Entrada Quick Start Guides
What is CBME?
- Traditional medical education with a time-based emphasis has been shown to result in gaps in competence of medical students and residents [Chen], [Crosson], [Mattar].
- CBME is a framework of education which focuses on both the process & outcomes of training.
- Several challenges with traditional model are specifically addressed by CBME [Regehr].
Traditional vs CBME – Comparison
No good data to determine educational value of rotations
Many data points for each rotation
ITERS high stakes
Frequent low stakes assessments
Late identification of residents in difficulty
Early identification of residents who require additional support
Failure of faculty to give timely, constructive feedback when deficiencies identified
Coaching in the moment around specific competencies
Faculty and Program expectations of residents not clear
Programs may respond to residents in difficulty with increased support or time, limited opportunity to facilitate enhanced learning for exceptional residents
More responsive educational construct to fit each resident’s unique educational trajectory.Traditional medical education with a time-based emphasis has been shown to result in gaps in competence of medical students and residents [Chen], [Crosson], [Mattar].
Competency by Design (CBD)
is the Royal College’s initiative to incorporate CBME into specialty education. CBD incorporates frequent observations and coaching [operationalized by assessment of Entrustable Professional Activities (EPA’s)] specific to stages of residency, Required Training Experiences (RTE’s) as well as other supporting documentation (e.g. exams).
The College of Family Physicians of Canada’s (CFPC) Triple C CBME Curriculum was implemented at UBC in 2012. The curriculum is based on principles of comprehensive care, continuity of education and patient care, and Family Medicine-centered.
To date, 22 Royal College programs have launched CBME:
- July 1, 2017 – Anesthesiology, Otolaryngology- Head and Neck Surgery
- July 1, 2018 – Emergency Medicine, Medical Oncology, Nephrology – Adult & Pediatric, Surgical Foundations, Urology
- July 1, 2019 – Anatomical Pathology, Cardiac Surgery, Critical Care Medicine – Adult & Pediatric, Gastroenterology – Adult & Pediatric, General Internal Medicine, Geriatric Medicine, Internal Medicine, Neurosurgery, Obstetrics & Gynecology, Radiation Oncology, Rheumatology – Adult & Pediatric
- July1, 2020 – Cardiology – Adult & Pediatric, Clinical Immunology – Adulty & Pediatric, General Surgery, Neonatal-Perinatal Medicine, Neurology Adult & Pediatric, Orthopedic Surgery, Pediatric Surgery, Physical Medicine and Rehabilitation, Plastic Surgery, Physciatry, Respirology Adult, Vascular Surgery
UBC CBME Leads
CBME Project Manager:
Eleni Tsakumis – firstname.lastname@example.org
CBME Entrada Support:
Elaine Molloy – email@example.com
Anika Sterba – firstname.lastname@example.org
Competency By Design:
Resident Training and Assessment
Faculty Development Resource:
Mock Competence Committee Cases for Practice Deliberation
Chen C, Kotliar D, Drolet BC. Medical education in the United States: do residents feel prepared? Perspect Med Educ. 2015;4. DOI: 10.1007/s40037-015-0194-8. [PubMed]
Crosson FJ, Leu J, Roemer BM, Ross MN. Gaps in residency training should be addressed to better prepare doctors for a twenty-first-century delivery system. Health Affairs. 2011;30:2142–8. doi: 10.1377/hlthaff.2011.0184. [PubMed] [Cross Ref]
Mattar SG, Alseidi AA, Jones DB. General surgery residency inadequately prepares trainees for fellowship: results of a survey of fellowship program directors. Ann Surg. 2013;258:440–9. doi: 10.1097/SLA.0b013e3182a191ca. [PubMed] [Cross Ref]
Regehr G. What does the College Want from Us Now? Peeking Behind the Curtain of Competency-based Medical Education. UBC Department of Surgery Grand Rounds. April 19, 2017.