Implementation of competence committees during the transition to CBME in Canada: A national fidelity-focused evaluation

Abstract

Purpose

This study evaluated the fidelity of competence committee (CC) implementation in Canadian postgraduate specialist training programs during the transition to competency-based medical education (CBME).

Methods

A national survey of CC chairs was distributed to all CBME training programs in November 2019. Survey questions were derived from guiding documents published by the Royal College of Physicians and Surgeons of Canada reflecting intended processes and design.

Results

Response rate was 39% (113/293) with representation from all eligible disciplines. Committee size ranged from 3 to 20 members, 42% of programs included external members, and 20% included a resident representative. Most programs (72%) reported that a primary review and synthesis of resident assessment data occurs prior to the meeting, with some data reviewed collectively during meetings. When determining entrustable professional activity (EPA) achievement, most programs followed the national specialty guidelines closely with some exceptions (53%). Documented concerns about professionalism, EPA narrative comments, and EPA entrustment scores were most highly weighted when determining resident progress decisions.

Conclusions

Heterogeneity in CC implementation likely reflects local adaptations, but may also explain some of the variable challenges faced by programs during the transition to CBME. Our results offer educational leaders important fidelity data that can help inform the larger evaluation and transformation of CBME.

Keywords:

• Competency-based medical education
• program evaluation
• competence committees
• implementation

Acknowledgments

The authors thank the study participants for their time and involvement in completing the survey and the Royal College of Physicians and Surgeons of Canada for providing administrative support for this study. The authors also thank Drs. Linda Snell, Denyse Richardson and Adelle Atkinson for their critical review of the original grant proposal associated with this study.

Ethical approval

This study received ethics exemption from the Ottawa Health Science Network Research Ethics Board.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data supporting the results are maintained by the Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.

Additional information

Funding

Funding for this research study was provided by the Royal College of Physicians and Surgeons of Canada Intramural Grant Program.

Notes on contributors

Warren J. Cheung

Warren J. Cheung, MD, MMEd, FRCPC, is Associate Professor, Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada and a Clinician Educator, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.

Natalie Wagner

Natalie Wagner, PhD, is Adjunct Professor and Education Developer, Office for Professional Development & Educational Scholarship, Queen’s University, Kingston, Ontario, Canada.

Jason R. Frank

Jason R. Frank, MD, MA(Ed), FRCPC, is Director of Specialty Education, Strategy, and Standards, Royal College of Physicians and Surgeons of Canada, Ottawa Ontario, Canada and Vice-Chair Education, Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Anna Oswald

Anna Oswald, MD, MMEd, FRCPC, is Professor, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada and a Clinician Educator, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.

Elaine Van Melle

Elaine Van Melle, PhD, is Senior Education Scientist, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada and Adjunct Faculty, Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada.

Alexandra Skutovich

Alexandra Skutovich, BA, MA, is Research Coordinator, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.

Timothy R. Dalseg

Timothy R. Dalseg, MD, MMEd, FRCPC, is Assistant Professor, Department of Medicine, Division of Emergency Medicine, University of Toronto, Toronto, Ontario, Canada and a Clinician Educator, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.

Lara J. Cooke

Lara J. Cooke, MD, MSc, FRCPC, is Professor, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada and a Clinician Educator, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.

Andrew K. Hall

Andrew K. Hall, MD, FRCPC, MMEd, is Associate Professor, Department of Emergency Medicine, University of Ottawa, Ottawa Ontario, Canada and a Clinician Educator, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.