Triple C Competency-based Curriculum

A Brief Overview for Residents

Copyright © 2013 The College of Family Physicians of Canada

Objectives

Describe the components of the “Triple C competency based curriculum”

• Explain the rationale supporting these key directions

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Triple C Competency-based Curriculum

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www.cfpc.ca/Triple_C

Competency-based Education

“…is an approach to preparing physicians for practice that is fundamentally oriented to graduate outcome abilities and organized around competencies derived from an analysis of societal and patient needs. It deemphasizes time-based training and promises greater accountability, flexibility, and learner centredness.”Adapted from: 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.

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Triple C Competency-based Curriculum

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Triple C Competency-based Curriculum

“ ... is a Family Medicine residency curriculum that provides the relevant learning contexts and strategies to enable residents to integrate competencies, while acquiring evidence to determine that a resident is ready to begin to practice in the specialty of Family Medicine.”

Alignment Sub-committee of the Triple C Competency-based Curriculum Task Force, November 2011

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Professional Competence

Competence• Is the array of abilities across multiple domains or aspects of physician performance in a certain context• Is multi-dimensional and dynamic• Changes over 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.

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From Competencies to Competence

By sampling competencies across multiple domains or settings, a program can infer competence, to the level of a physician ready to begin practice in the specialty of Family Medicine.

Adapted from: Crichton T, Allen T, Bethune C, Brailovsky C, Donoff M, Laughlin T, Lawrence K. Defining Competence in Family Medicine for the Purposes of Certification by the College of Family Physicians of Canada: The Evaluation objectives in Family Medicine (updated December 2010).

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1. Comprehensive Care and EducationResidency programs should prepare

residents

• For comprehensive care of patients:- Across Life cycles, Clinical settings, Clinical responsibilities - Including special populations and core procedures

• Through a comprehensive curriculum:- Modeling comprehensive care 9

2. Continuity of Education and Patient Care

Continuity of care:

– Follow patients over time– Follow patients in different settings– Experience relationship and responsibility of care

Continuity of education:

– Continuity of supervision and assessment– Continuity of learning environment– Continuity of curriculum and continuous integration

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3. Centred in Family MedicineFamily Medicine programs will have:• Control of goals and curricular elements• Primarily Family Medicine contexts and teachers

- Augmented as required with other experiences

• Content relevant to the needs of Family Medicine trainees• Opportunities to develop professional identity as a Family Physician

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Competence

Abilities Knowledge

AttitudesJugementValues

Internal Resources

External Resources

Patients and familiesFPs and other

professionals

In accordance with professional roles and responsibilities

Doing the right thingat the right timein the right wayin complex situations

By using and integrating the right internal and external resources

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How is this Different from the Traditional Model?

Tannenbaum D, Kerr J, Konkin J, Organek A, Parsons E, Saucier D, Shaw L, Walsh A. Triple C competency-based curriculum. Report of the Working Group on Postgraduate Curriculum Review-Part 1. Mississauga ON: College of Family Physicians of Canada; 2011

Rationale for Movingto a Triple C Competency-based CurriculumRising to the challenge to better train

family physicians, able to adapt to dynamic environments:- Based on educationally sound strategies and increased efficiency in training- With heightened authenticity of Family Medicine education- With increased accountability for educational outcomes

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How? The Triple C Competency-based Curriculum

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www.cfpc.ca/Triple_C

A Competency-based Program

• Design curriculum that leads to expected program outcomes

• Provide relevant educational experiences:Through a curriculum that allows for the development and demonstration of competencies

• Assess learners for competence:Assessment of competencies as a component

of the training program 17

Triple C Competency-based Curriculum

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Comprehensive Program Structure

• Reflects an integrated curriculum over two years

• Context-specific flexibility of design• Based on local resources• Provides relevant learning experiences

– Within the full range of the Domains of Clinical Care

– To encourage development of the CanMEDS-FM Roles

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Continuity of Patient Care

Opportunities for:• Continuity with patients and families over

time, through strategies such as:– Responsibility for a panel of patients– Longitudinal or integrated experiences

• Continuity of care, in different clinical settings

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Continuity of Education

a) Continuity of supervisionb) Continuity in the learning environmentc) Continuity in the curriculum

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a) Continuity of Supervision

• Ongoing interactions with designated key preceptors

• Communication of educational information between preceptors, and between learning contexts

• Allows for reliable and valid assessment

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b) Continuity in the Learning Environment

• Long placements that enable residents to develop relationships and understand context

• Continuity maintained in any new placement, either educational or clinical

• Creating a bounded, familiar educational and work environment (physical environment and health care team)

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c) Continuity in the Curriculum• Coherent academic programming over

learning experiences and settings• Explicit strategies to facilitate integration

of experiences into competencies

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Curriculum Design is Centred in Family Medicine• The program maintains ownership of all

aspects of the curriculum• Experiences based in comprehensive

Family Medicine contexts• Other relevant focused experiences as

required • Family physicians are the core teachers• Complemented by Family Medicine-

oriented consultants depending on local resources

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Teaching and Learning StrategiesStrategies focus on:• Achievement of competencies rather than

knowledge transmission• Development of professional identity• Becoming a reflective practitioner• Emphasis on the family physician’s

perspective

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Teaching and Learning Strategies

• Residents are encouraged to be active learners and to develop their autonomy

• There is explicit role modeling of the CanMEDS-FM Roles

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Academic Program

• Competency oriented• Well organized and comprehensive• Addresses key competencies• Complementary to the clinical experience• Encourages autonomous learning

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Academic Program• Uses relevant teaching and learning

strategies– Problem-solving and critical thinking– Engages residents to reflect in action and on

action

• Focuses on the family physician’s perspective on the problem

• Residents learn about context and content of the culture of Family Medicine 29

AcknowledgmentThis PowerPoint presentation was authored by: Danielle Saucier, MD, MA(Ed), CCFP, FCFPShirley Schipper, MD, CCFP

On behalf of the Alignment sub-committee of the Triple C Competency-based Curriculum Task Force:Danielle Saucier, MD, MA (Ed), CCFP, FCFP (Co-chair)Ivy Oandasan, MD, MHSc, CCFP, FCFP (Co-chair)Michel Donoff, MD, CCFP, FCFPKarl Iglar, MD, CCFPShirley Schipper, MD, CCFPEric Wong, MD, MClSc(FM), CCFP

Suggested citation: Saucier D, Oandasan I, Donoff M, Iglar K, Schipper S, Wong E.Triple C competency-based curriculum: A brief overview [PowerPoint presentation]. Mississauga ON: College of Family Physicians of Canada; 2011.

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Based UponTriple C competency-based Curriculum: Report of the Working Group on Postgraduate Curriculum Review-Part 1

Tannenbaum D, Kerr J, Konkin J, Organek A, Parsons E, Saucier D, Shaw L, Walsh A. Triple C competency-based curriculum. Report of the Working Group on Postgraduate Curriculum Review-Part 1. Mississauga ON: College of Family Physicians of Canada; 2011Available Here

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