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CBD assessment templates

There are four Competence by Design (CBD) assessment templates designed to operationalize the educational principles of CBD (e.g. narrative, actionable, timely feedback). They include validated components (e.g. entrustment anchors) that help to establish a common language of assessment, while also prompting conversations about the essential ingredients of competence and the factors contributing to entrustment decisions.

Your program/discipline may have other good assessment tools, possibly even validated tools, which you are encouraged to continue to use even after you transition to CBD. Locally driven innovations at the individual faculty level should complement and expand on the principles of CBD, including the four national templates below.

The important thing to remember is it’s not necessarily what tool(s) you use, but the fact that you’re conducting and documenting regular observations to inform the work of the competence committee.

While these templates will help programs transition to CBD, there is no magic in the forms themselves. They’re designed to support work based assessment, but the real improvement in assessment will come from regular observation and the coaching of residents. For this reason, individual faculties can use their own version of these assessment templates. The Royal College’s main expectation is that your program complies with the essential elements of the assessment strategy.

Four CBD assessment templates

It’s important to note that the templates do require customization. For example, programs need to modify the contexts that will change, the milestones and entrustable professional activities (EPAs) will also change.

Each template serves a slightly different purpose, but all four templates encourage narrative feedback. This is important because narrative feedback is shown to help trainees improve their performance.

Form 1: EPA observation
This form is designed for documenting a resident’s performance on any EPA (or a specific part of an EPA). It uses an entrustment scale to rate the level of performance with respect to the resident’s ability to do the task independently.

Form 2: procedural competencies
This form is used for documenting a resident’s ability to perform a procedure. It uses an entrustment scale to rate the resident’s level of performance with respect to the resident’s ability to do the task independently.

Form 3: multi-source feedback
This form may be completed by physicians, off-service physicians, or allied care team members as directed by the program/discipline.

Form 4: narrative observation
This form can be used to document any observation of a trainee’s performance. It does not use a rating scale. Rather the assessor is asked to describe the performance and make recommendations for improvement. It can essentially be used in any setting to provide any useful information to the trainee or competence committee and it can be linked to an EPA post-hoc if relevant.

Using work based assessment in your program