Competency Based Medical Education
The Royal College of Physicians and Surgeons of Canada (RCPSC) describes Competence by Design (CBD) as a “Royal College initiative to improve physician training and lifelong learning. The CBD initiative will transition specialist medical education from a traditional time-based model to a hybrid form of competency-based medical education (CBME). CBD does not discount or adjust the time spent in training; instead, it re-conceptualizes time as a resource for acquiring competencies.
CBD is a multi-year, transformational change initiative. It focuses on outcomes, asking the question, 'What abilities do physicians need at each stage of their career?' It organizes physician training around desired outcomes and looks at the needed competencies. The greater goal of CBD is to enhance patient care by improving learning and assessment across the continuum from residency to retirement. This will ensure that physicians continue to demonstrate the skills and behaviours needed to meet evolving patient needs.”
Here are some quick CBD references that you may find helpful:
- CBD Terminology
- Giving and Receiving Feedback
- Clarifying myths, misconceptions and Misunderstandings: Common questions regarding the implementation of Competence by Design
- General EPA Primer (227.63 KB)
The focus on assessment in CBD will be Entrustable Professional Activities (EPAs). These are tasks that you and your residents do every day that the Royal College Specialty Committee has identified as key tasks of the discipline. We make entrustment decisions now, but we will now be asking you to make these types of decisions in an explicit more formalized way when the residents are assessed based on their performance – i.e. do you need to be present during their next clinical encounter or procedure; or would you entrust them with the task? If they can work on their own you’ve entrusted them. If not, you’ll need to spend some more time to coach them and providing feedback on what they need to do what they need to do to enable you to entrust them.
Competence by Design Roll-Out Timelines & Cohorts
The RCPSC will be implementing CBD in phases and developed a roll-out schedule of seven cohorts. The first medicine adopters are medical oncology in cohort one and internal medicine and gastroenterology in cohort two. The Royal College of Physicians and Surgeons of Canada provides up to-to-date information on the roll-out schedule and cohorts.