Click to edit Master subtitle style Competence by Design (CBD) Foundations of Assessment

Purpose of CBD 2 To improve the health and health care of Canadians by ensuring specialists are consistently prepared to continuously meet evolving patient needs.

Foundations of CBD

Foundations of Assessment 4 CBD will introduce a culture of assessment by: Embedding continuous assessment throughout training Increasing the authenticity of feedback Increasing transparency of educational standards

Vision of Assessment: EPAs and Milestones 5 Entrustable Professional Activities (EPAs): for assessment EPAs are the key tasks of a discipline that a practitioner needs to be able to perform. Milestones: for teaching Milestones are the abilities expected of a health professional at a stage of development, based on the CanMEDS Roles.

Milestones and EPAs within Each Stage of Training 6 Provide clear learning and teaching paths Remove need to teach or evaluate everything at once – focused on discrete clinical tasks Allow for regular, meaningful feedback, tracking and coaching Generate practical and demonstrable evaluation data Assessment for learning

A Medical Oncology EPA 7 EPA - Foundations of Discipline Assessing uncomplicated patients with a new diagnosis of cancer Milestones Medical Expert 1.3 Apply a broad base and depth of knowledge 2.1 Ascertain/ address patient’s understanding 2.2 Select and interpret appropriate diagnostic tests 2.2 Assess patient’s status and assign ECOG or PS Communicator Use patient-centred interviewing skills 5.2 Communicate using written health records, EMRs etc… Collaborator Communicate with patient’s primary care provider

How Will it Work? Learner 8 Learner Supported by technology Plan learning Views Learning Plan EPAs & milestones Selects training activities Requests observation from Observer Participates in learning Works with Observer & peers Reflects on learning Contributes evidence of learning Reflects on observations & learnings Participates in observation encounter

How Will it Work? Observer 9 Observer Supported by technology Supports learning Works with learners Contributes narrative Reviews evidence Prepares for observation Reviews and accepts requests for observation Reviews EPAs and milestones Participates in observation encounter Evaluates EPA/milestones & records data via technology

How Will it Work? Learner and Observer 10 Learner Supported by technology Plan learning Views Learning Plan EPAs & milestones Selects training activities Requests observation from Observer Participates in learning Works with Observer & peers Reflects on learning Contributes evidence of learning Reflects on observations & learnings Observation encounter Observer Supports learning Works with learners Contributes narrative Reviews evidence Prepares for observation Reviews and accepts requests for observation Reviews EPAs and milestones Supported by technology Evaluates EPA/milestones & records data via technology

Assessment Strategy for Medical Oncology EPA 11 EPA: Assessing uncomplicated patients with a new diagnosis of cancer Observation Encounter Indirect observation (i.e. case discussion) through review of clinic note Direct observation by observing learner/patient interaction and following case discussion Assessment Strategy and Tools Collect at clinic visits across a range of presentations along the cancer continuum Collect observations for patients with a range of tumour types (at least 3) Collect observations from different supervisors (at least 3) EPA specific evaluation tools to be provided

Day in the Life of an Observer Clear evaluation path reduces need to teach and evaluate everything all the time. Flexible timeframes ensures you have the availability to teach and the resident has the time to learn. More frequent formative assessments and meaningful feedback foster performance improvements.

What Happens to the Observation Data? 13 Program Director Supported by technology Guides learning Meets with learners regularly Assigns EPAs to Observer Reviews learner progress using technology Reviews program status Reviews program data and investigates issues Prepares for Competence Committee meetings Competence Committee Assess overall achievement of EPAs & milestones Review learner EPAs/milestones Approve changes to learner status Promote learner to next stage of training Request Royal College certification Modify Learner program plan Monitory overall progress of learner Provides group decision process rather than single summative assessment Supported by technology

Summary 14 CBD is about improving patient care Assessment is a key component of CBD, with a focus on Programmatic, work-based assessment National standards of assessment Program Directors, Observers, and Learners shared responsibility for learning in residency

CBD and CanMEDS Resources 15 Visit us at CanMEDS: Introduction for Clinical Teachers – Video Series Contact us at

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