Because CBME is structured to assess sequential competencies, it lends itself to defining different levels of training (figure).
Streaming is the solution and CBME is the mechanism to achieve it.
This more rigorous and detailed tracking of residents' progress is in line with the learner-centred CBD framework, a key strength of CBME.
With the upcoming RCPSC's initiative to implement a CBME model to all residency training programs across Canada, this information can help in the development of effective, evidence-based curricula to maximize resident success.
This proposed 'allostatic shift' from a doctor-centered traditional curricular philosophy of dividing the five years of undergraduate training into basic sciences, preclinical and clinical components, to a CBME oriented, hands-on, patient-centered training is expected to yield better results.
A CBME approach in such a setting is recommended to have the following common percepts and principles:
The process of introducing CBME as a curricular philosophy with such ideals can best be initiated at the selection process of doctors, nurses and paramedics.
The CBME shift however requires a revamp of the existing selection and induction process, with a greater emphasis on psychometric evaluation and aptitude.
12) tested oral sprays containing CBME THC, CBD, ora 1:1 mix of THC and CBD for efficacy in 34 chronic pain patients poorly responsive to other modalities of pain control, including 16 with multiple sclerosis.
20) reported a randomized double-blind, placebo-controlled study of 160 MS patients using an oral CBME spray or placebo for a total of ten weeks (Table 1).
22) administered dronabinol, CBME or placebo to 16 multiple sclerosis patients for 4 weeks, with a 4-week washout period between treatments (see Table 1).
A successful shift towards a CBME
approach requires three critical components: (1) identifying the required abilities; (2) identifying ways to teach the required abilities; and (3) identifying ways to assess these abilities.