Table 2.

Changes to the CBAS program in response to feedback

ORIGINAL COMPONENT	USER FEEDBACK	RESPONSE TO FEEDBACK
Paper-based portfolio	An electronic filing system was needed, as well as online access	Development of eCBAS (electronic workbook)
Stacking (ie, open-ended method of categorizing FieldNotes)	Too open; residents wanted more guidance and direction	Stacking became optional; FieldNotes were now categorized by clinical domains and sentinel habits
Guiding principles: CFPC’s skill dimensions	Too abstract; residents failed to see a connection between the higher-level skill dimensions and their own day-to-day experiences in clinical practice	Identification of sentinel habits (the common skills and habits that make a good physician)
Expectation of 1 FieldNote per clinical half-day	Residents found it difficult to get FieldNotes in many rotations, and found many FieldNotes did not give good feedback	New expectation of 1 FieldNote per clinical day in first-year family medicine rotation, and 1 FieldNote per clinical call-back day. FieldNotes acquired beyond this were a bonus and were welcome
Residents to enter every FieldNote in eCBAS	Too time-consuming; many residents believed that this component was useless busywork	Electronic FieldNotes were strongly encouraged; paper FieldNotes were given to support staff for manual entry
Focus on FieldNotes and FieldNotes reviews to guide learning	Not enough of a link to assessment	Emphasis was on regularly scheduled meetings between residents and advisors; FieldNotes could be used for review and as documentation but were not the focus. Progress levels created for each FieldNote

CBAS—Competency-Based Achievement System, CFPC—College of Family Physicians of Canada.