Operationalizing Programmatic Assessment: The CBME Programmatic Assessment Practice Guidelines

Assessing the development and achievement of competence requires multiple formative and summative assessment strategies and the coordinated efforts of trainees and faculty (who often serve in multiple roles, such as academic advisors, program directors, and competency committee members). Operationalizing programmatic assessment (PA) in competency-based medical education (CBME) requires comprehensive practice guidelines, written in accessible language with descriptions of stakeholder activities, to move assessment theory into practice and to help guide the trainees and faculty who enact PA. Informed by the Appraisal of Guidelines for Research and Evaluation II (AGREE II) framework, the authors used a multiphase, multimethod approach to develop the CBME Programmatic Assessment Practice Guidelines (PA Guidelines). The 9 guidelines are organized by phases of assessment and include descriptions of stakeholder activities. A user guide provides a glossary of key terms and summarizes how the guidelines can be used by different stakeholder groups across postgraduate medical education (PGME) contexts. The 4 phases of guideline development, including internal stakeholder consultations and external expert review, occurred between August 2016 and March 2020. Local stakeholders and external experts agreed that the PA Guidelines hold potential for guiding initial operationalization and ongoing refinement of PA in CBME by individual stakeholders, residency programs, and PGME institutions. Since July 2020, the PA Guidelines have been used at Queen's University to inform faculty and resident development initiatives, including online CBME modules for faculty, workshops for academic advisors/competence committee members, and a guide that supports incoming residents' transition to CBME. Research exploring the use of the PA Guidelines and user guide in multiple programs and institutions will gather further evidence of their acceptability and utility for guiding operationalization of PA in different contexts.