A qualitative study of evaluators of Canadian postgraduate medical education programs: challenges and recommendations

Abstract

Abstract Background In Canada, postgraduate medical education has transitioned to Competence by Design, a form of competency-based medical education. Program evaluation can help us learn more about the efficiency and effectiveness of Competence by Design and the transition to it. While most Canadian postgraduate medical education programs conduct program evaluations to support improvement and accreditation, the quality of these evaluation activities is questionable. Program evaluation within these contexts is challenging due to limited time, a lack of knowledge of program evaluation, and limited resources. The purpose of this study is to investigate how evaluators support postgraduate medical education programs and how they can help build the capacity of these programs to conduct evaluations and utilize the findings. Methods Using a qualitative study design, we employed purposeful sampling to interview evaluators with knowledge and experience in evaluating postgraduate medical education programs. We conducted interviews with 12 evaluators. We thematically coded the data using a deductive and inductive process. Results Evaluators can support postgraduate medical education programs as temporary and external consultants or as internal evaluation experts employed by the universities where the programs reside. Evaluators can help programs build their capacities to do program evaluation and use the findings by suggesting evaluation approaches and methods, leveraging existing data, interpreting the findings, encouraging programs to share conclusions, co-developing a manageable follow-up plan, and establishing quality assurance that supports accreditation. Conclusions This study presents empirical research on program evaluation in medical education, as well as information for evaluators embarking on evaluations of medical education programs. While this study confirmed that some programs leverage qualified evaluators, the limited internal evaluation units within Canadian medical education universities are concerning. If the potential of evaluation is to be realized and sustainable in medical education, allocating adequate resources is essential. Selecting the appropriate evaluation type, questions, and approaches can support program directors and evaluators in continuing to transform medical education.