Abstract
Competency-based education requires that programs increase the breadth of direct observation and assessment to improve resident training. To achieve these goals, the authors developed and executed a multiple-trainee, multiple-level, multiple-competency (Multi-TLC) obstetrical emergencies simulation curriculum. Depending upon their training level (PGY1–PGY5), obstetrics and gynaecology residents participated in various roles (i.e., first responder, second responder, confederates, and evaluators) within four simulation scenarios designed to provide opportunities for education, direct observation, and assessment across a number of competencies (i.e., medical expert, communicator, collaborator, leader, advocate, and scholar). The curriculum was carried out over 8 h spread evenly across 2 days (i.e., 4 h/day) and involved periods of pre-briefing, live simulation, and debriefing. An evaluation of the Multi-TLC was operationalised via a context-input-process-product model. This report presents the outcomes of that evaluation derived from quasi-experimental comparisons of the new and previous curricula across four priorities for simulation-based education identified by the Department of Obstetrics and Gynecology at McMaster University (Hamilton, ON, Canada): increasing learning opportunities, maintaining or improving resident learning, maintaining or reducing program costs, and improving resident satisfaction. The evaluation revealed that the Multi-TLC curriculum permitted a greater breadth of direct observation and assessment across competencies, maintained the previous learning objectives while also addressing additional ones, and was done so in a way that reduced the overall financial and human resource costs associated with the department’s obstetrical emergency simulation curriculum. A Multi-TLC organisation of simulation curricula can facilitate efficient application of competency-based education principles.Electronic supplementary materialThe online version of this article (10.1007/s40037-019-00534-7) contains supplementary material, which is available to authorized users.
Highlights
Competency-based education demands that programs underpin entrustment decisions with sufficient observations to justify progression along each stage of the continuum [1]
In order to boost efficiency without compromising effectiveness, the Department of Obstetrics and Gynecology (OBGYN) at McMaster University (Hamilton, ON, Canada) prioritised the creation of an educational offering that: 1. Increases the competency-based learning opportunities afforded by simulation, 2
The competencies observed in the previous simulation curriculum include medical expert, communicator, and collaborator
Summary
Competency-based education demands that programs underpin entrustment decisions with sufficient observations to justify progression along each stage of the continuum [1]. These observations are largely conducted while residents are directly engaged with patients. For competence associated with high-stakes procedures and rare emergencies, simulation provides valuable opportunities to observe and assess residents. Simulation training is constrained by limited finances and faculty time. As more simulations are needed to observe more resi-. Increases the competency-based learning opportunities afforded by simulation, 2. Maintains or improves resident learning through simulation, 3. Maintains or reduces the monetary and time costs associated with simulation, 4.
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