Advancing Canada’s family medicine curriculum: Triple C

What is Triple C?

The WGCR, a subcommittee of the Section of Teachers Council, proposed the introduction of a competency-based curriculum for family medicine residency training, based on the CanMEDS–Family Medicine (CanMEDS-FM) framework² of competencies and the Evaluation Objectives in Family Medicine.³ The WGCR performed an extensive literature review and consulted with key internal and external stakeholders. Recommendations for change were reached through an iterative process reflecting needs, evidence, and international trends. The WGCR’s central recommendation was to establish a competency-based curriculum for family medicine residents that is comprehensive, focused on continuity of education and patient care, and centred in family medicine. Together these recommendations make up the Triple C Competency-based Curriculum. This renewed curriculum enhances what is taught, how it is taught, and how learners are assessed.

The goal of Triple C is to ensure that every family physician training program in Canada develops graduates who are

• competent to provide comprehensive care in any Canadian community,

• prepared for the evolving needs of society, and

• taught based upon the best available evidence on patient care and medical education.

Competency-based curriculum

The move toward competency-based education is in keeping with an international educational trend that supports the need for medical education to meet societal expectations of accountability. It depends upon well-defined program outcomes that are congruent with teaching and learning strategies, resident assessment methodologies, and an integrated curriculum design. This competency-based education approach moves away from traditional rotation-based models of residency training. It requires residents to be active learners, shifting the role of a resident supervisor toward that of a resident’s “coach.”

The CFPC’s competency framework has been developed based on the following:

• principles of family medicine;

• content of key family medicine contexts and clinical domains;

• evaluation objectives related to

  • -skill dimensions (patient-centred care, communication, professionalism, clinical reasoning, selectivity, and procedures),

  • -phases of the clinical encounter, and

  • -99 priority topics and key features; and

• roles that the Canadian public expects family physicians to carry out (CanMEDS-FM roles).

Using a competency-based curriculum, residency programs will provide relevant educational opportunities for residents. Clearly defined competency objectives will guide the selection of content, learning experiences, learning environment, assessment strategies, and remediation planning.

Three components of Triple C

In the context of family medicine, a competency-based curriculum requires the following Triple C characteristics.

Implementation of Triple C

The CFPC is coordinating the implementation of Triple C with university postgraduate family medicine residency programs and other key stakeholders. Family medicine residency programs are well on their way, building on the many successes they have already had within their programs. Implementation will be a multiyear process, enhancing and articulating the best of our superb delivery of family medicine education.

This is the first in a series of articles explaining the Triple C initiative. Look for the next installment, which will provide further explanations related to the key concepts behind the Triple C Competency-based Curriculum. Have questions? Visit www.cfpc.ca/triple_C or contact triplec{at}cfpc.ca for more information.