CJEM Articles: daily encounter cards
Displaying 1-2 of 2 results
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May
2011
13
3
David Lendrum, Glen Bandiera
Objectives: Controversy exists regarding the applicability of competency-based education during clinical rotations in emergency medicine (EM). Little has been written about the perceptions of front-line teachers regarding one such competency-based education paradigm, the CanMEDS framework. We undertook to determine 1) what perceptions exist among front-line teachers at two academic health science emergency departments (EDs) regarding the use of the CanMEDS roles to frame what residents should learn on ED rotations and 2) how those same teachers envision practically incorporating the CanMEDS roles into feedback provided to residents.
Methods: Teachers at two sites volunteered for a semistructured focus group study. Focus groups were moderated by an experienced qualitative researcher, and verbatim transcriptions were coded by two independent reviewers. The codes were merged into final themes. The final focus group was used to further explore issues raised and test assumptions made in the preceding groups.
Results: In five focus groups involving 21 participants, the Medical Expert and Professional roles were seen as most relevant to an EM rotation, whereas the Health Advocate, Manager, Scholar, and Collaborator roles were least relevant. On further exploration, however, faculty identified highly relevant components of each role that they could envision teaching in an ED. Participants also felt that the framework helped highlight the breadth of physician competencies and provided structure for teaching and feedback.
Conclusions: EM faculty find the CanMEDS framework helpful for structuring teaching and learning and that many elements of the roles, when defined, are feasible to integrate into a clinical rotation.
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January
2008
10
1
David Lendrum, Glen Bandiera
Objective: We sought to determine if a novel competency-based daily encounter card (DEC) that was designed to minimize leniency bias and maximize independent competency assessments could address the limitations of existing feedback mechanisms when applied to an emergency medicine rotation.
Methods: Learners in 2 tertiary academic emergency departments (EDs) presented a DEC to their teachers after each shift. DECs included dichotomous categorical rating scales (i.e., "needs attention" or "area of strength") for each of the 7 CanMEDS roles or competencies and an overall global rating scale. Teachers were instructed to choose which of the 7 competencies they wished to evaluate on each shift. Results were analyzed using both staff and resident as the units of analysis.
Results: Fifty-four learners submitted a total of 801 DECs that were then completed by 43 different teachers over 28 months. Teachers' patterns of selecting CanMEDS competencies to assess did not differ between the 2 sites. Teachers selected an average of 3 roles per DEC (range 0-7). Only 1.3% were rated as "needs further attention." The frequency with which each competency was selected ranged from 25% (Health Advocate) to 85% (Medical Expert).
Conclusion: Teachers chose to direct feedback toward a breadth of competencies. They provided feedback on all 7 CanMEDS roles in the ED, yet demonstrated a marked leniency bias.
