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Implementing competency-based medical education (CBME) in emergency medicine residency programs requires manageable staff time but faces mixed resident and faculty acceptance. Key challenges include resistance to change and time constraints.

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Area of Science:

  • Medical Education
  • Graduate Medical Education
  • Emergency Medicine Training

Background:

  • Graduate medical education programs are transitioning to competency-based medical education (CBME).
  • Many specialties face challenges integrating the 5 core components of CBME.
  • Emergency medicine (EM) residency programs require a structured approach to CBME adoption.

Purpose of the Study:

  • To develop and implement the 5 core components of CBME in 8 US EM residency programs.
  • To assess the acceptability and feasibility of this CBME implementation.
  • To evaluate the impact of CBME on residency training.

Main Methods:

  • Intervention designed to implement 5 CBME components: outcomes framework, developmental progression, tailored learning, competency coaching, and programmatic assessment.
  • Consensus process for framework and trajectory development.
  • Survey of site implementation leads on feasibility and acceptability post-implementation.

Main Results:

  • 100% survey response rate from 8 EM residency programs.
  • Estimated time commitment: 2-15 hrs/month for coordinators, 4-21.4 hrs/month for leadership.
  • Mixed acceptability reported; challenges included resistance to change, time limits, faculty discomfort with assessments, and technology barriers.

Conclusions:

  • Competency-based medical education implementation is estimated to require manageable time for program staff and leadership.
  • Acceptability of CBME among residents and faculty was mixed.
  • Addressing implementation challenges is crucial for successful CBME adoption in EM residency programs.