Introduction

It is postulated that implementation of Competency by Design (CBD) in Royal College of Physicians and Surgeons of Canada (RCPSC) programs has helped enhanced skills programs in emergency medicine (CCFP(EM)) move towards a more competency-based residency. The objectives of the study were to identify major competency-based medical educational (CBME) components of CCFP(EM) programs across the country; and determine how programs are delivering these components.

Methods

After a rigorous development process (expert content development, and pilot testing), a survey questionnaire was administered to all 17 CCFP(EM) program directors using a modified Dillman technique. Questions were structured and framed using the core components framework of CBME. The final survey included a total of 44 questions under six sections.

Results

There was a 100% response rate. Only 65% of programs currently map their program’s curriculum to an explicit outcomes-based framework. All but one program plan to map their program’s curriculum to Core Professional Activities that were released by the College of Family Physicians of Canada (CFPC) in May 2021. In 35% of programs, a curriculum is organized around developmental competencies that support resident progression. Individual coaches or a coaching team follow residents longitudinally in 65% of programs. In 81% of programs, the program meets with a resident at regular, pre-defined intervals to discuss their progression. In terms of assessment: data from direct observations are incorporated 94% of the time; 29% of programs have specific criteria for advancement; and all programs have a Competence Committee. With the introduction of CBD in RCPSC programs, 71% of program directors felt there was less understanding of the unique needs of CCFP(EM) residents.

Conclusion

This study summarizes the current state of CBME in CCFP(EM) programs. While many components of CBME are incorporated, further development and innovation is needed to fully adapt CBME to a 1-year training program.

中文翻译：

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CCFP（EM）计划中的基于能力的医学教育（CBME）

介绍

据推测，加拿大皇家内科外科学院 (RCPSC) 计划中实施能力设计 (CBD) 有助于增强急诊医学 (CCFP(EM)) 的技能计划，使其朝着更加以能力为基础的住院医师方向发展。该研究的目的是确定全国 CCFP(EM) 计划中基于能力的医学教育 (CBME) 的主要组成部分；并确定程序如何交付这些组件。

方法

在经过严格的开发过程（专家内容开发和试点测试）之后，使用改进的 Dillman 技术对所有 17 名 CCFP(EM) 项目主管进行了调查问卷。问题的结构和框架使用 CBME 的核心组件框架。最终调查包括六个部分共 44 个问题。

结果

有100％的响应率。目前只有 65% 的项目将他们的项目课程映射到一个明确的基于结果的框架。除一个项目外，所有项目都计划将其项目课程映射到加拿大家庭医师学院 (CFPC) 于 2021 年 5 月发布的核心专业活动。在 35% 的项目中，课程围绕支持居民进步的发展能力而组织。个人教练或教练团队在 65% 的项目中纵向跟踪居民。在 81% 的项目中，该项目会定期与居民会面，以讨论他们的进展情况。在评估方面：94% 的时间包含来自直接观察的数据；29% 的项目有特定的晋升标准；并且所有项目都有一个能力委员会。

结论

本研究总结了 CCFP(EM) 项目中 CBME 的现状。虽然包含了 CBME 的许多组成部分，但需要进一步的开发和创新才能使 CBME 完全适应 1 年的培训计划。