Implementing a Competency-Based Curriculum in a Pediatric Training Program. Author: Moyez Ladhani Date: October 25, 2014

Transcription

1 Implementing a Competency-Based Curriculum in a Pediatric Training Program Author: Moyez Ladhani Date: October 25, 2014

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: Lorem ipsum dolor sit Date: Dolor sit am

3 Three Take Home Points Many organizations are moving to a competency-based education model in place of the historical time-based model Competency-based education hopes to develop a competent holistic physician and makes sense Key to success:» Stepwise approach» The proper assessment of learners» The development of the assessors i.e. the faculty» Involve the key stakeholders» You have many of the tools already 3

4 Dr. Moyez Ladhani Dr. Andrea Hunter Dr. Natasha Johnson Dr. Katrin Scheinemann Dr. April Kam Dr. Audrey Lim Dr. Anne Niec Dr. Lucy Giglia Dr. Julia Frei Dr. Kim Genier Dr. Anne Moffat Dr. Willa Liao Shirley Ferguson Adrianna Flaiani 4

5 Introduction: The year 2005 Congratulations you have been selected as the Pediatric Program director 5

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9 * Apologies for cross posting * 9

10 Goals: 1. Implement a competency-based curriculum into the McMaster University, pediatric residency program. 1. Develop a tool, the Mini Milestones Assessment (Mini- MAS) to assess intrinsic medical competencies and progression through milestones using the Dreyfus Developmental Model. 1. Test the psychometric theories to assess the reliability, validity, acceptability and feasibility of the Mini-MAS tool. 1. FIRE: Fundamental Innovations in Residency Education. 10

11 Goals: 1. Implement a competency-based curriculum into the McMaster University, pediatric residency program. 1. Develop a tool, the Mini Milestones Assessment (Mini-MAS) to assess intrinsic medical competencies and progression through milestones using the Dreyfus Developmental Model. 1. Test the psychometric theories to assess the reliability, validity, acceptability and feasibility of the Mini-MAS tool. 1. FIRE: Fundamental Innovations in Residency Education. 11

12 CBME Competency-based education is an approach to preparing physicians for practice that is fundamentally oriented to graduate outcome abilities and organized around competencies derived from an analysis of societal and patient needs. It deemphasizes time-based training and promises greater accountability, flexibility, and learner centeredness (p636) Frank, J. R., Mungroo, R., Ahmad, Y., Wang, M., De Rossi, S., & Horsley, T. (2010). Toward a definition of competency-based education in medicine: A systematic review of published definitions. Medical Teacher, 32(8),

13 Tea- Steeping model The current model of education is a time-based model. Hodges describes this as the tea-steeping model : we put the student (tea) in medical school (hot water) for a fixed period of time and voila! After a historically determined interval of time, we assume a competent practitioner, like a good cup of tea, will result Hodges, B. D. (2010). A tea-steeping or i-doc model for medical education?. Academic Medicine, 85(9 Suppl), S

14 The Analogy 14

15 Ostrich, Peacock and the Beaver 17

16 What the beaver must do Statement of learning outcome Communication with staff and students Educational strategies Learning opportunities Course content Student progression Assessment Educational environment Student selection Harden, R. M. (2007). Outcome-based education--the ostrich, the peacock and the beaver. Medical Teacher, 29(7),

17 What the beaver must do Statement of learning outcome Communication with staff and students Educational strategies Learning opportunities Course content Student progression Assessment Educational environment Student selection 19

18 A two-day retreat was initially held to develop the curriculum; Members of the residency training committee including general pediatric faculty and resident representatives from each year were present. 20

19 The curriculum was started for only the general pediatric rotations as a pilot and to limit the number of faculty involved. The PGY 1 residents General Pediatric experiences ( 22 weeks)» CTU-4 weeks» Community Brampton-4 weeks» Community St. Joseph s Healthcare-4 weeks» CTU Waterloo-4 weeks» Float call at McMaster-6 weeks Occurred in the form of competency-based education with learning outcomes, milestones and assessment. 21

20 Learning Outcomes 22

21 Learning Outcomes 23

22 What the beaver must do Statement of learning outcome Communication with staff and students Educational strategies Learning opportunities Course content Student progression Assessment Educational environment Student selection 24

23 Educational strategies The residents had exposure to a variety of clinical situations and teaching sessions. Clinical Exposure-Total 22 weeks:» CTU-4 weeks» Community Brampton-4 weeks» Community St. Joseph s Healthcare-4 weeks» CTU Waterloo-4 weeks» Float call at McMaster-6 weeks 25

24 Learning opportunities» Academic Half Day including Clinical Skills Days» Simulation» Longitudinal CanMEDS Competencies (LCC)» Journal Club» Department Grand Rounds» Division of General Pediatrics Grand Rounds» Morbidity and Mortality Rounds» CTU Teaching Sessions» Subspecialty Rounds Faculty Development Courses Department Conferences Neonatal Resuscitation Program (NRP)/ Pediatric Advanced Life Support (PALS) courses Case Based Teaching Sessions (self directed) Mac at Night Curriculum PREP The Curriculum Self Directed Modules: CPSO, RCPSC, CPS and Pedialink Peer and Faculty Mentors» Work in Progress 26

25 Student Progression and Assessment Student progression was based on a comprehensive assessment program. The PGY 1 resident had to meet the milestones and objectives successfully. The competency-based medical education (CBME) curriculum was considered a comprehensive block of 22 weeks and thus they had the full time period to achieve the stated objectives. 27

26 Student Progression and Assessment Assessments at the end of each rotation block were formative to allow the resident to reflect on areas of improvement. At the end of their 22 weeks, all assessments were reviewed to see if the learner had met their objectives and reached the appropriate milestones. 28

27 Student Progression and Assessment Objective Structured Clinical exam (OSCE) twice a year. Multiple Choice Questions (MCQ) and Short Answer Questions (SAQ) twice a year. American Board of Pediatrics (ABP) In Training Exam, an MCQ exam held annually STACER Portfolio Multi-Source Feedback (MSF) Procedure Log Book End of Rotation Evaluation Mini-MAS 29

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29 2 a week, one competency at a time, 6 competencies

30 Three Take Home Points Many organizations are moving to a competency-based education model in place of the historical time-based model Competency-based education hopes to develop a competent holistic physician and makes sense Key to success:» Stepwise approach» The proper assessment of learners» The development of the assessors i.e. the faculty» Involve the key stakeholders» You have many of the tools already 32

31 Questions/Discussion 33

32 Help us improve. Your input matters. Download the ICRE App, Visit the evaluation area in Pre-function Hall B, near Registration, or Go to: icreevaluations to complete the session evaluation. Aidons-nous à nous améliorer. Votre opinion compte. Téléchargez l application de la CIFR Visitez la zone d évaluation, au vestibule de la salle B, près du kiosque d inscription, ou Visitez le afin de remplir une évaluation de la séance. You could be entered to win 1 of 3 $100 gift cards. Vous courrez la chance de gagner l un des trois chèques-cadeaux d une valeur de 100 $.