Stakeholder perceptions and experiences of competency-based training with entrustable professional activities (SPECTRE): protocol of a systematic review and thematic synthesis of qualitative research.

Background: Competency-Based Medical Education (CBME) aims to align educational outcomes with the demands of modern healthcare. Entrustable Professional Activities (EPAs) serve as key tools for feedback and professional development within CBME. With the growing body of literature on EPAs, there is a need to synthesize existing research on stakeholders' experiences and perceptions to enhance understanding of the implementation and impact of EPAs.

Can all roads lead to competency? School levels effects in Licensing examinations scores.

At the foundation of research concerned with professional training is the idea of an assumed causal chain between the policies and practices of education and the eventual behaviours of those that graduate these programs. In medicine, given the social accountability to ensure that teaching and learning gives way to a health human resource that is willing and able to provide the healthcare that patients and communities need, it is of critical importance to generate evidence regarding this causal relationship. One question that medical education scholars ask regularly is the degree to which the unique features of training programs and learning environments impact trainee achievement of the intended learning outcomes.

Learning Plan Use in Undergraduate Medical Education: A Scoping Review.

Purpose: How to best support self-regulated learning (SRL) skills development and track trainees' progress along their competency-based medical education learning trajectory is unclear. Learning plans (LPs) may be the answer; however, information on their use in undergraduate medical education (UME) is limited. This study summarizes the literature regarding LP use in UME, explores the student's role in LP development and implementation, and identifies additional research areas.

From admissions to licensure: education data associations from a multi-centre undergraduate medical education collaboration.

This paper reports the findings of a Canada based multi-institutional study designed to investigate the relationships between admissions criteria, in-program assessments, and performance on licensing exams. The study's objective is to provide valuable insights for improving educational practices across different institutions. Data were gathered from six medical schools: McMaster University, the Northern Ontario School of Medicine University, Queen's University, University of Ottawa, University of Toronto, and Western University.

Protocol for a scoping review study on learning plan use in undergraduate medical education.

Background: The current paradigm of competency-based medical education and learner-centredness requires learners to take an active role in their training. However, deliberate and planned continual assessment and performance improvement is hindered by the fragmented nature of many medical training programs. Attempts to bridge this continuity gap between supervision and feedback through learner handover have been controversial.

Data sharing and big data in health professions education: Ottawa consensus statement and recommendations for scholarship.

Changes in digital technology, increasing volume of data collection, and advances in methods have the potential to unleash the value of big data generated through the education of health professionals. Coupled with this potential are legitimate concerns about how data can be used or misused in ways that limit autonomy, equity, or harm stakeholders. This consensus statement is intended to address these issues by foregrounding the ethical imperatives for engaging with big data as well as the potential risks and challenges.

Implicit versus explicit first impressions in performance-based assessment: will raters overcome their first impressions when learner performance changes?

First impressions can influence rater-based judgments but their contribution to rater bias is unclear. Research suggests raters can overcome first impressions in experimental exam contexts with explicit first impressions, but these findings may not generalize to a workplace context with implicit first impressions. The study had two aims.

Family Physician Quality Improvement Plans: A Realist Inquiry Into What Works, for Whom, Under What Circumstances.

Introduction: Evaluation of quality improvement programs shows variable impact on physician performance often neglecting to examine how implementation varies across contexts and mechanisms that affect uptake. Realist evaluation enables the generation, refinement, and testing theories of change by unpacking what works for whom under what circumstances and why. This study used realist methods to explore relationships between outcomes, mechanisms (resources and reasoning), and context factors of a national multisource feedback (MSF) program.

How much is enough? Proposing achievement thresholds for core EPAs of graduating medical students in Canada.

Purpose: The transition towards Competency-Based Medical Education at the Cumming School of Medicine was accelerated by the reduced clinical time caused by the COVID-19 pandemic. The purpose of this study was to define a standard protocol for setting Entrustable Professional Activity (EPA) achievement thresholds and examine their feasibility within the clinical clerkship.

Methods: Achievement thresholds for each of the 12 AFMC EPAs for graduating Canadian medical students were set by using sequential rounds of revision by three consecutive groups of stakeholders and evaluation experts.

Cancel culture: exploring the unintended consequences of cancelling the Canadian national licensing clinical examination.

Assessment drives learning. However, when it comes to high-stakes examinations (e.g.

Who can do this procedure? Using entrustable professional activities to determine curriculum and entrustment in anesthesiology - An international survey.

Introduction: As competency-based curricula get increasing attention in postgraduate medical education, Entrustable Professional Activities (EPAs) are gaining in popularity. The aim of this survey was to determine the use of EPAs in anesthesiology training programs across Europe and North America.

Methods: A survey was developed and distributed to anesthesiology residency training program directors in Switzerland, Germany, Austria, Netherlands, USA and Canada.

Written-Based Progress Testing: A Scoping Review.

Purpose: Progress testing is an increasingly popular form of assessment in which a comprehensive test is administered to learners repeatedly over time. To inform potential users, this scoping review aimed to document barriers, facilitators, and potential outcomes of the use of written progress tests in higher education.

Method: The authors followed Arksey and O'Malley's scoping review methodology to identify and summarize the literature on progress testing.

Exploring Content Relationships Among Components of a Multisource Feedback Program.

Introduction: A new multisource feedback (MSF) program was specifically designed to support physician quality improvement (QI) around the CanMEDS roles of Collaborator , Communicator , and Professional . Quantitative ratings and qualitative comments are collected from a sample of physician colleagues, co-workers (C), and patients (PT). These data are supplemented with self-ratings and given back to physicians in individualized reports.

Wrestling With the Invincibility Myth: Exploring Physicians' Resistance to Wellness and Resilience-Building Interventions.

Purpose: Physicians are expected to provide compassionate, error-free care while navigating systemic challenges and organizational demands. Many are burning out. While organizations are scrambling to address the burnout crisis, physicians often resist interventions aimed at enhancing their wellness and building their resilience.

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.

Are raters influenced by prior information about a learner? A review of assimilation and contrast effects in assessment.

Understanding which factors can impact rater judgments in assessments is important to ensure quality ratings. One such factor is whether prior performance information (PPI) about learners influences subsequent decision making. The information can be acquired directly, when the rater sees the same learner, or different learners over multiple performances, or indirectly, when the rater is provided with external information about the same learner prior to rating a performance (i.

Will I publish this abstract? Determining the characteristics of medical education oral abstracts linked to publication.

Background: Prior studies have shown that most conference submissions fail to be published. Understanding factors that facilitate publication may be of benefit to authors. Using data from the Canadian Conference on Medical Education (CCME), our goal was to identify characteristics of conference submissions that predict the likelihood of publication with a specific focus on the utility of peer-review ratings.

How biased are you? The effect of prior performance information on attending physician ratings and implications for learner handover.

Learner handover (LH), the process of sharing of information about learners between faculty supervisors, allows for longitudinal assessment fundamental in the competency-based education model. However, the potential to bias future assessments has been raised as a concern. The purpose of this study is to determine whether prior performance information such as LH influences the assessment of learners in the clinical context.

The Influence of Prior Performance Information on Ratings of Current Performance and Implications for Learner Handover: A Scoping Review.

Purpose: Learner handover (LH) is the sharing of information about trainees between faculty supervisors. This scoping review aimed to summarize key concepts across disciplines surrounding the influence of prior performance information (PPI) on current performance ratings and implications for LH in medical education.

Method: The authors used the Arksey and O'Malley framework to systematically select and summarize the literature.

Overcoming the barriers of teaching physical examination at the bedside: more than just curriculum design.

Background: Physicians in training must achieve a high degree of proficiency in performing physical examinations and must strive to become experts in the field. Concerns are emerging about physicians' abilities to perform these basic skills, essential for clinical decision making. Learning at the bedside has the potential to support skill acquisition through deliberate practice.

Plus ça change, plus c'est pareil: Making a continued case for the use of MCQs in medical education.

Despite the increased emphasis on the use of workplace-based assessment in competency-based education models, there is still an important role for the use of multiple choice questions (MCQs) in the assessment of health professionals. The challenge, however, is to ensure that MCQs are developed in a way to allow educators to derive meaningful information about examinees' abilities. As educators' needs for high-quality test items have evolved so has our approach to developing MCQs.

Choosing Our Own Pathway to Competency-Based Undergraduate Medical Education.

After many years in the making, an increasing number of postgraduate medical education (PGME) training programs in North America are now adopting a competency-based medical education (CBME) framework based on entrustable professional activities (EPAs) that, in turn, encompass a larger number of competencies and training milestones. Following the lead of PGME, CBME is now being incorporated into undergraduate medical education (UME) in an attempt to improve integration across the medical education continuum and to facilitate a smooth transition from clerkship to residency by ensuring that all graduates are ready for indirect supervision of required EPAs on day one of residency training. The Association of Faculties of Medicine of Canada recently finalized its list of 12 EPAs, which closely parallels the list of 13 EPAs published earlier by the Association of American Medical Colleges, and defines the "core" EPAs that are an expectation of all medical school graduates.

Can physician examiners overcome their first impression when examinee performance changes?

There is an increasing focus on factors that influence the variability of rater-based judgments. First impressions are one such factor. First impressions are judgments about people that are made quickly and are based on little information.

A Call to Investigate the Relationship Between Education and Health Outcomes Using Big Data.

There exists an assumption that improving medical education will improve patient care. While seemingly logical, this premise has rarely been investigated. In this Invited Commentary, the authors propose the use of big data to test this assumption.