Lessons learned and new strategies for success: Evaluating the Implementation of Competency-Based Medical Education in Queen's Pediatrics

Amy Acker; Kirk Leifso; Lindsay Crawford; Heather Braund; Emily Hawksby; Andrew K Hall; Laura McEwen; Nancy Dalgarno; Jeffrey Damon Dagnone

doi:10.1093/pch/pxad021

Lessons learned and new strategies for success: Evaluating the Implementation of Competency-Based Medical Education in Queen's Pediatrics

Paediatr Child Health. 2023 Apr 29;28(8):463-467. doi: 10.1093/pch/pxad021. eCollection 2023 Dec.

Authors

Amy Acker¹, Kirk Leifso¹, Lindsay Crawford², Heather Braund³, Emily Hawksby¹, Andrew K Hall^{4

5}, Laura McEwen^{1

6}, Nancy Dalgarno^{7

8}, Jeffrey Damon Dagnone^{6

9}

Affiliations

¹ Department of Pediatrics, Queen's University, Kingston, Canada.
² Department of Medicine, Queen's University, Kingston, Canada.
³ Scholarship and Simulation Education, Office of Professional Development and Educational Scholarship, Faculty of Health Sciences, Queen's University, Kingston, Canada.
⁴ Department of Emergency Medicine, University of Ottawa, Ottawa, Canada.
⁵ Royal College of Physicians and Surgeons of Canada, Ottawa, Canada.
⁶ Postgraduate Medical Education Queen's University, Kingston, Canada.
⁷ Education Scholarship, Office of Professional Development and Educational Scholarship, Kingston, Canada.
⁸ Department of Biomedical and Molecular Sciences, Faculty of Health Sciences, Queen's University, Kingston, Canada.
⁹ Department of Emergency Medicine, Queen's University, Kingston, Canada.

Abstract

Objectives: In 2017, Queen's University launched Competency-Based Medical Education (CBME) across 29 programs simultaneously. Two years post-implementation, we asked key stakeholders (faculty, residents, and program leaders) within the Pediatrics program for their perspectives on and experiences with CBME so far.

Methods: Program leadership explicitly described the intended outcomes of implementing CBME. Focus groups and interviews were conducted with all stakeholders to describe the enacted implementation. The intended versus enacted implementations were compared to provide insight into needed adaptations for program improvement.

Results: Overall, stakeholders saw value in the concept of CBME. Residents felt they received more specific feedback and monthly Competence Committee (CC) meetings and Academic Advisors were helpful. Conversely, all stakeholders noted the increased expectations had led to a feeling of assessment fatigue. Faculty noted that direct observation and not knowing a resident's previous performance information was challenging. Residents wanted to see faculty initiate assessments and improved transparency around progress and promotion decisions.

Discussion: The results provided insight into how well the intended outcomes had been achieved as well as areas for improvement. Proposed adaptations included a need for increased direct observation and exploration of faculty accessing residents' previous performance information. Education was provided on the performance expectations of residents and how progress and promotion decisions are made. As well, "flex blocks" were created to help residents customize their training experience to meet their learning needs. The results of this study can be used to inform and guide implementation and adaptations in other programs and institutions.

Keywords: Competency-Based Education; Medical education; Pediatrics; Program evaluation.