Becoming a deliberately developmental organization: Using competency based assessment data for organizational development

Abstract

Medical education is situated within health care and educational organizations that frequently lag in their use of data to learn, develop, and improve performance. How might we leverage competency-based medical education (CBME) assessment data at the individual, program, and system levels, with the goal of redefining CBME from an initiative that supports the development of physicians to one that also fosters the development of the faculty, administrators, and programs within our organizations? In this paper we review the Deliberately Developmental Organization (DDO) framework proposed by Robert Kegan and Lisa Lahey, a theoretical framework that explains how organizations can foster the development of their people. We then describe the DDO’s conceptual alignment with CBME and outline how CBME assessment data could be used to spur the transformation of health care and educational organizations into digitally integrated DDOs. A DDO-oriented use of CBME assessment data will require intentional investment into both the digitalization of assessment data and the development of the people within our organizations. By reframing CBME in this light, we hope that educational and health care leaders will see their investments in CBME as an opportunity to spur the evolution of a developmental culture.

Keywords:

• Assessment–general
• medicine
• education environment
• postgraduate
• outcomes-based

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Acknowledgements

We would like to thank the Royal College of Physicians and Surgeons of Canada for coordinating the International Competency-Based Medical Education (ICBME) Summit in Ottawa in 2019, where many of the ideas presented in this manuscript were discussed. We would also like to thank the ICBME collaborators for their contributions to this work.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Glossary

Deliberately Developmental Organization: A concept brought forth by Robert Kegan and Lisa Lahey in their book ‘An Everyone Culture’ that describes an organization or schools where every member struggles and tribulations are viewed as growth opportunities, rather than being seen as causes for shame or blame. Aligned with Dweck’s work on growth mindset, this is an organization that incorporates that level of growth normalcy into the fabric of their organization structure.

Additional information

Notes on contributors

Brent Thoma

Brent Thoma, MD, MA, MSc, Associate Professor, Department of Emergency Medicine, University of Saskatchewan, Saskatoon, SK, Canada Clinician Educator, Royal College of Physicians and Surgeons of Canada.

Holly Caretta-Weyer

Holly Caretta-Weyer, Clinical Assistant Professor, Assistant Residency Program Director, Director of Evaluation and Assessment, Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA, United States.

Daniel J. Schumacher

Daniel J. Schumacher, MD, PhD Associate Professor, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.

Eric Warm

Eric Warm, MD, Professor of Medicine, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.

Andrew K. Hall

Andrew K. Hall, MD, MMEd, Associate Professor, Department of Emergency Medicine, Queen’s University, Kingston, ON, Canada, Clinician Educator, Royal College of Physicians and Surgeons of Canada.

Stanley J. Hamstra

Stanley J. Hamstra, PhD, Vice-President, Milestones Research and Evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois; Adjunct Professor, Faculty of Education, University of Ottawa, Ottawa, Ontario, Canada; Adjunct Professor, Department of Medical Education, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

Rodrigo Cavalcanti

Rodrigo Cavalcanti, MD, MSc, FRCPC, Associate Professor, Dept of Medicine, University of Toronto Director, Ho Ping Kong Centre for Excellence in Education and Practice, UHN, Toronto, ON, Canada.

Teresa M. Chan

Teresa M. Chan, MD, FRCPC, MHPE, Assistant Dean, Program for Faculty Development, Faculty of Health Sciences, McMaster University. Associate Professor, Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada. Adjunct Scientist, McMaster program for Education Research, Innovation, and Theory (MERIT), Hamilton, ON, Canada.