Preparing for CBME: How often are faculty observing residents?

Area of Science:

• Medical Education
• Paediatric Residency Training
• Competency-Based Medical Education

Background:

• The Royal College of Physicians and Surgeons of Canada transitioned to Competence by Design (CBD) in 2017, shifting from time-based to outcomes-based medical training.
• CBD implementation requires changes in resident assessment, emphasizing the need for increased direct observation to evaluate entrustable professional activities.

Purpose of the Study:

• To characterize faculty and resident experiences with direct observation in a paediatric residency program before Competence by Design implementation.
• To qualitatively identify perceived barriers and incentives influencing participation in direct observation.

Main Methods:

• Surveys were administered to paediatric residents and faculty to gather demographic data and assess observation frequency.
• Participants reported on current and ideal frequencies of resident observation for specific clinical tasks and identified factors affecting these frequencies.

Main Results:

• Faculty observed residents taking histories, performing physical exams, and delivering plans less frequently than residents reported being observed.
• Both faculty and residents desired higher observation frequencies than were currently occurring, with common barriers including patient load and scheduling conflicts.
• Key improvements suggested included scheduled observations, better assessment tools for faculty, and residents initiating observation requests.

Conclusions:

• Baseline data indicate current faculty observation frequency is insufficient for Competence by Design requirements.
• Addressing the time constraints of clinical service demands through improved scheduling and assessment tools is crucial for enhancing resident observation.