Exploring Change After Implementation of Family Medicine Residency Curriculum Reform.

ABSTRACT

BACKGROUND AND OBJECTIVES: In 2010, the College of Family Physicians of Canada (CFPC) launched its competency-based medical education (CBME) approach to residency curriculum and assessment. Named Triple C, this innovation was developed to ensure graduates of family medicine training programs are competent to begin unsupervised practice. Further, Triple C was intended to promote interest in practicing comprehensive family medicine. A program evaluation plan was launched by the CFPC alongside the implementation of Triple C to explore if intended outcomes were achieved. METHODS: We conducted retrospective secondary data analysis of survey findings from graduating family medicine residents from two sources National Physician Survey (NPS 2007 and 2010); and the Family Medicine Longitudinal Survey (FMLS 2015). Demographics and practice intentions reported by residents in the NPS 2007, NPS 2010, and FMLS 2015 were included in the analyses and a comparison between years was undertaken using a series of Pearson χ2 test. RESULTS: Findings indicate that in comparison to pre-Triple C (NPS 2007 and NPS 2010), significantly more residents reported the intention to include palliative care, intrapartum care, in-patient hospital care, care in the home, and practicing in rural settings after the implementation of Triple C (FMLS 2015; P<0.01). CONCLUSIONS: Family medicine graduates report an increase in intention to include a broader range of clinical domains after implementation of Triple C. While a causal relationship cannot be determined, using a historical control in the form of survey data that predates Triple C implementation could support future approaches to evaluation of education reform.