Competence by Design Innovators

You need to prepare well in advance of the launch date and assemble a team to help you. CBD implementation is a large task that’s feasible only with a group or, at the very least, a committed partner. Ideally, you should identify a CBD lead who is an experienced educator.

Completing the assessment forms for all EPAs and milestones on a daily basis has been the biggest challenge. Part of the issue has been working with a new electronic platform, which wasn’t up and running until a week before our launch; the other part has been getting people onside with the fact that this is another task they must complete.

Prepare early. Make sure everyone’s passwords and PIN numbers work. Have a good orientation with residents about the electronic platform and the fact that they need to take ownership of their learning. Tell people about the tasks they must complete rather than saying they can complete assessments “whenever.” We went from being laid back on that issue to being highly prescriptive.

First, a year out, we oriented faculty to the concept and purpose of CBD so they would understand why we were doing it. Second, just before launch, we taught them about the nuts and bolts of the workflow. Third, just after launch, we addressed specific bugs and concerns. Fourth, we did a workshop on the best practices for doing assessments and how to give higher quality feedback.

The quality and frequency of feedback to residents is better under CBD because it’s mandatory and happens early. Under the old system, we wouldn’t have documentation about a resident’s problems or weaknesses until a year or two into the process. Also, CBD pushes us to talk about education more often, which is good for the program.

First, our CBD lead ran our own internal workshops based on our experience. The workshops used the Royal College CBD website for certain resources. Second, we held a full-day retreat for faculty that was 30 percent dedicated to CBD. Third, our administrator reached out to faculty to deal with technical issues such as password problems.

I’m pleased that CBD has been accepted to so well by faculty. If I were getting grief from people or disengagement, I’d see that as a failure. But our program has been very willing to participate and has been engaged rather than viewing this transition as an annoyance.