Competence by Design in Cardiac Surgery Resident Training: A Qualitative Thematic Analysis.

Area of Science:

• Medical Education
• Surgical Training
• Competency-Based Education

Background:

• Competence by Design (CBD) shifts training from time-based to outcome-based evaluation using entrustable professional activities and milestones.
• This study assesses the current state of CBD in a single-center cardiac surgery training program.

Purpose of the Study:

• To conduct a qualitative quality assurance and improvement assessment of Competence by Design (CBD) in cardiac surgery training.
• To gather feedback from educators and trainees on the benefits and challenges of CBD.

Main Methods:

• Utilized a questionnaire distributed to educators, traditional trainees, and CBD trainees.
• Conducted in-depth interviews based on questionnaire responses.
• Performed qualitative thematic data analysis to identify recurrent themes.

Main Results:

• Thematic analysis identified 16 themes, including six major themes regarding CBD.
• CBD promotes standardized training, objective assessment, and focused skill development.
• Increased administrative workload and implementation challenges were noted for residents and educators.

Conclusions:

• This is the first study to evaluate CBD in a Canadian cardiac surgery program, incorporating educator and trainee perspectives.
• Participants recognized CBD's value in standardized, outcome-based training and detailed assessments.
• Specific challenges in understanding and implementing the CBD model were identified.