Curriculum reform for residency training: competence, change, and opportunities for leadership

Abstract

Purpose Certain pressures stemming from within the medical community and from society in general, such as the need for increased accountability in resident training and restricted resident duty hours, have prompted a re-examination of methods for training physicians. Leaders in medical education in North America and around the world champion competency-based medical education (CBME) as a solution. The Department of Anesthesiology at the University of Ottawa launched Canada's first CBME program for anesthesiology residents on July 1, 2015. In this paper, we discuss the opportunities and challenges associated with CBME and delineate the elements of the new CBME program at the University of Ottawa. Source Review of the current literature. Principal findings Competency-based medical education addresses some of the challenges associated with physician training, such as ensuring that specialists are competent in all key areas and reducing training costs. In principle, competency-based medical education can better meet the needs of patients, providers, and other stakeholders in the healthcare system, but its success will depend on support from all involved. As CBME is implemented, anesthesiologists have the opportunity to become leaders in innovation and medical education. The University of Ottawa has implemented a CBME program with a twofold purpose, namely, to focus learning opportunities on the development of the specific competencies required of practicing anesthesiologists and to test the effectiveness of a reduction in the length of training. Conclusion Canadian anesthesia residency programs will soon transition to CBME in order to promote better transparency, accountability, fairness, fiscal responsibility, and patient safety. Competency-based medical education offers significant potential advantages for healthcare stakeholders. RésuméObjectif Certaines pressions provenant de la communauté médicale et de la société en général, telles que la nécessité d'une imputabilité accrue lors de la résidence et des heures réduites pour les résidents, ont motivé un réexamen des méthodes de formation des médecins. Les chefs de file de la formation médicale en Amérique du Nord et de par le monde prô nent la formation médicale fondée sur les compétences (FMFC) comme solution. Le département d'anesthésiologie de l'Université d'Ottawa a lancé le premier programme canadien de FMFC destiné aux résidents en anesthésiologie le 1 er juillet 2015. Dans cet article, nous présentons les occasions et les défis associés à la FMFC et décrivons les éléments du nouveau programme de FMFC de l'Université d'Ottawa. Source Revue de la littérature actuelle. Constatations principales La formation médicale fondée sur les compétences relève certains des défis associés à la formation des médecins, tels que de garantir que les

Preparing anesthesiology faculty for competency-based medical education

“…On July 1, 2015, the Department of Anesthesiology at the University of Ottawa implemented a CBME program. 2,3 In this paper, we discuss the need for faculty development when implementing CBME, outline our efforts to prepare faculty to teach and assess residents within this new training paradigm, and share our experiences preparing faculty for CBME.…”

“…A complete description of the CBME curriculum and its development has previously been published. 2,3 Briefly, the Ottawa CBME program is divided into four main components: Transition to Discipline, Foundations of Discipline, Core of Discipline, and Transition to Practice. The academic year is divided into 13 four-week blocks.…”

Redesigning an anesthesiology resident training program to improve practical procedure competency

“…Therefore, numerous trials for teaching [2], assessing [34], and documenting the competency [5] of residents in a large number of procedures during residency training have been implemented and teaching quality has been evaluated [6]. In the context of practical skills, exposure to a predetermined time in a clinical subspecialty and a target number of cases does not guarantee competence in that clinical area [7].…”

“…A quantitative approach to resident training is now required, necessitating re-examination of the methods for training and assessing anesthesiology residents to provide learning opportunities for the specific competencies required by practicing anesthesiologists. By employing CUSUM analysis as quality control [910], competency-based medical education [2], and innovative competition-based simulation approaches [4] have been widely tested to evaluate the efficacy of an anesthesiology residency training program. Prompt adoption and application of advanced teaching and assessment programs are required.…”

Competency-based medical education: Its time has arrived

“…As described in this issue of the Journal, the Department of Anesthesiology at the University of Ottawa enrolled its first cohort of residents into an innovative competency-based program in July 2015. 1 Many department chairs, clinicians, funding agencies, and other stakeholders may ask why we should change the way we've been training physicians for the past 100 years. They well recognize that we already turn out the most highly educated physicians in history and would be hard pressed to show that most are not competent.…”