PGY3 general paediatric resident University of Toronto Temerty Faculty of Medicine Toronto, Ontario, Canada
Background: Assessment in competency-based medical education (CMBE) centers on observation and feedback of performance based on discrete, speciality-specific tasks called entrustable professional activities (EPAs). Canada’s CBME initiative, Competence by Design (CBD), was formally implemented in pediatrics programs nationwide in July 2021. In CBD, EPA assessments provide a structure for formative, low-stakes assessment with an emphasis on feedback to guide learning, while also contributing to summative decision-making regarding trainee progression. Prior to the formal launch of CBD, many programs piloted EPA assessments, whereby residents were encouraged to initiate assessments for formative feedback only without bearing on their progression. Resident assessment- and feedback-seeking behaviors are complex and associated with multiple factors, including learner engagement, goal orientation, and relationship with the feedback provider. Additionally, concerns have been raised that the dual formative and summative functions of EPA assessments may cause inherent tensions for learners. However, residents’ experiences with EPA-based assessments remain underexplored. Objective: This study aims to explore pediatric residents’ experiences with EPA-based assessment and feedback processes, in the contexts of both pilot and formal CBD implementation, to inform curricular improvements and strategies to enhance learner engagement. Design/Methods: A purposive sample of pediatric residents who had EPA assessments during either the pilot or formal implementation of CBD are being recruited to complete semi-structured interviews designed to elicit their experience of EPA-based assessment and feedback processes. Interview transcripts are being analyzed using grounded theory methodology, in which themes are identified iteratively, towards an explanatory framework that highlights relationships among themes. Recruitment will continue alongside analysis until no new insights arise from the data. Ethical approval was obtained, and data collection commenced in July 2022, with 18 interviews conducted to date.
