
Abstract
Evaluations serve as the backbone of any educational program and can be broadly divided into formative and summative evaluations. Formative evaluations are "just in time" evaluations focused on informing the learning process, whereas summative evaluations compare fellows to a preset standard to determine their readiness for unsupervised practice. In the nephrology fellowship programs, evaluations assess competence in the framework of ACGME Milestones 2.0. A variety of learning venues, evaluators, and tools should be incorporated into the measurement process. It is important to determine which milestones can be best assessed in each education venue to decrease the burden of assessment fatigue. Additionally, programs can diversify the evaluators to include nurses, medical students, peers, and program coordinators in addition to faculty to provide a well-rounded assessment of the fellows and share the assessment burden. Lastly, the evaluation data should be presented to fellows in a format where it can inform goal setting. The evaluation system needs to evolve along with the changes being made in curriculum design. This will help to make fellowship learning effective and efficient.
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Affiliation(s)
- Sana Waheed
- Piedmont Nephrology and Internal Medicine, Atlanta, GA
| | - Laura Maursetter
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI.
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Anderson HL, Kurtz J, West DC. Implementation and Use of Workplace-Based Assessment in Clinical Learning Environments: A Scoping Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:S164-S174. [PMID: 34406132 DOI: 10.1097/acm.0000000000004366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE Workplace-based assessment (WBA) serves a critical role in supporting competency-based medical education (CBME) by providing assessment data to inform competency decisions and support learning. Many WBA systems have been developed, but little is known about how to effectively implement WBA. Filling this gap is important for creating suitable and beneficial assessment processes that support large-scale use of CBME. As a step toward filling this gap, the authors describe what is known about WBA implementation and use to identify knowledge gaps and future directions. METHOD The authors used Arksey and O'Malley's 6-stage scoping review framework to conduct the review, including: (1) identifying the research question; (2) identifying relevant studies; (3) study selection; (4) charting the data; (5) collating, summarizing, and reporting the results; and (6) consulting with relevant stakeholders. RESULTS In 2019-2020, the authors searched and screened 726 papers for eligibility using defined inclusion and exclusion criteria. One hundred sixty-three met inclusion criteria. The authors identified 5 themes in their analysis: (1) Many WBA tools and programs have been implemented, and barriers are common across fields and specialties; (2) Theoretical perspectives emphasize the need for data-driven implementation strategies; (3) User perceptions of WBA vary and are often dependent on implementation factors; (4) Technology solutions could provide useful tools to support WBA; and (5) Many areas of future research and innovation remain. CONCLUSIONS Knowledge of WBA as an implemented practice to support CBME remains constrained. To remove these constraints, future research should aim to generate generalizable knowledge on WBA implementation and use, address implementation factors, and investigate remaining knowledge gaps.
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Affiliation(s)
- Hannah L Anderson
- H.L. Anderson is research associate, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; ORCID: http://orcid.org/0000-0002-9435-1535
| | - Joshua Kurtz
- J. Kurtz is a first-year resident, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Daniel C West
- D.C. West is professor of pediatrics, The Perelman School of Medicine at the University of Pennsylvania, and associate chair for education and senior director of medical education, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; ORCID: http://orcid.org/0000-0002-0909-4213
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Aryal K, Hamed M, Currow C. The usefulness of work-based assessments in higher surgical training: A systematic review. Int J Surg 2021; 94:106127. [PMID: 34597821 DOI: 10.1016/j.ijsu.2021.106127] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 09/09/2021] [Accepted: 09/23/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Work-based assessments including procedure based assessments, case based discussions, clinical evaluation exercises and direct observation of procedural skills are used in Higher Surgical Training Program. This systematic review aims to investigate the trainer and trainee's perception of the usefulness of workplace based assessments in Higher Surgical Training Programme. MATERIALS AND METHODS Embase, MEDLINE and PubMed databases were searched for relevant studies published up to Jan 15, 2021. The following search terms were used: procedure based assessments, case based discussions, clinical evaluation exercises, direct observation of procedural skills, Higher Surgical Training Program (with and without their abbreviations), surgical training, formative assessment. Usefulness was analysed according to van der Vleuten's utility formula, which is the product of educational impact, validity, reliability, acceptability, cost-effectiveness and feasibility. RESULTS 23 studies were included; Six on procedure based assessments, two on case based discussions, one on mini clinical evaluation exercises, three on direct observation of procedural skills and eleven on multiple methods. Overall, procedure based assessments had positive Kirkpatrick level 1 or 2 impact were valid, reliable and acceptable. Mini clinical evaluation exercises showed positive Kirkpatrick level 1 satisfaction in trainees and trainers and were feasible. Case based discussions were shown to have both positive and negative Kirkpatrick levels 1 and 2 impact and were rated valid and reliable. Direct observation of procedural skills were valid with favourable Kirkpatrick level 1 impact with more usage and modification of the forms. Multiple methods as used in the intercollegiate surgical curriculum programme portfolio was found to be less encouraging in achieving positive higher level of educational impact. The barriers included lack of time, lack of faculty development and lack of engagement. CONCLUSION It is important that work-based assessments are used properly, so that trainees get the maximum benefit from them. None of the studies included in our systematic review demonstrated an impact on behaviour or society (Kirkpatrick level 3 and 4), towards which future research should be directed to.
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Affiliation(s)
- Kamal Aryal
- Department of General Surgery, James Paget University Hospital, Great Yarmouth, NR31 6LA, UK
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Mishra S, Chung A, Rogoza C, Islam O, Mussari B, Wang X, Dagnone D, Cofie N, Dalgarno N, Kwan BYM. Creating a Competency-Based Medical Education Curriculum for Canadian Diagnostic Radiology Residency (Queen's Fundamental Innovations in Residency Education)-Part 2: Core of Discipline Stage. Can Assoc Radiol J 2021; 72:678-685. [PMID: 33656945 DOI: 10.1177/0846537121993058] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE All postgraduate residency programs in Canada are transitioning to a competency-based medical education (CBME) model divided into 4 stages of training. Queen's University has been the first Canadian institution to mandate transitioning to CBME across all residency programs, including Diagnostic Radiology. This study describes the implementation of CBME with a focus on the third developmental stage, Core of Discipline, in the Diagnostic Radiology residency program at Queen's University. We describe strategies applied and challenges encountered during the adoption and implementation process in order to inform the development of other CBME residency programs in Diagnostic Radiology. METHODS At Queen's University, the Core of Discipline stage was developed using the Royal College of Physicians and Surgeons of Canada's (RCPSC) competence continuum guidelines and the CanMEDS framework to create radiology-specific entrustable professional activities (EPAs) and milestones for assessment. New committees, administrative positions, and assessment strategies were created to develop these assessment guidelines. Currently, 2 cohorts of residents (n = 6) are enrolled in the Core of Discipline stage. RESULTS EPAs, milestones, and methods of evaluation for the Core of Discipline stage are described. Opportunities during implementation included tracking progress toward educational objectives and increased mentorship. Challenges included difficulty meeting procedural volume requirements, inconsistent procedural tracking, improving feedback mechanisms, and administrative burden. CONCLUSION The transition to a competency-based curriculum in an academic Diagnostic Radiology residency program is significantly resource and time intensive. This report describes challenges faced in developing the Core of Discipline stage and potential solutions to facilitate this process.
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Affiliation(s)
- Siddharth Mishra
- Department of Diagnostic Radiology, Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - Andrew Chung
- Department of Diagnostic Radiology, Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - Christina Rogoza
- 12363Queen's University Faculty of Health Sciences, Kingston, Ontario, Canada
| | - Omar Islam
- Department of Diagnostic Radiology, Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - Benedetto Mussari
- Department of Diagnostic Radiology, Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - Xi Wang
- Department of Diagnostic Radiology, Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - Damon Dagnone
- Department of Emergency Medicine, 71459Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - Nicholas Cofie
- 12363Queen's University Faculty of Health Sciences, Kingston, Ontario, Canada
| | - Nancy Dalgarno
- 12363Queen's University Faculty of Health Sciences, Kingston, Ontario, Canada
| | - Benjamin Y M Kwan
- Department of Diagnostic Radiology, Kingston Health Sciences Centre, Kingston, Ontario, Canada
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