Benefits and challenges of the Competence by Design (CBD) model have emerged from both formal program evaluation, and feedback from our invested partner groups. To align implementation with its intended goals and outcomes, the Royal College is engaging with national stakeholders to create the next iteration of CBD. Two of the recommendations emerging from this work are to simplify and enhance the EPA observation tool and process; and to enhance feedback and coaching. Locally, we are implementing the below changes in Elentra as of Block 8/January 16, 2024 – the first of a series of changes that will be implemented to assist the CBD renewal process. Note that these changes will not impact the CBME reporting dashboards, nor the Family Medicine Field Notes in Elentra.
Change #1: Comments and Overall Rating Scale Moved to the Beginning of the EPA Form
This change is intended to emphasize the importance of and encourage the completion of narrative feedback.
Change #2: New Labels for the Comment Fields on EPA Forms
This change is intended to encourage quality feedback and coaching.
Change #3: Removal of the Line that Separates “Achievement” from “Non-Achievement” Ratings on the Overall Rating Scale
This change is intended to ground faculty’s impressions in the language of the rating scale in order to emphasize EPAs as formative assessments (for residents’ learning).
Change #4: Limit Date of Encounter to 7-Days from the Date of Assessment Initiation
This change is intended to encourage more quality feedback and greater EPA completion.
Currently: Users can select the date of encounter retrospectively, without any limitations.
New: Users must initiate the assessment within 7 days of the encounter/observation. With this change, users will neither be able to trigger an assessment for an encounter set in the future (i.e., pre-emptively).
IMPORTANT NOTE: This change does not affect the current assessment expiry duration. Users will still have 14-days to complete an EPA assessment from the point of initiation (with the potential for an additional 7-day extension).
