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Area of Science:

  • Medical Education
  • Cardiology Training
  • Competency-Based Medical Education

Background:

  • Adult cardiology residency programs transitioned to Competency by Design (CBD) in July 2021.
  • Challenges in CBD include inconsistent staff participation and variable feedback timelines.
  • This project aimed to improve expiry rates and completion timelines for entrustable professional activities (EPAs).

Purpose of the Study:

  • To implement an intervention to enhance EPA completion rates and timelines in cardiology residency.
  • To address challenges associated with the Competency by Design (CBD) framework.

Main Methods:

  • Reviewed EPAs for cardiology residents at Dalhousie University from July 2020 to February 2023.
  • Intervention involved performance reviews (grand rounds presentation) and personalized data sets for supervisors.
  • Outcomes measured included EPAs completed per resident-months, time to completion, and percentage of expired EPAs.

Main Results:

  • Expired EPAs decreased from 35.0% to 21.5% (P=0.03) 12 months post-intervention.
  • Time to EPA completion decreased from 7.3 to 5.0 days (P<0.001).
  • EPAs completed per resident-months increased from 3.10 to 4.29 (P<0.001), with 71.5% completed within 48 hours (P=0.004).

Conclusions:

  • Performance reviews and personalized data positively impacted EPA expiry rates and completion timelines.
  • The intervention facilitated the transition to Competency by Design (CBD) in cardiology residency.
  • This strategy enhanced overall EPA completion rates and timeliness.