Competence by Design:
Fundamental elements of a new residency education system
Responding to the global movement to competency based medical education (CBME), the Royal College of Physicians and Surgeons of Canada, in collaboration with the seventeen Canadian Faculties of Medicine, has launched their own adaptation of CBME, implementing a particular, hybrid model of CBME that is built for the Canadian context of specialist medical education.
The Royal College’s particular brand of CBME is called Competence by Design (CBD). The Royal College has embarked upon the CBD Initiative because the enterprise of medical education is at a crossroads. CBD is prompted by powerful technological and societal changes including, not least of which, an increased focus on accountability. CBD aims to ensure accountability for the training of physicians who are optimally prepared to meet the health needs of Canadians in both their current and future practice.
This section outlines the key features of the CBD model, as it is being implemented in the Canadian context of specialist medical education. The CBD Model incorporates different elements of other CBME models, as well as enabling operational changes to ensure alignment with the principles of outcomes-focused education that are inherent to CBME. CBD is focused on the continuum of medical education, incorporating residency education, as well as continuing professional development. Ultimately, a move to CBD is about a better way to train health professionals.
Key Features of the Royal College CBD Residency Model
The key features of the CBD Initiative for residency education were constructed in order to align with the core components of CBME outlined by Van Melle (2016). The key features of the CBD Residency Model as they align with these core components are summarized below. Additional information about the CBD model can be found in more detail in the Royal College’s document: The Application of the Core Components of CBME in Competence by Design
|Core component of CBME||Features of the CBD Initiative|
|FRAMEWORK: Competencies are clearly articulated||
|PROGRESSION: Competencies are sequenced progressively||
|TAILORED EXPERIENCES:>Learning experiences facilitate progression||
|COMPETENCY-FOCUSED INSTRUCTION: Teaching practices promote progression||
|PROGRAMMATIC ASSESSMENT: Assessment practices support & document progression||
For more information about the CBD model, the application of the core components of CBME and its implementation across Canada, you may explore the following links: