Early adopter advice series on Competence by Design
Dr. Angèle Brabant-Trottier and Dr. Amy Nistico
CBD Co-Leads | Northern Ontario School of Medicine
What major lessons have you learned as you’ve implemented CBD?
It’s valuable to draw from the experience and work of others who have implemented CBD, and sharing resources is key. We have meetings periodically with other programs that are preparing to tackle this challenge. At the outset they have terror in their eyes but, at the end of an hour-long meeting, they’re much more comfortable.
What has been your biggest challenge in implementing CBD?
The geographic realities of implementing across all of Northern Ontario – from Huntsville to Kenora – in many different centres involving many different hospitals. We use teleconferencing for our bi-weekly meetings and encourage as many faculty as possible to participate in our implementation.
What advice would you provide to other program directors?
Neither of us is a program director, but we are fortunate to have interested and engaged faculty. So, our advice would be that the onus does not have to fall on the program director to drive the whole change. You need to engage your most interested faculty so they understand how they can contribute.
How are you tackling the big issue of engaging your faculty and managing their expectations?
Our best faculty development resources have been local champions, some of whom have been through CBD implementation with the Anesthesia program. We also used regular Department of Medicine meetings to make presentations to faculty about what’s new and exciting with CBD. We make honorable mentions for faculty who have done a high number of assessments. This helps positively reinforce CBD for others.
How do you see your program benefiting from CBD?
CBD involves multiple, low-stake inputs from many people that help guide residents through their journey. To have all that valuable feedback for residents as they train – as opposed to getting that feedback at the end of training – is tremendously valuable to the residents and for the program.
What tools are you using to engage faculty?
We’ve had a number of faculty development sessions and weekend retreats about the CBME concept. These sessions engaged faculty who ultimately became part of our implementation committee. In July, we’re implementing an “EPA of the month” newsletter. Our first issue will be on the concept of CBD and key terminology. We’ll also highlight case examples and address some of the mystery and myths surrounding CBD.
What are you particularly proud of about your CBD journey?
We’re most proud of having worked with a team at the Northern Ontario School of Medicine who have been central pillars in implementing CBD within the Internal Medicine program. Despite having worked together for 18 months, we’re still a cohesive group. Nobody has thrown their hands in the air and stomped off, so we’re quite proud of that.