In-Rotation Direct Supervision

Competency-based medical education will significantly change how we train residents within our program. One of the significant changes associated with CBME is the amount of direct supervision required during clinical rotations. CBME will require frequent resident supervision to assess and follow their developing competencies. Residents in programs that have already converted to CBME greatly appreciate the more frequent supervision and feedback they’re receiving. In order to improve resident training, prepare the program for CBME, and gently prepare our department of 250 attendings for the changes associated with CBME, the RPC has approved a stepwise approach towards structuring, formalizing and monitoring direct clinical supervision of residents.

The first step involves filling out the McGill Psychiatry Mini-Assessment of Clinical Expertise form on a monthly basis (form on one45). A minimum of 2 per period per rotation is required (1 MINI-ACE every 2 weeks per rotation). Supervisors need to provide residents direct supervision of a clinical encounter of at least 20 minutes in length. Following the clinical encounter, supervisors need to provide feedback to the resident and fill out the McGill Psychiatry Mini-Assessment of Clinical Expertise form. The MINI-ACE is meant to be a slow stake, focused and formative training experience. Feedback needs to be provided immediately after the clinical encounter. Moreover, the MINI-ACE needs to be pre-planned (focusing on a specific clinical encounter) and not completed retrospectively.   The resident uses the feedback provided to improve their clinical skills. Once the form is completed, the resident is responsible for delivering it to their hospital based resident administrative coordinator who will compile these evaluations for individual training directors.  Direct clinical encounters can range from a complete diagnostic interview, to a family intervention, to a team meeting, to a de-escalation intervention, to psycho-educative intervention, etc.