Crystal ball gazing – what the new MCCQE Part I and Part II will look like in 2018 and beyond
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| Business Session Crystal ball gazing – what the new MCCQE Part I and Part II will look like in 2018 and beyond CCME 2016 Montreal, QC
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Transcript of Crystal ball gazing – what the new MCCQE Part I and Part II will look like in 2018 and beyond
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Business Session
Crystal ball gazing – what the new MCCQE Part I and Part II
will look like in 2018 and beyond
CCME 2016 Montreal, QC
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Dr. Ian Bowmer, Executive Director of the MCC
Dr. Claire Touchie, Chief Medical Education Advisor, MCC
Dr. Sydney Smee, Assessment Advisor, MCC
3 | MCC | MCC © 2016
Setting the scene
• MCC Qualifying Examinations today• Where is the new Blueprint taking us? • How will this affect the existing exams?• MCC assessment gaps • How will candidates get ready?
4 | MCC | MCC © 2016
Today’s MCC Qualifying Examinations
Blueprint: Based on discipline
MCCQE Part I
196 MCQs
36 CDM Cases
MCCQE Part II
12 StationOSCE
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Where is the new Blueprint taking us?
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New MCC Blueprint
DIMENSIONS OF CARE
Health Promotion and Illness Prevention
Acute Chronic Psychosocial Aspects
PHYSICIAN ACTIVITIES
Assessment/Diagnosis
Management
Communication
Professional Behaviours
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Decision 1: Entry into residency
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Decision 1Entry to residency
MCCQE Part I
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Entry to residencyDIMENSIONS OF CARE
Health Promotion and Illness Prevention
Acute Chronic Psychosocial Aspects Row %
PHYSICIAN ACTIVITIES
Assessment/Diagnosis 30
Management 20
Communication 30
Professional Behaviours 20
Column % 20 30 30 20 100
10 | MCC | MCC © 2016
DIMENSIONS OF CARE
Health Promotion and Illness Prevention
Acute Chronic Psychosocial Aspects Row %
PHYSICIAN ACTIVITIES
Assessment/Diagnosis 45±5
Management 35±5
Communication 10±5
Professional Behaviours 10±5
Column % 20±5 35±5 30±5 15±5 100
MCCQE Part I – Test Specifications
These weights were approved by the MCC’s Central Examination Committee in June 2015
11 | MCC | MCC © 2016
Getting Ready to go Live: Spring 2018Alignment of the content with the new Blueprint
• More complex content• Increased focus on Health Promotion and Illness Prevention;
Psychosocial Aspects of Care• Updating the Objectives• Communication with the Faculties of Medicine
Moving towards better student experience• More frequent administrations (January 2019) • More access to exams
Setting the pass mark• New pass mark will be set post-examination in Spring 2018• Results reporting delay• New reports for candidates and deans
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13 | MCC | MCC © 2016
DIMENSIONS OF CARE
Health Promotion and
Illness Prevention
Acute Chronic Psychosocial Aspects Row % Part I Gap
PHYSICIAN ACTIVITIES
Assessment/Diagnosis 30±5 45±5
Management 20±5 35±5 Communication 30±5 10±5
Professional Behaviours 20±5 10±5
Column % 20±5 30±5 30±5 20±5 100
Part I 20±5 35±5 30±5 15±5
Gap
Entry into residency - gaps
14 | MCC | MCC © 2016
New MCC Blueprint
Decision 1Entry to residency
MCCQE Part I
Other Assessments?
| MCC | MCC © 2016
How can MCC collaborate to close the gap?
Undergraduate medical education • Methods to close gaps
◦ OSCEs◦ Other assessments
› Multisource feedback› Reflections› Entrustable professional activities (EPAs)
• Challenges◦ 17 medical schools◦ Shifting environment with many demands on schools◦ Unique curricula
• Opportunities◦ Engagement◦ Shared resources15
| MCC | MCC © 2016
Decision 2 – Entry to independent practice
17 | MCC | MCC © 2016
DIMENSIONS OF CAREHealth
Promotion and Illness
PreventionAcute Chronic Psychosocial
Aspects Row %
PHYSICIAN ACTIVITIES
Assessment/Diagnosis 25
Management 35
Communication 20
Professional Behaviours 20
Column % 20 25 35 20 100
Entry to Independent practice
| MCC | MCC © 2016
Current ModelDay 1: 8 10-minute stations (2+10 minutes)
+ 2 rests
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T01
T02
T03
T04
T05 (rest)
T06
T07
T08
T09
T10 (rest)
C01 + C02
C03 + C04
(pilot)
C05 + C06
C07 + C08
C09 + C10
Day 2: 4 couplets (2 + 6 + 2 + 6 minutes)
+ 1 pilot
| MCC | MCC © 2016
New Blueprint – New opportunity
Problem: Current delivery model limits the range of clinical presentations because of 5 and 10-minute limit on interactionsSolution: Longer stations Impact: Possible to assess:
• More complex, authentic problems• Inter/intra-professional skills• With paired stations replacing written post-encounter
probe component with more active role for examiners
Challenge: Fewer paired stations = higher examiner to candidate ratio
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New Model: Fall 2018
L01
L02
L03
L04
L05
L06
L07
L08 (pilot)
P01 (A+B)
P02 (A+B)
P03 (A+B)
P04 (A+B) (pilot)
Day 1: 7 14-minute stations (2+14 minutes)
+ 1 pilot
Day 2: 3 paired (2 + 6 + 2 + 6 minutes)
+ 1 pilot
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Topics for New Stations
Assessing “Core Foundational Competencies”• Discharge planning• Colleague in trouble• Falls with underlying complications• Goals of care for ill parent• Difficult news• Forgetfulness• Rx renewal – angry patient• Advice re alternative remedies request• Conflict within health care team
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| MCC | MCC © 2016
Getting Ready to Go Live: Fall 2018
• Engagement◦ Sites involved planning for the changes◦ Sites are already piloting new content◦ MCC is communicating candidates and other
stakeholders• Enhancing examiner and candidate orientation• Setting the pass mark for the new format / content
◦ Occurs post-exam in Fall 2018◦ Potential timing impact for results reporting◦ Will need new reports for candidate and deans
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23 | MCC | MCC © 2016
Decision 2 – Entry to independent practice
Decision 2Entry to independent
practice
MCCQE Part II
Other assessments?
Adding other component /
content formats?
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How will candidates get ready?New orientation program physiciansapply.ca/orientation
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| MCC | MCC © 2016
Program features
• Case studies and Communication Skills Module• Learning objectives, links to MCC objectives,
sentinel habits (PRA standards for Family Medicine and Psychiatry)
• Video/audio clips• Knowledge checks & commentaries• Reflective exercises & commentaries• Resources (journal articles, books, etc.)
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| MCC | MCC © 2016
Case topics
Case 1: Consent, confidentiality, HIV/AIDS, professional behavioursCase 2: Cross-cultural communication, cross-cultural diversity, cross-cultural bioethics, DNRCase 3: Communication with adolescents, interprofessional relationships, conflict resolution, eating disordersCase 4: Aboriginal health, communication with aboriginal patients, diabetes, socioeconomic and cultural determinants of healthCase 5: Mood and behaviour disorders, attention deficit disorder, elder abuse, depression, prescribing narcotics, substance abuse disorders
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| MCC | MCC © 2016
Communications topics
• Patient-centred approach vs doctor-centred approach
• Non-verbal communication • Communication challenges: • Sexual history• Interprofessional conflict• Boundary crosser• Ethical dilemmas• Cross-cultural interviewing • Breaking bad news
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| MCC | MCC © 2016
How will candidates get ready?Demonstration – interprofessional collaboration and discharge planning
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| MCC | MCC © 2016
New content development Case 6 – Complexities of care of the elderly (May 2016)
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| MCC | MCC © 2016
MCC Blueprint - A communication model
DIMENSIONS OF CARE
Health Promotion and Illness Prevention
Acute Chronic Psychosocial Aspects
PHYSICIAN ACTIVITIES
Assessment/Diagnosis
Management
Communication
Professional Behaviours
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| MCC | MCC © 2016
DIMENSIONS OF CARE
Health Promotion and Illness Prevention
Acute Chronic Psychosocial Aspects
PHYSICIAN ACTIVITIES
Assessment/Diagnosis
Management
Communication
Professional Behaviours
MCC BlueprintExample test topic:The Assessment/Diagnosis and Health Promotion of diabetes mellitus (Medical Expert Objective)Example task:List and interpret critical clinical findings including risk factorsExample scenario: “A consultant from an academic centre is sent to a First Nations reserve to study the increased incidence of diabetes mellitus in the population”
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| MCC | MCC © 2016
DIMENSIONS OF CARE
Health Promotion and Illness Prevention
Acute Chronic Psychosocial Aspects
PHYSICIAN ACTIVITIES
Assessment/Diagnosis
Management
Communication
Professional Behaviours
MCC Blueprint
Example test topic:Management of Psychosocial aspects of care of Dementia(Medical Expert Objective)Example task:Manage scarce health care resources in an ethical and informed manner, balancing individual and societal needs (Manager Objective)Example scenario: “The 45 year old caregiver of her father with dementia presents to your office, saying that she can no longer deal with him and ensure his safety.”
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| MCC | MCC © 2016
How will candidates get ready?
• New orientation (physiciansapply.ca/orientation)
• Improved Objectives• Enhanced preparatory material for the MCCQE
Part I◦ Preparatory guide
◦ Self-assessment examinations (SAEs)
◦ Preparatory examinations
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| MCC | MCC © 2016
Summary
The new Blueprint is aligning with 21st century medicine
• Blueprint in line with what types of problems physicians deal with and the types of activities physicians perform
• Enhanced examination experience• Enhanced examination preparation
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