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Review of Challenges to the Implementation of Competence by Design in Post-Graduate Medical Education: What Can Diagnostic Radiology Learn from the Experience of Other Specialty Disciplines?

  • Helena Bentley
    Correspondence
    Address correspondence to: H.B.
    Affiliations
    Department of Radiology, Faculty of Medicine, Gordon & Leslie Diamond Health Care Centre, University of British Columbia, 11th Floor, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada
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  • Kathryn E. Darras
    Affiliations
    Department of Radiology, Faculty of Medicine, Gordon & Leslie Diamond Health Care Centre, University of British Columbia, 11th Floor, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada

    Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada
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  • Bruce B. Forster
    Affiliations
    Department of Radiology, Faculty of Medicine, Gordon & Leslie Diamond Health Care Centre, University of British Columbia, 11th Floor, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada

    Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada
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  • Anto Sedlic
    Affiliations
    Department of Radiology, Faculty of Medicine, Gordon & Leslie Diamond Health Care Centre, University of British Columbia, 11th Floor, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada

    Department of Radiology, Vancouver General Hospital, Vancouver, BC, Canada
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  • Cameron J. Hague
    Affiliations
    Department of Radiology, Faculty of Medicine, Gordon & Leslie Diamond Health Care Centre, University of British Columbia, 11th Floor, 2775 Laurel Street, Vancouver, BC V5Z 1M9, Canada

    Department of Radiology, St Paul's Hospital, Vancouver, BC, Canada
    Search for articles by this author
Published:January 27, 2022DOI:https://doi.org/10.1016/j.acra.2021.11.025
      Competence by Design (CBD) is a medical education initiative instituted by the Royal College of Physicians and Surgeons of Canada to improve the training of resident physicians in specialty disciplines. CBD integrates Competency Based Medical Education with traditional specialty discipline post-graduate medical education (PGME) training through the application of an organizational framework of competencies. Various specialty disciplines in Canada have transitioned to CBD since 2017 in a staggered approach. Diagnostic radiology PGME programs in Canada are expected to transition to CBD in 2022 for the incoming resident physician cohort. This article reviews potential challenges to the implementation of CBD in diagnostic radiology PGME programs and proposes evidence-informed targeted strategies and solutions to address these challenges. It is important for diagnostic radiology PGME programs to understand the challenges pertaining to the implementation of CBD so that they may be able to successfully implement this or similar medical education initiatives in their programs. Moreover, as radiology subspecialty PGME programs, such as nuclear medicine, interventional radiology, neuroradiology, and pediatric radiology, likewise transition to CBD and diagnostic radiology PGME programs internationally increasingly implement other Competency Based Medical Education models, the implications of the challenges pertaining to the implementation of CBD will further become of increasing importance.

      Key Words

      Abbreviations:

      CBME (Competency Based Medical Education), CBD (Competence by Design), PGME (post-graduate medical education), RCPSC (Royal College of Physicians and Surgeons of Canada), EPA (entrustable professional activity)
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