title: Development and Early Piloting of a CanMEDS Competency-Based Feedback Tool for Surgical Grand Rounds.
abstract: OBJECTIVE
  Grand rounds offer an excellent opportunity for the evaluation of medical expertise, and other competencies, such as communication and professionalism. The purpose of this study was to develop a tool that would facilitate the provision of formative feedback for grand rounds to improve learning. The resulting CanMEDS-based evaluation tool was piloted in an academic surgical department.
  
  
  METHODS
  This study employed the use of a 3-phase, qualitatively-focused, embedded mixed methods approach. In Phase 1, an intrinsic case study was conducted to identify preliminary themes. These findings were crystallized using a quantitative survey. Following interpretation of these data, a grand rounds evaluation tool was developed in Phase 2. The tool was piloted in the Phase 3 focus group.
  
  
  METHODS
  This study was piloted at an academic surgical center among members of the Department of Surgery, McMaster University, Ontario, Canada.
  
  
  METHODS
  Purposive sampling was used for this study. A total of n = 7 individuals participated in the Phase 1 interviews, and n = 24 participants completed the Phase 1 survey. Participants included a representative sample of medical students, residents, fellows, and staff. The tool was piloted among n = 19 participants.
  
  
  RESULTS
  The proposed evaluation tool contains 13 Likert-scale questions and 2 open-ended questions. The tool outlines specific questions to assess grand rounds presenters within the structure of the 7 CanMEDS competency domains. "Evaluation fatigue" was identified as a major barrier in the willingness to provide effective feedback. Further, a number of factors regarding the preferred content, structure, and format of surgical grand rounds were identified.
  
  
  CONCLUSIONS
  This pilot study presents a CanMEDS-specific evaluation tool that can be applied to surgical grand rounds. With the increasing adoption of competency-based medical education, comprehensive evaluation of surgical activities is required. This form provides a template for the development of competency-based evaluation tools for medical and surgical learning activities.
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Fahim
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada; Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Mohit
authors.initials: M
authors.lastname: Bhandari
authors.affiliation: Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Ilun
authors.initials: I
authors.lastname: Yang
authors.affiliation: Department of Surgery, McMaster University, Hamilton, Ontario, Canada. Electronic address: ranil@skillslab.ca.
authors.forename: Ranil
authors.initials: R
authors.lastname: Sonnadara
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003162:Competency-Based Education / Q000379:methods; D004503:Education, Medical, Graduate / Q000379:methods*; D004521:Educational Measurement; D005246:Feedback; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D009864:Ontario; D009985:Orthopedics / Q000193:education*; D010865:Pilot Projects; D015397:Program Evaluation; D056164:Teaching Rounds
keywords: CanMEDS; Interpersonal and Communication Skills; Medical Knowledge; Practice-Based Learning and Improvement; Professionalism; Systems-Based Practice; competency-based medical education; evaluation fatigue; grand rounds; mixed methods research design; surgical evaluation