Analyzing the Administrative Burden of Competency Based Medical Education

Abstract

Purpose: Postgraduate residency programs in Canada are transitioning to a competency-based medical education (CBME) system. Within this system, resident performance is documented through frequent assessments that provide continual feedback and guidance for resident progression. An area of concern is the perception by faculty of added administrative burden imposed by the frequent evaluations. This study investigated the time spent in the documentation and submission of required assessment forms through analysis of quantitative data from the Queen’s University Diagnostic Radiology program. Methods and Materials: Data regarding time taken to complete Entrustable Professional Activities (EPA) assessments was collected from 24 full-time and part-time radiologists over a period of 18 months. This data was analyzed using SPSS to determine mean time of completion by individuals, departments, and by experience with the assessment process. Results: The average time taken to complete an EPA assessment form was 3 minutes and 6 seconds. Assuming 3 completed EPA assessment forms per week for each resident (n = 12) and equal distribution among all staff, this averaged out to an additional 18 minutes of administrative burden per staff member over a 4 week block. Conclusions: This study investigated the perception by faculty of additional administrative burden for assessment in the CBME framework. The data provided quantitative evidence of administrative burden for the documentation and submission of assessments. The data indicated that the added administrative burden may be reasonable given mandate for CBME implementation and the advantages of adoption for postgraduate medical education.

Making assessment a team sport: a qualitative study of facilitated group feedback in internal medicine residency

“…The growing burden of assessment tasks for faculty supervising multiple learners on clinical rotations represents a major barrier for collecting rich, narrative feedback in CBME. 41 Although faculty remained responsible for reviewing and signing off the rotation assessment forms, the facilitated approach used here relieved faculty of the work of collecting feedback and composing these narratives. This also promoted timely and accurate completion of documentation for learners.…”

Radiologist preferences for faculty development initiatives to improve resident feedback in the era of competency-based medical education

“…These results build on the published literature in which the importance of quality narrative feedback in CBME is reported by both trainees and preceptors, yet the actual documentation of consistent quality feedback can be challenging [ 18 , 19 ]. While preceptors may have a genuine desire to offer valuable feedback to residents, this intention is often hampered by time constraints, particularly in environments where faculty members lack dedicated time specifically allocated for providing feedback [ 20 ]. Further complicating the matter is the lack of rigorous oversight over the completion of assessment forms.…”

Some Things Change, Some Things Stay the Same: Trends in Canadian Education in Paediatric Cardiology and the Cardiac Sciences

“…Adjusting to the assessment model used in CBME has been particularly challenging for learners and for faculty. 38 Educators are recognizing the assessment burden that both learners 39 and faculty feel, 40 as well as the administrative burden to programs 41 when competency based education is implemented. The increased time required for assessment in CBME is substantial in that it requires multiple observers or multiple encounters at multiple times with multiple sorts of patients 42 .…”