CBD – Adult Critical Care Medicine

Welcome to our Critical Care Western Competence by Design (CBD) website!

Critical Care residency programs across Canada transitioned to a competency-based medical education system (CBME) in July 2019. The Royal College of Physicians and Surgeons of Canada’s brand name for CBME is called Competence By Design (CBD)

CBD is a wide-sweeping cultural shift in medical education that touches almost every facet of a residency training program. It impacts consultants in their daily interactions with trainees and requires them to act as coaches for senior residents. It affects trainees and requires them to seek more frequent work-based assessments. It will also eventually change the way practicing physicians approach Continuing Professional Development (CPD).

Key Differences in Critical Care Residency with CBD

  1. Teacher-learner relationship more of one of coaching with the expectation that the resident will request assessments and feedback.
  2. Residents as adult learners will drive their learning.
  3. The notion of stages of training (Transition to Discipline, Foundations, Core, and Transition to Practice) as opposed to strictly time-based clinical rotations.
  4. More low-stakes observations of resident performance aiming at enhancing resident learning with completion of task-based assessments. This contrasts with high-stakes evaluations that are often based on general impressions and are less likely to guide resident learning.
  5. The Competence Committee will review each resident and their progress, collating all of their assessment data and deciding whether a resident progresses to the next stage or requires an individual learning plan.
  6. The ability for multi-source feedback/360 assessments from physicians, nurses, respiratory therapists, and other allied health care workers.