In April, a delegation from the Medical Council of Canada (MCC) participated in the Canadian Conference on Medical Education (CCME) that took place in Niagara Falls from April 12 to 15, 2019. MCC employees gave presentations and participated in workshops related to MCC assessments, research, MCC 360 and much more. In addition, a MCC booth was set up to welcome participants and answer their MCC-related questions throughout the conference.
During the business session, Dr. Maureen Topps, MCC’s Executive Director and CEO, and Dr. André De Champlain, MCC’s Director of Psychometrics and Assessment Services, presented on “MCC’s Assessments: A Focus on the Future” and then engaged the audience in discussions on several topics linked to recent and potential future changes to assessment.
Following implementation of the new assessment Blueprint, the Medical Council of Canada Qualifying Examination (MCCQE) Part I and the MCCQE Part II were administered with updated test specifications for the first time in 2018.
The MCC has made some significant updates to the examination program over the last two years to ensure assessment is better aligned with the medical profession’s current reality. For example, the MCCQE Part II now focuses on Dimensions of Care and Physician Activities with an increased emphasis on professional behaviours.”
Dr. Maureen Topps,
Executive Director and CEO, MCC
Dr. Topps walked attendees through changes including the phase-out of the Medical Council of Canada Evaluating Examination (MCCEE) and the international delivery of the MCCQE Part I. Eligible candidates can now apply to the MCCQE Part I at any time and have access to an increased number of administrations (four in 2019 and up to five starting in 2020). Prometric, a trusted provider of technology-enabled testing and assessment solutions, was selected to administer the MCCQE Part I in over 80 countries worldwide.
Dr. Topps reminded the audience that a third exam, the National Assessment Collaboration Examination, was also recently updated. The first administration of this new exam took place on March 9, 2019. Each updated examination is followed by a rigorous standard-setting exercise to revisit and re-establish the passing score. The latter exercise is typically completed every three to five years, or after a major change is implemented to any examination program.
How will the MCC assess the competencies physicians will require in the future? Following the presentation, Dr. Topps and Dr. De Champlain turned to the audience to get their thoughts on this important question. A discussion workshop ensued engaging the audience composed of stakeholders, regulators and students. “It was an opportunity to hear our stakeholders’ perspectives on changes in medical education and the medical environment and how this will need to be taken into consideration when developing future assessments,” says Ms. Kathryn Keyes, MCC’s Director of Communications.
Four break-out groups discussed competencies that will be required of future physicians as well as topics that included how best to integrate technology. The groups provided insights on where they thought the MCC should focus its attention (communication, interprofessional skills, the use of artificial intelligence, etc.).
Following the discussion, Dr. De Champlain introduced ongoing MCC initiatives such as automated item generation and automated marking, with an emphasis on how these initiatives will contribute to supporting the assessment of emerging competencies in medicine. He also presented research currently being conducted to assess whether MCC examinations can be used for purposes other than initial licensure, specifically to better inform complaint rates and prescribing behaviour of practicing physicians.
“Since lifelong, tailored learning has now become a formal expectation of a physician’s professional trajectory, MCC assessment will need to reflect that shift moving forward,” explains Dr. De Champlain. This will be achieved by introducing scheduling flexibility, supplementing current exams with lower-stakes formative assessment and by promoting in-practice assessment.
MCC 360 is a tool offered by the MCC to evaluate physicians’ performance in practice. It specifically focuses on three CanMEDS roles (Collaborator, Communicator and Professional). Physician colleagues, non-physician co-workers, and patients who work with or are in contact with the physician participating in the MCC 360 program are asked about various elements linked to performance. Participating physicians receive a report that highlights what they are doing well and the aspects they could improve upon. To help them reflect on this information, physicians are also provided with facilitated feedback and a coaching session.
A workshop entitled “Using Multi-Source Feedback (MSF) reports to have feedback conversations about collaboration, communication, and professionalism” was presented at CCME. Ms. Alexa Fotheringham, Program Manager for MCC 360, and Dr. Marguerite Roy, Medical Education Researcher at the MCC, co-led the workshop. Participants shared their insight on how to deliver MSF to physicians using the MCC 360 report. The group provided a range of ideas during the discussion.
Now that the initial MCC 360 pilot with the College of Physicians & Surgeons of Alberta has successfully drawn to a close, the MCC is working with other organizations such as the College of Physicians and Surgeons of Manitoba, the College of Physicians and Surgeons of British Columbia and a variety of health authorities.
“We’re now operational in delivering MCC 360, excited to be onboarding organizations from across the country and working toward making it the national MSF program for physicians in practice,” says Dr. Claire Touchie, Chief Medical Education Officer at the MCC. Some regional health authorities and hospitals have plans to adopt MCC 360 this coming fall. As MCC 360 was designed to assess physicians across their practice continuum, the MCC is also working with four Canadian medical schools to research the feasibility of using the MSF tool at the undergraduate level.
The MCC thanks all those who participated in our various sessions and will use the discussions and the feedback collected at CCME in Niagara Falls to continue to shape and inform our work.
Photo: Dr. Maureen Topps, MCC’s Executive Director and CEO.