Competency-Based Medical Education implementation: Are we transforming the culture of assessment?

Abstract

Purpose: Adopting CBME is challenging in medicine. It mandates a change in processes and approach, ultimately a change in institutional culture with stakeholders ideally embracing and valuing the new processes. Adopting the transformational change model, this study describes the shift in assessment culture by Academic Advisors (AAs) and preceptors over three years of CBME implementation in one Department of Family Medicine.

Methods: A qualitative grounded theory method was used for this two-part study. Interviews were conducted with 12 AAs in 2013 and nine AAs in 2016 using similar interview questions. Data were analyzed through a constant comparative method.

Results: Three overarching themes emerged from the data: (1) specific identified shifts in assessment culture, (2) factors supporting the shifts in culture, and (3) outcomes related to the culture shift.

Conclusions: In both parts of the study, participants noted that assessment took more time and effort. In Part 2, however, the effort was mitigated by a sense of value for all stakeholders. With support from the mandate of regulatory bodies, local leadership, department, faculty development and an electronic platform, a cultural transformation occurred in assessment that enhanced learning and teaching, use of embedded standards for performance decisions, and tracking and documentation performance.

Disclosure statement

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

Additional information

Funding

We would like to thank the Centre for Studies in Primary Care, Department of Family Medicine for the funding to conduct this research, and to the FM physicians who willingly volunteered to participate in the interviews.

Notes on contributors

Jane Griffiths

Jane Griffiths, MD is an associate professor and was director of assessment when this paper was written, Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada.

Nancy Dalgarno

Nancy Dalgarno, MEd, PhD is director of education scholarship, Office of Professional Development and Educational Scholarship, Faculty of Health Sciences, and assistant professor (adjunct), Department of Queen’s University, Kingston, Ontario, Canada.

Karen Schultz

Karen Schultz, MD is a professor and was program director when this paper was written, Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada.

Han Han

Han Han, MA, PhD is a research associate, Centre for Studies in Primary Care, Queen’s University, Kingston, Ontario, Canada.

Elaine van Melle

Elaine van Melle, MHSc, MEd, PhD is a senior education scientist, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada and assistant professor (adjunct), Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada.