1. Triple C Competency-based Curriculum A Brief Overview for Residents Copyright © 2013 The College of Family Physicians of Canada

2. Objectives Describe the components of the “Triple C competency based curriculum” Explain the rationale supporting these key directions 2

3. Triple C Competency-based Curriculum 3 www.cfpc.ca/Triple_C

4. Competency-based Education “…is an approach to preparing physicians for practice that is fundamentally oriented to graduate outcome abilities and organized around competencies derived from an analysis of societal and patient needs. It deemphasizes time-based training and promises greater accountability, flexibility, and learner centredness.” Adapted from: Frank JR, Snell L, ten Cate O, Holmboe ES, Carraccio C, Swing SR, et al. Competency-based medical education: theory to practice. Med Teacher. 2010;32:638-45. 4

5. Triple C Competency-based Curriculum 5

6. “... is a Family Medicine residency curriculum that provides the relevant learning contexts and strategies to enable residents to integrate competencies, while acquiring evidence to determine that a resident is ready to begin to practice in the specialty of Family Medicine.” Alignment Sub-committee of the Triple C Competency-based Curriculum Task Force, November 2011 6

7. Professional Competence Competence Is the array of abilities across multiple domains or aspects of physician performance in a certain context Is multi-dimensional and dynamic Changes over time, experience, and setting Frank JR, Snell L, ten Cate O, Holmboe ES, Carraccio C, Swing SR, et al. Competency-based medical education: theory to practice. Med Teacher. 2010;32:638-45. 7

8. From Competencies to Competence By sampling competencies across multiple domains or settings, a program can infer competence, to the level of a physician ready to begin practice in the specialty of Family Medicine. Adapted from: Crichton T, Allen T, Bethune C, Brailovsky C, Donoff M, Laughlin T, Lawrence K. Defining Competence in Family Medicine for the Purposes of Certification by the College of Family Physicians of Canada: The Evaluation objectives in Family Medicine (updated December 2010). 8

9. 1. Comprehensive Care and Education Residency programs should prepare residents For comprehensive care of patients: - Across Life cycles, Clinical settings, Clinical responsibilities - Including special populations and core procedures Through a comprehensive curriculum: - Modeling comprehensive care 9

10. 2. Continuity of Education and Patient Care Continuity of care: – Follow patients over time – Follow patients in different settings – Experience relationship and responsibility of care Continuity of education: – Continuity of supervision and assessment – Continuity of learning environment – Continuity of curriculum and continuous integration 10

11. 3. Centred in Family Medicine Family Medicine programs will have: Control of goals and curricular elements Primarily Family Medicine contexts and teachers - Augmented as required with other experiences Content relevant to the needs of Family Medicine trainees Opportunities to develop professional identity as a Family Physician 11

12. Competence Abilities Knowledge Attitudes Jugement Values Internal Resources External Resources Patients and families FPs and other professionals In accordance with professional roles and responsibilities Doing the right thing at the right time in the right way in complex situations By using and integrating the right internal and external resources

13. Becoming a Family Physician 13 UNDERGRADUATE MEDICAL EDUCATION CFPC CERTIFICATION Beginning Specialist in Family Medicine FAMILY MEDICINE RESIDENCY TRAINING A Lifelong Journey CONTINUING PROFESSIONAL DEVELOPMENT *Includes Formal Enhanced Skills Training

14. 14 How is this Different from the Traditional Model? Tannenbaum D, Kerr J, Konkin J, Organek A, Parsons E, Saucier D, Shaw L, Walsh A. Triple C competency-based curriculum. Report of the Working Group on Postgraduate Curriculum Review-Part 1. Mississauga ON: College of Family Physicians of Canada; 2011

15. Rationale for Moving to a Triple C Competency-based Curriculum Rising to the challenge to better train family physicians, able to adapt to dynamic environments:  Based on educationally sound strategies and increased efficiency in training - With heightened authenticity of Family Medicine education - With increased accountability for educational outcomes 15

16. How? The Triple C Competency-based Curriculum 16 www.cfpc.ca/Triple_C

17. A Competency-based Program Design curriculum that leads to expected program outcomes Provide relevant educational experiences: Through a curriculum that allows for the development and demonstration of competencies Assess learners for competence: Assessment of competencies as a component of the training program 17

18. Triple C Competency-based Curriculum 18

19. Comprehensive Program Structure Reflects an integrated curriculum over two years Context-specific flexibility of design Based on local resources Provides relevant learning experiences –Within the full range of the Domains of Clinical Care –To encourage development of the CanMEDS-FM Roles 19

20. Continuity of Patient Care Opportunities for: Continuity with patients and families over time, through strategies such as: –Responsibility for a panel of patients –Longitudinal or integrated experiences Continuity of care, in different clinical settings 20

21. Continuity of Education a) Continuity of supervision b) Continuity in the learning environment c) Continuity in the curriculum 21

22. a) Continuity of Supervision Ongoing interactions with designated key preceptors Communication of educational information between preceptors, and between learning contexts Allows for reliable and valid assessment 22

23. b) Continuity in the Learning Environment Long placements that enable residents to develop relationships and understand context Continuity maintained in any new placement, either educational or clinical Creating a bounded, familiar educational and work environment (physical environment and health care team) 23

24. c) Continuity in the Curriculum Coherent academic programming over learning experiences and settings Explicit strategies to facilitate integration of experiences into competencies 24

25. Curriculum Design is Centred in Family Medicine The program maintains ownership of all aspects of the curriculum Experiences based in comprehensive Family Medicine contexts Other relevant focused experiences as required Family physicians are the core teachers Complemented by Family Medicine-oriented consultants depending on local resources 25

26. Teaching and Learning Strategies Strategies focus on: Achievement of competencies rather than knowledge transmission Development of professional identity Becoming a reflective practitioner Emphasis on the family physician’s perspective 26

27. Teaching and Learning Strategies Residents are encouraged to be active learners and to develop their autonomy There is explicit role modeling of the CanMEDS-FM Roles 27

28. Academic Program Competency oriented Well organized and comprehensive Addresses key competencies Complementary to the clinical experience Encourages autonomous learning 28

29. Academic Program Uses relevant teaching and learning strategies –Problem-solving and critical thinking –Engages residents to reflect in action and on action Focuses on the family physician’s perspective on the problem Residents learn about context and content of the culture of Family Medicine 29

30. Acknowledgment This PowerPoint presentation was authored by: Danielle Saucier, MD, MA(Ed), CCFP, FCFP Shirley Schipper, MD, CCFP On behalf of the Alignment sub-committee of the Triple C Competency-based Curriculum Task Force: Danielle Saucier, MD, MA (Ed), CCFP, FCFP (Co-chair) Ivy Oandasan, MD, MHSc, CCFP, FCFP (Co-chair) Michel Donoff, MD, CCFP, FCFP Karl Iglar, MD, CCFP Shirley Schipper, MD, CCFP Eric Wong, MD, MClSc(FM), CCFP Suggested citation: Saucier D, Oandasan I, Donoff M, Iglar K, Schipper S, Wong E. Triple C competency-based curriculum: A brief overview [PowerPoint presentation]. Mississauga ON: College of Family Physicians of Canada; 2011. 30

31. Based Upon Triple C competency-based Curriculum: Report of the Working Group on Postgraduate Curriculum Review-Part 1 Tannenbaum D, Kerr J, Konkin J, Organek A, Parsons E, Saucier D, Shaw L, Walsh A. Triple C competency-based curriculum. Report of the Working Group on Postgraduate Curriculum Review-Part 1. Mississauga ON: College of Family Physicians of Canada; 2011 Available Here 31