{"title":"Lost in translation: the case for embedding newcomer care in medical education","authors":"Tina Madani Kia","doi":"10.36834/cmej.78045","DOIUrl":"https://doi.org/10.36834/cmej.78045","url":null,"abstract":"","PeriodicalId":72503,"journal":{"name":"Canadian medical education journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136142429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eugene K Choo, Rob Woods, Mary Ellen Walker, Jennifer M O'Brien, Teresa M Chan
Background: Competency based residency programs depend on high quality feedback from the assessment of entrustable professional activities (EPA). The Quality of Assessment for Learning (QuAL) score is a tool developed to rate the quality of narrative comments in workplace-based assessments; it has validity evidence for scoring the quality of narrative feedback provided to emergency medicine residents, but it is unknown whether the QuAL score is reliable in the assessment of narrative feedback in other postgraduate programs. Methods: Fifty sets of EPA narratives from a single academic year at our competency based medical education post-graduate anesthesia program were selected by stratified sampling within defined parameters [e.g. resident gender and stage of training, assessor gender, Competency By Design training level, and word count (≥17 or <17 words)]. Two competency committee members and two medical students rated the quality of narrative feedback using a utility score and QuAL score. We used Kendall’s tau-b co-efficient to compare the perceived utility of the written feedback to the quality assessed with the QuAL score. The authors used generalizability and decision studies to estimate the reliability and generalizability coefficients. Results: Both the faculty’s utility scores and QuAL scores (r = 0.646, p < 0.001) and the trainees’ utility scores and QuAL scores (r = 0.667, p < 0.001) were moderately correlated. Results from the generalizability studies showed that utility scores were reliable with two raters for both faculty (Epsilon=0.87, Phi=0.86) and trainees (Epsilon=0.88, Phi=0.88). Conclusions: The QuAL score is correlated with faculty- and trainee-rated utility of anesthesia EPA feedback. Both faculty and trainees can reliability apply the QuAL score to anesthesia EPA narrative feedback. This tool has the potential to be used for faculty development and program evaluation in Competency Based Medical Education. Other programs could consider replicating our study in their specialty.
背景:基于能力的住院医师项目依赖于来自可信赖的专业活动(EPA)评估的高质量反馈。学习评估质量(Quality of Assessment for Learning, QuAL)分数是一种工具,用于评估基于工作场所的评估中叙述性评论的质量;对急诊医学住院医师的叙事反馈质量评分有效度证据,但对其他研究生项目的叙事反馈评价是否可靠尚不清楚。方法:采用分层抽样的方法,从我们基于能力的医学教育麻醉研究生项目的一个学年中选取50组EPA叙述,并按照规定的参数(如住院医师性别和培训阶段、评估者性别、能力设计培训水平和字数(≥17或17个单词))进行抽样。两名能力委员会成员和两名医学生使用效用分数和质量分数来评定叙述反馈的质量。我们使用Kendall的tau-b系数来比较书面反馈的感知效用与用QuAL评分评估的质量。作者利用概括性研究和决策研究来估计可靠性系数和概括性系数。结果:教师的效用得分和QuAL得分(r = 0.646, p <0.001),学员的效用得分和QuAL得分(r = 0.667, p <0.001)中度相关。通用性研究的结果表明,对于教师(Epsilon=0.87, Phi=0.86)和实习生(Epsilon=0.88, Phi=0.88),效用评分是可靠的。结论:QuAL评分与教师和培训生评价的麻醉EPA反馈效用相关。教师和学员均可可靠地将QuAL评分应用于麻醉EPA叙事反馈。这个工具有潜力被用于教师发展和项目评估能力为基础的医学教育。其他项目可以考虑在他们的专业中复制我们的研究。
{"title":"The Quality of Assessment for Learning score for evaluating written feedback in anesthesiology postgraduate medical education: a generalizability and decision study","authors":"Eugene K Choo, Rob Woods, Mary Ellen Walker, Jennifer M O'Brien, Teresa M Chan","doi":"10.36834/cmej.75876","DOIUrl":"https://doi.org/10.36834/cmej.75876","url":null,"abstract":"Background: Competency based residency programs depend on high quality feedback from the assessment of entrustable professional activities (EPA). The Quality of Assessment for Learning (QuAL) score is a tool developed to rate the quality of narrative comments in workplace-based assessments; it has validity evidence for scoring the quality of narrative feedback provided to emergency medicine residents, but it is unknown whether the QuAL score is reliable in the assessment of narrative feedback in other postgraduate programs. Methods: Fifty sets of EPA narratives from a single academic year at our competency based medical education post-graduate anesthesia program were selected by stratified sampling within defined parameters [e.g. resident gender and stage of training, assessor gender, Competency By Design training level, and word count (≥17 or <17 words)]. Two competency committee members and two medical students rated the quality of narrative feedback using a utility score and QuAL score. We used Kendall’s tau-b co-efficient to compare the perceived utility of the written feedback to the quality assessed with the QuAL score. The authors used generalizability and decision studies to estimate the reliability and generalizability coefficients. Results: Both the faculty’s utility scores and QuAL scores (r = 0.646, p < 0.001) and the trainees’ utility scores and QuAL scores (r = 0.667, p < 0.001) were moderately correlated. Results from the generalizability studies showed that utility scores were reliable with two raters for both faculty (Epsilon=0.87, Phi=0.86) and trainees (Epsilon=0.88, Phi=0.88). Conclusions: The QuAL score is correlated with faculty- and trainee-rated utility of anesthesia EPA feedback. Both faculty and trainees can reliability apply the QuAL score to anesthesia EPA narrative feedback. This tool has the potential to be used for faculty development and program evaluation in Competency Based Medical Education. Other programs could consider replicating our study in their specialty.","PeriodicalId":72503,"journal":{"name":"Canadian medical education journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136359357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Arts and Humanities (A/H) training is a powerful strategy to help medical students develop key competencies which align with the CanMEDS roles that Canadian physicians are expected to embody. Students with backgrounds in A/H may enter medical school with the skills and dispositions that A/H training provides. This paper explores the varied experiences of medical students with prior A/H backgrounds, with an emphasis on how they navigate relationships with their student cohorts and participate in undergraduate medical training environments. Methods: Descriptive qualitative research methodology was used to conduct and analyze semi-structured interviews exploring the perspectives of Canadian medical students with either a A/H degree or training in A/H (n = 13). Domains such as identity, integration of interests, and challenges in maintaining A/H interests during medical training were explored. Results: Participants described their A/H identity as intertwined with their identity as medical trainees and described their sense of interconnection between the disciplines. Challenges included imposter syndrome and difficulties in relating with peers from science backgrounds. Participants described returning to their A/H interests as a tool for wellness amidst medical training. Conclusions: Medical students with a background in A/H training describe this background as offering both affordances and challenges for their sense of identity, belonging, and wellness. These students offer an untapped resource: they come with dispositions of value to medicine, and they perceive a positive, hidden A/H curriculum that supports their maintenance of these dispositions during training. Understanding more about these hidden treasures could help foster the development of well-rounded and humanistic physicians in the entire medical class.
{"title":"Exploring the experiences of Canadian medical students with a background in the arts and humanities","authors":"Khadija Ahmed, Arjun Patel, Lorelei Lingard","doi":"10.36834/cmej.77005","DOIUrl":"https://doi.org/10.36834/cmej.77005","url":null,"abstract":"Background: Arts and Humanities (A/H) training is a powerful strategy to help medical students develop key competencies which align with the CanMEDS roles that Canadian physicians are expected to embody. Students with backgrounds in A/H may enter medical school with the skills and dispositions that A/H training provides. This paper explores the varied experiences of medical students with prior A/H backgrounds, with an emphasis on how they navigate relationships with their student cohorts and participate in undergraduate medical training environments. Methods: Descriptive qualitative research methodology was used to conduct and analyze semi-structured interviews exploring the perspectives of Canadian medical students with either a A/H degree or training in A/H (n = 13). Domains such as identity, integration of interests, and challenges in maintaining A/H interests during medical training were explored. Results: Participants described their A/H identity as intertwined with their identity as medical trainees and described their sense of interconnection between the disciplines. Challenges included imposter syndrome and difficulties in relating with peers from science backgrounds. Participants described returning to their A/H interests as a tool for wellness amidst medical training. Conclusions: Medical students with a background in A/H training describe this background as offering both affordances and challenges for their sense of identity, belonging, and wellness. These students offer an untapped resource: they come with dispositions of value to medicine, and they perceive a positive, hidden A/H curriculum that supports their maintenance of these dispositions during training. Understanding more about these hidden treasures could help foster the development of well-rounded and humanistic physicians in the entire medical class.","PeriodicalId":72503,"journal":{"name":"Canadian medical education journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135547590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daiana R Pur, Andrew Samuel, Amirthan Sothivannan, Stuti M Tanya, Anne X Nguyen
Implication Statement We share our experience of organizing a one-day virtual educational event, the first Canadian national student ophthalmology conference, in response to the need for ophthalmology career exploration. The conference included mentorship with residents, research presentations, keynote speakers, and more. Following the event, students expressed some improvement in accessing ophthalmology mentorship and research opportunities, along with a modest enhancement in their understanding of the specialty. We provide insights into the organizational framework and quality improvement results, aiming to assist students in adapting similar events for various specialities.
{"title":"Perspectives on a virtual student-led research conference in ophthalmology","authors":"Daiana R Pur, Andrew Samuel, Amirthan Sothivannan, Stuti M Tanya, Anne X Nguyen","doi":"10.36834/cmej.77019","DOIUrl":"https://doi.org/10.36834/cmej.77019","url":null,"abstract":"Implication Statement We share our experience of organizing a one-day virtual educational event, the first Canadian national student ophthalmology conference, in response to the need for ophthalmology career exploration. The conference included mentorship with residents, research presentations, keynote speakers, and more. Following the event, students expressed some improvement in accessing ophthalmology mentorship and research opportunities, along with a modest enhancement in their understanding of the specialty. We provide insights into the organizational framework and quality improvement results, aiming to assist students in adapting similar events for various specialities.","PeriodicalId":72503,"journal":{"name":"Canadian medical education journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135902443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pulse and passion","authors":"Antonio Yaghy, Maria Yaghy","doi":"10.36834/cmej.78130","DOIUrl":"https://doi.org/10.36834/cmej.78130","url":null,"abstract":"","PeriodicalId":72503,"journal":{"name":"Canadian medical education journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135902450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The cornerstone of medical care","authors":"Antonio Yaghy","doi":"10.36834/cmej.78128","DOIUrl":"https://doi.org/10.36834/cmej.78128","url":null,"abstract":"","PeriodicalId":72503,"journal":{"name":"Canadian medical education journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135902453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brian M Ross, Shreedhar Acharya, Meggan Welch, Katherine Biasiol, Owen Prowse, Elaine Hogard
Background: Students are selected for admission to the Northern Ontario School of Medicine University (NOSM U) MD degree program using criteria aiming to maximize access of persons thought most likely to practice in the region, including use of a geographic context score (GCS) which ranks those with lived experience in northern Ontario and/or rurality most highly. This study investigates the effect of this admissions process upon medical school academic performance. Methods: We used a retrospective cohort design combined with multiple linear regression analysis to investigate the relationship between admission scores and performance on pre-clerkship courses, and the Medical Council of Canada Qualifying Exam Part 1 (MCCQE1). The GCS did not significantly explain performance variance on any pre-clerkship course, nor on the MCCQE1, while the undergraduate Grade Point Average correlated with most assessment scores. The number of prior undergraduate biomedical courses predicted science and clinical skills performance, particularly in Year 1, but not with MCCQE1 scores. Performance on Year 2 courses, particularly foundational sciences and clinical skills, significantly predicted MCCQE1 scores. Results: Our data suggest that admission geographic context scoring is unrelated to future academic performance. Further, students with fewer prior undergraduate biomedical courses may benefit from increased support and/or a modified program during the early years.
{"title":"A geographic-location-based medical school admissions process does not influence pre-clerkship and licensing examination academic performance","authors":"Brian M Ross, Shreedhar Acharya, Meggan Welch, Katherine Biasiol, Owen Prowse, Elaine Hogard","doi":"10.36834/cmej.75532","DOIUrl":"https://doi.org/10.36834/cmej.75532","url":null,"abstract":"Background: Students are selected for admission to the Northern Ontario School of Medicine University (NOSM U) MD degree program using criteria aiming to maximize access of persons thought most likely to practice in the region, including use of a geographic context score (GCS) which ranks those with lived experience in northern Ontario and/or rurality most highly. This study investigates the effect of this admissions process upon medical school academic performance. Methods: We used a retrospective cohort design combined with multiple linear regression analysis to investigate the relationship between admission scores and performance on pre-clerkship courses, and the Medical Council of Canada Qualifying Exam Part 1 (MCCQE1). The GCS did not significantly explain performance variance on any pre-clerkship course, nor on the MCCQE1, while the undergraduate Grade Point Average correlated with most assessment scores. The number of prior undergraduate biomedical courses predicted science and clinical skills performance, particularly in Year 1, but not with MCCQE1 scores. Performance on Year 2 courses, particularly foundational sciences and clinical skills, significantly predicted MCCQE1 scores. Results: Our data suggest that admission geographic context scoring is unrelated to future academic performance. Further, students with fewer prior undergraduate biomedical courses may benefit from increased support and/or a modified program during the early years.","PeriodicalId":72503,"journal":{"name":"Canadian medical education journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135866444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Implication Statement Faculty development programs should provide transformative resources and prioritize the unique needs of faculty. However, if faculty members face difficulty in accessing these programs, the potential impact of the valuable resources may be limited. To alleviate this issue, we designed a faculty development program that is available to anyone at any time and in any configuration. By allowing faculty to choose from a diverse range of medical education topics, they may promptly apply crucial concepts in their teaching and education leadership roles. This program allows faculty members to engage in personalized professional development, enhance their teaching practices, and foster professional growth. Also, program coordinators and administrators can seamlessly integrate our resources into their existing faculty development program. These resources can serve as self-study materials, supplements for existing programs, or a stand-alone curriculum with high accessibility, versatility, and ease of use.
{"title":"A practical model of faculty development in medical education: make it accessible, versatile, and easy to use!","authors":"Henry Moon, Marcel D'Eon","doi":"10.36834/cmej.77076","DOIUrl":"https://doi.org/10.36834/cmej.77076","url":null,"abstract":"Implication Statement Faculty development programs should provide transformative resources and prioritize the unique needs of faculty. However, if faculty members face difficulty in accessing these programs, the potential impact of the valuable resources may be limited. To alleviate this issue, we designed a faculty development program that is available to anyone at any time and in any configuration. By allowing faculty to choose from a diverse range of medical education topics, they may promptly apply crucial concepts in their teaching and education leadership roles. This program allows faculty members to engage in personalized professional development, enhance their teaching practices, and foster professional growth. Also, program coordinators and administrators can seamlessly integrate our resources into their existing faculty development program. These resources can serve as self-study materials, supplements for existing programs, or a stand-alone curriculum with high accessibility, versatility, and ease of use.","PeriodicalId":72503,"journal":{"name":"Canadian medical education journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135866571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Having a rural background is one of the most predictive factors in eventually having a rural practice, but people from rural areas face several barriers to post-secondary education. Pre-professional rural pathway initiatives are a potential solution. The Rural Pre-Medicine Program (RPM) at Selkirk College, British Columbia was developed to provide students with the credits necessary to apply to medicine and other health professional programs, an introduction to rural healthcare issues, and a unique and comprehensive support program to enable success. Methods: We administered a cross-sectional survey to former students who left the program from its inception in September 2014 to May 2020 to explore the extent to which program aims are being met. Results: The response rate was 49.4% (40/81). Respondents agreed the program increased their skills, their understanding of rural healthcare issues, and enhanced their competitiveness for applying to health professional programs. Most agreed the program increased their future rural work intentions. Respondents suggested that academic programming be more flexible to allow for more varied post-program pathways. Conclusion: This survey provides preliminary evidence the RPM Program is on track to increase the number of people with a rural affinity who prepare to become health professionals.
{"title":"Evaluation of a pre-professional pathway program: perspectives of former students in the rural pre-medicine program at Selkirk College","authors":"Sara McEwen, Jonathan Vanderhoek, Takaia Larsen","doi":"10.36834/cmej.76951","DOIUrl":"https://doi.org/10.36834/cmej.76951","url":null,"abstract":"Background: Having a rural background is one of the most predictive factors in eventually having a rural practice, but people from rural areas face several barriers to post-secondary education. Pre-professional rural pathway initiatives are a potential solution. The Rural Pre-Medicine Program (RPM) at Selkirk College, British Columbia was developed to provide students with the credits necessary to apply to medicine and other health professional programs, an introduction to rural healthcare issues, and a unique and comprehensive support program to enable success. Methods: We administered a cross-sectional survey to former students who left the program from its inception in September 2014 to May 2020 to explore the extent to which program aims are being met. Results: The response rate was 49.4% (40/81). Respondents agreed the program increased their skills, their understanding of rural healthcare issues, and enhanced their competitiveness for applying to health professional programs. Most agreed the program increased their future rural work intentions. Respondents suggested that academic programming be more flexible to allow for more varied post-program pathways. Conclusion: This survey provides preliminary evidence the RPM Program is on track to increase the number of people with a rural affinity who prepare to become health professionals.","PeriodicalId":72503,"journal":{"name":"Canadian medical education journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135109281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: While immigrant international medical graduates (I-IMGs) contribute significantly to the physician workforce in North America, researchers have highlighted the myriad of ways sociocultural challenges can negatively impact their success. Conceptual understanding that unpacks the complex processes of how I-IMGs effectively manage sociocultural challenges is relatively sparse. In addressing this critical knowledge gap, this study explored how I-IMGs successfully manage sociocultural differences as postgraduate residents. Methods: We interviewed eleven I-IMGs from diverse backgrounds who are in training or recently trained in a distributed multi-site postgraduate medical training program in Canada. We used the lens of sociocultural learning theory to gain insights into the processes of how I-IMGs describe successful management of sociocultural challenges. Results: The overarching storyline of participants emphasized that their experiences were humbling as they grappled with inner struggles, emotions, and vulnerabilities while embracing the ambiguity of not knowing what was expected of them. The following dominant themes from their narratives encapsulate the salient processes for how I-IMGs conceptualize and successfully manage sociocultural challenges: 1) successfully navigating transitions; 2) resisting or altering elements of prior sociocultural norms while embracing the new; 3) living and being in community and having supportive social networks; 4) risk taking to self-advocate and actively seek help. Conclusion: Understanding the strengths and positive strategies for how I-IMGs interface with complex sociocultural challenges has application for medical training institutions. Our insights suggest the need for practical, effective, and continuous assistance within I-IMG training programs to better support future trainees dealing with sociocultural challenges.
{"title":"Exploring how immigrant international medical graduates successfully manage complex sociocultural challenges","authors":"Azaria Marthyman, Laura Nimmon","doi":"10.36834/cmej.76244","DOIUrl":"https://doi.org/10.36834/cmej.76244","url":null,"abstract":"Background: While immigrant international medical graduates (I-IMGs) contribute significantly to the physician workforce in North America, researchers have highlighted the myriad of ways sociocultural challenges can negatively impact their success. Conceptual understanding that unpacks the complex processes of how I-IMGs effectively manage sociocultural challenges is relatively sparse. In addressing this critical knowledge gap, this study explored how I-IMGs successfully manage sociocultural differences as postgraduate residents. Methods: We interviewed eleven I-IMGs from diverse backgrounds who are in training or recently trained in a distributed multi-site postgraduate medical training program in Canada. We used the lens of sociocultural learning theory to gain insights into the processes of how I-IMGs describe successful management of sociocultural challenges. Results: The overarching storyline of participants emphasized that their experiences were humbling as they grappled with inner struggles, emotions, and vulnerabilities while embracing the ambiguity of not knowing what was expected of them. The following dominant themes from their narratives encapsulate the salient processes for how I-IMGs conceptualize and successfully manage sociocultural challenges: 1) successfully navigating transitions; 2) resisting or altering elements of prior sociocultural norms while embracing the new; 3) living and being in community and having supportive social networks; 4) risk taking to self-advocate and actively seek help. Conclusion: Understanding the strengths and positive strategies for how I-IMGs interface with complex sociocultural challenges has application for medical training institutions. Our insights suggest the need for practical, effective, and continuous assistance within I-IMG training programs to better support future trainees dealing with sociocultural challenges.","PeriodicalId":72503,"journal":{"name":"Canadian medical education journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135109282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}