Implementing changes to a residency program curriculum before competency-based medical education: a survey of Canadian medical oncology program directors.

R Arora,T Hsu,J Sussman,J W Henning,O Levine,G Kazemi,S K Basi,S D Mukherjee

doi:10.3747/co.27.6659

R Arora, T Hsu + Show 6 more

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https://doi.org/10.3747/co.27.6659

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Postgraduate medical education is undergoing a paradigm shift in many universities worldwide, transitioning from a time-based model to competency-based medical education (cbme). Residency programs might have to alter clinical rotations, educational curricula, assessment methods, and faculty involvement in preparation for cbme, a process not yet characterized in the literature. We surveyed Canadian medical oncology program directors on planned or newly implemented residency program changes in preparation for cbme. Prior to implementing cbme, all program directors changed at least 1 clinical rotation, most commonly making hematology/oncology (74%) entirely outpatient and eliminating radiation oncology (64%). Introductory rotations were altered to focus on common tumour sites, and later rotations were changed to increase learner autonomy. Most program directors planned to enhance resident learning with electronic teaching modules (79%), new training experiences (71%), and academic half-day changes (50%). Most program directors (64%) planned to change assessment methods to be entirely based on entrustable professional activities. All programs had developed a competence committee to review learner progress, and most (86%) had integrated academic coaches. Transitioning to cbme led to major structural and curricular changes within medical oncology training programs. Identifying these commonly implemented changes could help other programs transition to cbme.

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Competency-based medical education is the most recent curricular paradigm adopted in Canada
Our study demonstrates that medical oncology program directors across Canada implemented many changes in curriculum and clinical rotation design as well as overall program structure in preparation for the transition to cbme
We found that the most common changes included re-sequencing of rotations to start with more core rotations early in training, introducing e-modules as a supplementary learning resource for trainees, introducing epas as the primary means of evaluation of competencies, and engagement of faculty members through a competence committee and as academic coaches

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Competency-based medical education (cbme) is the most recent curricular paradigm adopted in Canada. Several years of preparation have gone into cbme, including the University of Toronto’s orthopedic surgery residency program, which has piloted the cbme model since. Cbme has been officially implemented in numerous other specialties in Canada, and widespread adoption of cbme by all disciplines is anticipated by 20222. In the traditional medical education model, residents’ competence was presumed upon completion of the requisite time in training and demonstration of required knowledge acquisition through end-of-clinical-rotation evaluations. Postgraduate medical education is undergoing a paradigm shift in many universities worldwide, transitioning from a time-based model to competency-based medical education (cbme). Residency programs might have to alter clinical rotations, educational curricula, assessment methods, and faculty involvement in preparation for cbme, a process not yet characterized in the literature

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