Competency Based Learning

Transition to CBME

Residents who began their Emergency Medicine training in 2018 at McMaster were the first large cohort of residents training in the CBD model. With pre-planning and our amazing resident group, it has been a smooth and successful transition.

CBD will use exposures rather than time as the basis for progression. It is not anticipated that the duration of training will change for the majority of trainees. Residency programs will be broken down into stages, and each stage will have a series of milestones based on required competencies. These milestones will create more targeted learning outcomes and involve more frequent, formative assessments within the clinical workplace to ensure residents are developing and receiving feedback on the skills they need.

The Specialty Committee at the Royal College have developed:

  • Entrustable Professional Activities (EPAs). EPAs are cardinal tasks that are required to become a competent emergency physician. EPAs will form the basis of evaluation and promotion in the Competency Based Education Model.
  • Required training experiences which will help determine which rotations/experiences residents must undertake.

The new stages for residency programs under CBD are:

Transition to Discipline
Foundations
Core
Transition to Practice
Transition to Discipline
~3 Months
Foundations
~9 Months
Core
~3 Years
Transition to Practice
~1 Year

Note: Transition between stages will take place once the requisite competencies in a particular stage have been completed.

We have also implemented a highly-rated, new Academic Half Day curriculum, bootcamp series, administration and CQI curriculum in conjunction with CBD.

CBME has resulted in:

  • Fewer off-service rotations
  • Modifications to off-service rotations to maximize their relevancy to EM
  • A program that will be more tailored to individual residents

The Exam will take place after the core stage. Transition to Practice will also include time for training in an Area of Focused Competence.

Remember: What you need to learn to be a safe and competent Emergency Physician has not changed at all. We may be putting some new labels on things and grouping them in different ways, but the job itself has not changed as a result of CBD. Rest assured that the program will continue to train excellent emergency physicians under CBD.

At McMaster University’s Division of Emergency Medicine (EM), it’s our mission to foster world-class research, education, and leadership with a strong focus on clinical applicability.

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