In 2012, along with other Family Practice Residency programs across Canada, UBC started the move to a competency-based assessment model for residents.
Benefits of Competency-Based Assessment
Think of the professional musician or athlete coached by many experts. In residency, the practice, coaching and assessment are done primarily in the workplace. Outcome competencies are defined. The focus is on improvement. It is okay for residents to ‘not know’ and to learn from experience and constructive feedback. Progress is supported and celebrated; reflection is essential. Goals are set and achieved. The outcome is a competent, reflective, professional Family Physician.
Resident Assessment Overview
The Resident Assessment System seeks to provide valid, reliable and meaningful information to support resident learning and inform program assessment decisions. The system facilitates information sharing between residents and faculty to determine progress and inform future learning, as well as provide opportunities to guide self-reflection. Residents participate fully as adult learners.
Components of the Resident Assessment System
Electronic Field Notes (eFNs) — the cornerstone of the assessment system — are a collaborative process between the resident and preceptor (coach). Both the resident and preceptor have the T-Res E-Field Note app on which either may contemporaneously document a brief specific coaching narrative (what was done well, and where could improvements be made). Daily reflection is best. Field notes from multiple preceptors are critical. Aggregates of eFNs are used to inform the In Training Assessment Report (ITAR) and the Periodic Review of Progress.
Direct observation, good coaching and the ability to see oneself in the workplace are a powerful combination for learning. Four video reviews per year of a patient interview are a mandatory minimum. Please see the Video Review link for important information on the process.
The In Training Assessment Report (ITAR) process is the main connection between curricular objectives and the assessment process. The learning experience starts with a review of the curricular objectives, site objectives and resident goals. A “rotation” learning plan is written. Progress is checked upon at the mid point, and a final report, informed by eFN, and multiple observers whom have worked with the resident during this learning event, is produced. While the ITAR is primarily formative, it does require a summative decision.
The every 4-month periodic review is a guided self-reflection for the resident conducted by the Site Director or designate. Preparation is critical. Residents present evidence of their progress in many forms. A face-to-face meeting occurs, resulting in a learning plan for the next 4 months. Periodic review brings in all aspects of the curriculum: academic and clinical assessments, scholar work, reflective ability, as well as professional identity development, wellness, resilience and many other aspects. Progress is discussed. A decision on advancement is made.