Competence by Design Innovators

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.

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.

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.

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.

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.

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.

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.