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| CHALLENGES |
ROYAL COLLEGE RESPONSES TO CHALLENGES |
INSIGHTS AND LESSONS WE LEARNED ALONG THE WAY |
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1. Standardizing process and procedures while maintaining flexibility
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Disseminated national terms of reference and policy documents Articulated where there is flexibility in the process to allow adaptation to local structures and increased ownership through a technical guide Created a community of practice model through the CC chairs forums to help identify and develop best practices among programs with similar contexts Developed annual pulse surveys distributed to invested groups to identify whether processes were implemented as intended and to identify any unforeseen challenges
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Provide clear guidance and simplified expectations to ensure consistent messaging and practices Anticipate local adaptations as there is no one-size-fits-all approach Anticipate tensions between flexibility and standardization of interventions Use program evaluation as a key enabler to help identify and mitigate any divergence in practices and to maintain fidelity and integrity during implementation
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2. Addressing the contextual variability within institutions, programs, and systems
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Identified and recruited a national CBME Leads group with Leads within each university Created a network of peers within each university and externally through individual specialties through the CC chairs forums Developed ongoing two-way dialogue between the Royal College and invested groups Organized multiple in-person and virtual CC chairs forums for clear communication, sharing of best practices, and identification of common challenges with implementation
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Recognize that each university and individual program will have unique contexts that require adaptable implementation Identify and group common elements related to context (e.g., size of programs, institutional policies, and resources) that can help provide direction on ways to adapt CC implementation Be mindful that when new systems of assessment are applied too rigidly it can lead to frustration or overburdened assessment practices Engage invested groups in the process to create a shared vision and build trust
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3. Working with finite human and financial resources
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Provided centralized investment through development of free key resources (e.g., electronic platform, assessment templates, e-modules, and adaptable slide decks for faculty development) Provided a venue to share best practices and locally developed approaches that could be adapted by institutions via national CBME Leads group and the national CC chairs forum
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Recognize and plan to accommodate the wide variations in financial and human resources among institutions and programs Expect the need for and support additional faculty time for portfolio review and attendance at meetings as CCs are a new structure Be mindful that individual institutions may feel more comfortable using existing or locally developed resources, which may increase the resource burden to that institution
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4. Providing faculty development and ensuring engagement
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Developed and maintained a curated repository of online faculty development resources (e-modules, workshops, webinars) Created a national CC chairs forum to enable effective networking, innovation sharing, and movement of knowledge to those who need it to improve their CC practices
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Plan for faculty development activities that involve longitudinal and multimodal offerings aimed at all invested groups (e.g., CC chairs, administrators, faculty, and trainees) Develop faculty development strategies that emphasize interconnectedness and relationship building to help support insights on effective knowledge translation in complex systems
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5. Changing the culture of assessment
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Worked toward shared mental models among invested groups of intended CC implementation Ensured alignment of national institutional policies and accreditation standards to avoid confusing or mixed messages
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Provide guidance on the policies, processes, and procedures that guide CC functioning Communicate the purpose and flow of CC work to all invested groups to build transparency in the assessment system Acknowledge the dual purpose of assessment for developmental and summative progress purposes while providing rationale and strategies on how to manage this tension Monitor for linear or reductionist approaches to programmatic assessment that can lead to negative assessment behaviors and practices
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