Early adopter advice series on Competence by Design
Dr. Suzanne Bridge
Program and Fellowship Director | Queen’s University
What major lessons have you learned as you’ve implemented CBD?
Creating enthusiasm around the concept of CBD was easier than I anticipated. I’ve learned that to be successful, you need to provide faculty and residents with and easy-to-understand system where people are clear on what they have to do. If you provide people with the right tools and framework, they remain enthusiastic. If not, they tend to get frustrated.
What has been your biggest challenge in implementing CBD?
The volume of data that CBD produces can be hard for faculty and competence committees to manage. Initially, our system gave them the raw data from 1,000 individual assessments – too much for a single person to process. We’ve developed a way to collate and present the data, which has improved efficiency as well as the experience for individuals concerned.
What advice would you provide to other program directors?
Embrace that CBD implementation is an iterative process. You have to be willing to adapt to the needs of your residents and faculty. No matter how much time you spend up front making sure it’s perfect, there will always be changes as you adapt to optimize the approach to your system.
How are you tackling the big issue of engaging your faculty and managing their expectations?
I’ve been pleasantly surprised at how well faculty has embraced this. As long as the system is user friendly, as I explained earlier, faculty will be engaged. We’ve leveraged the success of our transition so far to maintain buy-in from faculty.
How do you see your program benefiting from CBD?
I think the practical language of CBD and the concept of entrustment that it introduces was a natural extension of a coaching feel. Over the past couple of years with that coaching, discussions about performance have transitioned for residents from a fear of being evaluated to ones where the residents are eagerly seeking out feedback as more of a normalized expectation. It was a subtle shift, but faculty and residents are working together more collaboratively to ensure the residents succeed in the program.
What tools are you using to engage faculty?
Early on we used a lot of presentations and small group sessions. We also used a lot of one-on-one sessions to make sure all faculty’s questions were answered, their concerns had been addressed and they were supported through the transition. For example, sitting with a faculty member and helping them log into the system for the first time is a good investment. It goes back to this theme of keeping people engaged by making sure they know what they need to do.
What are you particularly proud of about your CBD journey?
My faculty and trainees impressed me with their willingness to embrace change despite the apprehension that may have existed. All early growing pains seemed completely overshadowed by their enthusiasm. I’m also really proud of the culture that we’ve created with the residents. They seem to crave honest and constructive feedback, and faculty are eager to provide it.