Ready, set, go! Evaluating readiness to implement competency-based medical education

Abstract

Purpose

Organizational readiness is critical for successful implementation of an innovation. We evaluated program readiness to implement Competence by Design (CBD), a model of Competency-Based Medical Education (CBME), among Canadian postgraduate training programs.

Methods

A survey of program directors was distributed 1 month prior to CBD implementation in 2019. Questions were informed by the R = MC² framework of organizational readiness and addressed: program motivation, general capacity for change, and innovation-specific capacity. An overall readiness score was calculated. An ANOVA was conducted to compare overall readiness between disciplines.

Results

Survey response rate was 42% (n = 79). The mean overall readiness score was 74% (30–98%). There was no difference in scores between disciplines. The majority of respondents agreed that successful implementation of CBD was a priority (74%), and that their leadership (94%) and faculty and residents (87%) were supportive of change. Fewer perceived that CBD was a move in the right direction (58%) and that implementation was a manageable change (53%). Curriculum mapping, competence committees and programmatic assessment activities were completed by >90% of programs, while <50% had engaged off-service disciplines.

Conclusion

Our study highlights important areas where programs excelled in their preparation for CBD, as well as common challenges that serve as targets for future intervention to improve program readiness for CBD implementation.

Keywords:

• Competency-based medical education
• implementation
• readiness

Glossary

Organizational Readiness: Is the extent to which an organization is willing (psychologically prepared) and able (behaviorally prepared) to implement an innovation.

Weiner BJ, Amick H, Lee S-YD. 2008. Review: conceptualization and measurement of organizational readiness for change. Med Care Res Rev. 65(4):379–436. doi:10.1177/1077558708317802.

Drzensky F, Egold N, van Dick R. 2012. Ready for a change? A longitudinal study of antecedents, consequences and contingencies of readiness for change. J Chang Manag. 12(1):95–111. doi:10.1080/14697017.2011.652377.

Acknowledgements

The authors would like to thank all Program Directors who participated in this study. They would also like to thank the Royal College of Physicians and Surgeons of Canada for providing administrative support.

Disclosure statement

The authors report no conflicts of interest.

Data availability statement

Data supporting the results are maintained by the Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.

Additional information

Notes on contributors

Warren J. Cheung

Warren J. Cheung, MD, MMEd, FRCPC, is associate professor, Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada and a Clinician Educator, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.

Andrew K. Hall

Andrew K. Hall, MD, MMEd, FRCPC, is associate professor, Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada and a Clinician Educator, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.

Alexandra Skutovich

Alexandra Skutovich, BA, MA, is research coordinator, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.

Stacey Brzezina

Stacey Brzezina, BA (hons), MA, is program evaluation analyst, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.

Timothy R. Dalseg

Timothy R. Dalseg, MD, MMEd, FRCPC, is assistant professor, Department of Medicine, Division of Emergency Medicine, University of Toronto, Toronto, Ontario, Canada and a Clinician Educator, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.

Anna Oswald

Anna Oswald, MD, MMEd, FRCPC, is professor, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada and a Clinician Educator, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.

Lara J. Cooke

Lara J. Cooke, MD, MSc, FRCPC, is professor, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada and a Clinician Educator, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.

Elaine Van Melle

Elaine Van Melle, PhD, is Senior Education Scientist, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada and Adjunct Faculty, Department of Family Medicine, Queen’s University, Kingston, Ontario, Canada.

Stanley J. Hamstra

Stanley T. Hamstra, PhD, is professor, Department of Surgery, University of Toronto, Toronto, Ontario, Canada and Senior Scientist, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Jason R. Frank

Jason R. Frank, MD, MA(Ed.), FRCPC, is Director of Specialty Education, Strategy, and Standards, Royal College of Physicians and Surgeons of Canada, Ottawa Ontario, Canada and Vice-Chair Education, Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada.