Khalife Roy, Gonsalves Carol, Code Catherine, Halman Samantha
Department of Medicine, University of Ottawa, Ontario, Canada.
Division of Hematology, University of Ottawa, Ontario, Canada.
Can Med Educ J. 2018 Jul 27;9(3):e64-e75. eCollection 2018 Jul.
Residency programs are facing significant restructuring through the "Competence by Design" (CBD) framework proposed by the Royal College of Physicians and Surgeons of Canada (RCPSC). Our goal was to establish the competencies to be acquired during the transition to a senior role within Internal Medicine (IM) training.
Using a modified Delphi technique, practicing IM physicians and recent graduates were polled to develop consensus on the required competencies to effectively transition from junior to senior medical resident. Participants rated each competency on a three-point Likert scale. Each competency was linked to an Entrustable Professional Activity (EPA) identified by the RCPSC IM Specialty Committee.
A total of eighteen participants took part in item generation (16% response rate) and nineteen in the initial ranking with seventeen completing all three iterations (89% completion rate). Eighty-three competencies were identified during questionnaire development. A final list of seventy-seven competencies reached consensus after three rounds. Most competencies matched to core of discipline EPAs.
This consensus-based list of competencies will help create a framework and tools for the assessment of junior residents as they prepare to transition to the role of senior in the new CBD curricula for IM trainees at our institution.
住院医师培训项目正通过加拿大皇家内科医师与外科医师学院（RCPSC）提出的“以设计促能力提升”（CBD）框架进行重大重组。我们的目标是确定在内科（IM）培训中向高级角色过渡期间应获得的能力。
采用改良的德尔菲技术，对在职内科医生和近期毕业生进行调查，以就从初级住院医有效过渡到高级住院医所需的能力达成共识。参与者用三点李克特量表对每项能力进行评分。每项能力都与RCPSC内科专业委员会确定的可托付专业活动（EPA）相关联。
共有18名参与者参与了项目生成（回复率16%），19名参与了初始排名，其中17名完成了所有三轮（完成率89%）。问卷制定过程中确定了83项能力。三轮后，77项能力的最终清单达成了共识。大多数能力与学科核心EPA相匹配。
这份基于共识的能力清单将有助于创建一个框架和工具，用于评估初级住院医在准备过渡到我们机构内科培训新CBD课程中的高级角色时的情况。
