Competence by Design through the lens of a program coordinator
For four years, Massih Bidhendi has been program coordinator with the Paediatric Nephrology Program at The Hospital for Sick Children in Toronto. Working closely with Program Director Dr. Damien Noone, Massih has been actively involved in the program’s implementation of Competence By Design (CBD) from its earliest days and shares his advice and lessons learned.
How do you see your program, faculty and residents benefitting from CBD?
Coaching and feedback have always occurred in medical education. Prior to CBD, it was informal and difficult to track. The introduction of CBD has given feedback definition, structure and, more important, a paper trail. If a trainee falls behind, the program director and I can look to the data, pinpoint the cause and address the problem – modifying their education plan to make sure they succeed.
What are you most proud of in SickKids’ journey toward CBD implementation?
When the journey started, we (nephrology) would meet alongside core paediatrics with the University’s CBD leads to work on implementation. We developed our own curriculum maps, assessments tools, rotation plans – all of it. As more specialties became involved, we as a department (paediatrics) began pooling our resources and supporting one another by sharing documents and working collaboratively on CBD implementation. Now we look forward to our monthly group meetings, excited to provide feedback and support to one another as everyone prepares to launch.
When it comes to CBD, what are residents saying?
I don’t like to speak on behalf of residents and I’m not sure enough time has passed since we’ve launched for any measurable observations. But I did notice that, at first, residents found CBD daunting as they felt they were under a spotlight: everyone was watching them. The onus was on the trainee and they weren’t that comfortable approaching faculty about EPAs. This has slowly changed over time as staff become more involved and share the burden of responsibility when it comes to assessments and providing feedback.
Compared to the traditional learning model, what do you see as the key differences in a resident’s learning experience under CBD?
With CBD, all data is taken into consideration, such as OSCE scores, feedback emails, assessments and many other sources of information. In my opinion, the biggest shift is that what was formerly peripheral data, stored and reviewed annually, is now being looked at and reviewed more regularly. It’s funny because I get live notifications whenever members of our competence committee view the files and you can see the change!
What unique challenges are program administrators (PAs) facing in the transition to CBD?
Exporting and collating data from online systems is a daily task under CBME. This makes adding an electronic data management system imperative – and it’s a major undertaking. We at the University of Toronto use the Elentra platform to manage all of our EPA assessments. I would advise any PA implementing CBD to refresh their understanding of basic data management and become comfortable with technology, which goes hand in hand with mastering a platform like Elentra.
If you could pass on one piece of advice to another PA embarking on CBD implementation, what would that be?
For PAs, my advice would be to get involved in CBD as early as possible. I had the good fortune of having a program director who enthusiastically included me in his journey from day one. The PA is the go-to person who is physically present in the office helping staff and trainees. You will be asked a million questions for which you need to have the answers – and be patient and confident when helping! That will be imperative to your program’s ability to transition to CBD on a path of least resistance.