AUSTRALIA November 2015 Dr Herbert Schneider (Team Leader) Dr Howard Batho, Dr Barry Stemshorn, Dr Alex Thiermann PVS Evaluation Report.
Defining competency- based evaluation objectives in family medicine. Abstract. Objective To develop a definition of competence in family medicine sufficient to guide a review of Certification examinations by the.
Board of Examiners of the College of Family Physicians of Canada. Two expert. groups used a modified Delphi consensus process to analyze responses and generate 2 basic components of this definition of.
Of the elements. 2. The expert groups identified 6 essential skills, the phases of the clinical encounter. More than 2. 0% of respondents cited 3. This survey represents the first level of definition of evaluation objectives in family medicine. It is expressed. in terms of the problems that are dealt with during the practice of family medicine and in terms of the skills that are necessary.
The Information Literacy Competency Standards for Higher Education (originally approved in 2000) were rescinded by the ACRL Board of Directors on June 25, 2016, at the 2016 ALA Annual Conference in Orlando, Florida, which. Cultural Competency Assessment, Developed by Kelly Bjoralt, OTS, and Kristy Henson, OTS, 2008. Assessment of Organizational Cultural Competence. This brochure provides a definition of cultural competency and health care.
This definition, once completed, will be the basis of a revised assessment. Certification by the College of Family Physicians of Canada (CFPC), so particular emphasis has been placed on the. The process was free of all constraints that are commonly imposed by predetermined.
Competence is very task specific. Van der Vleuten. 2 has reviewed the literature in medicine and concluded that no distinct traits have been well- defined and there is no consensus.
For this reason clinical competence cannot yet be characterized as an aggregate of distinct. He stated that this should not be surprising, as “the notion of inherent and robust traits has. Components of competence show great variability across.
Any definition of competence must recognize the effect of the interaction. Epstein and Hundert derived their definition largely from 4 slightly more comprehensive. North. America: the 4 principles of family medicine of the CFPC4; Educating Future Physicians for Ontario. Can. MEDS 2. 00. 56; and the Accreditation Council for Graduate Medical Education competency framework. There are both considerable differences and similarities among these 4 frameworks as well as others.
However, they all have. Albanese. and colleagues.
A competency should do the following. Focus on the performance of the end product or goal of instruction. Reflect expectations that apply what is learned in the immediate instructional program. Be expressed in a measurable behaviour. Use a standard for judging competence that is not dependent on the performance of other learners.
Inform learners, as well as other stakeholders, of what is expected of them. Defining competency in family medicine. In 1. 99. 8 the Board of Examiners of the CFPC observed that no definition of competence in family medicine existed that was sufficient. Certification. Members of the Board of Examiners therefore. Certification process. Job analysis is a time- honoured.
As such it follows the Coan (versus Cnidian) tradition of the practice of medicine, a tradition. This approach is also compatible with the situational model of competence suggested by Klass. This model is patient- and encounter- centred. This report deals with the first part of this exercise, namely overall definition of competence in family medicine in terms. Kane,1 and of the skills most useful to dealing with these problems in a competent fashion. The second part of the exercise has.
Van der Vleuten. 2 and Albanese et al. These detailed interactions between the problems and the skills, or the operational competency- based evaluation objectives. No demographic data were collected on. The survey and analysis were done from 1. Respondents were asked. Qualitative approaches, such as the Delphi.
Expert groups of 6 to 8 family physicians and 1 educational consultant analyzed the responses to the survey and used a modified. Delphi consensus process to derive an initial definition of competence based on the priority topics to be dealt with and the. There were multiple iterations until consensus. All members of the expert groups had experience in assessing competence in family.
Canadian context as far as region, sex, language, community type, and experience are concerned. The first expert group, which was the CFPC Board of Examiners at the time, concentrated. The starting point was their own experiences plus the nontopic elements from.
After several iterations, working with the responses from the survey. The nontopic elements of all. This group concentrated on the topic elements of the survey responses.
They started with all the topic names generated from. The process was repeated. Figure 2). Frequencies of topic name citation were then calculated for all the survey responses. The total number of elements in the answers to the questions in all responses was 5. The maximum number of elements expected per responder was 3. Of the elements, 2. The other 2. 40. 1 were skills, behaviour.
The number 9. 9 was not predetermined; it resulted entirely from the analytic process. All of the elements coded to 1 of. The expert groups maintained, as much as possible, the terminology of the responders. No standardized taxonomy was applied to the topics: the types of terms used can be seen in the topic list.
Grouping. of slightly dissimilar responses under more general topic names was minimal, and occurred only at the end of the process for. Citation rates of topics varied from 8. The distribution of the frequencies of citation was markedly skewed, with some.
Twenty topics were cited in more than 3. The meaning of each dimension is fairly self- evident in some cases; for example, competence could be categorized according.
For the others. “psychomotor” refers to the skills necessary to perform technical procedures or physical examinations; “communication” refers. Three other dimension names were used as follows: “4 principles” refers to the 4 principles of family medicine of the CFPC4; “professional qualities” include the great variety of characteristics that let a physician act professionally, in both the. The other category includes the traditional parts of the clinical. Frequencies. were calculated for each, but they are reported here within 1 descriptive dimension of competence: the phase of the encounter. Three dimensions were not used at all, and the other 3 in only 2% or 3% of the responses. Psychomotor skills appeared.
The phase of. the encounter dimension, including all 7 phases, was frequently cited. The diagnostic parts of the encounter (history, physical. The domain of competence. There. has been no reorganization in any systematic fashion in order to try to fit the results into an established theoretical competency. It is our contention that this has advantages as far as accessibility is concerned, particularly for use in the. The terms used are familiar to clinician- teachers and learners, and can be easily used to identify and label situations deemed.
The number of priority topics is fewer than similar lists. The Medical Council of Canada has 2. Qualifying Examination. Canada. 1. 4 The Royal College of General Practitioners (United Kingdom) Condensed Curriculum Guide has 3. The latter does further define competence for the many outcomes, but appears to cover the whole domain of family medicine.
Good evaluation. requires a “plausible inference of overall competence from a limited number of observations.”1 If an evaluation of the present skills in the various phases of the clinical encounter over an adequate sample of these priority. It is more important to avoid including. The domain as currently. Its other strength is its transparency. Even though the results reported do not include. There might be some nonclinical topics or tasks that could be added at a future date if appropriate consideration shows. It is interesting, but perhaps not surprising, that the survey.
Unless a specific practice. Competence is much more than a checklist of specific technical abilities,1.
Notwithstanding this conclusion, once the early results of the study were known, the CFPC Board of Examiners. Certification. A sixth essential. This has been reported elsewhere. Since this study began, various competency frameworks have become popular for the organization of postgraduate medical education. For evaluation purposes, some suggest that the domain of competence should be organized according to one of these frameworks.
The frameworks can usefully identify some pertinent nonclinical topics to add to the list, but these might not. Govaerts. 18 strongly supports the efforts of Albanese and colleagues.
He states that “effective assessment programmes . Definition to this level. Further analysis is required to define these skills as well as their interactions with the priority topics in order to. This has been done as the second part of the overall project and is reported elsewhere. Limitations. The absence of demographic data on the survey respondents, even though they were drawn from a group previously selected to. Canadian family physicians, makes it impossible to compare them with Canadian family physicians as a. We cannot, therefore, infer with certainty that the survey responses reflect the views of the larger group.
A validation. survey has been done to verify priority topic choices by a stratified and representative sample of family physicians from. The results will be reported elsewhere. This might be true if we were talking about specific treatments or investigative modalities or specific presentations. The particular ways in which topics that present must be dealt with by a family physician do evolve, but the. Similarly the exact competent use of the essential skills can change slowly, but the generic. Periodic review will be desirable, but these first layers of a definition of competence.
They define and limit the expectations for both candidates and teachers, and, as such, represent. They provide a next level of clarity for medical competence as defined by Epstein and Hundert,3 but further definition is required, particularly with respect to the specific interactions among the topics and the skill. Once this has been done, it would be reasonable to state that a candidate who can demonstrate competency using the 6 essential.