Effect of a competence based medical education program on training quality in Intensive Care Medicine. COBALIDATION TRIAL.

Objectives: The main objective of this study was to evaluate whether the implementation of CoBaTrICE (Competency-Based Training in Intensive Care Medicine in Europe) provides higher levels of competency in comparison with the current official time-based program in Intensive Care Medicine in Spain. Secondary objectives were: 1) To determine the percentage of critical essential performance elements (CEPE) accomplished, 2) To determine compliance with workplace-based assessments (wba).

Design: Multicenter cluster randomized trial.

Setting: Thirteen Spanish ICU Departments.

Participants: Thirty-six residents INTERVENTION: The implementation of CoBaTrICE included: (1) Training the trainers; (2) Wba; (3) The use of an electronic portfolio. The level of competency achieved by each participant was determined by a simulation-based Objective Structured Clinical Exam (OSCE) performed at the end of the 5th year of training period.

Main variables of interest: Total scoring in the five scenarios, CEPE completed, level of competency (1-5) achieved.

Results: A total of 119 performances from 26 residents (17 from CoBaTrICE group and 9 from control group) were analyzed in the OSCE. CoBaTrICE residents´ achieved higher levels of competency [2 (1-5) vs. 2 (1-3), p = 0.07) and higher percentages of CEPE´s accomplishment than the control group (78% vs. 71%, p = 0.09).

Conclusions: The CoBaTrICE group showed a better performance trend in comparison to the control group, but the differences were not statistically significant. Since the number of Wba performed was low, additional research is needed to determine the potential superiority of CoBaTrICE.