Using a rapid-cycle approach to evaluate implementation of competency-based medical education in ophthalmology

Objective: As competency-based medical education is being implemented across Canada, there is an increasing need to evaluate the progress to date, including identification of strengths and weaknesses, to inform program development. Ophthalmology is preparing for a national launch in coming years. The purpose of this study was to describe key stakeholders' lived experiences in the competency-based medical education foundation-of-discipline stage in one ophthalmology department. Design: Using a case-study approach, a qualitative rapid-cycle evaluation was conducted during the 2018-2019 academic year. Participants: Residents, faculty, academic advisors, competence committee members, the program director, the program administrator, and the educational consultant were invited to participate in the program evaluation. Methods: The rapid-cycle evaluation consisted of 2 evaluation cycles, with the first round of interviews and focus groups occurring in October 2018 and the second round in March 2019. Recommendations were implemented in November 2019 and June 2019. All data were analyzed thematically using NVivo. Results: Three main themes emerged across all data sets: developing a shared understanding (e.g., role expectations and changes to assessment), refining assessment processes and tools (e.g., the need for streamlining and clarification), and feedback (e.g., perceived benefits and value of narrative comments). Conclusions: Exploring lived experiences in this study resulted in positive and immediate improvements to the residency program. The recommendations and approach will be useful to other Canadian departments and institutions as they prepare for Competence by Design.