Early adopter advice series on Competence by Design

 Competence by Design Advice from Dr. Katz

LAUNCH : 2019

Dr. Steven Katz

Competence by Design Advice from Dr. Katz | University of Alberta

Discipline :
Internal Medicine

What major lesson have you learned?

Don’t use the word “pilot” in the context of CBD implementation. As soon as you market something as a pilot project, your level of engagement goes down. Never sell CBD implementation as an experiment.

What has been your biggest challenge in implementing CBD?

This is a massive change-management exercise that requires people to establish new habits and a new culture of learning. We need to make sure we understand people’s concerns and the best ways to overcome them.

Advice to other program directors?

Communication is the big thing with all our stakeholders, be it residents, staff, the department leadership, everyone. Making sure great ideas are brought forward is how you encourage engagement and get results.

How are you tackling the big issue of engaging your faculty and managing their expectations?

A big part of the challenge is in getting faculty to understand the importance of being open to providing residents with feedback. We need staff to give residents the impression that it’s okay to ask questions.

How do you see your program benefiting from CBD?

If done well, CBD creates an environment where faculty and residents are engaging in better feedback. It means residents can identify where they need to improve and, ideally, they’re doing that earlier under CBD. For faculty and administration, there’s a great benefit in identifying issues with residents earlier and giving them resources they need to get on track. The process of self-reflection and subsequent improvement makes for a better resident, and a better physician down the road.

What tools are you using to engage faculty?

We’ve been to most sites and sat down with staff in group sessions to explain CBD, the benefits and what’s expected, and to hear people’s concerns and feedback. We’ve engaged regularly with the leadership at our various sites though emails and posters. We also made a La-La Land-inspired video this year as a different way to engage faculty.

What are you particularly proud of?

As one example of progress, a year ago, most residents were weren’t attempting EPAs where they felt vulnerable. So, one message we’ve been fine tuning is that doing EPAs is not about jumping through hoops, and “passing.” It’s about making attempts and learning. Residents are hearing the message.