University Of Calgary Postgraduate Medicine

Assessment for Learning

Background 

Triple-C Curriculum assessment focuses on assessment for learning, rather than the traditional, assessment of learning. The system developed and implemented at the University of Calgary is solidly based in current medical education research and evidence. Those familiar with this literature will recognize ideas and tools situated coming out of international scholarship. For a complete list of references, please contact the program.How to assess learning has been broadly addressed by others. The University of Calgary Department of Family Medicine has built upon work completed by colleagues at the University of Ottawa and summarized the system in a Calgary Learning Strategies Grid.The Learning Strategies Grid lists 20 ways in which skills dimensions and CanMEDS roles may be learned during Family Medicine Residency. The College of Family Physicians of Canada defines competence in Family Medicine in their Evaluation Objectives webpage. The document, Examples of Resident Issues Related to Skill Dimensions Related to Skill Dimensions, provides examples helpful to learners and educators.

Overview

The Department of Family Medicine assess residents on each of the CanMeds roles outlined by the CCFP, with specific objectives and EPAs (Entrustable Professional Activities) designed for each rotation within the Domains of Care. Using a variety of assessment tools the Program is able to track your learning throughout the two year Program, in order to ensure you gain all the skills required to be a competent Family Physician.

Assessment

Maternity Care and Care of Newborn
Care of the Child and Adolescent
Care of the Adult
Care of the Elderly
Palliative Care and End of Life Care
Behavioural Medicine and Mental Health
Care of Indigenous Populations
Care of Vulnerable and Underserved Populations

Please visit the curriculum page for more information on each Domain of Care.


 Entrustable Professional Activities (EPAs)

Entrustable Professional Activities (EPAs) are a unit of professional practice that can be fully entrusted to a resident, as soon as he or she has demonstrated the necessary competence to execute this activity unsupervised. There is a set of EPAs in the Program that the Resident must demonstrate readiness for unsupervised practice in, to complete training.

The Family Medicine Program has 26 EPAs, for both the Calgary and Rural Residents. For specific information and guidance on EPA sign off and assessment tools that inform these decisions, please see the documents below.  

EPA List & Guidance
EPA Grid – Calgary Program
EPA Grid - Rural Program 
EPA Assessment & Sign Off – Calgary Program
EPA Assessment & Sign Off – Rural Program 


 Skill Dimensions 

  1. The Patient-Centered Approach
  2. Communication Skills
  3. Professionalism
  4. Clinical Reasoning Skills
  5. Selectivity
  6. Procedure Skills

For more information on each of the 6 skill Dimensions please visit the CFPC website 


 Tools 

Direct Observation of Procedural Skills (DOPS)

A specific field note to record performance and feedback provided related to the observation of a procedure completed by a Resident. Provided by the Program to the Residents in the form of a logbook.
DOPS Form

Field Notes (FN)

A categorized, narrative record of feedback provided by a supervising Preceptor or other health care professional based on direct observation of Resident performance/behavior or case discussion. Provided by the Program to the Residents in the form of a logbook.
Blank FN
Mock FN
FN Guide 

In Training Evaluation Report (ITER)

Our program utilizes a variety of weekly, mid and overall rotation ITERs throughout residency to track competency. ITERs are aligned with the set learning objectives for the rotation, the CFPC 6 skill dimensions and relevant EPAs.
Internal Medicine ORITER - Calgary Program
Internal Medicine ORITER - Rural Program

Intra-Partum Field Note (IPFN)

A narrative record of feedback, completed by a supervising Preceptor at the end of a clinical intra-partum experience. Provided by the Program to the Residents in the form of a logbook.
IPFN Form
IPFN Guidance Document 

Informed Self-Assessment of Progress (iSAP)

A reflective tool completed by Residents ahead of each progress review meeting with their Primary Preceptor.
iSAP Form

Patient Centred Skills Form (PCSF)

Completed at the end of the of a patient centred care lab (PCCL) following review of a video consultation of a patient by the Resident. Please visit the PCCL page for more information.  

PCSF Form

Progress Reviews

Midterm Review (8 week review) – Informal 15-20 minute meeting between Primary Preceptor and Resident approximately mid-way between progress reviews. A short mid-term review report is completed by the Preceptor at the end of the meeting using One45.

4 Month Progress Review – scheduled meeting between the Resident and Primary Preceptor/Site Director, which occurs generally every 4-5 months over the period of training. Dring this meeting, the Primary Preceptor/Site Direcotr reviews with the Resident, the Resident’s assessment data collected over the previous 4-5 months and provides feedback on how the Primary Preceptor/site Director feeld the Resident is progressing (on track, or not) in relation to the identified set of EPAs and expected level of competency (level of supervision) for the time point at which the review occurs. A progress report is completed at the end of each review, which must be signed by the Resident, Primary Preceptor and Division Director/Site Director.

 Please see the Progress Review Process section for more information

 American Board of Family Medicine In-Training Examination (USITE) 

 In the fall of each academic year the Residents write the American Board of Family Medicine In-Training Exam. Residents are scheduled time within academics to complete the online exam. The formative exam gives the Residents an opportunity to assess their progress and to identify any learning gaps. Individual scores are included in the Residents assessment portfolio and shared with their Primary Preceptor/Site Director in order to promote discussion around any areas of weakness or learning needs.
2016 USIT Examination Questions 
2016 USIT Examination Pictorial Atlas 
2016 USIT Examination Answer Key 
JAMA Conversion Chart 


Progress Review Process

Each Resident attends regularly scheduled progress reviews with their Lead Preceptors/Site Director throughout their program (4 month progress reviews and mid-term 8 week reviews). It is the Residents responsibility to coordinate a meeting ahead of the progress review submission deadline. Residents provide evidence of their progress in their assessment portfolios, which contain the following:

  1. Field Notes
  2. ITERs (In-training evaluations on One45)
  3. USITE Results in Block 8 of R1 and R2 (please see below for more information on the USITE)
  4. IPFNs if available
  5. DOPs forms if available

Four-Month Progress Review Procedure

Resident

At least one week before the Progress Review meeting, the Resident is required to:

  1. Download the 4-month Progress Review and Informed Self-Assessment of Progress (iSAP) forms – link to appropriate pages;
  2. Complete the Informed Self-Assessment of Progress (iSAP) form:
  3. Compile the top copies of all field notes, available IPFNs and DOPs for the 4 block period being reviewed;
  4. Complete Parts I through IV of the 4-Month Progress Review form;
  5. Send all of the above to Lead Preceptor/Site Director;

    After the meeting please collected all required documents and submit to your division Program Coordinator. Complete the checklist to confirm you have all required documents, and submit a copy with your completed progress review package.

Preceptor/Site Director

Schedule the Meeting

                One on one meeting with the Resident, closed door protected time session, approximately 30-45 minutes

The Primary Preceptor receives copies of all completed ITER’s, PCOF’s, 8-week mid-term review, the completed last 4-month Progress Report, and any other assessment data available to review a week before the end of the block. Sent by the Program Coordinator in your Division.

The Resident and Preceptor meet, and the Preceptor records the outcome of the meeting.

  1. On Track – update Learning Plan in Progress Report
  2. Focused Attention Needed – write and implement a Focused Learning Plan (FLP) please see the FLP page for more information and to access the forms required (insert link to FLP page).
  3. Refer to the Resident Progress SubCommittee (RPS) for review

    Provide a copy of the report, and all documents to the Resident. The Resident is responsible for submitting all documents to the Program.

Progress Review Form Word - Calgary Program
Progress Review Form PDF - Calgary Program
Progress Review Form PDF Fillable - Calgary Program
Progress Review Form Word - Rural Program
Progress Review Form PDF - Rural Program
Progress Review Form PDF Fillable - Rural Program


Requirements & Timelines

Assessment Tools Chart - Calgary Program
Assessment Tools Chart - Rural Program
Triple C Curriculum Requirements - Calgary Program
Assessment Program Timelines - Calgary Program
Assessment Program Timelines - Rural Program DRAFT
Mandatory Events Calendar  

            R1
            R2


Outcomes

 At the end of each Progress review the Primary Preceptor makes a recommendation, based on a complete review of the elements submitted in the learning portfolio.

The Preceptor may recommend that the Resident:

  • Is on track
  • Has some identified areas where focused attention is need (Focused Learning Plan)
  • Be referred to the Resident Progress Sub-Committee (RPS) for review

On Track

Set new learning objectives for the next 4 months

Focused Learning Plan (FLP)

A Structured learning plan drawn up by the Resident and Primary Preceptor (with input from Division Director if needed) to describe an area of performance deficiency requiring focused attention to bring the Resident up to the expected level of proficiency but not requiring a formal period of remediation. The plan includes a description of how the deficiency will be addressed and how it will be assessed and does not require any extension to training or result in any delay to promotion from PGY1 to PGY2.

FLP Form Word
FLP Form PDF
FLP Guidance
FLP Writing Learning Objectives

Referral to Resident Progress Sub-Committee (RPS)

Due to identified areas of significant concern around performance. The RPS will determine what action is required, including deciding if a period of remediation or probation may be required. This may require an extension to training or may involve a period of remediation or probation.

Remediation

A formal program of individualized education support, assessment and monitoring to assist in correcting identified performance deficiencies

Probation

A formal program of individualized educational support, assessment and monitoring with the requirement that the resident must demonstrate sufficient improvement  in order to continue in the Residency Program.

For more information on remediation and probation please refer to the PGME Remediation and Probation guidelines 

Promotion to R2

A Resident will be promoted to the next PGY level when the resident has met the expectations of the preceding PGY level, including rotations and any other program-specific criteria. The program must approve each resident’s promotion to the next PGY level (or completion status).

Please review the Promotion and Completion Requirements Policy for a complete overview of requirements for promotion to R2.

Calgary Promotion & Completion Requirements

Rural Promotion & Completion Requirements 

Program Completion

A Resident will be considered for completion once all requirements for completion of training have been met. Please review the Promotion and Completion policy for a complete list of requirements.

Calgary Promotion & Completion Requirements 

Rural Promotion & Completion Requirements  


Teaching Resources

For helpful resources on teaching & resident assessment please visit the Preceptor Resources page