Table.

Themes and Representative Quotes

Theme	Faculty Quote	Resident Quote
Both faculty and residents see themselves as somewhat knowledgeable about CBME, but sources of knowledge vary.	“I would say that I’m fairly familiar because I also supervise family medicine residents, and I believe they transitioned before the geriatric psychiatry program. And I’ve read about it and learned about it also in the context of other projects.”	“So, as I mentioned, I only feel like I have a basic understanding of [CBME]. And given competing demands of other requirements of my training, I have not spent a lot of time researching it or reading about it in depth … I basically know what information has been sent to me in orientation packages and spoken with staff about it as needed.”
More frequent feedback is beneficial.	“I think the only way that [feedback has] changed is in the frequency of feedback. I’m giving feedback much more frequently based on doing things like EPAs, than I would have before.”	“I guess getting more frequent feedback can be helpful as well. Earlier on, rather than just at the end of a rotation, like [at the] beginning and end.”
Aspects of CBME that are challenging for residents are beneficial for faculty.	“The number of successful EPAs that our residents need to complete seems to be very reasonable and doable in the time allowed.”	“I think it asks a lot of residents … The goal shouldn’t be keeping track of the EPAs … it should be keeping track of what you need to do to become a better learner and a better clinician.”
Competence committees are perceived positively despite most participants’ limited firsthand experience with them.	“I don’t know very much at all [about competence committees], other than there is going to be a committee that will oversee the completion of the EPAs.”	“I know I’ve been reviewed by committees, but I’ve never been at the committees while I’ve been reviewed … So, I’m not aware of what occurs at the committee meetings … it’s the type of thing that’s always nice to know that it’s happening and that you are kind of being reviewed and any concerns would be addressed. So, I think it’s helpful to have them, but I haven’t been aware of the inner workings.”
Small program size is both a barrier and facilitator to providing and receiving feedback.	“I think the tendency to provide honest, constructive feedback is harder in a small program because we all know each other and … we sort of work together in a very close environment. And in many instances, the subspecialty trainee is 6 months away from becoming a colleague.”	“I feel like it makes it easier, like if it’s a supervisor you know well, you value their opinion, you know that clinically you have worked with them. So, you know how they work. And I find that I value their feedback even more when I know them, and I know how experienced they are … I wonder if [faculty] feel more or less comfortable sharing [constructive] feedback. If they’ve known you so well and you have that kind of relationship already. Not sure.”
Suggestions for improvement are centered on helping manage faculty and resident workload imposed by CBME.	List of feedback/coaching phrases Ongoing training Ongoing technology support Centralized directory for resources and tools	Joint check-ins Automated EPA tracking

Abbreviations: CBME, competency-based medical education; EPA, entrustable professional activity.