10/30/2015. Q: What is competency-based medical education (CBME)?

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1 CanMEDS 2015 How will I teach my residents about patient safety? (Co-developed Workshop) I do not have an affiliation (financial or otherwise) with a pharmaceutical, medical device or communications organization. Dr. Ellen Tsai and Ms. Tunde Gondocz, CMPA Friday October 23, 2015 Je n ai aucune affiliation (financière ou autre) avec une entreprise pharmaceutique, un fabricant d appareils médicaux ou un cabinet de communication. Dr. Ellen Tsai and Ms. Tunde Gondocz, CMPA Friday October 23, 2015 The International Conference on Residency Education La Conférence internationale sur la formation des résidents The International Conference on Residency Education La Conférence internationale sur la formation des résidents Workshop Outline How do you teach patient safety? Consider how to incorporate patient safety into competency-based curricula Learn short cuts to find resources in the CMPA Good Practices Guide Work in small groups to develop ideas to assess CanMEDS milestones Q: What is competency-based medical education (CBME)? A: An approach to designing medical training that is focused on outcomes in the form of the abilities of graduates. 1

2 CSHM Conference Pre-Course Transitions of Care Dr. Ellen Tsai, Physician Risk Manager, CMPA Dr. Marcel Doré, McMaster University Ms. Tunde Gondocz, Manager, Education Programs, CMPA September 24, 2015 Multiple Transition Points Learning Objectives Admission In-hospital transfers Discharge 1. Using realistic examples, such as handovers, recognize and manage high risk situations that arise during transitions of care in an acute care inpatient setting 2. Develop methods to effectively communicate and document transitions of care to patients, families and other healthcare practitioners Workshop Agenda Communication at transitions of care Documentation of transfers of care Workshop Competencies CSHM Core Competencies in Hospital Medicine: Care of the Medical Inpatient (Phase 1) Draft CanMEDS 2015 Physician Competency Framework Communication with patients/families 2

3 Collaborator: Inpatient Management CanMEDS 2015 Collaborator Role 20.Communicate with consultants, other health care providers re: Course, revisions, diagnosis, management, etc. 22.Ensure effective handover. 24.Promote patient safety through effective health care communication. Key competency 3. Hand over the care of a patient to another health care professional to facilitate continuity of safe patient care Enabling competency 3.2 Demonstrate safe handover of care, using both verbal and written communication, during a patient transition to a different health care professional, setting, or stage of care Hospital handover by resident Ln6q6RfYBIXX9bCORVJZ0kl71aEyuH9iW &v=arcn9mzriwa Over 50% of communication breakdowns occur during handoffs Suggestions for Improving Handovers Standardizing Content Limit interruptions, distractions Allow appropriate time, prioritize with most sick Face-face exchange allowing interactive questioning 3

4 Structured Handover Tools SBAR/ ISBAR SIGNOUT ANTICipate DeMIST/ MIST HANDOFFS I PASS the BATON Implementation of bundle associated with 30% reduction in preventable AEs I-PASS Handoff Bundle Resident training (theory and simulation) Change in institutional culture Faculty development and observation tools [Am J Med Qual 2009:24(3); ] Role Play Exercise Patient #1 Work in groups of 3 3 different clinical scenarios I-PASS template Write notes for 1 scenario Verbally handover case Observer completes checklist Rotate roles Illness severity Patient summary Action list Situational awareness Contingency plan Synthesis by receiver Universal standards Training and CPD for all physicians Policy Statement: Handover Education in Canadian Residency Programs (published April 2014) When Trainees Involved (MIMEPS) 1. Lack of technical competence 2. Lack of supervision 3. Handoff problems 4. Excessive workload [Singh Arch Intern Med 2007] Teamwork factors contributed to 70% of trainee errors US Malpractice Study (MIMEPS) Handoff problems more common in claims involving trainees: 19% [Singh Arch Intern Med 2007] 4

5 Competencies and Milestones Competency observable ability of a health care professional that develops through stages of expertise from novice to master clinician Milestone expected ability of a health care professional at a stage of expertise?? CanMEDS 2015 Collaborator Role Enabling competency 3.2 Demonstrate safe handover of care, using both verbal and written communication, during a patient transition to a different health care professional, setting, or stage of care Milestone Foundations of discipline Communicate with health care professionals during transitions in care, clarifying issues after transfer as needed 5

6 Develop Your Own Checklist The CMPA Good Practices Guide Working in small groups or on your own: 1. Select stage of expertise and relevant milestone 2. Review sample checklist 3. Create/modify checklist based on the stage of practice/relevant milestone If we really want to improve medical care, maybe we need to expand our educational offerings to target medical students. History of the GPG CMPA EMBARKS ON PLAN TO INCREASE INVOLVEMENT IN MEDICAL SCHOOLS CMPA HOSTS EXPERT CONSULTATION MEETING CMPA Good Practices Guide FACULTY SECTION RELEASED CMPA Good Practices Guide OFFICIALLY LAUNCHED 91,236 CMPA physician and resident members 11,565 Canadian UGME students 2015 WHAT S NEXT FOR THE CMPA Good Practices Guide? Medical Trainee Program Investment in the future of the profession Face-to-face presentations to medical students and residents across Canada Medical student internship program CMPA Good Practices Guide Faculty development workshops GPG Student Section 6

7 GPG Faculty Section Real-Life Case Studies Interactive Activities Quizzes Using the GPG Student Section Self-directed learning Foundational knowledge Reverse classroom 7

8 What s New for the GPG? ecommunication and Social Media in 2016 GPG Faculty Section GPG Videos on YouTube! Index Mapped to CanMEDS 2015 Filter by Type of Activity 8

9 Resources Organized by Domain Coming soon: Additional filters Print button MCC Objectives Mobile functionality Want to learn more We are here to build future physicians Engagements Workshops Contemporary Assessment Tools Written tests SAQs, essays, MCQs Structured oral examinations Direct observation OSCEs and OSPREs Standardized patients Multi-source feedback (360 evaluation) Portfolios and logbooks Simulation-based assessment Encounter cards 9

10 Milestones and EPAs Develop an Assessment Plan Milestone observable marker of individual's ability along developmental continuum Milestones used for planning and teaching Entrustable Professional Activity (EPA) task in clinical setting that may be delegated to resident once sufficient competence has been demonstrated Typically, each EPA integrates multiple milestones EPAs used for overall assessment Working in small groups or on your own: 1. Choose a key and enabling competency 2. Select stage of expertise and relevant milestone 3. Find suitable resources (student and faculty) in the CMPA Good Practices Guide 4. Create an assessment plan Activity Debrief Workshop Outline What are your challenges in teaching and assessing residents? Do you have ideas to share with others on competency-based medical education? Consider how to incorporate patient safety into competency-based curricula Learn short cuts to find resources in the CMPA Good Practices Guide Work in small groups to develop ideas to assess CanMEDS milestones Help us improve. Your input matters. Download the ICRE App, Visit the evaluation area in the West Ballroom Foyer, near Registration, or Go to: icreevaluations to complete the session evaluation. Aidons-nous à nous améliorer. Votre opinion compte. Téléchargez l application de la CIFR Visitez la zone d évaluation, foyer de la salle de bal Ouest, près du comptoir d inscription, ou Visitez le afin de remplir une évaluation de la séance. You could be entered to win 1 of 3 $100 gift cards. Vous courrez la chance de gagner l un des trois chèques-cadeaux d une valeur de 100 $. The International Conference on Residency Education La Conférence internationale sur la formation des résidents 10