Was it all worth it? A graduating resident perspective on CBME

Abstract

Background

Our institution simultaneously transitioned all postgraduate specialty training programs to competency-based medical education (CBME) curricula. We explored experiences of CBME-trained residents graduating from five-year programs to inform the continued evolution of CBME in Canada.

Methods

We utilized qualitative description to explore residents’ experiences and inform continued CBME improvement. Data were collected from fifteen residents from various specialties through focus groups, interviews, and written responses. The data were analyzed inductively, using conventional content analysis.

Results

We identified five overarching themes. Three themes provided insight into residents’ experiences with CBME, describing discrepancies between the intentions of CBME and how it was enacted, challenges with implementation, and variation in residents’ experiences. Two themes – adaptations and recommendations – could inform meaningful refinements for CBME going forward.

Conclusions

Residents graduating from CBME training programs offered a balanced perspective, including criticism and recognition of the potential value of CBME when implemented as intended. Their experiences provide a better understanding of residents’ needs within CBME curricula, including greater balance and flexibility within programs of assessment and curricula. Many challenges that residents faced with CBME could be alleviated by greater accountability at program, institutional, and national levels. We conclude with actionable recommendations for addressing residents’ needs in CBME.

Keywords:

• Competency-based medical education
• implementation
• medical education research

Disclosure statement

The authors report that there are no competing interests to declare.

Data availability statement

Our data are qualitative and may contain information that identifies our participants, and as such we do not have permission to share these data.

Additional information

Funding

Royal College of Physicians and Surgeons of Canada.

Notes on contributors

Portia Kalun

Portia Kalun, PhD, is a postdoctoral fellow at Sunnybrook Health Sciences, Toronto, Ontario, Canada.

Heather Braund

Heather Braund, PhD, is associate director of scholarship and simulation education, Office of Professional Development and Educational Scholarship, and assistant (adjunct) professor, Department of Biomedical and Molecular Sciences and School of Medicine, Queen’s University, Kingston, Ontario, Canada.

Natalie McGuire

Natalie McGuire, PhD, is educational developer and adjunct faculty, Office of Professional Development & Educational Scholarship, Queen’s Health Sciences, Queen’s University, Kingston, Ontario, Canada.

Laura McEwen

Laura McEwen, PhD, is director of assessment and evaluation of postgraduate medical education and assistant professor, Department of Pediatrics, Postgraduate Medical Education, Queen’s University, Kingston, Ontario, Canada.

Steve Mann

Steve Mann, MD, MMEd, FRCSC, is associate professor, Division of Orthopaedic Surgery, Department of Surgery, Queen’s University, Kingston, Ontario, Canada.

Jessica Trier

Jessica Trier, MD, FRCPC, is assistant professor, Department of Physical Medicine and Rehabilitation, Queen’s University, Kingston, Ontario, Canada.

Karen Schultz

Karen W Schultz, MD, CCFP, FCFP, is professor, Department of Family Medicine, and associate dean of Postgraduate Medical Education, Queen’s University, Kingston, Ontario, Canada.

Rachel Curtis

Rachel Curtis, MD, FRCSC, is assistant professor, Department of Ophthalmology, Queen’s University, Kingston, Ontario, Canada.

Andrew McGuire

Andrew McGuire, MD, FRCSC, is a clinical fellow, Division of Orthopaedic Surgery, Department of Surgery, University of Ottawa, Ottawa, Ontario.

Ian Pereira

Ian Pereira, MD, is a PGY4 resident, Department of Radiation Oncology, Queen’s University, Kingston, Ontario, Canada.

Damon Dagnone

Damon J Dagnone, MD, FRCPC, MSc, MMEd, is associate professor, Department of Emergency Medicine, Queen’s University, Kingston, Ontario, Canada.