Competency-based training in the Netherlands. Professor Gerrit Glas MD PhD Liesbeth Vleugel MD

Transcription

1 Competency-based training in the Netherlands Professor Gerrit Glas MD PhD Liesbeth Vleugel MD

2 Het Competency-based opleidingsplan: training de theorie in the Netherlands Overview Introduction: why competency-based learning? What is competency-based learning? Building a training programma.

3 Competency-based learning: competence as a concept Competency-based training in the Netherlands: why? Government initiatives Rearrangement of the landscape of professions Emphasis on demand-side instead of supply side Shortening length of medical specialist training Science of teaching Approaches of the initial professional education (MD) applied to medical specialist training (problem oriented teaching; homework assignments; discussion; reflection on learning process) Transfer of responsibility Trainee is responsible for his/her own learning process Preparation for life-long learning (education permanente)

4 Competency-based learning: competence as a concept Competence is the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice for the benefit of the individual and community being served. R.M. Epstein & E.M. Hundert, JAMA, Vol 287 (2002), Mindful practice R.M. Epstein, JAMA, Vol. 282 (1999),

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6 Het Competency-based opleidingsplan: de learning: theorie the CanMEDS Roles Framework

7 Het Competency-based opleidingsplan: de learning: theorie competence as a concept Competencies of the medical specialist Based on CanMEDS: 7 competency areas, each with 4 specified competencies Competency area Medical Communication Scholarly attributes Collaboration Organisational knowledge Health advocacy Professional behaviour relates to: Knowledge and skills of the profession Patient, family and professionals Evidence-based medicine; teaching; informing the public; participation in research Colleagues and health providers within and outside the hospital/clinic Appropriate working with others; optimization of health logistics Prevention; knowledge / application of legislation; risk management; dealing with adverse events Ethics; reflection; knowledge of own limitations

8 Het Competency-based opleidingsplan: de learning: theorie competence as a concept Some examples of general competencies Medical Communication Collaboration Organisation Health advocate Scholarly attributes Professional the specialist has state of the art knowledge and skills the specialist creates effective diagnostic and treatment relations with patients the specialist refers/transfers adequately the specialist works effectively and efficiently within a health care organisation the specialist works according to the relevant legislation the specialist contemplates medical information critically, encourages expertise development of students, colleagues, etc. the specialist shows awareness of his/her own competencies and limitations

9 Het The opleidingsplan: Training Programme: de theorie praktijk in Practice

10 Het The opleidingsplan: Training Programme: de theorie Legislation Legislation

11 Het The opleidingsplan: Training Programme: de theorie Profile of the Specialism and Competencies Profile of the specialism Competencies of the specialist Legislation

12 Het The opleidingsplan: Training Programme: de theorie Foundation Profile of the specialism Global picture of the profession and its position in health care, now and in the years to come The competencies of the specialist The capacity to perform, in an adequate way, a professional activity in a specific, authentic context through integration of knowledge, skills and attitude

13 Het The Training opleidingsplan: Programme: de theorie Themes, Operationalised competencies, Assessment Themes Operationalised competencies Assessment Profile of the specialism Competencies of the specialist Legislation

14 Het The opleidingsplan: Training Programme: de theorie Work as Point of Departure Themes: Activities which belong together/ recognizable parts of the training Arrangement of the training programme on the basis of the work of the medical specialist Operationalised competencies Competencies made explicit within the context of the training programme Knowledge, skills and attitudes which the trainee attains in the course of the training Assessment Description of a vision and the starting points of a programme of assessment Assessment methods

15 Het The opleidingsplan: Training Programme: de theorie Themes: general view versus details Themes show a general view, no detailled plan

16 Het The opleidingsplan: Training Programme: de theorie Assessment Vision of the training programme on assessment Why do you want to assess? What do you want to assess? How much do you want to assess? When do you want to assess? Who does the assessment? Which instruments do you want to use?

17 Het The opleidingsplan: Training Programme: de theorie Assessment Philosophy Why assessment? Developmental focus: Selection focus: formative summative When assessment? Dependent on objectives and content: before, during, after completed training, before, during, after practical work Who does the assessment Dependent on objectives and content; trainee, fellow trainee, director of training, supervisor, nurse, patiënt.. Wat What toetsen? has be assessed? Which instruments? Knowledge, skills, attitude, competencies Not everything can be formally assessed; A mix of instruments is important

18 Het The opleidingsplan: Training Programme: de theorie Training Method, Activities and Material Training method Themes Training activities Operationalised competencies Training material Assessment Profile of the specialism Competencies of the specialist Legislation

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20 Het The opleidingsplan: Training Programme: de theorie Training Method, Activities and Material Training method Philosophy about training: how do we want to train? Principles of training of professionals and of competency-based training Training activities Learning clinical medicine in workplaces/courses/self Training material What material do we need for training activities to be effective?

21 Het The opleidingsplan: Training Programme: de theorie Training Method According to the principles of learning by professionals Stimulating work and learning climate Experience-based learning: competency development on the basis of previous experiences Rolmodelling and coaching (feedback) Reflection on and insight in own competencies Increasing responsibility and independence Individual adaptation of the training scheme on the basis of portfolio Opportunities to study and train with e.g. modern media (e-learning, virtual reality, skillslab, training courses)

22 Het The opleidingsplan: Training Programme: de theorie Training Activities Training activities: patient reporting journal clubs teaching round out patient clinic patient round consultations mortality/morbidity review multidisplinary conferences structured series of conferences OR teaching.

23 Het The opleidingsplan: Training Programme: de theorie Quality control Quality control: Training process Check on legislation Professionalizing trainers and trainees Research of education Training method Themes Training activities Operationalised competencies Training material Assessment Profile of the specialism Competencies of the specialist Legislation

24 Het The opleidingsplan: Training Programme: de theorie Quality control Quality control visitation internal audit professionalizing trainers and trainees (participation) in research of education

25 Het The opleidingsplan: Training Programme: de theorie checklist Checklist training programme: Profile of the specialism The competencies of the specialist Themes Operationalised competencies Assessment philosophy methods programme Educational method Educational activities Educational material Quality control educational process legislation check professionalizing trainees and trainers research of educational process Support by peers

26 The Training Programme: in Practice Quality control: Training process Check on legislation Professionalizing trainers and trainees Research of education Training method Themes Training activities Operationalised competencies Training material Assessment Profile of the specialism Competencies of the specialist Legislation Support by peers

27 In a nutshell

28 Portfolio Logbook; collection Reflection