Table 1.

Summary of each PAR cycle* during development and implementation of the CBAS

PAR CYCLEPARTICIPANTSREFLECTIONPLAN AND ACTIONOBSERVATION
1Program directors, advisors, CBAS teamOrganization system needed for FieldNotesPaper-based CBAS portfolio organized by CFPC’s skill dimensions and 99 priority topicsSystem is workable, but electronic version would be preferred by some
2Advisors, program directors, CBAS teamClear way to direct resident learning needed within systemElectronic system developed; “stacking” created (ie, self-determined topic stacks for targeted learning)Faculty development in use of the CBAS needed; resident training needed; range of responses to “stacking”
3Advisors, program directors, residents, CBAS teamResident training will need to be competency basedPilot implementation of the CBAS at 3 pilot sitesMore faculty development needed; residents expect feedback to follow best practices as explained to them
4Advisors, program directors, residents, CBAS teamIncrease the CBAS’s value to learningFieldNotes more clearly tied to summative evaluation through new 4-month report (version 1)Stacking is confusing; tie between skill dimensions and CanMEDS-FM and workplace assessment not clear; a clearer understanding of progress is required
5Advisors, program directors, residents, CBAS teamFind “missing link” between skill dimensions and CanMEDS-FM and workplaceDevelopment of sentinel habits; introduction of progress levels on FieldNotes; match ITERs to sentinel habitsSaturation appears to have been reached on FieldNotes; advisors and residents actively using eCBAS (electronic workbook); sentinel habits appear to be useful and intuitive
6Advisors, program directors, residents, CBAS teamValidate the CBASFull CBAS implementation; new 4-month report (version 2)Data collection under way
  • CanMEDS-FM—CanMEDS–family medicine, CBAS—Competency-Based Achievement System, CFPC—College of Family Physicians of Canada, ITERs—in-training evaluation reports, PAR—participatory action research.

  • * All data were collected through focus groups and interviews.