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Critical Analysis of a Pedagogical Paradigm Shift in Medical Residency in Québec [r-libre/2935]

Boyer, Christian; Bissonnette, Steve; Baillargeon, Normand et Morneau-Guérin, Frédéric (2023). Critical Analysis of a Pedagogical Paradigm Shift in Medical Residency in Québec. Montréal, Canada : Éditions de l'Apprentissage, coll. « Des points sur les i et des barres sur les t ». ISBN 978-2-923805-73-3

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Résumé : Medical progress over the past two centuries essentially took place because medicine became increasingly grounded in scientific research, reflecting reverence for rigour, rationality, scientific method, and evidence. In the early 20th century, the Flexner report (1910) led to this decisive momentum being driven even more rapidly. Central to this history is the content of learning, but also the pedagogical framework of the training aimed at the learning of that content. In the 21st century, the learning content of medical training is clearly on the side of evidence and rigour. But what of the pedagogical framework of medical training and, in the case at hand, medical residency? In 2009, the University of Toronto piloted a pedagogical approach in medical residency developed by the Royal College of Physicians and Surgeons of Canada (RCPSC) entitled Competence by Design (CBD). CBD is a direct descendant of competency-based education (CBE), a pedagogical movement launched in the United States in the wake of the Soviets’ Sputnik satellite, which was sent into orbit in 1957. Today, the CBE trend is to be found in general education (elementary, secondary, and postsecondary), vocational education, and medical education. On what theoretical framework is the RCPSC’s CBE (CBD) based? Was this framework scientifically validated, wholly or partially? The following pages maintain that the RCPSC’s CBE did not follow an exemplary, rigorous process and is not based on evidence from scientific research, in either general pedagogy or medical education. More specifically, we assert that the Canadian and Québec medical world, in adopting the RCPSC’s CBE, has moved away from the evidence, necessary rigour, and conscientious caution it usually shows with regard to medical innovations. As we move forward in this text, we also briefly examine the effectiveness of CBE’s sometimes co-occurring pedagogical methods that can also provide at least a partial alternative to traditional residency and CBE applied to residency (e.g., technology-enhanced simulation, standardized patients, deliberate practice, mastery learning, and competency-based progression).
Déposant: Morneau-Guérin, Frédéric
Responsable : Frédéric Morneau-Guérin
Dépôt : 06 avr. 2023 19:13
Dernière modification : 06 avr. 2023 19:13

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