Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
Competency Based Medical Education, University of Ottawa, Ottawa, ON, Canada.
Perspect Med Educ. 2024 Feb 6;13(1):24-32. doi: 10.5334/pme.957. eCollection 2024.
In the past decade, the Canadian system of postgraduate medical education has been transformed with the implementation of a new approach to competency based medical education called Competence by Design. The Royal College of Physicians and Surgeons of Canada (Royal College) developed an approach to time-variable competency based medical education and adapted that design for medical, surgical, and diagnostic disciplines. New educational standards and entrustable professional activities consistent with this approach were co-created with 67 specialties and subspecialties, and implementation was scaled up across 17 universities and over 1000 postgraduate training programs. Partner engagement, systematic design of workshops to create discipline specific competency-based standards of education, and agile adaptation were all key ingredients for success. This paper describes the strategies applied by the Royal College, lessons learned regarding transformative change in the complex system of postgraduate medical education, and the current status of the Competence by Design initiative. The approach taken and lessons learned by the Royal College may be useful for other educators who are planning a transformation to CBME or any other major educational reform.
在过去的十年中，随着以设计为基础的能力本位医学教育这一新方法的实施，加拿大的研究生医学教育系统发生了转变。加拿大皇家内科医生和外科医生学院（皇家学院）开发了一种时间变量的能力本位医学教育方法，并将该设计应用于医学、外科学和诊断学科。与这种方法一致的新的教育标准和可委托的专业活动是与 67 个专业和专科共同创建的，在 17 所大学和 1000 多个研究生培训项目中得到了推广。合作伙伴的参与、创建特定学科能力本位教育标准的系统设计以及灵活的适应都是成功的关键因素。本文描述了皇家学院应用的策略、在研究生医学教育这一复杂系统中进行变革所获得的经验教训，以及以设计为基础的能力本位倡议的现状。皇家学院采取的方法和获得的经验教训可能对其他计划向 CBME 或任何其他重大教育改革转变的教育工作者有用。
