Continuity of supervision: Balancing continuous and episodic relationships for assessment and learning.

Introduction: Meaningful supervisor-resident relationships enhance feedback and learning, yet not all relationships reach this potential. While there is increasing interest in continuity of supervision (CoS) to build relationships that support feedback and promote learning, there remains a limited understanding of how relationships develop and influence assessment over time. The aim of this study was to explore how supervisors and learners in postgraduate medical education perceive CoS relationships and their impact on feedback and assessment.

Mini Med School: Knowledge and Resources for Underrepresented in Medicine Youth.

Background And Objectives: Physician demographics in North America do not yet reflect the diversity of the communities they serve, accounted to systemic barriers targeting underrepresented in medicine (URiM) groups. URiM medical graduates are more likely to pursue generalist specialties, including family medicine. Mini Med Schools (MMSs) are pathway programs intended to motivate URiM youth to pursue medicine.

Defining and prioritizing modifiable risk factors towards the co-creation of a urinary incontinence self-management intervention for older men: A sequential multimethod study protocol.

Urinary incontinence (UI), characterized by involuntary urine leakage is a chronic, embarrassing and stigmatizing condition that is under-reported and under-treated). UI is under-prioritized and under-researched, particularly in older men (defined here as men 65+), and there have been calls for more targeted research focusing on this specific group. No existing self-management interventions focus on the needs of older men and none incorporate the perspectives of older men into their development.

Making sense of competency-based medical education (CBME) literary conversations: A BEME scoping review: BEME Guide No. 78.

Background: Competency-based medical education (CBME) received increased attention in the early 2000s by educators, clinicians, and policy makers as a way to address concerns about physician preparedness and patient safety in a rapidly changing healthcare environment. Opinions and perspectives around this shift in medical education vary and, to date, a systematic search and synthesis of the literature has yet to be undertaken. The aim of this scoping review is to present a comprehensive map of the literary conversations surrounding CBME.

Making sense of adaptive expertise for frontline clinical educators: a scoping review of definitions and strategies.

Adaptive expertise has been promoted as an emerging model of expertise in health professions education in response to the inherent complexities of patient care; however, as the concept increasingly influences the structure of professional training and practice, it creates the potential for misunderstandings of the definition and implications of adaptive expertise. To foster a common understanding of the concept, we conducted a scoping review to explore how adaptive expertise has been discussed within health professions education literature. Five databases-MedLine, PubMed, ERIC, CINAHL, and PsycINFO-were searched using the exact term "adaptive expertise", producing 212 unique articles.

Using Learning Analytics to Examine Differences in Assessment Forms From Continuous Versus Episodic Supervisors of Family Medicine Residents.

Background: It is assumed that there is a need for continuity of supervision within competency-based medical education, despite most evidence coming from the undergraduate medical education rather than the graduate medical education (GME) context. This evidence gap must be addressed to justify the time and effort needed to redesign GME programs to support continuity of supervision.

Objective: To examine differences in assessment behaviors of continuous supervisors (CS) versus episodic supervisors (ES), using completed formative assessment forms, FieldNotes, as a proxy.

A Comparison of Resident-Completed and Preceptor-Completed Formative Workplace-Based Assessments in a Competency-Based Medical Education Program.

Background And Objectives: In competency-based medical education (CBME), should resident self-assessments be included in the array of evidence upon which summative progress decisions are made? We examined the congruence between self-assessments and preceptor assessments of residents using assessment data collected in a 2-year Canadian family medicine residency program that uses programmatic assessment as part of their approach to CBME.

Methods: This was a retrospective observational cohort study using a learning analytics approach. The data source was archived formative workplace-based assessment forms (fieldnotes) stored in an online portfolio by family medicine residents and preceptors.

Development, Implementation, and Meta-Evaluation of a National Approach to Programmatic Assessment in Canadian Family Medicine Residency Training.

The growing international adoption of competency-based medical education has created a desire for descriptions of innovative assessment approaches that generate appropriate and sufficient information to allow for informed, defensible decisions about learner progress. In this article, the authors provide an overview of the development and implementation of the approach to programmatic assessment in postgraduate family medicine training programs in Canada, called Continuous Reflective Assessment for Training (CRAFT). CRAFT is a principles-guided, high-level approach to workplace-based assessment that was intentionally designed to be adaptable to local contexts, including size of program, resources available, and structural enablers and barriers.

Development of and Preliminary Validity Evidence for the EFeCT Feedback Scoring Tool.

Background: Narrative feedback, like verbal feedback, is essential to learning. Regardless of form, all feedback should be of high quality. This is becoming even more important as programs incorporate narrative feedback into the constellation of evidence used for summative decision-making.

Effective competency-based medical education requires learning environments that promote a mastery goal orientation: A narrative review.

Purpose: Competency-based medical education (CBME) emphasizes the need for learners to be central to their own learning and to take an active role in learning. This approach has a dual aim: to encourage learners to actively engage in their own learning, and to push learners to develop learning strategies that will prepare them for lifelong learning. This review paper proposes a theoretical bridge between CBME and lifelong learning and puts forth the argument that in order for CBME programs to produce the physicians truly needed in our society now and in the future, learning environments must be intentionally designed to foster mastery goal orientations and to support the development of adaptive self-regulated learning skills and behaviours.

Perceptions of family medicine in Canada through the eyes of learners.

Objective: To examine the perceptions of family medicine (FM) residents about their chosen specialty and how they perceive that patients, other specialists, and the government value FM.

Design: Self-report data from the Family Medicine Longitudinal Survey collected from 2014 (time 1 [T1]) to 2016 (time 2 [T2]).

Setting: Canada.

Growth mindset in competency-based medical education.

The ongoing adoption of competency-based medical education (CBME) across health professions training draws focus to learner-centred educational design and the importance of fostering a growth mindset in learners, teachers, and educational programs. An emerging body of literature addresses the instructional practices and features of learning environments that foster the skills and strategies necessary for trainees to be partners in their own learning and progression to competence and to develop skills for lifelong learning. Aligned with this emerging area is an interest in Dweck's self theory and the concept of the growth mindset.

Key considerations in planning and designing programmatic assessment in competency-based medical education.

Programmatic assessment as a concept is still novel for many in clinical education, and there may be a disconnect between the academics who publish about programmatic assessment and the front-line clinical educators who must put theory into practice. In this paper, we clearly define programmatic assessment and present high-level guidelines about its implementation in competency-based medical education (CBME) programs. The guidelines are informed by literature and by lessons learned from established programmatic assessment approaches.

Questioning medical competence: Should the Covid-19 crisis affect the goals of medical education?

The COVID-19 pandemic has disrupted many societal institutions, including health care and education. Although the pandemic's impact was initially assumed to be temporary, there is growing conviction that medical education might change more permanently. The International Competency-based Medical Education (ICBME) collaborators, scholars devoted to improving physician training, deliberated how the pandemic raises questions about medical competence.

On the validity of summative entrustment decisions.

Health care revolves around trust. Patients are often in a position that gives them no other choice than to trust the people taking care of them. Educational programs thus have the responsibility to develop physicians who can be trusted to deliver safe and effective care, ultimately making a final decision to entrust trainees to graduate to unsupervised practice.

Clarifying essential terminology in entrustment.

With the rapid uptake of entrustable professional activties and entrustment decision-making as an approach in undergraduate and graduate education in medicine and other health professions, there is a risk of confusion in the use of new terminologies. The authors seek to clarify the use of many words related to the concept of entrustment, based on existing literature, with the aim to establish logical consistency in their use. The list of proposed definitions includes independence, autonomy, supervision, unsupervised practice, oversight, general and task-specific trustworthiness, trust, entrust(ment), entrustable professional activity, entrustment decision, entrustability, entrustment-supervision scale, retrospective and prospective entrustment-supervision scales, and entrustment-based discussion.

Five ways to get a grip on evaluating and improving educational continuity in health professions education programs.

Presence of educational continuity is essential for progressive development of competence. Educational continuity appears to be a simple concept, but in practice, it is challenging to implement and evaluate because of its multifaceted nature. In this Black Ice article, we present some practical tips to help avoid misunderstandings and irregularities in implementation for those involved in evaluating and improving educational continuity in health professions education programs.

Entrustment Decision Making: Extending Miller's Pyramid.

The iconic Miller's pyramid, proposed in 1989, characterizes 4 levels of assessment in medical education ("knows," "knows how," "shows how," "does"). The frame work has created a worldwide awareness of the need to have different assessment approaches for different expected outcomes of education and training. At the time, Miller stressed the innovative use of simulation techniques, geared at the third level ("shows how"); however, the "does" level, assessment in the workplace, remained a largely uncharted area.

Continuity of supervision: Does it mean what we think it means?

Context: Continuity of supervision (CoS) is generally accepted as an important element of competency-based medical education (CBME). However, collecting and interpreting evidence for its effectiveness are a challenge because we lack a shared understanding of CoS. Translating the available evidence about CoS into practice is an even greater challenge because the evidence largely exists in the undergraduate medical education (UME) literature, whereas literature about CBME is mostly situated in postgraduate medical education (PGME).