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It's a Marathon, Not a Sprint: Rapid Evaluation of Competency-Based Medical Education Program Implementation
Andrew K Hall1, Jessica Rich, J Damon Dagnone
1A.K. Hall is associate professor, Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada, and clinician educator, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada; ORCID: http://orcid.org/0000-0003-1227-5397. J. Rich is research associate, Faculty of Education, Queen's University, Kingston, Ontario, Canada; ORCID: http://orcid.org/0000-0001-7409-559X. J.D. Dagnone is associate professor, Department of Emergency Medicine, and CBME faculty lead, Postgraduate Medicine, Queen's University, Kingston, Ontario, Canada; ORCID: http://orcid.org/000-0001-6963-7948. K. Weersink is a resident, Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada; ORCID: http://orcid.org/0000-0002-0325-3172. J. Caudle is assistant professor, Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada. J. Sherbino is professor, Division of Emergency Medicine, Department of Medicine, and assistant dean, Health Professions Education Research, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada. J.R. Frank is director, Specialty Education, Royal College of Physicians and Surgeons of Canada, and associate professor and director, Educational Research and Development, Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada; ORCID: http://orcid.org/0000-0002-6076-0146. G. Bandiera is professor, Department of Medicine, and associate dean, Postgraduate Medical Education, University of Toronto, Toronto, Ontario, Canada. E. Van Melle is senior education scientist, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada, and adjunct faculty, Department of Family Medicine, Queen's University, Kingston, Ontario, Canada.
Implementing competency-based medical education (CBME) requires iterative evaluation and sustained effort. Rapid evaluation identified challenges in assessment and feedback, highlighting the need for continuous faculty and resident development for successful cultural change.
Area of Science:
- Medical Education Research
- Health Professions Education
- Competency-Based Medical Education (CBME)
Background:
- Competency-based medical education (CBME) is widely endorsed but faces implementation challenges.
- Effective program implementation is crucial for realizing CBME's potential benefits.
Purpose of the Study:
- To evaluate the fidelity of CBME implementation in an emergency medicine residency program.
- To identify early outcomes and challenges associated with CBME implementation.
- To utilize Rapid Evaluation to facilitate transformative change in medical education.
Main Methods:
- A case study methodology was employed at Queen's University's emergency medicine postgraduate program.
- Iterative cycles of Rapid Evaluation were conducted over 2017-2018.
- Stakeholder focus groups and interviews were analyzed using abductive reasoning and a CBME framework.
Main Results:
- Lack of a shared mental model impacted assessment and feedback, leading to adjustments in evaluation methods.
- Resident engagement with personal learning plans and tailored learning experiences showed slow adoption.
- Implementation fidelity varied, revealing opportunities for program adaptation.
Conclusions:
- Rapid Evaluation provided critical insights into operationalizing CBME.
- Implementing practical CBME components was a "sprint," while cultural change was a "marathon."
- Sustained effort, including frequent evaluation and continuous development, is essential for successful CBME transformation.
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