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Harrington KL, Teramoto M, Black L, Carey H, Hartley G, Yung E, Osborne J, Goldberg P, Tran RT, Hillegass E. Physical Therapist Residency Competency-Based Education: Development of an Assessment Instrument. Phys Ther 2022; 102:6535133. [PMID: 35225348 DOI: 10.1093/ptj/pzac019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/20/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The objective of this study was to develop generic domains of competence (DoC) with associated competencies and milestones for physical therapist residency education. This work was intended to culminate in establishing validity evidence to support a competency-based assessment instrument that could be used by residency programs to evaluate resident achievement of the competencies, regardless of specialty area. METHODS Employing the modified Delphi method, a residency education work group developed an evaluation instrument that included 7 DoC and 31 associated competencies with 6 milestones as rating scales for each competency. The instrument was distributed to mentors and residents in accredited physical therapist residency programs to establish validity evidence. Evaluations (measured by milestones) and demographics were collected at 3 time points (program entry, midterm, and final). Scores across these time points were compared using Kruskal-Wallis tests. Reliability was assessed with kappa statistics (interrater reliability) and alpha reliability coefficients (internal consistency). Construct validity was examined using confirmatory factor analysis via structural equation modeling. RESULTS Overall, 237 mentors and 228 residents completed 824 evaluations (460 by mentors and 364 resident self-evaluations) across the time points. Scores significantly increased from entry through final time points. The interrater reliability of the associated behaviors ranged from moderate to substantial agreement (κ = 0.417-0.774). The internal consistency was high for all DoC at every time point (α reliability coefficients = .881-.955 for entry, .857-.925 for midterm, and .824-.902 for final). After confirmatory factor analysis with structural equation modeling was performed, a model that included 7 DoC and 20 associated competencies was proposed. CONCLUSIONS The residency assessment instrument developed demonstrates interrater reliability and validity evidence and therefore supports competency-based assessment of resident clinical performance across specialty areas. Additionally, the instrument aligns the physical therapy profession with other professions, such as medicine, dentistry, and pharmacy, that have transitioned to competency-based education. IMPACT This study outlines the benefits of moving to competency-based education for physical therapist residents, using a sound evaluation tool that evaluates residents across specialty areas. The instrument will allow for transition to competency-based education in physical therapist residency education programs.
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Affiliation(s)
- Kendra L Harrington
- Residency and Fellowship Education, American Physical Therapy Association, Alexandria, Virginia, USA
| | - Masaru Teramoto
- Division of Physical Medicine and Rehabilitation, University of Utah, Salt Lake City, Utah, USA
| | - Lisa Black
- Department of Physical Therapy, Creighton University, Omaha, Nebraska, USA
| | - Helen Carey
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, Indiana, USA
| | - Greg Hartley
- Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, Florida, USA
| | - Emmanuel Yung
- Department of Physical Therapy, Sacred Heart University College of Health Professions, Fairfield, Connecticut, USA
| | - Jacqueline Osborne
- Brooks Rehabilitation Institute of Higher Learning, Jacksonville, Florida, USA
| | | | - Rachel Tabak Tran
- Casa Colina Hospital and Centers for Healthcare, Pomona, California, USA
| | - Ellen Hillegass
- Department of Physical Therapy, Mercer University College of Health Professions, Atlanta, Georgia, USA
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Wei CJ, Lu TH, Chien SC, Huang WT, Liu YP, Chan CY, Chiu CH. The development and use of a pharmacist-specific Mini-CEX for postgraduate year trainees in Taiwan. BMC MEDICAL EDUCATION 2019; 19:165. [PMID: 31118004 PMCID: PMC6530012 DOI: 10.1186/s12909-019-1602-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 05/13/2019] [Indexed: 06/03/2023]
Abstract
BACKGROUND Clinical pharmacists must have a complex combination of academic knowledge and practical experience that integrates all aspects of practice. Taiwan's Ministry of Health and Welfare in 2007 launched the Postgraduate Year (PGY) training program to increase the standard of pharmaceutical care. This study aims to develop a pharmacist-specific Chinese-language Mini-Clinical Evaluation Exercise (Mini-CEX) to evaluate the professional development of postgraduate year trainees. METHOD The specialized Mini-CEX was developed based on the core competencies of pharmacists, published literature, and expert opinion. A pilot test and evaluator workshop were held prior to the administration of the main test. Fifty-three samples were recruited. The main study was conducted at two regional teaching hospitals and a medical center teaching hospital in Taiwan between February and June 2012. The results were analyzed with the kappa statistic (inter-rater reliability) and descriptive statistics, while the Kruskal-Wallis test was used to examine the PGY trainees' Mini-CEX scores based on their performances. RESULTS Trainees who had recently completed PGY programs (C-PGY) and 2nd year PGY trainees (PGY2) earned excellent scores, while the 1st year PGY trainees (PGY1) earned satisfactory scores in overall performance. C-PGY and PGY2 trainees also performed significantly better than PGY1 trainees in the organization and efficiency domain, and the communication skills domain. CONCLUSION This study demonstrates the feasibility of using the newly developed pharmacist-specific Chinese-language version of the Mini-CEX instrument to evaluate the core competencies of PGY trainees in clinical settings.
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Affiliation(s)
- Chung-Jen Wei
- Department of Public Health, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Tzu-Hsuan Lu
- Medical Quality Department, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| | - Shu-Chen Chien
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Department of Pharmacy, Taipei Medical University Hospital, Taipei, Taiwan
| | - Wan-Tsui Huang
- Department of Pharmacy. Cathay General Hospital, Taipei, Taiwan. School of Pharmacy. Taipei Medical University, Taipei, Taiwan
| | - Yueh-Ping Liu
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Cho-Yu Chan
- Changhua Christian Hospital, Chunghua, Taiwan
| | - Chiung-Hsuan Chiu
- Department of Pharmacy. Cathay General Hospital, Taipei, Taiwan. School of Pharmacy. Taipei Medical University, Taipei, Taiwan
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Frank JR, Snell L, Englander R, Holmboe ES. Implementing competency-based medical education: Moving forward. MEDICAL TEACHER 2017; 39:568-573. [PMID: 28598743 DOI: 10.1080/0142159x.2017.1315069] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
For more than 60 years, competency-based education has been proposed as an approach to education in many disciplines. In medical education, interest in CBME has grown dramatically in the last decade. This editorial introduces a series of papers that resulted from summits held in 2013 and 2016 by the International CBME Collaborators, a scholarly network whose members are interested in developing competency-based approaches to preparing the next generation of health professionals. An overview of the papers is given, as well as a summary of landmarks in the conceptual evolution and implementation of CBME. This series follows on a first collection of papers published by the International CBME Collaborators in Medical Teacher in 2010.
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Affiliation(s)
- Jason R Frank
- a Royal College of Physicians and Surgeons of Canada , Ottawa , Canada
- b Department of Emergency Medicine , University of Ottawa , Ottawa , Canada
| | - Linda Snell
- a Royal College of Physicians and Surgeons of Canada , Ottawa , Canada
- c Centre for Medical and Department of General Internal Medicine , McGill University , Montreal , Quebec, Canada
| | - Robert Englander
- d School of Medicine, University of Minnesota , Minneapolis , MN , USA
| | - Eric S Holmboe
- e Accreditation Council for Graduate Medical Education , Chicago , IL , USA
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Jang TB, Coates WC, Liu YT. The competency-based mandate for emergency bedside sonography training and a tale of two residency programs. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2012; 31:515-521. [PMID: 22441907 DOI: 10.7863/jum.2012.31.4.515] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Timothy B Jang
- Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles Biomedical Institute at Harbor-UCLA, 1000 W Carson Ave, D-9A, Torrance, CA 90502, USA.
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Saenz R, Skledar SJ, Yourich B, Mark SM. Educational program for pharmacists at a multifacility academic medical center. Am J Health Syst Pharm 2010; 67:1368-72. [PMID: 20689128 DOI: 10.2146/ajhp090680] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE An educational program for pharmacists in a multifacility health care setting is described. SUMMARY The expansion of pharmacy services at a university medical center from a centralized to a decentralized, unit-based model created the need for enhanced education of staff pharmacists. A steering committee with pharmacy department and school of pharmacy representation surveyed educational and professional needs related to the expanded services. Pharmacists indicated that they needed an educational program that was comprehensive, interactive, and accessible to all shifts. Pharmacy school clinical faculty members provided most of the initial educational sessions, which combined didactic presentations and case-based discussion. The needs survey was used in selecting topics that were most relevant to the pharmacists' expanded practice. Each major topic was covered in a series of one-hour sessions held at two-week intervals and scheduled at a time convenient for afternoon-shift pharmacists. Incentives were offered to encourage participation. The live presentations were recorded with video-streaming technology and made available via the Internet to pharmacists on all shifts in all facilities of the health system as well as to faculty members. Since program implementation in 2005, attendance at the live sessions has averaged 25. In postimplementation surveys, pharmacists indicated that the program was meeting their needs and improving patient care. Since 2008, pharmacists have been able to earn continuing-education (CE) credit for the sessions. CONCLUSION A collaborative educational series with online access, clinical content, and CE credit has been effective in meeting pharmacists' needs in a multifacility health care setting.
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Affiliation(s)
- Rafael Saenz
- Pharmacy Operations,University of Pittsburgh Medical Center Presbyterian, 200 Lothrop Street, Pittsburgh, PA 15213, USA
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Frank JR, Snell LS, Cate OT, Holmboe ES, Carraccio C, Swing SR, Harris P, Glasgow NJ, Campbell C, Dath D, Harden RM, Iobst W, Long DM, Mungroo R, Richardson DL, Sherbino J, Silver I, Taber S, Talbot M, Harris KA. Competency-based medical education: theory to practice. MEDICAL TEACHER 2010; 32:638-45. [PMID: 20662574 DOI: 10.3109/0142159x.2010.501190] [Citation(s) in RCA: 1231] [Impact Index Per Article: 87.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Although competency-based medical education (CBME) has attracted renewed interest in recent years among educators and policy-makers in the health care professions, there is little agreement on many aspects of this paradigm. We convened a unique partnership - the International CBME Collaborators - to examine conceptual issues and current debates in CBME. We engaged in a multi-stage group process and held a consensus conference with the aim of reviewing the scholarly literature of competency-based medical education, identifying controversies in need of clarification, proposing definitions and concepts that could be useful to educators across many jurisdictions, and exploring future directions for this approach to preparing health professionals. In this paper, we describe the evolution of CBME from the outcomes movement in the 20th century to a renewed approach that, focused on accountability and curricular outcomes and organized around competencies, promotes greater learner-centredness and de-emphasizes time-based curricular design. In this paradigm, competence and related terms are redefined to emphasize their multi-dimensional, dynamic, developmental, and contextual nature. CBME therefore has significant implications for the planning of medical curricula and will have an important impact in reshaping the enterprise of medical education. We elaborate on this emerging CBME approach and its related concepts, and invite medical educators everywhere to enter into further dialogue about the promise and the potential perils of competency-based medical curricula for the 21st century.
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Affiliation(s)
- Jason R Frank
- Royal College of Physicians and Surgeons of Canada, Canada.
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Vermeulen LC, Rough SS, Thielke TS, Shane RR, Ivey MF, Woodward BW, Pierpaoli PG, Thomley SM, Borr CA, Zilz DA. Strategic approach for improving the medication-use process in health systems: The high-performance pharmacy practice framework. Am J Health Syst Pharm 2007; 64:1699-710. [PMID: 17687058 DOI: 10.2146/ajhp060558] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE A strategic approach to improving the medication-use process in health systems by using a framework for setting priorities on the basis of feasibility, the potential for financial return, and the effect on quality and safety is described. SUMMARY A panel consisting of leaders in health-system pharmacy identified seven dimensions of high-performance pharmacy (HPP) framework: medication preparation and delivery, patient care services, medication safety, medication-use policy, financial performance, human resources, and education. Performance elements, which are specific policies, procedures, activities, and practices that indicate high performance and result in a financial or clinical return on investment of resources, within each dimension were identified. References, practice standards, and policies related to each performance element were also identified. By consensus, the panel assigned qualitative metric scores for each of the 69 performance elements that represent the panel's assessment of the resources necessary to achieve full implementation of the element and the potential financial and quality and safety returns if the element has not yet been implemented. It is noted that a pharmacy department's actual outlay of resources and expected financial return will differ depending on the size of the health system, the size of pharmacy staff, and the extent of previous implementation efforts. The framework can also be used to rejustify existing services and programs and identify opportunities for improvement. CONCLUSION The HPP framework characterizes pharmacy performance elements on the basis of feasibility, financial return, and effect on quality and safety. The framework provides pharmacists with a means to establish priorities in improving the medication-use system.
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Affiliation(s)
- Lee C Vermeulen
- University of Wisconsin Hospital and Clinics, School of Pharmacy, University of Wisconsin-Madison, Madison, WI 53792-1530, USA.
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