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Table 3 Revised Program Theory for CBME as it relates to rivalries for attention [2, 17]

From: Rivalries for attention: insights from a realist evaluation of a postgraduate competency-based medical education implementation in Canada

Context (C)

Rivalries for attention

 + Mechanisms (M)

 1. Team and Resources

  Program-level

   a. Learning about CBD using a variety of resources and faculty development strategies

   b. Develop a team and connect with other people in your institution to learn about policies and practices

  Institutional-level

   c. Provide human and financial resources for additional activities related to CBME such as protected time or additional administrative resources

   d. Develop training resources and technical support for CMS and other technology that supports CBME

 2. Capacity Building

  Program-level

   a. Pilot EPAs

   b. Conduct faculty and resident development

   c. Promote a culture of feedback and coaching

   d. Develop resident-friendly resources

  Institutional-level

   e. Develop a CMS that supports and facilitates the curricular and assessment needs of CBME

   f. Stagger implementation of new initiatives when possible

 = Outcomes (O)

 1. Outcome competencies are clearly articulated

 2. Competencies and their developmental markers are sequenced progressively

 3. Learning experiences facilitate the developmental acquisition of competencies

 4. Teaching practices promote the developmental acquisition of competencies

 5. Assessment practices support & document the developmental acquisition of competencies