1. Transition to Practice Queen’s Emergency Medicine CBME ANDREW K. HALL MD, FRCPC ASSISTANT PROFESSOR AND FRCPC PROGRAM CBME LEAD DEPT. EMERGENCY MEDICINE, QUEEN’S UNIVERSITY SEPT 23, 2015 – CBME WORKSHOP II

2. Competency-based Model: 5 years Transition to Specialty Foundations of Discipline Core of Discipline Transition to Practice Entrustable Professional Activities (EPAs) Competencies Learning Experiences and Assessments Milestones Entrustable Professional Activities (EPAs) Competencies Learning Experiences and Assessments Milestones Entrustable Professional Activities (EPAs) Competencies Learning Experiences and Assessments Milestones Entrustable Professional Activities (EPAs) Competencies Learning Experiences and Assessments Milestones

3. Experience with CBME transition to date…

4.  Queen’s EM July 2017  ALL Canadian EM programs July 2018  SOOOO….

5. Queen’s EM CBME Transition  Queen’s EM is transitioning only 1 year ahead of the rest of the country  Isolation  Underwent local Delphi to develop Scope of Practice EPAs  Issue of granularity  Had hoped to collaborate nationally and expedite the national process of EPA development  BUT….

6. Queen’s EM CBME Transition  Royal College cautioned us against proceeding  Decided to expediate Specialty Committee process of Development of EPAs to Jan/Feb 2016  How to proceed locally?

7. Our transition to CBME…

8. Competency-based Model: 5 years Transition to Specialty Foundations of Discipline Core of Discipline Transition to Practice Entrustable Professional Activities (EPAs) Competencies Learning Experiences and Assessments Milestones Entrustable Professional Activities (EPAs) Competencies Learning Experiences and Assessments Milestones Entrustable Professional Activities (EPAs) Competencies Learning Experiences and Assessments Milestones Entrustable Professional Activities (EPAs) Competencies Learning Experiences and Assessments Milestones

9. Transition to DisciplineFoundations of DisciplineCore of DisciplineTransition to Practice Duration 2 months (July-Aug)PGY1-2PGY3-4PGY-5 EPAs Resuscitation Acute Care (Med/Surg/Psych/Peds) Procedures ED Patient Encounter Resuscitation Acute Care (Med/Surg/Psych/Peds) Ambulatory Care Procedures Diagnostic Investigations Consultation Documentation Research and Literature Resuscitation Acute Care (Med/Surg/Psych/Peds) Special Concepts (Ex Palliation, Tox, etc.) Ambulatory Care Procedures Diagnostic Investigations Consultation Documentation ED Management and Triage Healthcare Team EMS and Disaster Research and Literature Education Consultation and Disposition Documentation ED Management and Triage Healthcare Team ED Advocacy and Community Support EMS and Disaster Research and Literature Administration Education EM Learning Activities Emergency Medicine Clinical Shifts Jr Resus Rounds Summer Seminar Series / Bootcamp Emergency Medicine Clinical Shifts Core Rounds Jr Resus Rounds Journal Club Attendee CAT Project Emergency Medicine Clinical Shifts Core Rounds Jr Resus Rounds Instruction Sr Resus Rounds Journal Club Administration Advanced Research Project (optional) Medical Student Curriculum Teaching Core Rounds Instruction Emergency Medicine Jr Attending Shifts Emergency Medicine Teaching Shifts Administration Off-service Rotations ICU Anesthesia Neurosurgery Plastic Surgery Psych General Surgery Obstetrics and Gynecology Internal Medicine Pediatric EM Trauma Cardiology Pediatric EM Toxicology ?Fellowship/Advanced Training Trauma Electives ?Fellowship/Advanced Training Assessments Work-place based assessments Simulation OSCE Procedural Assessments Work-place based assessments Pre-rounds written exams Bruder written exams National In-training exam Simulation OSCE Practice Orals Self-assessment Resident Research Day feedback 360 evals Work-place based assessments Pre-round written exams Bruder written exams National In-training exam Simulation OSCE Practice Orals Self-assessment Resident Research Day evaluation Journal Club evaluation 360 evaluations Medical Student Teaching evaluation FRCPC Examination Work-place based assessments Simulation OSCE Teaching Shift Evaluations

10. TRANSITION TO PRACTICE EM EPAS  Seek appropriate consultation referral to other health professionals  Assemble and convey medical information effectively and professionally from and to other caregivers, agencies, patients and their family members.  Manage the ED and triage patients to optimize patient care  Participate effectively and appropriately within an inter-professional and multidisciplinary health care team.  Respond to individual patient, population, and community health needs as it relates to the delivery of ED care in the region.  Provide on-line supervision and direction for all Emergency Medical Services (EMS), including transport/transfer, disaster management, medical directives, and specific patient management.  Critically evaluate new research, integrate medical advances into practice, and contribute to the creation and dissemination of new knowledge and clinical practices  Demonstrate and understanding of administrative issues related to Emergency Medicine at local, regional, national and international levels  Manage the education of students, residents and other health professionals in the Emergency Department

11. Thanks! andrew.hall@queensu.ca