Status recommendations
The primary reviewer will recommend a learner status based on the documented observations and will initiate a discussion on the issues arising from their review.
Competence committee members will discuss the status recommendation and vote on the learner’s official status in the program. (i.e., progressing as expected, not progressing as expected, progress is accelerated, failure to progress or inactive) and any resident action required (i.e., monitor, modify or promote).
If a learner’s status is not progressing as expected, progress is accelerated, failing to progress or inactive then the PG Dean needs to be aware. If the learner is progressing as expected but is eligible for the Royal College exam or is eligible for Royal College certification the PG Dean is also notified.
Learner Status | Learner - Resident Action | PG Dean approval / awareness |
---|---|---|
Progressing As Expected | Monitor Learner - Resident | Not required |
Modify Learning Plan – Suggested Focus on EPA/IM observations or RTE | Not required | |
Promote Learner - Resident – to Stage 2 | Not required | |
Promote Learner - Resident – to Stage 3 | Not required | |
Promote Learner - Resident – RC Exam Eligible* | Awareness | |
Promote Learner - Resident – to Stage 4 | Not required | |
Promote Learner - Resident – RC Certification Eligible | Required* | |
Not Progressing As Expected | Modify Learning Plan – Additional Focus on EPA/IM observations or RTE | Not required |
Formal Remediation | Required | |
Progress Is Accelerated | Modify Learning Plan – Modify required EPA/IM observations or RTE | Awareness |
Promote Learner - Resident – to Stage 2 | Awareness | |
Promote Learner - Resident – to Stage 3 | Awareness | |
Promote Learner - Resident – RC Exam Eligible | Awareness | |
Promote Learner - Resident – to Stage 4 | Awareness | |
Promote Learner - Resident – RC Certification Eligible | Required* | |
Failure to Progress | Modify Learning Plan – Additional Focus on EPA/IM observations or RTE | Awareness |
Formal Remediation | Required | |
Withdraw Training | Required | |
Inactive | Monitor Learner - Resident (i.e. expected return - parental leave, sick leave, etc.) | Required |
Withdraw Training | Required |
Reporting back
The competence committee chair will report the recommended status of each resident to the RPC. The RPC will be asked to ratify the recommendations and action any implications (e.g., status/promotion, formal remediation, inform the PG office, etc.)
The decisions of the competence committee must be shared with the learner followed by a discussion of what they should work on next.
Suggested resource(s)
The article Reviewing residents' competence: a qualitative study of the role of clinical competency committees in performance assessment1 looks at how Competence Committees actually work. This paper was written very early in the transition of CBME, but has some interesting findings. Drs. Frank, Snell and Sherbino discuss this article in KeyLIME Episode #124.
Managing a competence committee
How they deliberate
Resources
- Tools and resources
- Mock Competence Committee Cases for Practice Deliberation
- Competence Committees — Guidelines for the Terms of Reference
- Competence Committees — Process and Procedures in Decision Making: A framework
- Set up a Competence Committee (CBD for Program Directors)
- VIDEO (01:05) What is the goal/mandate of a Competence Committee?
- VIDEO (04:24) Setting up a Competence Committee
- VIDEO (02:42) What can one do to help ease the transition to Competence By Design?
- VIDEO (01:56) What is the workload like for a Competence Committee member?
- VIDEO (01:59) CBD – You are not alone
- VIDEO (01:17) How is information stored in programs?
- VIDEO (03:08) CBD benchmarks – How are we doing?
- VIDEO (02:24) How does a competence committee decide to promote a resident?
- VIDEO (01:23) What does a Competence Committee do with the aggregate data?
- Listen to the KeyLIME Episode #124 on Competency Committees entitled: "Reality check… How Clinical Competency Committees REALLY work"
1Hauer KE, Chesluk B, Iobst W, Holmboe E, Baron RB, Boscardin CK, Cate OT, O'Sullivan PS. Reviewing residents' competence: a qualitative study of the role of clinical competency committees in performance assessment. Academic Medicine. 2015 Aug;90(8):1084-92.