Managing residents in difficulty within CBME residency educational systems: a scoping review

Lisa St Amant,Susan Glover Takahashi,Jonathan Pirie

doi:10.1186/s12909-020-02150-0

Lisa St Amant, Susan Glover Takahashi + Show 1 more

Open Access

https://doi.org/10.1186/s12909-020-02150-0

Copy DOI

Abstract

BackgroundBest practices in managing residents in difficulty (RID) in the era of competency-based medical education (CBME) are not well described. This scoping review aimed to inventory the current literature and identify major themes in the articles that address or employ CBME as part of the identification and remediation of residents in difficulty.MethodsArticles published between 2011 to 2017 were included if they were about postgraduate medical education, RID, and offered information to inform the structure and/or processes of CBME. All three reviewers performed a primary screening, followed by a secondary screening of abstracts of the chosen articles, and then a final comprehensive sub-analysis of the 11 articles identified as using a CBME framework.ResultsOf 165 articles initially identified, 92 qualified for secondary screening; the 63 remaining articles underwent full-text abstracting. Ten themes were identified from the content analysis with “identification of RID” (41%) and “defining and classifying deficiencies” (30%) being the most frequent. In the CBME article sub-analysis, the most frequent themes were: need to identify RID (64%), improving assessment tools (45%), and roles and responsibilities of players involved in remediation (27%). Almost half of the CBME articles were published in 2016–2017.ConclusionsAlthough CBME programs have been implemented for many years, articles have only recently begun specifically addressing RID within a competency framework. Much work is needed to describe the sequenced progression, tailored learning experiences, and competency-focused instruction. Finally, future research should focus on the outcomes of remediation in CBME programs.

Highlights

Best practices in managing residents in difficulty (RID) in the era of competency-based medical education (CBME) are not well described
Dupras [4] reported on a survey across Internal Medicine (IM) programs that sought to define prevalence, problems, and remediation in the era of core competencies, which preceded the roll-out of CBME residency training programs
The purpose of this paper is to provide a review of the current literature on residents in difficulty, spanning the era of the introduction of CBME to post-graduate training programs

Summary

Introduction

Best practices in managing residents in difficulty (RID) in the era of competency-based medical education (CBME) are not well described. This scoping review aimed to inventory the current literature and identify major themes in the articles that address or employ CBME as part of the identification and remediation of residents in difficulty. Zbieranowski [2] and Guerrasio [3] each looked at a 10-year period at one university, ending in 2009 and 2012 respectively In both articles, competency-based models were not in effect during the eras studied. Dupras [4] reported on a survey across Internal Medicine (IM) programs that sought to define prevalence, problems, and remediation in the era of core competencies, which preceded the roll-out of CBME residency training programs

Methods

Results

Discussion

Conclusion