This past week, the Royal College hosted a number of thought leaders to discuss next steps in the Competency By Design (e.g. Canadian CBME) initiative. Deepak Dath reflects on the process. – Jonathan (@sherbino)
By Deepak Dath (@drddath)
Competency based medical education (CBME) is here. CanMEDS 2015 Series II was just launched. One of the next steps will be curating existing teaching and assessing instruments that map to various CanMEDS Roles. Of course, the process of blueprinting these instruments to the CanMEDS competencies will reveal areas that have few existing resources for teaching and assessment.
This will require the development (and evaluation) of new tools. Suppose you could devise a CBME research lab. What would it look like? Ideally, it would be accessible and part of current education infrastructure. An applied research lab would integrate learners, allowing regular workplace observation. Collaboration between similar centres would be feasible.
Well… there is such a laboratory, a kind of natural experimental environment. It is called the operating room (OR) (also known as a Theatre outside of North America), and it exists in every hospital. The OR is a microcosm of medical education where surgeons frequently teach and learners. Many ORs have video recording capability and some are wired for live transmission. Despite the clinical complexity of the associated surgical equipment, the OR environment is fairly uniform with respect to staffing and human activity (e.g. culture)
An example of the research potential of an operating room is found in the explosion of research, in the early 90s, around laparoscopic surgery. The volume of publications and the number of cases captured on video for analysis was (is) substantial. Now, CBME is here. The OR offers itself as a natural laboratory for CBME. What better venue for surgeons to study clinical competence than the OR.
Share your ideas for a surgical study below.
Image (“Operating_room”) courtesy of John Crawford, via Wikimedia Commons