A view from the Emergency Department - their keys to CBME planning success

CBME Lead Dr. Allison Meiwald and postgraduate Program Director Dr. Robert Sedran are gearing up for the transition to CBME for the Emergency Medicine Residency Program.

With seven months until implementation, we wanted to check-in with them to see what they have accomplished to date, what’s next on their list, what’s been the most challenging and if they had any insightful tips they could share with others.

What are your responsibilities?

Dr. Sedran: As the Program Director, I sit on the national specialty committee and with the broader group came up with the entrustable professional activities (EPAs), as well as all the other components related to CBME. Locally, I’m responsible to ensure everything is ready to go by July 2018.

Dr. Meiwald: As CBME Lead, the first thing is that you need to work with the Program Director and Assistant Director to ensure that all the things happening at the national level are translated locally. This includes all milestones and EPAs. You also have to ensure that they are achievable at a local level. As the lead, I am also responsible for developing a competence committee, and for curriculum mapping. I also work to determine what rotations we will be doing and ensure faculty and staff are educated in order that they can perform evaluations/assessment, understand the technical programs they will be using and ensure residents know what they need to do as part of the assessments.

What are you focused on right now in your preparation?

There isn’t one major component that we are focused on; it seems like there are lots of little things along the way. We are having discussions about rotations and the impact on services with the Postgraduate Medical Education office and the other programs to ensure we are all in-sync with any potential changes. Once that is all in place, our next hurdle is education and engagement with faculty and staff. We will need to map the curriculum and once that is complete, we will investigate the evaluative tools we will be using. Currently the Royal College is promoting ePortfolio, but we want to look at all the options available.  

How do you feel about your level of preparation to date given that you have seven months to go until implementation?

We are in a good place, although it’s still anxiety provoking. Once we have the curriculum mapping in place, we’ll feel even more prepared. But our incoming residents are excited to start the process. And we have a bit of an advantage as two of the programs we work with (Anesthesia and Otolaryngololgy – head and neck surgery) have already transitioned so we’ve had an opportunity to start education with our staff and faculty, and we’ve been able to do some trouble shooting, which has been really helpful.  

What has helped you to achieve the success to date with your planning?

A lot of it comes down to a good working team and good organization. The Royal College came up with the EPAs early, and that was communicated. We engaged residents early in the process and we’ve established a process for staff and faculty education. Having frequent meetings with the people involved and keeping people updated really makes a difference too. And we have a very supportive Chair/Chief. He asked right away – how can I help? And that made a huge difference.

What has been or will be the most challenging aspect of this transition?

Evaluation and communication have been and will be the most challenging part of this transition. We will need ensure the 70+ faculty understand the evaluation process and buy into it.

What are your top 6 tips that you would like to pass along to your colleagues?

1.   Don’t get discouraged. This is a new process, which has a multitude of positive aspects to it. But there will be bumps along the way.

2.    Keep the lines of communication open.

3.    Trust the mechanisms offered by the Royal College.

4.    Get as many people involved in your area and find your champions.

5.    People need to know it’s an exciting process. It’s easy to look in as an outsider and fear it, but it’s very exciting.

6.    Get started early.