Evidence map›Paper›PMID 35906632›Full record

ArticleBMC medical education2022

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

Christen Rachul, Benjamin Collins, Ming-Ka Chan, Ganesh Srinivasan, Joanne Hamilton

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medical education, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Change Management and Innovation in Graduate Medical Education.Journal of graduate medical education · 2025
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Christen RachulOffice of Innovation and Scholarship in Medical Education, Max Rady College of Medicine, University of Manitoba, S204, Medical Services Building, 750 Bannatyne Ave, Winnipeg, MB, R3E 0W2, Canada. christen.rachul@umanitoba.ca.
Benjamin CollinsDepartment of Anthropology, University of Manitoba, Winnipeg, Canada.
Ming-Ka ChanDepartment of Pediatrics and Child Health, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada.
Ganesh SrinivasanDepartment of Pediatrics and Child Health, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada.
Joanne HamiltonOffice of Innovation and Scholarship in Medical Education, Max Rady College of Medicine, University of Manitoba, S204, Medical Services Building, 750 Bannatyne Ave, Winnipeg, MB, R3E 0W2, Canada.

Funding

Royal College of Physicians and Surgeons of Canada 2018 Strategic Initiative Grant: Advancing Competency-based Medical Education across the Continuum
6 · The paper itself

Abstract

backgroundImplementing competency-based medical education (CBME) in post-graduate medical education (PGME) is a complex process that requires multiple systemic changes in a complex system that is simultaneously engaged in multiple initiatives. These initiatives often compete for attention during the implementation of CBME and produce unintended and unanticipated consequences. Understanding the impact of this context is necessary for evaluating the effectiveness of CBME. The purpose of the study was to identify factors, such as contexts and processes, that contribute to the implementation of CBME.

methodsWe conducted a realist evaluation using data collected from 15 programs through focus groups with residents (2 groups, n = 16) and faculty (one group, n = 8), and semi-structured interviews with program directors (n = 18), and program administrators (n = 12) from 2018 to 2021. Data were analyzed using a template analysis based on a coding framework that was developed from a sample of transcripts, the context-mechanism-outcomes framework for realist evaluations, and the core components of CBME.

resultsThe findings demonstrate that simultaneous initiatives in the academic health sciences system creates a key context for CBME implementation - rivalries for attention - and specifically, the introduction of curricular management systems (CMS) concurrent to, but separate from, the implementation of CBME. This context influenced participants' participation, communication, and adaptation during CBME implementation, which led to change fatigue and unmet expectations for the collection and use of assessment data.

conclusionsRival initiatives, such as the concurrent implementation of a new CMS, can have an impact on how programs implement CBME and greatly affect the outcomes of CBME. Mitigating the effects of rivals for attention with flexibility, clear communication, and training can facilitate effective implementation of CBME.

Indexed as

Competency-Based EducationEducation, MedicalCanadaEducation, Medical, GraduateFocus GroupsHumansCompetency-based medical educationCurriculum Management SystemImplementationPost graduate medical educationRealist evaluationSpecialty training

Identifiers

PMID35906632
PMCPMC9336173

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.