We sat down with Curtis Nickel, MD Med FRCPC, Assistant Professor and Clinical Anesthesiologist at the University of Ottawa, to discuss how simulation can help competency-based medical education move beyond knowledge checks toward observable, practice-ready performance.

Watch the video or read the transcript below. 

Tell us about yourself.

“My name is Curtis Nickel. I’m an anesthesiologist in Ottawa at the University of Ottawa and the Ottawa Hospital. I’m also a simulation educator, and I’ve been involved in our competency-based medical education (CBME) enrollment, implementation, and overall ongoing [management] within our residency program.

I love it because I love teaching. I love being involved with our residents, and love simulation. And I love being able to help the next group go forward and do what I do—and hopefully even better than I do it!” 

“It’s really interesting. I think simulation fits in beautifully with a competency-based education—whether it’s medical or not. I think it’s one of those things [where] the goals of each are already  aligned. The goals of simulation education are already learner-focused. We’re already scaling and making things more or less difficult.

Competency-based education is the same. We’re really trying to focus on competencies and taking it from being more system-focused than learner-focused, and moving it to be more learner-focused. I think the use of simulation within that is a perfect fit, and something that we should be doing more of.

It has the opportunity to take us from the lower levels of demonstration of skill or knowledge—in that Bloom’s Taxonomy “knows how”—and move us into more of that “shows” and “dos,” or that higher element of knowledge evaluation. And that’s really a huge thing for getting people ready to be competent practitioners as soon as they leave their training program.” 

What’s one tip or strategy you recommend to help accelerate/improve implementation of CBE in healthcare education?

“We’ve been doing CBE and CBME for a long time now. Canada converted a while ago, and anesthesia was at the forefront of that. I think the biggest thing I’ve learned is listening to your learners, and really getting an idea of where they’re at, getting their stakeholder input, getting their feedback, because they’re going to tell you how it’s working for them.

We are now moving my system to a bit more about them instead of being about us. So getting that feedback from your learner right away as to how your educational initiatives are working. Are they being burdened by the amount of assessment that’s happening? And putting that into place alongside all your other stakeholder input is probably the easiest and best way to get it going quickly.” 

Looking ahead, what innovations in simulation or digital learning do you believe will have the greatest impact on advancing CBE in healthcare education?

“I think now the thing that excites me the most whenever I go to a conference or I talk to people about this, is data and data analytics and learner analytics. I think the ability to get a huge amount of data that’s out there—because that’s really what competency-based education is. It’s multiple aggregates of data points to say whether a person’s competent or not.

Now we’re gathering that and hopefully getting a better idea of targeting what pieces of data we need. But being able to put that together in a package and that analytics side of things, that’s the next step. With the people that I see who are doing it and doing it well, it’s incredible. And I think that’s where we’re going next. That’s going to be the next big thing.”