Introduction to CBD

What is Competency-Based Medical Education (CBME)?

Competency-Based Medical Education (CBME) refers to an overarching approach to medical training that is outcomes-based as it centers around expected learner competencies.  CBME is a broad term used internationally and in research literature to describe the philosophy and approach of this outcomes-based paradigm in which trainee progression is determined by demonstration of competence.  

CBD (Competence-by-Design) is the Royal College’s version of CBME being used for implementation across Canada, including at the University of Alberta. CBD introduces hybrid curricula where progression is based on demonstration of competence without being time-free; instead, time will be re-conceptualized as a resource for learners and programs rather than as the key determinant of program requirements. Defining features of CBD include:

  • Clearly defined, measurable training outcomes and objectives
    • Entrustable Professional Activities and Milestones based on the CanMEDS framework
    • Curriculum and rotations aligned with required learning outcomes
    • Prevent gaps in learning, increase accountability to patients
  • Direct observation of professional tasks in the workplace
    • Feedback and coaching events based on directly observed performance
    • Multiple assessment points
  • Multiple sources of evidence of competence
    • Portfolios of performance reviewed by competence committees
    • Increased learner autonomy and lifelong learning skills
  • Progression of training in stages
    • Graduated entrustment and expectations
    • Gaps and deficiencies addressed prior to progression to next stage

Competency by Design Training Stages 

Residents are defined by Stages of Training rather than only by PGY year.

Examples of stages from the Anesthesiology program

1. Transition to Discipline (2 blocks)
2. Foundations (24 blocks)
3. Core (30 blocks)
4. Transition to Practice (Flexible duration, approx. 9 blocks)
cbd_stages_of-_training.png

Introduction video

Introduction to CBME and CBD by Royal College of Physicians and Surgeons of Canada.

Contact Us

For all CBD/CBME related inquiries, please contact the PGME CBD Coordinator at pged@ualberta.ca.

For all .med Suite related inquiries, please contact the PGME Technology Learning Analyst at pgtla@ualberta.ca.