Competence by Design

All pediatric residency training programs are currently anticipated to launch Competence By Design (CBD) in July 2021. Other residency training programs such as Anesthesia and Otolaryngology launched in July 2017, and a number of other programs will roll out before the Pediatric discipline. In preparation for this launch, many initiatives have been launched at the national, faculty and departmental levels.

Where are we at for CBME/CBD in Pediatrics nationally?

Currently, program directors and CBME/CBD educational leaders across Canada and the RCPSC are actively working on finalizing the CBD curriculum and document suites for General Pediatrics. The EPAs, assessment benchmarks and required training experiences for each stage of training have been approved and finalized. The milestones are currently in the process of finalization and should be approved by the end of 2020. Other important issues being actively worked on are:

  • Timing of the RCPSC exams
  • The PGY-4 training model for those entering subspecialties (overlap versus no overlap training)

Useful links for more information:  RCPSC Competence By Design (CBD)

Who is involved in supporting the transition to CBME/CBD at McGill?

At McGill, the PGME Enhancement Education Committee (PEEC) is mandated by the Associate Dean, Postgraduate Medical Education (PGME), Dr. Armand Aalamian, to identify educational priorities for residency training programs and to develop and implement educational principles for PGME trainees based on the best evidence and innovative practices for enhanced residency education. The Chair of this Committee is Dr. Leon Tourian, Assistant Dean, PGME. The dossier of transitioning programs to CBD is led by Dr. Regina Husa, CBME Lead, Postgraduate Medical Education.

Through PEEC, a number of useful tools and resources have been developed including faculty and trainee workshops, handbooks, and guidelines. The committee is also closely involved in the preparation, launch and implementation of CBD in all disciplines.

PEEC also provides a setting for the discussion, implementation and monitoring of educational enhancement initiatives between PGME, faculty leads, program directors and curriculum leads, as well as liaising with governing bodies (Royal College of Physicians and Surgeons of Canada, The College of Family Physicians Canada, Collège des médecins du Québec).

For more information please visit PGME's Competency-Based Medical Education page.

 

Where are we at in CBME/CBD in the Department of Pediatrics?

To be pro-active in the process of transitioning to CBME, the Department's Pediatric Residency Training Program has put in place a number of initiatives that are aligned with CBME/CBD. The 2016 Departmental retreat focused on providing faculty with the rationale and key principles of CBME.

Please see Competence By Design Department initiatives below.


Competence By Design in General Pediatrics

Competence By Design Steering Committee (Curriculum and Assessment)


The CBD Steering Committee mandate is to support and guide the McGill Pediatrics Residency Program in its transition and implementation of Competency-Based Medical Education (CBME) and Competence By Design (CBD), ensuring alignment with the RCPSC and PGME requirements.

Committee Members
Dr. Elisa Ruano Cea Chair of the Committee
Assistant Director, Pediatrics Residency Program
elisa.ruanocea [at] mcgill.ca (Email)
Diana Gorea Committee Administrator aec9-studentaffairs.med [at] mcgill.ca (Email)
Dr. Laurie Plotnick Department Associate Chair of Education  
Dr. Evelyn Constantin CBD Consultant  
Dr. Mylene Dandavino General Pediatrics Faculty Representative (in-patient practice)  
Dr. June Ortenberg General Pediatrics Faculty Representative (out-patient practice)  
Dr. David Zielinkski Sub-specialty Faculty Representative  
Ariel Chackowicz Resident Representative  
Cassandre Tetu Resident Representative  
David D'Arienzo Resident Representative  
Rosie Dion Resident Representative  

Committee Responsibilities:

  1. Identify faculty and resident development needs around CBME/CBD, and take an active role for the planning and dissemination of faculty and trainee development around these topics.
  2. Discuss best practices regarding CBD curriculum design and alignment, innovative CBD instructional approaches and assessment of learners, and updates from the RCPSC and PGME educational enhancement committee.
  3. Determine the educational strategies that can best fit the needs of our Pediatric Residency Training Program with regards to CBME/CBD transition and implementation, and formulate recommendations (based on consensus with the committee members) to report to the Residency Program Committee (RPC).

    In particular, the CBD Steering Committee will provide recommendations with regard to:
    - Establishing an "ideal timeline" for the transition and implementation of CBD in our residency program.
    - Ensuring alignment of our teaching and assessment methods with CBD.
    - Defining new program expectations to meet the RCPSC and PGME requirements.
    - The establishment, composition, and functioning of the 'Competence Committee' as well as how this committee will function within the PGME promotions structure during this transitional period.
     

Summer Pediatrics Boot Camp


Launched in July 2017, the boot camp curriculum is part of the summer protected teaching/academic half day, specific to each level of training. The Boot Camp aims to cover the "must know" topics that are essential to function competently within the new roles and expectation of a given training year. PGY1 focuses on starting residency in general, and PGY2 focuses on but is not limited to the ward senior role.

Goal
To best prepare trainees for their new clinical roles and responsibilities as they progress through their different stages of training. Ultimately, we aim to enhance patient care in the context of key transition period during pediatric residency training.

Curriculum Leads of the Pediatric Boot Camp
Ariel Chackowicz R1 Bootcamp
Lara Berliner R1 Bootcamp
David D'Arienzo R1 Bootcamp
Cassandre Tetu R2-R3 Bootcamp
Rosie Dion R2-R3 Bootcamp
Dr. Elisa Ruano Cea (on leave) Faculty Supervisor
Dr. Holly Agostino (acting) Faculty Supervisor

The boot camp curriculum is currently structured as follows:

PGY1 Boot Camp (4 days at the beginning of residency)
- Clinical Skills sessions (e.g. handover, beside presentation, and documentation)
- Procedural Skills in a simulated setting (e.g. lumbar puncture and wound management)
- Dealing with emergency clinical situations in a simulated setting (e.g. case scenarios covering the initial steps expected to be done by an incoming PGY1 resident, such as respiratory deterioration, hypovolemic shock and seizures).

PGY2 and PGY3 Boot Camp (3 summer academic half-days)
- Topics for PGY2s include: hematological emergencies, coaching junior trainees, approach to time management during night float.
- Topics for PGY3s include: learning beside rounds, leading multi-disciplinary meetings, the discharge of patients with medical complexities.
- Topics for both PGY2s and PGY3s include: dealing with the palliative care patients, challenging communication with supervisors.

Focus on Direct Observation

Academic Pediatric Faculty Project Leads
Dr. Elisa Ruano Cea CBME Lead elisa.ruanocea [at] mcgill.ca (Email)
Dr. Evelyn Constantin Director of the Pediatrics Residency Program robert.sternszus [at] mcgill.ca (Email)
Dr. Mylene Dandavino Head of the Montreal Children's Hospital General Pediatrics Wards mylene.dandavino [at] mcgill.ca (Email)

Due to the upcoming new Royal College of Physicians and Surgeons of Canada expectations around CBME, and the need for regular documentation and monitoring of trainee performance, the General Pediatrics Residency Program put in place a pilot-project on direct observation. This project was launched in October 2016 as one of the initial steps for the transition to Competency-Based Medical Education and has evolved considerably since this time.

The goals of this pilot project were to:

  1. Introduce principles of CBME in trainee assessments
  2. Enhance faculty practices around feedback and direct observation
  3. Enhance trainee initiatives to seek for feedback

The Pediatrics Residency Program Committee mandated that residents have two direct observation forms completed per rotation. The project starting by focusing on a small number of rotations and was eventually expanded to include all rotations. Significant faculty and residency development was undertaken in support of this transition.

In 2020-2021, the program is beginning the 'soft launch' of its CBD curriculum with direct observations now being focused on specific Entrustable Professional Activities (EPAs). Please visit Curriculum Mapping in General Pediatrics for details about this exciting initiative.

 

Contacts:

Elisa.ruanocea [at] mcgill.ca (Dr. Elisa Ruano Cea), CBME Lead
Division of General Pediatrics
514-412-4400 ext. 22563

pediatrics-residency.med [at] mcgill.ca (Alessandra Tedeschi), Student Affairs Advisor
General Pediatrics Residency Program
Room B.RC.6366 | 514-412-4400 ext. 24475

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