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Becoming familiar with the Competence by Design (CBD) transformation process is the first step to implementing CBD. One of the best ways to support change on the scale of CBD, is by helping the people experiencing the change spread new ways of thinking and behaving. These high-level steps are outlined in more detail in the CBD Meantime Guide.

1. Improve your knowledge and skills as a local resource person or CBD Champion

2. Make CBD your own

It helps if you can present the case for change with a motivating story or a cause that people care about. Demonstrate the gap between what is and what could be — what could this fix? Emphasize how CBD can better address the educational needs of learners, the care needs of patients, and our collective accountability to the public in the present day.

3. Show that CBD is relevant to your program’s success

Host local conversations at your regular meetings such as divisional business meetings, grand rounds, and resident retreats, to share your CBD story and help ensure that CBD is viewed as relevant to your program’s success.

4. Lead by example: be a CBD champion and bring other champions on board

Model the change and make progress visible. Invite and support other local CBD champions to discuss the need for change, including why CBD is so important. Tweet your findings or post talking points on LinkedIn, Facebook or local platforms.

5. Share and make explicit the CBD design, emphasizing key activities and language (e.g., direct observation, coaching feedback and documentation)

Begin to explore what it might take to implement CBD locally. Test out new behaviours and activities, and share and celebrate early successes.

6. Build broader ownership and commitment

Think about how you will enlist your local stakeholders. Who do you need to engage? Who are the key opinion leaders? What new or existing mechanisms can you use (e.g., departmental meeting, PGE Committee, faculty retreat, grand rounds, regular emails and newsletters)?

7. Ease the way for change

Review the CBD concepts and make sure enablers are in place for your program (e.g., preparation for coaching feedback, supports for Competence Committee). Consider aspects of your program context and environment that will need reviewing when your program transitions to CBD (e.g., culture, policies, processes, systems, supports).