Bring CBME to Your Family Medicine Residency Program

Use this page for practical strategies, examples, and tools to help your family medicine residency program implement competency-based medical education in daily teaching, assessment, and program operations.

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Getting Started With CBME

Core Outcomes, Competencies, and Milestones

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Competency-Based Assessments

Engaging Residents

Clinical Competency Committees

As family medicine residency programs transition toward a Competency-Based Medical Education (CBME) framework, many find themselves at different stages of readiness. To move from theory to practice, programs must identify their current position, recognize barriers, and set actionable goals.ACGME family medicine program requirements and ABFM board certification requirements necessitate a transition within programs to competency-based medical education (CBME) to ensure that the discipline is training physicians to meet the United States' health care needs. A task force formed by STFM created recommendations for implementation of CBME.The STFM CBME Task Force reviewed papers written by CBME experts and, through group discussions and consensus, drafted recommendations. Feedback on drafts of the recommendations was provided by leaders of the American Academy of Family Physicians, American Board of Family Medicine, American College of Osteopathic Family Physicians, Association of Departments of Family Medicine, Association of Family Medicine Residency Directors, North American Primary Care Research Group, and STFM.

Implementation Framework

To ensure a successful and collaborative transition, follow these strategic steps:

Assemble a Core Team: This process is most effective when conducted by a diverse group of faculty members and stakeholders responsible for the CBME curriculum.
Identify Your Stage: Use the Implementation Road Map to pinpoint exactly where your program sits within each "pillar" of the CBME framework.
Assess and Define: Have each team member complete the Needs Assessment and Planning Tool. Use these insights to develop SMARTIE Objectives (Strategic, Measurable, Ambitious, Realistic, Time-bound, Inclusive, and Equitable) for each pillar.
Build Consensus: Create dedicated forums for discussion. Share individual assessments to establish a unified vision and a shared set of program-wide SMARTIE goals.
Establish a Cycle of Improvement: CBME implementation is an iterative process. Create a formal system to review the program’s progress annually using the Road Map and Needs Assessment tools as benchmarks.

National Recommendations for Implementation

The STFM CBME Task Force created 12 recommendations to guide programs and one recommendation for the specialty of family medicine for implementation of CBME.

Recommendations for Programs

Thirteen recommendations, guided by the best available evidence, task force expertise, group consensus, and input from leaders of family medicine organizations were compiled to guide transition to CBME in family medicine residency programs.

Programs should create learning environments that support residents in the development of the characteristics of a master adaptive learner (MAL) with the use of individualized coaching, reflection, and faculty development.
Programs should provide residency administrators/coordinators adequate time and training to implement and manage tracking systems for competency-based medical education assessment.
Programs should engage residents in tailoring elective time to meet individual educational goals and to progress toward competence in the family medicine core outcomes.
Programs should foster a culture of reflective feedback conversations.
Resident assessment should occur frequently throughout the continuum of care using multiple modalities, with most assessments being grounded in direct observation.
Throughout training, a five-level entrustment framework should be used to assess residents on their progression toward entrustability.
Programs should provide residents updates on their progress toward achieving the family medicine core outcomes based on holistic resident review done by the Clinical Competency Committee at least every 6 months.
Programs should provide dedicated time for structured ongoing faculty development in the implementation of CBME.
Programs should engage faculty and residents to create an assessment system that minimizes the assessment burden on faculty and residents.
Programs should provide faculty development in coaching skills to engage residents in self-regulated learning
Individualized learning plans should be created with all residents during the first 6 months of residency and updated quarterly throughout training, with interval coaching/advising to facilitate growth.
Individualized learning plans should include specific , measurable , attainable, relevant, time-bound, inclusive, and equitable (SMART-IE) objectives that are aligned with the family medicine core outcomes.

Recommendation for the Specialty

Relevant stakeholders in family medicine graduate medical education should collaborate to develop and implement a mobile application to streamline the ability of faculty to provide real-time feedback and assessment of residents.

Read the full Family Medicine journal article: "National Recommendations for Implementation of Competency-Based Medical Education in Family Medicine"

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Tips for Using STFM's AI Assistant

STFM's AI Assistant is designed to help you find information and answers about Family Medicine education. While it's a powerful tool, getting the best results depends on how you phrase your questions. Here's how to make the most of your interactions:

1. Avoid Ambiguous Language

Be Clear and Specific: Use precise terms and avoid vague words like "it" or "that" without clear references.

Example:

Instead of: "Can you help me with that?"

Try: "Can you help me update our Family Medicine clerkship curriculum?"

Why this is important: Ambiguous language can confuse the AI, leading to irrelevant or unclear responses. Clear references help the chatbot understand exactly what you're asking.

2. Use Specific Terms

Identify the Subject Clearly: Clearly state the subject or area you need information about.

Example:

Instead of: "What resources does STFM provide?"

Try: "I'm a new program coordinator for a Family Medicine clerkship. What STFM resources are available to help me design or update clerkship curricula?"

Why this is better: Providing details about your role ("program coordinator") and your goal ("design or update clerkship curricula") gives the chatbot enough context to offer more targeted information.

3. Don't Assume the AI Knows Everything

Provide Necessary Details:The STFM AI Assistant has been trained on STFM's business and resources. The AI can only use the information you provide or that it has been trained on.

Example:

Instead of: "How can I improve my program?"

Try: "As a program coordinator for a Family Medicine clerkship, what resources does STFM provide to help me improve student engagement and learning outcomes?"

Why this is important: Including relevant details helps the AI understand your specific situation, leading to more accurate and useful responses.

4. Reset if You Change Topics

Clear Chat History When Switching Topics:

If you move to a completely new topic and the chatbot doesn't recognize the change, click the Clear Chat History button and restate your question.

Note: Clearing your chat history removes all previous context from the chatbot's memory.

Why this is important: Resetting ensures the AI does not carry over irrelevant information, which could lead to confusion or inaccurate answers.

5. Provide Enough Context

Include Background Information: The more context you provide, the better the chatbot can understand and respond to your question.

Example:

Instead of: "What are the best practices?"

Try: "In the context of Family Medicine education, what are the best practices for integrating clinical simulations into the curriculum?"

Why this is important: Specific goals, constraints, or preferences allow the AI to tailor its responses to your unique needs.

6. Ask One Question at a Time

Break Down Complex Queries: If you have multiple questions, ask them separately.

Example:

Instead of: "What are the requirements for faculty development, how do I register for conferences, and what grants are available?"

Try: Start with "What are the faculty development requirements for Family Medicine educators?" Then follow up with your other questions after receiving the response.

Why this is important: This approach ensures each question gets full attention and a complete answer.

Examples of Good vs. Bad Prompts

Bad Prompt

"What type of membership is best for me?"

Why it's bad: The AI Chat Assistant has no information about your background or needs.

Good Prompt

"I'm the chair of the Department of Family Medicine at a major university, and I plan to retire next year. I'd like to stay involved with Family Medicine education. What type of membership is best for me?"

Why it's good: The AI Chat Assistant knows your role, your future plans, and your interest in staying involved, enabling it to provide more relevant advice.

Double Check Important Information

While the AI Chat Assistant is a helpful tool, it can still produce inaccurate or incomplete responses. Always verify critical information with reliable sources or colleagues before taking action.

Technical Limitations

The Chat Assistant:

Cannot access external websites or open links
Cannot process or view images
Cannot make changes to STFM systems or process transactions
Cannot access real-time information (like your STFM Member Profile information)

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Bring CBME to Your Family Medicine Residency Program

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AI Chatbot Tips

Tips for Using STFM's AI Assistant

1. Avoid Ambiguous Language

Example:

2. Use Specific Terms

Example:

3. Don't Assume the AI Knows Everything

Example:

4. Reset if You Change Topics

5. Provide Enough Context

Example:

6. Ask One Question at a Time

Example:

Examples of Good vs. Bad Prompts

Bad Prompt

Good Prompt

Double Check Important Information

Technical Limitations

STFM AI Assistant