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Cheung WJ, Bhanji F, Gofton W, Hall AK, Karpinski J, Richardson D, Frank JR, Dudek N. Design and Implementation of a National Program of Assessment Model - Integrating Entrustable Professional Activity Assessments in Canadian Specialist Postgraduate Medical Education. PERSPECTIVES ON MEDICAL EDUCATION 2024; 13:44-55. [PMID: 38343554 PMCID: PMC10854461 DOI: 10.5334/pme.956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 09/04/2023] [Indexed: 02/15/2024]
Abstract
Traditional approaches to assessment in health professions education systems, which have generally focused on the summative function of assessment through the development and episodic use of individual high-stakes examinations, may no longer be appropriate in an era of competency based medical education. Contemporary assessment programs should not only ensure collection of high-quality performance data to support robust decision-making on learners' achievement and competence development but also facilitate the provision of meaningful feedback to learners to support reflective practice and performance improvement. Programmatic assessment is a specific approach to designing assessment systems through the intentional selection and combination of a variety of assessment methods and activities embedded within an educational framework to simultaneously optimize the decision-making and learning function of assessment. It is a core component of competency based medical education and is aligned with the goals of promoting assessment for learning and coaching learners to achieve predefined levels of competence. In Canada, postgraduate specialist medical education has undergone a transformative change to a competency based model centred around entrustable professional activities (EPAs). In this paper, we describe and reflect on the large scale, national implementation of a program of assessment model designed to guide learning and ensure that robust data is collected to support defensible decisions about EPA achievement and progress through training. Reflecting on the design and implications of this assessment system may help others who want to incorporate a competency based approach in their own country.
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Affiliation(s)
- Warren J. Cheung
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, CA
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada, 1053 Carling Avenue, Rm F660, Ottawa, ON K1Y 4E9, CA
| | - Farhan Bhanji
- Department of Pediatrics (Critical Care), Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, CA
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, CA
| | - Wade Gofton
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, CA
- Department of Surgery, Division of Orthopaedic Surgery, University of Ottawa, Ottawa, ON, CA
| | - Andrew K. Hall
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, CA
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, CA
| | - Jolanta Karpinski
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, CA
- Department of Medicine, University of Ottawa, Ottawa, ON, CA
| | - Denyse Richardson
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, CA
- Department of Physical Medicine and Rehabilitation, Queen’s University, Kingston, ON, CA
| | - Jason R. Frank
- Department of Emergency Medicine, Director, Centre for Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, ON, CA
| | - Nancy Dudek
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, CA
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Ottawa, Ottawa, ON, CA
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Curtis C, Kassam A, Lord J, Cooke LJ. Competence committees decision-making; an interplay of data, group orientation, and intangible impressions. BMC MEDICAL EDUCATION 2023; 23:748. [PMID: 37817152 PMCID: PMC10565978 DOI: 10.1186/s12909-023-04693-4] [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: 11/05/2022] [Accepted: 09/16/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND The implementation of competency-based medical education and utilization of competence committees (CC) represents a paradigm shift in residency education. This qualitative study aimed to explore the methods used by two operational CC and their members to make decisions about progression and competence of their residents. METHODS An instrumental case study methodology was used to study the CC of two postgraduate training programs. Transcripts from observed CC meetings, member interviews, and guiding documents were analyzed using a constructivist grounded theory approach to reveal themes explaining the decision-making process. RESULTS Our study found that the CC followed a process that began within a social decision schema model and evolved to a discussion that invoked social influence theory, shared mental models, and social judgment scheme to clarify the points of contention. We identified that the CC decision-making was at risk of bias, primarily influenced by the group composition, the group orientation and individual members' mindset, as well as their personal experiences with the trainees. CONCLUSIONS Increased awareness of the sources of bias in CC functioning and familiarity with the CC role in competency-based medical education would enable committees to provide valuable feedback to all trainees regardless of their trajectory.
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Affiliation(s)
- Colleen Curtis
- Department of Pediatrics, University of Calgary, 28 Oki Dr. NW, Calgary, AB, T3B 6A8, Canada.
| | - Aliya Kassam
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Jason Lord
- Departments of Emergency Medicine and Critical Care Medicine, University of Calgary, Calgary, Canada
| | - Lara J Cooke
- Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
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Hall AK, Oswald A. Optimising prospective entrustment: Defaulting on default progression. MEDICAL EDUCATION 2022; 56:870-872. [PMID: 35701709 DOI: 10.1111/medu.14856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 06/09/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Andrew K Hall
- Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada
| | - Anna Oswald
- Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada
- Division of Rheumatology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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