Submission ID 77682

Code OC-4-4
At the end of this workshop, participants will be able to:
Category Medical Education
Type Oral
Will the presenter be a: Other
Presenter Other Faculty
Title Operationalizing Subspecialty Training in the Competence by Design Model: A Case Study of Lived Experiences
Background/Purpose With the transition and implementation of competency based medical education (CBME) and the Royal College framework Competence by Design (CBD), residency training programs must align theoretical constructs to practice. Some unique factors associated with subspecialty programs are highly subspecialized Entrustable Professional Activities (EPAs) and a short period to operationalize the 4-stage CBD model. Exploring lived experiences of leaders within subspecialty programs may help bridge the theory practice gap. This project describes the lived experiences of leaders in implementing CBD in subspecialty programs at Queen's University.
Methods This grounded theory study recruited program directors, CBME Leads, educational consultants, and resident leads across subspecialty programs. A total of 16 participants completed semi-structured interviews which were audio recorded and transcribed verbatim. The data were analyzed using open, axial, and selective coding.
Results Programs had varied approaches in CBD development and emphasized the need for ongoing refinement. Common challenges included assessment completion, administrative burden, software use, and developing the CBD stages. Strengths included frequent assessment, formal documentation of performance, and enhanced accountability. A challenge unique to subspecialty training in Psychiatry was the "overlap year", where in PGY5 the resident is enrolled officially in a Psychiatry program while completing subspecialty requirements. Participants shared recommendations which included faculty development, and iterative process in developing EPAs, and flexibility with timelines and stages.
Discussion This study shared the lived experiences of key program stakeholders as they helped transition their subspecialty program to CBD. Some strengths as theorized were evident and participants had several recommendations for program leaders to operationalize CBD implementation.
Keyword 1 CBD
Keyword 2 Subspecialty
Keyword 3 Grounded Theory
Abstract content most relevant to: (check all that apply) Residency Education
Abstract Track - First Choice Curriculum
Curriculum Competency-Based Education
Authors Heather Braund
Nancy Dalgarno
Melissa Andrew
Xiaolin Xu
Laura Marcotte
Peggy DeJong
Noah Letofsky
Maria Hussain

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