Dr. Ian McintyreEditor

Welcome to CBME Anesthesia, a newsletter designed to inform our department about exciting upcoming changes in residency education.

Competency-based medical education starts in the Department of Anesthesia on July 1st 2017. Anesthesia and ENT are the first to roll out this innovative nation-wide program. While it is an honor and a privilege to be one of the first programs selected, it does create numerous challenges.

One key challenge is communicating the different concepts of CBME to our faculty to further their understanding and enlist their support. We are fortunate that we already have an engaged faculty, and a stellar reputation as an excellent residency program on which to build a CBME program.

CBME is an all-hands-on-deck venture for our department and we need your help as faculty to make it a success. Please take the time to provide thoughtful, frequent feedback to the incoming PGY1 class. If we work together, I believe that CBME can be a source of pride for our department for years to come.

Issue Inside• On-line learning platforms

and Boot camp

• Using Eportfolio for Residents

• CBME: Framework for Learning

• Tips for Giving High-Quality Feedback

• Boot Camp Overview

Competency Based Medical Education: coming to a theatre near you!

Dear Colleagues,Thank you for taking the time to learn about Competency-based education. The purpose of

this newsletter, combined with other educational sessions, including recent grand rounds, site visits and conversations about CBME, is to enhance our collective understanding of CBME to insure a smooth transition to the new curriculum and evaluation process. I cannot promise that this will be perfect. Change is difficult. We ask for your patience as the new system begins to take shape.

In this edition, you will find numerous articles from our faculty about CBME, how the evaluation process will work, and other aspects of the development and implementation of CBME.

Dr. Eric Sutherland writes about his experience over the past 3 years on the Royal College Nucleus Committee and the history of CBME at the Royal College level. Dr. Erika Blouw, who developed our very successful anesthesia boot camp, summarizes the boot camp curriculum. In addition, we are delighted to use this forum to introduce our competency committee members and faculty mentors and describe the important new role that these positions will have as we move forward with CBME.

As always, please accept my thanks for your interest, and your commitment to residency education.

Ian W. McIntyre

CBME

Editorial

News Letter Issue 1 Volume 1 June 2017

Department of Anesthesia

Competency Based Medical Education

CBME 2

“

On-line Learning Platforms and Boot Camp Assist CBME

As part of our role out of CBME, we have designed a number of online courses, boot camp modules and clinical skills sessions to aid incoming residents in the acquisition of new knowledge and skills.

By way of example, Dr. Rebecca Ashcroft will provide an in-depth mini-course on common monitors in the OR, including pulse oximetry, capnography, NIBP, arterial lines and EKGs. This session will provide an intellectual and practical basis for Transition to Discipline EPA #3: Monitoring adult ASA 1 or 2 patients undergoing minor scheduled surgical procedures, under general or regional anesthesia. Nested within this EPA are a number of important milestones, and for your reference I have included TTD EPA #3 (Below). As you can see, the milestones within this EPA have very practical end-points for assessment, including:

TD ME 1.3 Apply the CAS Guidelines to the Practice of Anesthesia in preparing an operating room for patient care, including preparation of the required monitoring equipment and,

TD ME 1.3 Apply knowledge of the normal and abnormal physiologic values for an ASA 1 or 2 adult patient during general or regional anesthesia.

I see these practical, well-defined milestones as a major advantage of CBME. Based on the exposure that the residents will receive in boot camp and other resources afforded to them, as a teacher you can reasonably expect them to know the CAS Guidelines to The Practice of Anesthesia (Milestone #2, EPA#3). If they are knowledgeable about this topic, then it is also reasonable to recognize this with narrative comments and if appropriate, “I did not need to be there” descriptor from the entrustability scale on their evaluation.

Dr. Faisal Siddiqui will be doing a simulation session involving standardized patients. This session sets the groundwork for learning professionalism and the CanMEDs communicator role which are central and ongoing components of competency-based medical education. Dr. Jenifer Ballen has designed a comprehensive airway skills lab that will set the standard in this area. With (5) interactive stations staffed by staff and senior residents, this session promises to be a great learning experience. Dr. Vasudha Misra will instruct a session on sterile technique

we have designed a number of on-line courses, boot camp modules and clinical skills sessions to aid incoming residents in the acquisi-tion of new knowledge and skills

and neuraxial anesthesia. Dr. Misra has been working hard on a number of on-line modules and procedural checklists to support the skills session. Our goal during the initial (2) months of training is for the residents to become familiar with these checklists and then draw on this knowledge later in Foundations (CBME stage 2) when working on procedural EPAs, including neuraxial anesthesia and CVL insertion. I wish to thank all the mentors involved for their dedication to resident education.

Interestingly, CBME affords opportunities for resident education in facilities where traditionally, residents have not been present. Dr. Archie Benoit has enthusiastically agreed again to supervise our incoming PGY1’s for IV skills at the Misericordia Hospital. This is an excellent opportunity to acquire IV skills, as the Misericordia eye program has a rapid turnover, high volume practice. For interested faculty, I would encourage you to think about the educational opportunities that your facility, clinic or work environment could provide our residents.

Further, Dr. Johann Strumpher, Program Director, continues his excellent transthoracic echocardiography workshops with the incoming residents. Dr. Judy Littleford will provide a comprehensive and meticulous anesthesia cockpit session, including the machine check, the importance of vigilance, monitoring, among other concepts. Other subspecialists, including Dr. Jamit Dhaliwal (Pain Medicine), Dr. Jag Gill (Obstetric Anesthesia), Dr. Jo Swartz (Pedatric Anesthesia), Dr. Ron Cappellani (Neuroanesthesia), Dr. Marcus Blouw (ICU and Respirology) and Dr. Ying (Radiology) have generously agreed to provide didactic lectures to support the curriculum. We are indebted to individuals and very appreciative of their efforts.

In summary, Boot Camp promises to be a successful experience again this year. The success of this program is a direct result of the tireless efforts of Dr. Erika Blouw. Thank-you Erika for all of your hard work. The success of Boot camp in anesthesia has not gone unnoticed among other departments and residency programs. We have had preliminary discussions with emergency medicine and ENT to adapt some of our boot camp sessions with the goal of multi-disciplinary AW and other simulation sessions in the future. There will be many opportunities to become involved in competency-based education in the coming years and I would like to encourage colleagues from all of our hospitals to engage in this important endeavour.

Yours respectfully,Ian McIntyre“

CBME 3Entrustable Professional Activity Spotlight

Anesthesiology: Transition to Discipline EPA #3

Monitoring adult ASA 1 or 2 patients undergoing minor scheduled surgical procedures, under general or regional anesthesia

Key features:- This EPA focuses on applying the procedures of safe patient monitoring, and recognizing and initiating manage-

ment for critical changes in patient status- At this stage of training, this task does not include managing all situations- This EPA includes

o Installing basic monitoring equipment appropriatelyo Recording physiologic values at appropriate intervals in the anesthetic charto Identifying irregularities and abnormalities in vital signs and other anesthetic monitors such as ventilation

parameters, neuromuscular blockade monitoring and depth of anesthesiao Initiating management of critical abnormalities and calling for help when needed (not expected to inde-

pendently manage all situations)

Assessment plan:Supervisor does assessment based on direct observation

Use Form 1. Form collects information on- Type of anesthesia: general with neuromuscular blockade; general without neuromuscular blockade; regional- Type of procedure: general surgery; gynecology; ophthalmology; orthopedic surgery; otolaryngology; plastic sur-

gery; urology

Collect 2 observations of achievement - At least one general with neuromuscular blockade - At least 2 different assessors

Relevant milestones

1. TD ME 1.1 Demonstrate a commitment to high-quality care for their patients

2. TD ME 1.3 Apply the CAS Guidelines to the Practice of Anesthesia in preparing an operating room for patient care, including preparation of the required monitoring equipment

3. TD ME 1.3 Apply knowledge of the normal and abnormal physiologic values for an ASA 1 or 2 adult patient during general or regional anesthesia

4. TD ME 1.5 Demonstrate awareness of limitations and seek help efficiently and effectively

5. TD ME 3.1 Apply appropriate monitors correctly for the planned surgical procedure

6. TD COM 5.1 Document anesthetic care and physiologic values at appropriate intervals during the continued monitoring under general or regional anesthesia

7. TD COL 1.3 Actively contribute as a member of the team towards the continued safety of the patient by communicating abnor-mal physiologic values that require attention

8. TD HA 1.3 Demonstrate a knowledge of appropriate setting of visual and auditory alarms in the continued monitoring of the adult ASA1 or 2 patient under general or regional anesthesia undergoing a minor elective surgical procedure

9. TD P 1.1 Consistently prioritize the needs of patients and others to ensure the patient’s legitimate needs are met

CBME 4

to reveal the individual milestones. Above the milestones section there will be a 5-point

entrustability scale with the following options: “I had to do”, “I had to talk them through”, “I had to direct them”, “I needed to be there just in case”, “I did not need to be there”. Kindly indicate beside each milestone whether the milestone is in-progress,

achieved or not observed. Above you will observe the vitally important area for narrative comments (feedback to resident). Please use this area to give Specific, Constructive, Timely Feedback that focuses on Behaviors and sets Expectations. This last point is very important as your feedback is essential to allow the Competence Committee to do it’s job well.

Lastly, the final section of the Observer view asks for data on

professionalism and patient safety. A section is also available to provide details if there was a breach of patient safety or professionalism.

In Summary, ePortfolio is the new platform from the Royal College that we will use to collect evaluations and store data for competency-based education. For more information, please contact me or consult the royal college website at: http://www.royalcollege.ca/rcsite/cbd/cbd-eportfolio-e

You will find additional information and resources including an ePortfolio webinar hosted by Dr. Jason Frank and colleagues from the Royal College.

The Royal College has designed an on-line platform for tabulating and recording observations of resident performance called ePortfolio. ePortfolio is designed to support competency-based education and capture the many low-stakes observations that will be used at the competency committee level. Prior to the July 1st launch of CBME, we wanted to introduce you to ePortfolio and it’s functionality.

Below you will see an initial example screen of the observer view, when you log into your Royal College account. Of note, we are in the process of registering the faculty with the Royal College to insure access on July 1st. In the Observer view, you can see your account info and evaluations that are either accepted or pending acceptance. On the far-right hand side of the pending acceptance icon there is a drop-down menu. This menu gives you the option to accept or reject

the observation. This may occur in certain situations when a resident was mistakenly assigned to you. Assuming that you accept the evaluation, the evaluation becomes active. Now the evaluation will populate the accepted icon and the specific

EPA will appear under the observations column. Simply click on the EPA under observations and the following screen(s) will appear. The screen will then show information pertaining to the specific EPA stage and title, learner’s name, date of the observation and the context in which the clinical encounter was observed. The context may be the OR, PAC clinic, Pain clinic, a Consult or the PACU.

An unfortunate issue with ePortfolio is the fact that the Milestones portion of the EPA has a default setting that collapses all the Milestones so that they are not immediately visible (See above). I would strongly urge you to open this icon

Using ePortfolio for Resident Evaluations

CBME 5

Decision making regarding the structure, composition and organization of our competency committee was informed by the “Terms of Reference for Competency Committees” from the Royal College. Further information and guidelines brought forward by the office of Postgraduate Medical Education (PGME) informed the selection process. Dr. Cliff Yaffe, Associate Dean PGME, provided a framework and policy manual for CBME that was well received and gave additional advice regarding organizational structure.

The following principles will be employed as the foundation of the Competence Committee: Patient safety, Excellent clinical care, Fairness, Collaboration, Transparency, Confidentiality, Timely decision making and Public accountability.

Using these principles, the CC is empowered by the Royal College to synthesize the results from multiple assessments and observations to make decisions related to:

What are the Guiding Principles and Responsibilities of our Competency Committee and how was membership decided?

• The promotion of residents to the next stage of training

• The review and approval of formal individual learning plans developed to address areas in need of improvement

• Determining readiness to challenge the Royal College examinations

• Determine readiness to enter independent practice on the completion of the transition to practice stage

• Determine that the trainee is failing to progress within the program

• Monitor the progress of any learning or improvement program developed for an individual resident

• Maintaining confidentiality and promoting trust by sharing information only with individuals directly involved in the development or implementation of a learning or remediation plan

Competency Committee(IM Chair)

FacultyMentor

Residents

Site Leaders(HSC, SBGH, Childrens,

Community)

Residents

EPC / Education Committee

CBME 6CBME Road Map: What does it all look like?

Bootcamp Anesthesia Anesthesia InternalMedicine GoldSurgery GeneralSurgery AdultER Pediatrics PediatricER ObstetricsDuration(months) 1 1 2 2 1 1 1 1 1 1EPAs D1,D2,D3,D4 D1,D2,D3,D4 F1,F2,F3 F4,F5,F6,F7 F4,F5,F7 F4,F5,F6,F7 F4,F6,F7 F6,F7,F25,F26 F4,F6,F7 F4,F5,F6,F18

F4,F12,F16,F17

ICU✪ ObsAnesthesia Community Cardiology CCU RespirologyDuration(months) 1or2 1 1 1 1 2EPAs F4,F7,F8❏ F17,F18,F19, F1,F2,F3,F9-12 F4,F5,F6 F4,F5,F6 F4,F5,F6

F12,F13,F14 F20,F21,F22 F13,F15,F16 F12,F13F1-3,F7,F9 F17,F18,F27

F11-12,F16,F27❏❏F8mayoccuroutsideORsettingifsupervisedbyanattendinganesthesiologist

PICU ICU Neuro Community PainDuration(months) 1 1 1 1 1to3EPAs C3,C4,C5,C6,C7 C3,C4,C5,C6,C7 C33,C34 C1-3,C8-12 C15,C19✦,C29,C30

C14,C33,C37,C41 C14,C33,C37,C41 C1-4 C13-17,C19,C29 C38,C39,C42,P9✓C42,C44,P12✓ C42,C44 C34,C41,C42

Pain Cardiac Elective⭐� Transfusion/PAC* ICU Thoracics* PedsDuration(months) 1to3 2 2 1 1or2 1 1EPAs C15,C19✦,C29,C30 C31,C32 C1,C2,C3,C8,C9,C10 C1-3,C43 C3,C4,C5,C6,C7 C18,C19✦,C35,C36 C17,C19✦,C24,C25

C38,C39,C42,P9✓ C42 C11-19,C29,C30,C32-37 F14✦,C42 C14,C33,C37,C41 C42 C26,C27,C28C1-4,C8,C9 C41,C42,C44 C42,C44,P12✓ C1-3,C8,C9,C10 C29,C37,C42

C1-3,C8,C9,C10

ICU-ICCS** SSCU Obs IHA/PACDuration(months) 1 1 1 1EPAs C3,C4,C5,C6,C7 C1-C3,C4,C6,C7,C11,C15 C20,C21,C22 P1,P2-P6

C14,C31,C32,C37 C19✦,C42,P12✓ C23,C24,P6✓C41,C42,C44,P12✓ C1-3,C8,C9

Legend

PGY2

CompetencyBasedEducationStage

Rotation

RotationCore

PGY2Anesthesia5or6

F1,F2,F3,F4,F7,F8,F9,F10,F11,F12,F13,F14,F15,F16

✪✪ICUincludesSICU,MICU,MSICU

Foundations

F17,F18,F19,F20,F21,F22,F23

PGY3

CompetencyBasedEducationStage

YearPGY1

CompetencyBasedEducationStage

Year

RotationTransitiontoDiscipline

Year

PedsAnesthesia2

F24✓,F25✓,F27✓,C10,C42

PGY4

CompetencyBasedEducationStage

***Scholarlyactivityiscurrentlyalloted6months.Allocationofthistimeisonacase-by-casebasisandsubjecttoapprovalbythePD.Callrequirementsandclinicaldutiesapply

AdultAnesthesia5to6

D=TransitiontoDisciplineEPA,F=FoundationsEPA,C=CoreEPA,P=TransitiontoPracticeEPAs,Suggested pathtoEPAcompletion

*Recentintroductionofnewrotations:a.)Thoracics-CanbedoneinlatePGY3orPGY4infirst6monthsofacademicyear,b.)Transfusion/PAC-CannotbedoneinPGY5Foreachacademicyearthereare12Clinicalrotationsperyear,and1blockofvacation=1month.Notevacationweeksnotincludedabove

P1-P6,P8-P12

**6MonthsTotalofICU,ICCSrecommended.Mustdo:MICU,MSICU,PICU,SICU

RotationTransitiontoPracticeCore

Certification,Continuingprofessionaldevelopment(maintenanceofcompetenceandadvancedexpertise)

Core

YearPGY5

CompetencyBasedEducationStage

Scholarly***Rotation

✓✓Out-of-phaseEPA,orOptionalforphase.NotedintheselocationsduetogreateropportunityforassessmentorrarenatureofEPA

TotalEPAsperstage/TotalOverall:TTP=4,Foundations=27,Core=44,TransitiontoPractice=12/Total=87

✦✦F14tobereviewedduringCoreTransfusionrotationwithBM,otherinterestedfaculty;C19:EBUS,Brachytherapy,Radiationtherapy,MRI,CT,CathLab,OffsitesonPainatdiscretionofSectionHeadforPainMedicine

Foundations

AdultAnesthesia2to3

C1,C2,C3,C8,C9,C10,C11-19C29,C30,C32,C33,C34,C35,C36

C37,C41,C42,C44

6C40,C42,C43,P10,P11

C1,C2,C3,C8,C9,C10,C11-19C29,C30,C32,C33,C34,C35,C36C37,C41,C42,C44,P10✓,P11✓

Peds

⭐�⭐�ElectiverotationssubjecttoapprovalbyPD,couldinclude:Out-of-provinceelective,Palliative,Echo,Sleepmedicine,other

1C17,C19✦,C24,C25

C26,C27,C28C29,C37,C42,P7✓

C1-3,C8,C9,C10

CBME 7

Colleagues,

The Royal College, in concert with the Medical School Deans and Postgraduate Administration, initiated the launch of Competency-Based Medical Education for July 2017, beginning with Anesthesiology and Otolaryngology. This was not an easy decision. As a member of the Specialty Committee representing Region #2 for Anesthesiology, I shared the task of developing our Competency Curriculum with approximately 30 other members from across the country.

Canada is one of the last international jurisdictions to embrace a post graduate medical educational approach that focuses on competencies as a hallmark of training. Using the newly revised language of CanMEDS 2015, the Specialty Committee derived specialty-specific delegatable tasks describing what an Anesthesiologist does. These tasks serve as an outline for our training programs but also serve a similar purpose for Maintenance of Certification as we look 5 – 10 years into the future. These defined, delegatable clinical tasks are what we are calling Entrustable Professional Activities (or EPAs). The tasks vary according to training stages. They do, however, follow a progression leading to independent practice.

CanMEDS was an instrumental tool as we constructed the EPAs built from milestones. The milestones were developed to give us discreet, manageable points of measurement for education and evaluation purposes. For example, let’s say an EPA or task is composed of 8 milestones. If all 8 are accomplished, the task was performed. If 7 are accomplished, more work needs to be done for that EPA or task to be fully completed. One completion does not make that entrustable – one successful arterial line insertion does not make you ready for independent performance. The numbers of successful completions to garner entrustability vary from task to task.

During the initial stages of CBME, the clinician-educators will be asked to observe the performance of stage-specific EPAs and to coach the resident towards successful completion of the task through formative feedback. Evaluation will not be pass/fail but an Entrustability score will be assigned by the staff that day, ranging from “I had to do everything” to “I didn’t need to be there”. There will always be the chance to submit comments on any particular activity or behaviour that was observed that day, regardless of the EPA being worked on.

The daily EPA assessments and all comments will be organized and presented at a Competency Committee. The Competency Committee is an advisory committee to the Program Director. Decisions and rationale for advancement or not through to the next stage of training would be made at the Competency Committee level. Ian McIntyre, Associate Program Director, will chair the Competency Committee locally and will oversee the implementation of CBME at the University of Manitoba Department of Anesthesiology. Learning plans will be generated at the Program Director level, under the auspices of our Program Director, Johann Strumpher. The plans will focus our training objectives for

CBME: A Framework for Progression in Learning

all residents: accelerated, on-track or remedial. One final addition to the Competency Committee will be a lay person representing the Public to whom we are ultimately responsible.

The theory and practice behind CBME is solid. The execution of the planned implementation is muddy. Consensus was generated amongst all the Program Directors in the country and the Specialty Committee. “Good enough” meant acceptable for launch but also refocused the committee members on the ongoing need for revision as CBME unfolded. EPA number and content will change – probably the numbers will drop. Milestone language will change – many were written directly by the Royal College lacking the Specialty Specific language that makes them immediately understandable and resonant within our specialty. It was a tremendous amount of work by a large number of people that brought this document forward. Momentum was harnessed as a resource to propel us forward and educate other specialties as they begin the same arduous process we started 3 years ago.

In the end, we hope to have a better description of what an Anesthesiologist does, how we train ourselves and maintain competency throughout the span of our careers.

Sincerely,

Eric Sutherland

CBME 8

High quality feedback is the cornerstone of competency-based education. Your feedback about residents in the coming months and years is essential to the success of our new program. Feedback has been shown to improve diagnostic and procedural skills, improve documentation and resource allocation. Further, feedback enhances communication, self-regulation and teaching ability. These are precisely the areas that we care about from the CanMEDs roles. Without good feedback mistakes go uncorrected, bad habits and overconfidence develop, and perhaps worse, positive behaviors are not reinforced.

CBME differs from our conventional assessment system in that CBME requires feedback that is continuous, more frequent and work-based whenever possible. With this in mind, please see suggestions below for providing high-quality feedback.

Tips for Giving High-Quality Feedback

Ask for self-assessment from the resident

Be Specific with your feedback

Be relevant

Be Constructive

Reinforce good behavior with specifics

How do we achieve the goal of high quality feedback?

Focus on behaviors (not personality)

Limit feedback to (1) or (2) teaching points

Set expectations (Ok to have high expectations but must be achievable for level)

Clarify and Summarize

Insure feedback is timely

A fundamental component of Competency-based Medical Education (CBME) is the presence of a decision-making body called a Competency Committee (CC). Competency Committees are designed to collate, discuss and render decisions on resident progress based on the acquisition of various milestones which are the component parts of Entrustrable Professional Activities, or EPAs. Through the curation of many low-stakes direct and indirect observations of individual EPAs, decisions about resident progress can be made in a contemplative fashion with specific attention to the acquisition of specific skills, behaviours and knowledge. This information is used to decide whether

a.) a resident should progress along a conventional trajectory (as expected in most cases),

b.) progress in an accelerated manner, or c.) where deficiencies are observed, be subject to

remediation. This is a significant responsibility for competency

committee members and I am pleased to say that we have recruited a diverse group of individuals that have a proven track record as excellent educators, with high standards and who are up to the challenge.

The competence committee is a separate and distinct

entity from the anesthesia education committee. Whereas the CC does report to the education committee, the CC is empowered by the Royal College to make decisions on matters regarding progression through the stages of training, promotion, remediation, and liases with the resident learner and faculty mentor to highlight areas where deficiencies and strengths exist in the resident’s portfolio. We will take a comprehensive approach to assessment using multisource feedback, examination results, simulation scenarios among other data (See Figure below) to facilitate informed decision making.

What is a Competency Committee

Sim Lab

Can NascSimulationExam

ScholarlyActivity

Clinical SkillsCourse

Indirect Observations(Nursing, Chart, Patient)

Modules

ClinicalCompetencyCommittee

Progress on Milestones

DirectObservations

Teaching evals,journal club UM Learn

AnesthesiaKnowledge Test

CBME 9

I would like to take this opportunity to introduce Boot Camp and the Transition to Discipline portion of the new curriculum.

This year, we have continued to develop Boot Camp to help provide all incoming anesthesia residents with an introduction to residency. The objective of Boot Camp is to give first-year  residents  a better idea of what is expected of them throughout  residency, and what they can expect to gain from their years in the program.  As the inaugural year for the new Competency-based Curriculum, Boot Camp has been reimagined as the first component of this new residency, forming half of the Transition to Discipline block.  

The rotation continues to grow, and is now comprised of four main courses:   hands-on skills sessions,  simulation-based  learning, didactic seminars, and self-directed course work.  A wide range of clinical and professional topics are covered in these sessions, giving residents a broad overview of how residency will shape them into well-rounded, professional, and competent clinicians.  New for this year, the residents will also be working towards completing the first four EPAs of their curriculum: obtaining a history & physical, CAS guidelines, monitoring, and safe post-op transfer of care.

Our residents and fellows will also be participating as teachers, providing the them with valuable teaching exposure early on in residency. 

We would like to extend a HUGE thank-you to all those who are helping out with the Boot Camp curriculum this year.  The rotation has been well-received in past years, and we are excited to continue developing the program as our residency evolves. 

Dr. Erika Blouw

1. Provide incoming anesthesiology residents with an orientation to the Department of Anesthesiology and Perioperative Medicine at the University of Manitoba.

2. Introduce core clinical skills which will be essential to, and developed throughout, practice.  Completing EPAs 1-4 of the CBD curriculum is mandatory.

3. Introduce communication and teaching skills through simulation sessions both as a participant and an educator.

4. Provide residents with introductions into key social aspects of medical practice, including physician wellness and practice management.

5. Provide residents with focused self-directed time to complete some mandatory components  of the PGME curriculum. 

GOALS AND OBJECTIVES

Boot Camp

Boot Camp Schedule for July 2017

- ◄ June 2017 July 2017 August 2017 ►

Sun Mon Tue Wed Thu Fri Sat 1

2

3

4 Welcome to the Department Dr. Christodoulou Dr. Struumpher, Penny Godawatte Dr. McIntyre Drs. Ravi Jayas, Ethan Bohn

5 ½ Day Intro to PACU Self study Dr. McIntyre CMPA Session 12-1pm

6 Misericordia IV Day Intro to Respirology – Dr.M Blouw CBE and Effective Feedback McIntyre

7 Misericordia IV Day Intro to Consults – Dr. E. Blouw ACA 101 (Ratz) Self study – Bloody easy

8 Reading – Skills modules Bloody easy

9

10 OR Day Self study – Preparing the OR for and anesthetic

11 OR Cockpit Session- Dr. J. Littleford

12 ½ Day Transthoracic Echo – Dr. Strumpher

13 Intro to Cardiac – Dr. Thorleifson Intro to Radiology – Dr. Ying

14 Skills Lab Neuraxial L&D – Dr. Misra

15 Reading – Skills modules Bloody easy Day/Night weekend buddy calls

16 Day/Night weekend buddy calls

17 Standardized Patient Session Consent – Dr. Siddiqui

18 EPR Training

19 ½ Day Transthroacic Echo – Dr. Strumpher

20 Intro to Obs Anesthesia – Dr. Gill OR Day (PM)

21 Dr. Harms 0830 (AM) OR Day 1030(AM)

22 Reading – Skills modules Monitoring module Day/Night weekend buddy calls

23 Day/Night weekend buddy calls

24 OR Day Self study - Monitoring

25 Skills Course Monitoring – Dr. R. Ashcroft Self study – MRI safety / Off site considerations

26 ½ Day KIAM Orientation / MRI Safety Dr. R. Cappellani

27 Intro to Pain - Dr. J. Dhaliwal Intro to Peds – Dr. J. Swartz BLS Review – Dr. J. Swartz

28 OR Day

29 Reading – Skills modules CAE Ultrasound course

30

31 OR Day

Notes: All PGY1 residents are responsible for the simultaneous completion of TTD EPAs 1-4 within the 1st 2 months of training. A minimum mark of 80% on skills modules is required for completion. Passing mark in Bloody easy, Bloody easy coagulation and CAE ultrasound course. Minimum 2 Buddy calls

CBME 10

Competence Committee Members Faculty Mentors

Dr. Mani BhanguDr. Erika BlouwDr. Ryan BrinkmanDr. Duane Funk Dr. Jag GillDr. Craig Haberman

Dr. Rénee El-GabalawyDr. Ian McIntyreDr. Andrea PetropolisDr. Sanjay SareenDr. Johann StrumpherDr. Eric Sutherland

Want to learn more? Visit our website at royalcollege.ca

Understanding the power of the CBD ePortfolio (for residency)

ALLOWS OBSERVERS TO:

• Assess a learning encounter against Royal College educational standards

• Record observations for a learner

• Provide constructive feedback and coaching to learners

ALLOWS LEARNERS TO:

• Plan their learning

• Safely store artefacts as evidence of learning

• Review feedback provided by observers

• Reflect on learning experiences

Allows for electronic capture of observations

Contains up-to-date Royal College educational standards and program learning plans

Enables Competence Committees to assess learners’ progress

Facilitates learner and observer interaction

Produces analytics and reports for monitoring and benchmarking

Archives a physician’s learning data in a single secure location

Time

Stag

es

ePORTFOLIO DATA OUTPUT:How my program compares to others

ALLOWS PROGRAMS TO:

• Monitor progress and performance of individual learners

• Make promotion decisions at the Competence Committee

• Monitor progress and performance of the program

© Sept 2016 Royal College of Physicians and Surgeons of Canada

CBME 11

Sean Jardine

I would like to take this opportunity to extend my sincere thanks to Sean Jardine, who has been an outstanding contributor to CBME development through the UM learn platform and this newsletter. Sean has a commanding knowledge of web page construction, adobe in design and UM learn and combines this with a very busy career as an Anesthesia Clinical Assistant. Sean has been working very hard on evenings and weekends to assist our roll-out of CBME and I am very grateful. Thank-you Sean.

Penny Godawatte

Penny Godawatte is the program administrator for our residency program. I am delighted that Penny will be our administrative lead for CBME. Penny will work closely with the Competency Committee and will attend our meetings as a non-voting member. Penny will assist with the important job of collating evaluations and other documentation that our committee will need to facilitate decision making. Penny is an outstanding member of our team and her hard work is greatly appreciated.

CBME Spotlight

Thank-you to the PGY5's for a great 5 years!

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