Era Of Competency-based Medical Education Research Articles

Addressing the opioid crisis in the era of competency-based medical education: recommendations for emergency department interventions.

Addressing the opioid crisis in the era of competency-based medical education: recommendations for emergency department interventions.

Determining Training and Assessment Needs for Residents in Radiation Treatment Planning in the era of Competency-Based Medical Education

Determining Training and Assessment Needs for Residents in Radiation Treatment Planning in the era of Competency-Based Medical Education

Addressing the competency of breaking bad news: What are Canadian general paediatric residency programs currently doing.

To describe how breaking bad news (BBN) is currently taught in Canadian general paediatric residency programs and the confidence level of fourth year paediatric residents (Ped-PGY4) in BBN and managing end-of-life-care (EOLC). A prospective, cross-sectional survey of General Paediatric Residency Program Directors (PDs) and Ped-PGY4s was conducted. When learning to BBN, residents state faculty observation (22/23) and interactive workshops (14/23) are the most helpful, while PDs state interactive workshops (9/16) and deliberate practice (5/16) are ideal. Residents identified a knowledge gap and discomfort with providing anticipatory guidance, and symptom management, including prescribing opioids. In the era of competency-based medical education, there is an opportunity to create a standardized national curriculum addressing universal competencies related to BBN and EOLC.

Assessment in Neurologic Education.

Neurology trainee assessment is a required component of the education feedback loop, allowing programs and trainees to measure their progress toward established educational goals. In the era of competency-based medical education, assessment systems should be designed to inform decisions about each trainee's acquisition of the many competencies required for independent clinical neurology practice. In addition to the need to inform trainees and programs regarding trainee performance, assessment systems must be equipped to satisfy requirements established by accrediting bodies. Educational goals should be thoughtfully established prior to assessment system design to ensure that assessment priorities align with the overall goal of equipping graduates to deliver high-quality neurologic care. This article provides an overview of modern principles of medical education as they can be applied to neurologic education, complemented by practical recommendations for neurologic educators to develop or improve assessment systems within their own training programs.

Making the McMOST out of Milestones and Objectives: Reimagining Standard Setting Using the McMaster Milestones and Objectives Stratification Technique.

As we enter the era of milestones and competency-based medical education (CBME), there is an increasing need to examine the procedures for stratifying objectives into levels of achievement. Most techniques used to date (e.g., Delphi surveys) involve some sort of consensus-based process, essentially crowd-sourcing wisdom of multiple educators to set anticipated milestones. In most graduate education settings, however, many simply use the judgment of one or two educators when setting educational objectives. Meanwhile, standard-setting procedures have been historically used in medical education for setting cut-points to determine levels of acceptable performance and do so in a more robust manner. Inspired by these standard-setting procedures, the authors sought to develop a new way to stratify objectives into three relative levels of achievement (junior [ACGME level 1], intermediate [ACGME level 2-3], senior [ACGME level 4]). The authors describe a novel, stepwise method that is composed of four steps. There are four steps to the McMOST procedure: 1) sorting objectives with a group of experienced teachers, 2) factor analysis to group preferences, 3) labeling components and reorganizing groupings, and 4) confirmation and final review by educational and content experts. Using McMOST method resulted in a change of placement for 15 of 34 (44%) of the milestones and improved agreement in two of three levels (intermediate from intraclass correlation of 0.56 to 0.80; senior from 0.69 to 0.79). The authors describe a novel protocol for stratifying objectives that may be useful to stratify and sort competencies into various levels of achievement (e.g., milestones) in this era of CBME.

Simulation-Based Procedural Skills Training in Pediatric Emergency Medicine

Procedural skills are integral to the practice of pediatric emergency medicine, but provider experience is limited by case rarity. Simulation-based medical education allows for the practice of rare procedures without compromising patient safety. Simulation-based procedural training improves provider confidence, knowledge, and performance, and may translate to better patient outcomes. However, optimal instructional designs for simulation-based training remain unclear, and educators have a plethora of didactic approaches and simulator characteristics to consider. This article reviews how simulation can be used for pediatric procedural skills training and maintenance, focusing on instructional design features, simulation modalities, and the use of simulation as an assessment tool in the era of competency-based medical education.

Observations: Scholarship in Residency: Invoking Change in the Era of Competency-Based Medical Education.

The current research literature suggests that some gender imbalances prevail within postgraduate medical education. Specifically, trainees interested in research continue to be predominantly male.1 This academic gender imbalance is reflected by a significant lag, and in some specialties, a decline in female senior authors compared to their male counterparts.2 We hypothesize that the implementation of a writing mentorship program for female residents is a novel strategy to assist in creating and publishing their academic work. Such an approach could assist resident physicians in becoming lifelong learners, educators, and scholars. A resident mentoring program for academic writing was piloted at McMaster University in Canada to determine whether it would influence the academic productivity of female psychiatry residents, as measured by number of publications. The McMaster postgraduate psychiatry training program is a 5-year program, and scholarly publication is not a current requirement. The number of all resident publications in peer-reviewed journals was measured over a 3-year period, predating and postdating implementation of a scholarly mentorship program for writing that has been offered on a voluntary basis to third-year female residents as of August 2011. In this program, interested participants (n = 5) were consecutively assigned to the same female faculty mentor, who assisted in the residents' creation and submission of manuscripts to peer-reviewed journals. All participants were successful in generating multiple peer-reviewed publications. Since the implementation of the mentorship program, female-mentored trainees authored approximately two-thirds (n = 9) of all resident publications (n = 15), with 7 of 10 total projects with mentored participants as first author. As shown in the table, shifting trends toward increasing numbers of publications by female residents, as well as women in the first authorship role, compared to their male peers were noted with the addition of a structured mentorship program for women. Comparatively, downward trends were seen in male peers. TABLE Total Number of Published Residents and Scholarly Productivity by Sex and Academic Year Group Effective scientific communication and dissemination of research findings are key skills for a physician. Yet there is rarely formal instruction offered in medical writing, nor are scholarship opportunities explicitly provided to residents, unless they are in a dedicated research track. In Canada, the Royal College Competence by Design initiative is being implemented in specialties over the next 5 years to support competency-based medical education on a national level.3 In this personalized, outcomes-driven educational model, residents will be required to actively assimilate the necessary knowledge and skills at each stage of training and career development. A writing mentorship program supports the development of numerous core competencies outlined in competency-based medical education. In addition to developing written communication skills, academic writing requires residents to collaborate with coauthors, and to professionally interact with editors and stakeholders as they work toward publication. While our program was aimed at female trainees, this type of academic writing mentorship could benefit the scholarly productivity of all residents. Residency programs should make academic productivity a curricular goal, with a stance of offering multiple opportunities for residents to generate academic products. Although there are limitations to any interpretations deriving from a study limited to 1 department at 1 institution, it raises questions about the importance of formal training to promote scholarship within residency programs. Future studies are needed to explore the long-term impact of scholarly mentorship on residents of both sexes and across various specialties.

Quick reference guides for pediatric trauma care.

Procedural skills are integral to the practice of pediatric emergency medicine, but provider experience is limited by case rarity. Simulation-based medical education allows for the practice of rare procedures without compromising patient safety. Simulation-based procedural training improves provider confidence, knowledge, and performance, and may translate to better patient outcomes. However, optimal instructional designs for simulation-based training remain unclear, and educators have a plethora of didactic approaches and simulator characteristics to consider. This article reviews how simulation can be used for pediatric procedural skills training and maintenance, focusing on instructional design features, simulation modalities, and the use of simulation as an assessment tool in the era of competency-based medical education.