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Ivy F. Oandasan MD CCFP MHSc Associate Professor, Department of Family & Community Medicine
University of Toronto
Director of Education College of Family Physicians of Canada
Academic Family Physician, Toronto Western Hospital
“Self-assessment should not imply an isolated or
individualistic activity; it should commonly involve
peers, teachers, and other sources of information.”
Competence is multi-dimensional and dynamic
– it changes with time, experience and setting
Frank JR, Snell L, ten Cate O, Holmboe ES, Carraccio C, Swing SR, et al.
Competency-based medical education: theory to practice. Med Teacher. 2010;32:638-45.
Doctors require self-understanding and insight to
the nature and limitations of their knowledge and
their capacity to apply it are crucial.
Helping both learner and preceptor/assessor understand
how much has been learned & what yet needs to be learned
A Competency based Curriculum that is: Comprehensive, focused on Continuity of Care & Centred in learning
specific for Family Physicians
Launched in 2011
FUNDAMENTAL TEACHING ACTIVITIES FRAMEWORK
College of Family Physicians of Canada
Framework Taxonomy
DOMAIN Clinical Preceptor
TASKS Clinical Coach- a supervisor in day-to day practice Competency Coach – an educational advisor along the course of a learner’s training
ACTIVITIES
Explicitly embodies the roles attitudes and competencies of a family physician in clinical work
Helps learners design and update their individual learning plans
Promotes and stimulates clinical reasoning and problem solving
Guides a comprehensive periodic progress review informed by the learners’ self-analysis
Gives learner-centred feedback at the appropriate time Assists learners in their professional development
Uses program assessment tools to document observed learners’ performance according to their level of training.
Adjusts interventions to support learners facing progression challenges
Employs reflective practices to refine clinical supervision
An instructor with andragogical philosophy aims to create an
informal, collaborative and respectful climate. He involves the
learner in the process of designing and evaluation of the
learning activities which are based on the learner’s problem
areas.
Davenport, J., & Davenport, J. H. (1985). Knowles or Lindeman: Would the real father of
American andragogy pleas stand up? Lifelong Learning, 9(3), 4-5.
Competent AND Capable
Competency can be understood as a proven
ability in acquiring knowledge and skills based
against a standard
Values/ethics for IP Practice
Roles/Responsibilities
Interprofessional
Communication
Teams and teamwork
American Interprofessional Education Collaborative Expert
Panel, 2011
Task Design
Task Type
Management
Project
Care delivery
patient/disease type
(e.g., geriatric/stroke)
care delivery setting
(e.g., acute)
Task Features
Interdependence
Autonomy
Specialized knowledge/expertise
Clarity of rules and procedures
Work cycle
Use of quality framework/guidelines
Team Composition
Size, age, gender, tenure
Discipline
Diversity
Team Processes Communication
Collaboration
Coordination
Conflict
Leadership
Decision-making
Participation
Team Effectiveness
Objective Outcomes
Patient (e.g., functional
status, satisfaction)
Team (e.g., clinical quality of
care)
Organization (e.g., cost-
effectiveness)
Subjective Outcomes
Perceived team effectiveness
by team members (e.g.,
perceived task outcomes, well
being, and willingness to work
together in the future)
Team Psycho-
Social Traits
Cohesion
Norms
Efficacy
Problem-solving
effectiveness
Organizational Context
Goals/Standards
Structure/Characteristics
Rewards/Supervision
Resources (human, technological)
Training environment
Information system
Social and
Policy Context
Capable people exhibit the following traits:
self-efficacy, in knowing how to learn and continuously reflect on the learning process;
communication and teamwork skills, working well with others and being openly communicative;
creativity, particularly in applying competencies to new and unfamiliar situations
being adaptable and flexible in approach;
Having positive values
(Hase & Kenyon, 2000; Kenyon & Hase, 2010; Gardner et al., 2007).
heutagogy
An approach that supports development of an ability
of a learner to reflect upon his/her problem solving
process, the outcome chosen, considering what was
learned through the process.
Self-determined
Hase & Kenyon, 2000: http://www.psy.gla.ac.uk/~steve/pr/Heutagogy.html
Heutagogy is the study of self-determined learning enabling a
learner to reflect upon his/her problem solving process, the
outcome chosen and considering what was learned through
the process
From: Lisa Marie Blaschke: http://www.slideshare.net/lisamarieblaschke/sustaining-lifelong-learning-a-review-of-
heutagogical-practice?related=2
From: Lisa Marie Blaschke: http://www.slideshare.net/lisamarieblaschke/sustaining-
lifelong-learning-a-review-of-heutagogical-practice?related=2
Is self-reflection a skill
that is teachable?
Can we help learners self-
assess in order to act for
improvement?
self-awareness,
self-regulation,
self-motivation,
social awareness,
and social skills
40
Emotional Intelligence
Intrapersonal and Interpersonal
skills in the areas of…
What assumptions am I making?
Where did I learn these values?
What values orient me?
How might someone whose role is different than mine look at this?
Why do I feel threatened when I am challenged on this issue?
McKee, 2003
General professional competencies including the ability to
work in a team, metacognitive skills, professional behaviour,
the ability to reflect and to carry out self-appraisal are
highlighted as future trends
The advancement of more qualitative approaches 360
degrees, peer assessment, reflective portfolios - OSCE’s
that can be used to demonstrate capability and ongoing
daily workplace assessments by clinical preceptors …
A change in mindset in how we think about assessment is
needed by learners and assessors
An assessment process including formative assessments is
a curricular opportunities
We need Competent and Capable graduates – let us look
at theoretical models like heutagogy to help guide us