Acceptance and validity of the methods used to implement a competency based medical education programme in an Intensive Care Department of a teaching referral center

OBJECTIVES

1. To determine the satisfaction of tutors and residents with a specific methodology used to implement CoBaTrICE. 2. To determine the reliability and validity of the global rating scales designed ad hoc to assess the performance of the residents for training purposes.

DESIGN

Prospective cohort study.

PARTICIPANTS

All the residents and tutors of the ICU Department of the Hospital Universitario y Politécnico la Fe de Valencia.

INTERVENTION

CoBaTrICE implementation started in March 2016, it was based on: (1) Training the tutors in feedback techniques; (2) Performing multiple objective and structured work based assessments to achieve the competences of the program; and (3) The use of an electronic portfolio to promote learning reflection and to collect the evidence that learning was taking place.

METHODS

The acceptance of CoBaTrICE was explored through a satisfaction survey conducted after 9 months of implementation of the training program. The 15 residents and 5 tutors of the ICU Department were asked about the methodology of the formative assessments, the quality of the feedback, self-learning regulation and the electronic portfolio usefulness. The validity of the global rating scales was assessed through the tests alfa de Cronbach, reliability and generalizability indexes, and intraclass correlation coefficient.

RESULTS

The implementation of CoBaTrICE was satisfactory in all the dimensions studied. The global rating scales used for formative purposes showed reliability and validity.

CONCLUSIONS

The methodology used to implement CoBaTrICE was highly valued by tutors and residents. The global rating scales used for formative purposes showed reliability and validity.

Entrustable professional activities (EPAs) for postgraduate competency based intensive care medicine training in the Netherlands: The next step towards excellence in intensive care medicine training

INTRODUCTION

The Competency Based Training in Intensive Care Education (CoBaTrICE) programme developed common standards of ICM training by describing competencies of an intensivist. Entrustable Professional Activities (EPAs) of Intensive Care Medicine (ICM) (EPAsICM) are presented as a new workplace-based assessment tool in competency-based training of intensivists. EPAs are activities to be entrusted to a trainee once he (or she) has attained competence. EPAs emphasise the role of trust between trainees and supervisors. EPAs bridge the gap between competencies and competence.

METHODS

An expert panel of ICM (vice)programme directors and intensivists in The Netherlands integrated the CoBaTrICE and CanMEDS competencies into EPAsICM. Comment and feedback was sought from other ICM programme directors and educational experts and processed in the final version of EPAsICM before implementation in the Dutch ICM training programme.

RESULTS

A list of 15 EPAsICM are considered to reflect the spectrum of clinical practice while incorporating the competencies of CoBaTrICE and CanMEDS. The grading system is designed as a 5-point entrustment scale based on the amount of supervision a trainee needs, aligning with daily judgement of trainees by intensivists.

CONCLUSION

EPAsICM is an assessment tool that formalises entrustment decisions and can be a valuable addition in international ICM training.

Are graduated intensivists prepared for practice? A case study from The Netherlands

PURPOSE

An evaluation of the alignment between intensive care medicine (ICM) training and practice provides valuable information for the development of ICM training. Therefore this study examines how well recently licensed intensivists feel prepared for practice and whether intensivists from different background specialties attain comparable preparedness rates.

METHODS

An inventory was developed to cover the tasks that constitute ICM practice. Two hundred five recently licensed Dutch intensivists received a questionnaire in which they could indicate how well their ICM training programme prepared them for these tasks on a 5-point Likert scale.

RESULTS

Ninety-one respondents returned the questionnaire (response 45%). Respondents felt excellently prepared for 67 tasks, well prepared for 16 tasks, marginally sufficiently prepared for 6 tasks and insufficiently prepared for 15 tasks. Intensivists from anaesthesiology felt better prepared for IC specific activities (mean 4.25, SD 0.38) than those from internal medicine (mean 4.01, SD 0.40, P=.02).Average scores on tasks related to medical expertise were relatively high while tasks relating to management and leadership, science and professional development scored lower.

CONCLUSIONS

Although recently licensed intensivists are well prepared for most tasks in ICM, lower preparedness scores on tasks related to leadership and management, science, and professional development call for re-evaluation of the current curriculum.