1. Curriculum mapping for Administrators
Jan Taylor, Program Administrator, Internal Medicine
November 2018

2. Defining Curriculum Map – where content can be taught and learned
Assessment Map – where content can be demonstrated and assessed
EPA Map – where EPAs can best be achieved
Reverse Map – opposite perspective
A wide variety of resources and approaches to curriculum mapping. Often refers to review of specific objectives of training and where these are taught and assessed. Our focus today though on EPA mapping

3. Mapping: Been there, done that
Session
CanMEDS Role
PRAM Meetings
Manager, Collaborator
Grand Rounds Prep
Communicator, Scholar
Diagnostic Interviewing
Communicator
Evidence Based Rounds
Scholar
OSCE Preparation
Communicator, Medical Expert
Child Psychopharmocology
Medical Expert, Scholar
Research Seminars
Medical Expert
Complex Case Rounds
Teaching on the Fly
Town Hall Meetings
Manager
Many here already have experience with mapping - eg CanMEDS roles to academic sessions. Psychiatry example

4. Teaching in the Clinical Setting Teaching in the Non-clinical Setting
CanMEDS Competency
Teaching in the Clinical Setting
Teaching in the Non-clinical Setting
written communication
One-on-one feedback on elements of effective discharge summaries during PGY1 CTU rotations (g)
Effective Medical Writing workshop for PGY2 residents
oral communication
Direct observation and feedback on communication with patients, obtaining informed consent and patient counseling, and through patient scenarios and role playing.
PGY1 Retreat: Communication lecture and workshop including standardized patients
PGY1 Patient Education workshop, Half Day curriculum
PGY2 Presentation Workshop, Half Day curriculum
other specialty specific Communicator goals - refer to OTR/STR)
Geriatrics rotation - develop specific skills in communication challenges due to confusion or sensory impairment.(ss)
Palliative Care rotation- understand the role of autonomy, and respect patient privacy and dignity in End of Life Care (ss)
Palliative Care case-based learning session for PGY3 on breaking bad news
Recognize this? Accreditation PSQ, Standard B5 – CanMeds Specific Teaching. Used as a reporting tool, but equally useful format for planning purposes

5. Knowledge Verbal skills Written skills Competency Assessment Method
Frequency
Knowledge
1. OSCE – Junior and Senior
2. Mini-CEX for SMR and JMR
Annually
4 per year on CTU rotations
Verbal skills
1. OSCE communication stations
2. Patient Evaluation of PGY1 residents
3. Advanced Clinician Rounds (PGY2)
4. Chief Medical Resident Grand Rounds (PGY3)
5. Daily Medical Liaison Field Note evaluation
4 per year on CTU
2 per year
2 rotations per year for PGY3
Written skills
1. Review of Discharge summary
2. Review of 2 consultation notes
3. Review of final Continuous Quality Improvement manuscript by supervising faculty
Total of 2 (2 per 2 CTU blocks)
2 during PGY1; 1 during PGY2/3
Annually for PGY3
Or this one: Accreditation standard B6 Assessment of Resident Performance

6. Purposes of EPA mapping
Aligns EPAs with the distribution of training activities
Ensures that all EPA components are included in training
Plans learning activities along CBD Stages
Points stakeholders in the right direction

7. Introducing 10 steps for successful curriculum mapping
Assemble a dynamic team
Review/develop your program’s mission and/or goals
Create a diagram, map or spreadsheet to visualize the existing curriculum in one place
Review existing training experiences
Place EPAs in context and map them to existing training experiences
Validate the distribution of EPAs (and assessment tools) across the stages of the program
Ensure a logical progression of learning
Include formal observation/feedback opportunities
Ensure the program complies with accreditation standards
Evaluate the program regularly with the goal of continuous improvement
Boucher outlines 10 steps. We’ll look at a few relevant steps for our purposes

8. 1.Assemble a dynamic team
Recruit individuals who are passionate and committed:
Members of the program committee
Clinician educators
Resident representatives
An expert in Competence by Design
Program Administrator
(last but not least)
Boucher says:

9. Assemble a dynamic team
Once you have assembled your team, plan a series of closely spaced meetings to make sure you keep the momentum going.
Boucher advises to keep the momentum going. We all know where the momentum often comes from in a training program. Don’t underestimate your contribution to keep the ball rolling.

10. 2. Become friendly with your EPAs
Make time to explore and get to know your program EPAs
EPA

11. EPAs – Key Features
Identifying and assessing unstable patients, providing initial management, and obtaining help
Key features
This EPA includes recognizing critical illness, implementing initial emergent care, and obtaining assistance.
This EPA does not include leading a resuscitation team beyond initial care (i.e. not entrusted with diagnosing etiologies or on-going critical care management)
RC document called Key Features. Identifies what is and is not included in this EPA

12. EPA’s – Assessment Table
Foundations of Discipline
EPA
Foundations 1
Name
Assessing, diagnosing and initial mgmt for pts with common acute medical presentations in acute care settings
Notes
Supervisor (staff or resident); Direct or Indirect Observation
Tracking
Location of patient visit: ED; Ward
Case Mix: chest pain; SOB; altered LOC; fever; hemodynamic instability; other
Guideline for CC
At least three in ED
At least one of each from case mix
At least 5 direct observation
At least 3 from staff
Nobody expects you to memorize the ins and outs of every EPA.
Beyond this slide: Reminder some EPA’s may have distinct parts: Eg Managing patients admitted to acute care. Part A – Assessment and Mgmt; Part B – Communication with Patient/Family; Part C - Handover

13. The Competency-Based Approach
Competencies are assessed during the performance of tasks in an authentic workplace setting
The focus is on performance of competencies as outlined in the EPAs
Learners are responsible for monitoring their own progress ☺☺
Reminder that authentic workplace setting can include simulation. Educate yourself on which of your EPA’s can be met through Simulation. Go ahead and laugh about ‘Learners are responsible for monitoring their own progress’. You know you want to!

14. Non-procedural example
Core
Description
# required
Notes
Guideline for CC
EPA 8
Caring for patients who have experienced a patient safety incident (adverse event) 2
Supervisor does assessment based on direct observation and/or case review
Setting: clinical; simulation
Type of event: error; near miss; adverse event
Disclosure observed: yes; no
Distinguish between what can be taught in Simulation and what can be assessed in Simulation in your program. (Eg: code blue inter-professional group practice – great for learning, bad for assessment)