Ivy F. Oandasan MD CCFP MHSc Associate Professor, Department of Family & Community Medicine University of Toronto Director of Education College of Family Physicians of Canada Academic Family Physician, Toronto Western Hospital Presented at Perspectives in Competency Assessment A Symposium by Touchstone Institute www.touchstoneinstitute.ca

1.  
Ivy F. Oandasan MD CCFP MHSc
Associate Professor, Department of Family & Community Medicine
University of Toronto
Director of Education College of Family Physicians of Canada
Academic Family Physician, Toronto Western Hospital

3. A Change in Mindset is Needed
 Assessment is a curriculum tool
 Competency & Capability

13. “Self-assessment should not imply an isolated or
individualistic activity; it should commonly involve
peers, teachers, and other sources of information.”

14. 

15. Competence is multi-dimensional and dynamic
– it changes with time, experience and setting
Frank JR, Snell L, ten Cate O, Holmboe ES, Carraccio C, Swing SR, et al.
Competency-based medical education: theory to practice. Med Teacher. 2010;32:638-45.

16. Metacognition: the ability of learning how to learn
and transferring learning to new contexts.

17. Doctors require self-understanding and insight to
the nature and limitations of their knowledge and
their capacity to apply it are crucial.

19. Helping both learner and preceptor/assessor understand
how much has been learned & what yet needs to be learned

20. A Competency based Curriculum that is:
Comprehensive, focused on Continuity of Care & Centred in learning
specific for Family Physicians
Launched in 2011

21. FUNDAMENTAL TEACHING ACTIVITIES FRAMEWORK
College of Family Physicians of Canada
Framework Taxonomy
DOMAIN Clinical Preceptor
TASKS Clinical Coach- a supervisor in day-to day practice
Competency Coach – an educational advisor
along the course of a learner’s training
ACTIVITIES
Explicitly embodies the roles attitudes and
competencies of a family physician in clinical work
Helps learners design and update their individual
learning plans
Promotes and stimulates clinical reasoning and problem
solving
Guides a comprehensive periodic progress review
informed by the learners’ self-analysis
Gives learner-centred feedback at the appropriate time Assists learners in their professional development
Uses program assessment tools to document observed
learners’ performance according to their level of
training.
Adjusts interventions to support learners facing
progression challenges
Employs reflective practices to refine clinical supervision

22. Competent in assessing what they
yet need to improve

23. An instructor with andragogical philosophy aims to create an
informal, collaborative and respectful climate. He involves the
learner in the process of designing and evaluation of the
learning activities which are based on the learner’s problem
areas.
Davenport, J., & Davenport, J. H. (1985). Knowles or Lindeman: Would the real father of
American andragogy pleas stand up? Lifelong Learning, 9(3), 4-5.

24. Competent AND Capable
Competency can be understood as a proven
ability in acquiring knowledge and skills based
against a standard

26. www.cihc.ca

27.  Values/ethics for IP Practice
 Roles/Responsibilities
 Interprofessional
Communication
 Teams and teamwork
American Interprofessional Education Collaborative Expert
Panel, 2011

28. 2011

31. Task Design
Task Type
 Management
 Project
 Care delivery
patient/disease type
(e.g., geriatric/stroke)
care delivery setting
(e.g., acute)
Task Features
 Interdependence
 Autonomy
 Specialized knowledge/expertise
 Clarity of rules and procedures
 Work cycle
 Use of quality framework/guidelines
Team Composition
 Size, age, gender, tenure
 Discipline
 Diversity
Team Processes
 Communication
 Collaboration
 Coordination
 Conflict
 Leadership
 Decision-making
 Participation
Team Effectiveness
Objective Outcomes
 Patient (e.g., functional
 status, satisfaction)
 Team (e.g., clinical quality of
care)
 Organization (e.g., cost-
 effectiveness)
Subjective Outcomes
Perceived team effectiveness
by team members (e.g.,
perceived task outcomes, well
being, and willingness to work
together in the future)
Team Psycho-
Social Traits
 Cohesion
 Norms
 Efficacy
 Problem-solving
effectiveness
Organizational Context
 Goals/Standards
 Structure/Characteristics
 Rewards/Supervision
 Resources (human, technological)
 Training environment
 Information system
Social and
Policy Context

32. Competent? Incompetent? Capable but….
What is the best outcome expected?

33. Capable people exhibit the following traits:
 self-efficacy, in knowing how to learn and continuously reflect
on the learning process;
 communication and teamwork skills, working well with others
and being openly communicative;
 creativity, particularly in applying competencies to new and
unfamiliar situations
 being adaptable and flexible in approach;
 Having positive values
(Hase & Kenyon, 2000; Kenyon & Hase, 2010; Gardner et al., 2007).

34. heutagogy
An approach that supports development of an ability
of a learner to reflect upon his/her problem solving
process, the outcome chosen, considering what was
learned through the process.
Self-determined
Hase & Kenyon, 2000: http://www.psy.gla.ac.uk/~steve/pr/Heutagogy.html

35. Heutagogy is the study of self-determined learning enabling a
learner to reflect upon his/her problem solving process, the
outcome chosen and considering what was learned through
the process
From: Lisa Marie Blaschke: http://www.slideshare.net/lisamarieblaschke/sustaining-lifelong-learning-a-review-of-
heutagogical-practice?related=2

36. From: Lisa Marie Blaschke: http://www.slideshare.net/lisamarieblaschke/sustaining-
lifelong-learning-a-review-of-heutagogical-practice?related=2

37. Is self-reflection a skill
that is teachable?
Can we help learners self-
assess in order to act for
improvement?

38. 


40. self-awareness,
self-regulation,
self-motivation,
social awareness,
and social skills
40
Emotional Intelligence
Intrapersonal and Interpersonal
skills in the areas of…

41.  What assumptions am I making?
 Where did I learn these values?
 What values orient me?
 How might someone whose role is different than mine look
at this?
 Why do I feel threatened when I am challenged on this
issue?
McKee, 2003

43.  General professional competencies including the ability to
work in a team, metacognitive skills, professional behaviour,
the ability to reflect and to carry out self-appraisal are
highlighted as future trends
 The advancement of more qualitative approaches 360
degrees, peer assessment, reflective portfolios - OSCE’s
that can be used to demonstrate capability and ongoing
daily workplace assessments by clinical preceptors …

44.  A change in mindset in how we think about assessment is
needed by learners and assessors
 An assessment process including formative assessments is
a curricular opportunities
 We need Competent and Capable graduates – let us look
at theoretical models like heutagogy to help guide us

45.  
i.oandasan@utoronto.ca