Making competencies make sense for workplacebased assessment: The Sentinel Habits
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1 Making competencies make sense for workplacebased assessment: The Sentinel Habits Author: Shelley Ross, Michel Guy Donoff, Shirley Schipper, Paul Humphries Date: September 27, 2013
2 I do not have an affiliation (financial or otherwise) with a pharmaceutical, medical device or communications organization. Je n ai aucune affiliation (financière ou autre) avec une entreprise pharmaceutique, un fabricant d appareils médicaux ou un cabinet de communication. Author: Shelley Ross, Terra Manca, Michel Guy Donoff, Shirley Schipper, Paul Humphries Date: September 28, 2013
3 Acknowledgements CBAS team (core competency-based assessment research group, University of Alberta):» Mike Donoff, Paul Humphries, Shirley Schipper Sentinel Habits development contributors:» Darren Nichols, Ivan Steiner, Fred Janke Funding:» Teaching and Learning Enhancement Fund, University of Alberta 3
4 The Problem: Preceptors were struggling with CanMEDS for direct observation» Language was not natural for workplace assessment 4
5 Background: The Big Questions What are the essential elements that you want to assess in residents and fellows?» What are the behaviours you want to see repeatedly?» What are the general areas you want to assess repeatedly to know that you have a good overall idea of how your learners are doing? 5
6 Methods Modified Delphi Part 1:» Expert teachers and clinicians:» First conducted in family medicine» Repeated multiple times nationally, with mix of family physicians and other specialists 6
7 Methods Modified Delphi Part 2:» Expert team (2 program directors, 1 medical education researcher, an assessment director, 2 master teachers) categorized answers into everyday language statements» Statements member-checked with similar/same groups as in Part 1» Mapped to CanMEDS 7
8 Results: Sentinel Habits Incorporates the patient s experience and context into problem identification and management» Medical Expert/ Health Advocate/Collaborator Generates relevant hypotheses resulting in a safe and prioritized differential diagnosis» Medical Expert Manages patients using available best practices» Medical Expert/Health Advocate/Collaborator/Manager 8
9 Results: Sentinel Habits Demonstrates respect and/or responsibility towards peers, colleagues, staff, and patients» Professional/Health Advocate/Collaborator Selects and attends to the appropriate focus and priority in a situation» Medical Expert Verbal or written communication is clear and timely» Communicator 9
10 Results: Sentinel Habits Uses generic key features when performing a procedure» Medical Expert Teaches to relevant and achievable objectives» Scholar Participates with practice/quality management» Manager Seeks out and responds appropriately to feedback» Scholar/Professional 10
11 Elements of Assessment CanMEDS roles, ACGME Competencies Sentinel Habits Granularity Entrustable Professional Activities Key features, rotation objectives, specific procedures
12 Sentinel Habits» Do not replace CanMEDS» Simply give more accessible language for workplacebased assessment» A holistic approach to guide what to watch for repeatedly in the workplace» Evaluations are positive from preceptors and residents; very positive from program directors 12
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