CBME Program Specific Resources

A message from the Program Director, Dr. Nazanin Meshkat

July 2018 marks a landmark in the history of medical education as we launch Competence by Design in our Emergency Medicine program.

A few years back, on a shift like any other shift, I recall working with a PGY 1 resident who kept apologizing for not being “capable” of handling all the cases he’d seen that night. I found the expectation surprising…after all, how would a PGY1 manage “all cases”?

At the same time the feeling was naggingly familiar.

Walking home, leaving behind the flurry of the shift, I remembered why. Rewind back to my time in medical school and residency, and I had experienced that same sentiment…any time I was not able to manage a case I was acutely aware of my limitations, and the failure felt crushing. The need to be excellent was overwhelming…and frankly crippling at times, stunting growth and a necessary process in my journey to learn. Intellectually, we all know that the road to competence is a long journey, bumpy, and with lots of ups and downs. Emotionally, there is a dissonance of a never-ending need for positive feedback, and a devastating emotional response to constructive feedback. This has led to a dysfunction – a dysfunction in our ability to give and receive feedback.

Competence by design is a crossroad in our trajectory as individuals, educators, programs, and clinicians. With more accurate, varied, and focused assessments, we have the opportunity to engage our learners in their learning, and rewiring us not only to solicit and incorporate feedback, but also to give feedback.

The experience so far with programs that have implemented Competence by Design, is that yes, the rewiring was hard at first…until the tipping point was reached. Join us in our climb to the tipping point. Below you will find some resources that will help in your journey.

Introduction to CBD in the Division of Emergency Medicine

• Introduction to CBD in Emergency Medicine
  
• Emergency Medicine CBD Committee Members
• Key Terms
• Year by Year Curriculum (coming soon)

Timeline of Implementation

Emergency Medicine's Timeline Chart

Competence Committee

The Competence Committee makes promotion recommendations based on a framework of entrustable professional activities (EPAs) used to determine competence. It can also help arrange support for residents who are having difficulty achieving an appropriate level of competence at their stage of training.

• Structure and Roles Infographic
• Division of Emergency Medicine Competence Committee Members & Terms of Reference (coming soon)

Assessment

• Emergency Medicine Entrustable Professional Activities and Milestones Infographic
• Assessment Tools (coming Spring 2018)
• How to Give Feedback
• Thanks for the Feedback: The Science and Art of Receiving Feedback Well by Douglas Stone & Sheila Heen
• Difficult Conversations: How to Discuss What Matters Most by Douglas Stone, Bruce Patton & Sheila Heen
• Using an EPA Assessment Tool (coming Spring 2018)

Mythbusters

Fact or Fiction? Can residents finish their whole program in just one week? Will CBD make you look ten years younger? Do you have a sneaking suspicion that CBD is a plot to make our residents the best emergency docs ever? (hint, that last one’s true…) We’re exploring the myths and legends of CBD! Do you have a burning question about CBD? Chances are others are wondering the same thing! Submit it here to be included in our ongoing Mythbusters series: division.em@utoronto.ca.