Competence by Design Innovators

I was surprised how positive it was to implement change. In education, it’s the people who are important, and everyone involved in this process has found it a complex, challenging, rewarding, fulfilling and dynamic exercise.

Managing the details. As you work, you find layer after layer of opportunities, including changes required in culture, attitudes, processes and so much more. We just finished redoing our handbook for the program and we’ve changed everything – from our terms of reference, to role descriptions, program evaluations forms and documentation that defines the structure of our program. It can seem never-ending.

Two things: Remember that you’re not in this alone. Talk to other program directors who are in various stages of CBD implementation, because there’s so much opportunity to learn from each other. Second, bring a CBD mindset to CBD implementation. In other words, as you implement a phase, observe, ask questions, be curious and reflect – then start the whole process over again with another phase. Think of CBD implementation as your own opportunity to experience how CBD should work.

We present information to faculty only when they need it, and in a way that they can easily use. For example, we piloted EPAs by picking one rotation. We explained to faculty how to use the EPAs, then met with staff and residents to solve whatever problems came up. The key thing was to start with something manageable and then scale up, rather than flood faculty with abstract ideas about CBD.

CBD implementation gave us an opportunity to go back to basics – to figure out what really good quality education is and looks like, and how learning occurs – and bring that into our program. Also, because education and clinical practice link so closely, we’ve been able to improve the quality, efficiency and effectiveness of our practice environment based on what we’ve learned about education.

We’ve done workshops and small groups as well as one-on-one coaching with faculty. More than anything, we provide an environment where learning can take place. Because we have a strong community of education in our program, the actual exchange between residents and faculty has been an effective tool for engagement.

The CBD journey has strengthened our community of practice and learning within the program, and we’ve got some new people engaged in education who weren’t that strongly engaged before. What’s most gratifying is watching as the light bulb goes on and people begin to learn in new ways