As of July 1 2017, all new anesthesiology residents in Canada will be assessed via the Royal College's competence by design (CBD) program. 

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At present (July 2019), the R4 and R5 residents are in the traditional program and the R1-R3 residents are in the CBD curriculum.

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R4-5 residents should have a daily assessment or narrative completed EVERY day. This is an opportunity to review their daily performance and provide feedback directly to the resident and to myself via the daily assessment form so that I can complete an end of rotation evaluation (ITER). We have decided to terminate the paper evaluations and replace them with a google form. The Google form is identical to the paper assessment and is much easier to complete. The resident will email you the form to complete or open it in a web browser at the end of the day. Please make time every day to provide feedback to the residents.  

 

Daily resident evaluation form: https://forms.gle/W8rN3d2YBsRBMXUBA

Open the form in a Google Chrome browser or on your smartphone. The residents are listed by PGY year. Select your name from the list – if it is not there please let me know.

 

The R1-R3 CBD residents should receive daily narrative assessments using the same document. They will also request from you completion of EPA assessments for specific tasks they perform during the day, which are completed through the online Entrada platform.

 

Entrada: https://entrada.med.ubc.ca/

Use your CWL login to access your dashboard. Email Brenda if you do not have a CWL.

An EPA stands for "Entrustable Professional Activity". If a resident would like to complete an EPA they need to tell you PROSPECTIVELY; the resident will communicate to you that they wish to be evaluated on an EPA which you will then observe (in contrast to narratives which are retrospective).

What is an example of an EPA?

4 EPAs exist for new residents (i.e. in the Transition to Discipline stage):
1. Performing preoperative assessments for ASA 1 or 2 patients who will be undergoing a minor scheduled surgical procedure
2. Preparing the operating room (OR) for minor scheduled surgical procedures for ASA 1 or 2 patients
3. Monitoring ASA 1 or 2 adult patients undergoing minor scheduled surgical procedures under general or regional anesthesia.
4. Performing the postoperative transfer of care of ASA 1 or 2 adult patients following minor surgical procedures including postoperative orders

Obviously as residents progress through the stages of CBD training, EPAs become more complex.

How do residents transition through the stages of CBD?

Residents must complete all EPAs in their particular stage of training in order to advance to the next stage (i.e. through the stages of Transition to Discipline, Foundations of Discipline, Core of Discipline, Transition to Practice). However, progression is not determined by a single evaluation - multiple observations by multiple observers over time provide a better overall assessment of trainee’s competence and informs promotion decisions. In other words, a single evaluation is not high stakes and should not deter you from failing a resident on a given EPA if warranted. Indeed, residents should not expect to pass every EPA.

Who are my go-to people at VGH if I need help with CBD resident evaluations?

Your CBD site leaders are Chris Durkin and Travis Schisler. Please do not hesitate to seek one of us out if you have questions or encounter difficulties with the new evaluation system. Please remember that we are also learning the new system. If we can't answer your question right away, we will seek out an answer in a timely fashion.

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