Competency-Based Achievement System
CBAS is a programmatic assessment system that is based on the belief that the most important place to assess competence is in the workplace. CBAS supports assessment for, as, and of learning, and uses continuous formative feedback to inform summative assessment. CBAS was developed using key theories and evidence of best practices in assessment and learning, and is continuously evaluated & revised based on multiple sources of information. CBAS was the basis for the CFPC Continuous Reflective Assessment for Training (CRAFT) guidelines for assessment in family medicine training. CBAS was adapted for the Medical Council of Canada's NAC PRA program, and is used across Canada for practice-readiness assessments of internationally-trained physicians seeking to be licensed for practice in Canada.
Programmatic Assessment
CBAS is a programmatic assessment system. Multiple assessment tools are used to capture evidence about learner competence. This evidence is periodically reviewed to make decisions about how each learner is progressing as they go through the training program.
FieldNotes
The main workplace-based assessment tool used in CBAS is the FieldNote. Each FieldNote includes a brief summary of what was observed, as well as a narrative summary of the feedback that was shared with the learner.
FieldNotes capture the essential components of expert assessment of a learner: 1) What did you see?; 2) How did it go?; and 3) What is your judgement of competence?
How FieldNotes work
FieldNotes are used for workplace-based assessment. Learners are observed in the workplace, and observers shared feedback based on that observation. FieldNotes function as a purposive sampling of the observation and feedback that happens regularly in clinical teaching.
CBAS = assessment + learning
CBAS incorporates multiple low-stakes and high-stakes assessment tools and processes, integrated with learning plans, to support a learner's progress to competence. Decision-making supported by CBAS focuses on the individual developmental trajectory of each learner. CBAS mirrors CRAFT, the CFPC expectation guidelines for assessment.
CBAS Publications
CBAS & CRAFT program descriptions
Ross S, Lawrence K, Bethune C, van der Goes T, Pélissier-Simard L, Donoff M, Crichton T, Laughlin T, Dhillon K, Potter M, Schultz K. Development, implementation, and meta-evaluation of a national approach to programmatic assessment in family medicine residency training. Academic Medicine (in press) (July 2022 early online DOI 10.1097/ACM.0000000000004750)
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Ross S, Poth C, Donoff M, Humphries P, Steiner I, Schipper S, Janke F, Nichols D. The Competency-Based Achievement System (CBAS): Using formative feedback to teach and assess competencies with Family Medicine residents. Canadian Family Physician. 2011;57:e323-e330.
FieldNotes
Donoff MG. Field notes: Assisting achievement and documenting competence. Canadian Family Physician. 2009;55(12):1260-1262.
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Donoff MG. The Science of In-Training Evaluation. Canadian Family Physician. 1990;36:2002-2006.
CBAS research papers (selected)
Lee A, Donoff C, Ross S. Using learning analytics to examine differences in assessment forms completed by continuous versus episodic supervisors. J Grad Med Educ (2022) 14 (5): 606–612.
https://doi.org/10.4300/JGME-D-21-00832.1
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Lee JR, Ross S. A comparison of resident-completed and preceptor-completed formative workplace-based assessments in a competency-based medical education program. Fam Med. 2022;54(8):599-605.
DOI: 10.22454/FamMed.2022.854689
Ross S, Binczyk N, Hamza D, Schipper S, Humphries P, Nichols D, Donoff M. Association of a competency-based assessment system with identification of and support for medical residents in difficulty. JAMA Network Open 2018; 1 (7): e184581.
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Ross S, Poth C, Donoff M, Papile C, Humphries P, Stasiuk S, Georgis R. Involving Users in the Refinement of the Competency-Based Achievement System (CBAS), an Innovative Approach to Competency-Based Assessment. Medical Teacher. 2012; 34:e413-e417.
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