Canadian Journal of Cardiology



      Adult Cardiology Residency Training Programs across the country made the formal transition to Competency By Design (CBD) in July 2021, with some programs launching earlier, including Dalhousie University. The overarching goal of CBD is to ensure physicians complete their training with competencies deemed necessary to meet evolving health care needs. CBD was designed to establish clear learning expectations and increased opportunities for coaching. However, cited challenges include an increased administrative burden for residents, inconsistent participation by staff, and variable timelines for receiving feedback. The goal of this project is to implement a simple intervention to improve completion rates and timelines of Entrustable Professional Activities (EPAs).

      Methods and Results

      EPAs triggered by cardiology residents at Dalhousie University between July 1, 2020 and Dec 31, 2021 were reviewed in the one45 software program. Data including number of EPAs triggered, completed, expired, and time to completion were collected according to supervisor. The intervention was the distribution of a personalized data set to each staff supervisor with individual statistics for collected data points, along with group averages for comparison. The outcomes of interest include average number of EPAs completed per staff, average time to completion and percentage of expired EPAs, evaluated at 6- and 18-months post-intervention. Between July 1, 2020 to Dec 31, 2021, a total of 568 EPAs were triggered, 385 (67.78%) completed and 183 (32.22%) expired. The average number of EPAs completed per staff was 9.14±11.80. The average time to completion was 7.32±5.98 days, which is above the 48-hour targeted timeline for completion. A higher percentage of EPAs were completed in the first 7 days after being triggered, with 33.1% and 16.7% of EPAs being completed on day 0 and 1 respectively, and only 18.8% of EPAs completed between 8-14 days.


      Next steps include data collection at 6- and 18-months post-intervention. We hope this simple intervention will increase supervisor awareness of and participation in CBD, as timely completion of EPAs is necessary for good quality and actionable feedback. Findings will be helpful to implement further CBD-related curriculum changes, which may include continuing this strategy annually.
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