Resident Assessment System – How You are Evaluated
The UBC Family Practice Program Resident Assessment System forms a continuum throughout the program. The emphasis of the Resident Assessment System is on formative assessment. As adult learners, residents are awarded many opportunities to reflect upon their progress, and fully participate in ensuring that coaching and assessment drive their learning.
Assessment Process Components
Field Notes are a collaborative process between you and your preceptor, documenting coaching you have received in the workplace. At your Site Orientation you set up and learn your T-Res app. All preceptors can have this app. Either of you may enter a FN. Both of you will see this FN on your respective T-Res webpage. Your collection of Field Notes should be a representative sample of your experience across all domains of care, skill dimensions (including procedural skills) and CanMEDS-FM roles. You may also free text in a Priority Topic as a tag. The UBC Curriculum shows the association between Priority Topics and various rotations. As part of your preparation for your periodic review of progress, please review your 101 Aggregate Field Note report (generate from your T-Res webpage) and reflect upon your progress and needs for future learning. Field Notes are a safe place to “not know” and to demonstrate your improvement.
In Training Assessment Reports (ITARs) are completed by your preceptor or a 'head evaluator' on One45’s Web Eval system. Ideally this is done as part of a face-to-face discussion on your progress at the end of a rotation. Please prompt your preceptor or rotation coordinator early on to set up a time to do this.
The ITAR is informed by:
- multiple observers via field notes,
- in person observation and discussion with colleagues,
- review of cases, and
- review of progress notes and other clinical documentation.
The ITAR process includes:
- Collaborative creation of a learning plan on the Goals ITAR using SMART goals based on the your unique needs and program objectives for the learning experience with your preceptor or rotation coordinator.
- A written Mid Point ITAR that is a documentation of the discussion between you and your preceptor. This must be written:
- every 3 months for horizontal rotations,
- if the block rotation is greater than 4 weeks, or
- regardless of length, if you, the learner, are not progressing as expected.
- Where the rotation is 4 weeks or shorter and you are progressing as expected, the Mid Point review may be a verbal discussion between you and your preceptor.
- A written End of Rotation ITAR, documenting the progress towards achievements of goals and related competencies.
Please review each ITAR promptly. You may appeal an ITAR based on process, within 10 days of a review.
Video recording of you in a patient encounter is the best place to get specific coaching on a variety of skills, particularly the Patient Centred Approach, communications skills and professionalism skills (all 3 are Skill Dimensions). You must have a minimum of 4 recordings per year. As this recording involves a patient, there are policies and regulations you must know. Highlights of these are:
- You must get the patient’s written consent before and at the end of the recording.
- Always use the camera system provided at your site, never your cell phone, or any other Internet-connected device.
Video Review FAQ
Video Recording Guidelines: College of Physicians & Surgeons of B.C.
- Management of this data is your responsibility. Treat it as it if is part of the patient’s medical record.
UBC Video Review Policy
Being reflective in your professional practice is crucial to your success. Reflective practice is integrated in to many aspects of your residency program — your clinical work, the behavioural medicine component of your academic curriculum, and at multiple points in the resident assessment system to name a few. We believe it is a defined skill that takes trust, and safety, and is approached by each person in an individual way. Most of your reflective activity will not be 'assessed' in any way.
The program has developed a rubric to both guide and improve this valuable skill. You are asked to write reflective paragraphs on some component of your educational experience in preparation for your periodic review of progress. These paragraphs are the only reflective activity that may be formally assessed with the rubric and even then, only to improve your reflective capacity (formative), not to give you a 'pass or fail' (summative). Your Behavioral Medicine Faculty or designate will ensure your familiarity with the rubric.
Periodic Review is done every 4 months with your Site Director or designate. You, as an adult learner, are responsible for ensuring that you are being observed and given written (field note) coaching on all the CanMEDS roles and Skill Dimensions, for a variety of Priority Topics, across all the Domains of Care over the course of your residency. The Periodic Review includes progress on your Scholar project and many other program expectations (see below), as well as a check-in on your wellbeing and resilience. The preparation period prior to the Periodic Review is the time to check that you have a good cross section of field notes, and that any 'follow-up' field note has been addressed. The site faculty will assist residents to achieve this goal. Steps for the periodic review are
- Preparation with a review of your progress documentation to date. This is done on a Web Eval form (One45).
- Meeting in person with your Site Director to discuss progress and update your learning plan.
- A decision on advancement
- Action plan to engage relevant individuals, and to ensure needed learning opportunities are provided.
The Periodic Review is a guided self-reflective process, which is cumulative across your entire program. The final two steps, as you near the end of your program, are:
- You are deemed eligible to write the CFPC Certification Examination, and
- You have completed the program and received a Final In Training Evaluation Report (FITER).
Specific Expectations for Program Completion
For successful completion of the Family Medicine Residency Program, residents must meet the following criteria:
Achievement of Family Medicine competencies in the following domains, as evidenced by ITARs and Field Notes:
- Maternity /Newborn Care
- Care of Children and Adolescents
- Care of Adults
- Care of Elderly
- Palliative Care
- Mental Health Care
- Family Medicine
Achievement of Family Medicine competencies in the following CanMeds-FM roles, as evidenced by ITARs, reflections (3/year), periodic reviews (3/year) and Field Notes, as well as the completion of Scholar Expectations:
- Family Medicine Expert
- Manager / Leader
Achievement of the following skill dimensions, as evidenced by direct observation and documented by Field Notes, video reviews (minimum 8 over 2 years), as well as ITARs:
- Patient-Centered Approach
- Clinical Reasoning Skills
- Clinical and Procedural Skills
- Communication Skills
- Professionalism Skills
Demonstration of competency in the Scholar role (teaching skills, EBM, Quality Assurance, Critical Appraisal, Reflection and Knowledge Creation and Translation) by:
End of R1:
- Satisfactory completion of TCPS Research Ethics Tutorial
- Satisfactory completion of York University Academic Integrity Tutorial and Quiz
- Satisfactory completion of Practice Improvement Project or Continuous Quality Improvement Project
End of R2:
- Satisfactory completion of Resident Scholar Project
- Presentation of Scholar Project
- Evidence of effective teaching skills (field notes, presentation evaluations)
- Evidence of reflective practice as evidenced in the periodic review reflections/discussions
Promotion to R2
- Successful completion of all clinical rotations/experiences offered in the R1 year for promotion to R2.
- Successful completion of the R1 Scholar expectations.
The Site Director will review Field Notes, periodic reviews, and ITARs in determining readiness for R2 responsibilities. The summated evaluation data will inform the Site Director that the resident has attained the 12-month benchmark for residency training.
Recommendation will be made by the Site Director to the Program Director for promotion to R2.
The Site Director will review R2 performance, as informed by ITARS, Field Notes, reflections, professional behaviour and attainment of scholarship expectations. A recommendation will then be made to the CFPC that there is evidence to support that: “The resident has achieved competence in the six essential skill dimensions and the phases of the clinical encounter, throughout the seven CanMEDS-FM roles, over a sufficient sample of the priority topics, themes, core procedures, and competencies, as defined by the Evaluation Objectives and CanMEDS-FM.”