Early adopter advice series on Competence by Design
Dr. Mark Ropeleski
Program Director and CBME Lead | Queen’s University
What major lessons have you learned as you’ve implemented CBD?
CBD gives us a new capture system for assessment, which is useful. But our department already had such a strong culture of education that the task of implementation has been pretty straightforward. What I learned was to tap into faculty’s existing expertise and acknowledge the skills they've already contributed.
What has been your biggest challenge in implementing CBD?
The biggest challenge has been helping the residents integrate and balance the new requirements of CBD. They had to learn a whole new approach, including a new electronic interface. They had to get used to the notion of spending time every couple weeks looking at the requirements – all while the platform was under development at Queen’s. There were a lot of moving parts and we asked a lot of them.
What advice would you provide to other program directors?
Offer strong encouragement for learners and faculty, and recognize the assets they bring to the table as they adopt this new process. Tap into that culture of education that your program already has and remind faculty that they’ve been great teachers all long.
How are you tackling the big issue of engaging your faculty and managing their expectations?
Initially, it was a question of raising awareness and giving talks to faculty at our grand rounds. Some faculty are finding it a challenge to assess the EPAs against specific standards, so I’m creating a snapshot of what trainees should look like at each stage upon transition based on the EPAs and milestones. Hopefully this will give the group a more global feel for things.
How do you see your program benefiting from CBD?
I believe CBD is the right way to do things. We have our first cohort in July who won’t be studying for the Royal College internal medicine exam. I’ve framed that group as the beginning of the golden age in GI training. Residents will be able to jump into the CBME environment and not have another looming, competing priority. I also suspect that the uptake and engagement and frequency of assessments will create better learner self-awareness.
What tools are you using to engage faculty?
Early on, we used videos, presentations at rounds, and CBD resources from the Royal College website. Then we provided a venue at our division meetings for faculty to express their concerns. It’s important to facilitate communication between faculty and the program in a way that streamlines their ability to communicate.
What are you particularly proud of about your CBD journey?
I’m really proud of our residents, who have approached CBD with an open mind and engaged to the best of their abilities, realising this was something completely new. Faculty has also remained really well engaged and brought issues up as necessary so we could improve things.