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Lost in translation: the case for embedding newcomer care in medical education 迷失在翻译中:在医学教育中嵌入新人护理的案例
Pub Date : 2023-10-16 DOI: 10.36834/cmej.78045
Tina Madani Kia
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引用次数: 0
The Quality of Assessment for Learning score for evaluating written feedback in anesthesiology postgraduate medical education: a generalizability and decision study 麻醉学研究生医学教育中书面反馈评价的学习分数质量评估:一项可推广性和决策性研究
Pub Date : 2023-10-10 DOI: 10.36834/cmej.75876
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。
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引用次数: 0
Exploring the experiences of Canadian medical students with a background in the arts and humanities 探索具有艺术和人文背景的加拿大医科学生的经历
Pub Date : 2023-10-05 DOI: 10.36834/cmej.77005
Khadija Ahmed, Arjun Patel, Lorelei Lingard
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.
背景:艺术与人文(A/H)培训是帮助医学生发展关键能力的有力策略,这些能力与加拿大医生期望体现的CanMEDS角色相一致。有医疗卫生背景的学生可以带着医疗卫生培训提供的技能和性格进入医学院。本文探讨了具有先前的A/H背景的医学生的不同经历,重点是他们如何处理与学生群体的关系以及参与本科医学培训环境。方法:采用描述性定性研究方法进行半结构化访谈,探讨具有a /H学位或a /H培训的加拿大医学生的观点(n = 13)。在医学培训中,探讨了身份认同、利益整合和维护A/H利益的挑战等领域。结果:参与者描述了他们的A/H身份与他们作为医学实习生的身份交织在一起,并描述了他们在学科之间的相互联系感。挑战包括冒名顶替综合症和与科学背景的同龄人交往的困难。参与者描述说,在医疗培训期间,回到他们对健康的兴趣是一种健康的工具。结论:接受过a /H培训的医学生认为,这一背景对他们的认同感、归属感和健康感既有利又有挑战。这些学生提供了一种未开发的资源:他们具有对医学有价值的性格,他们认为一个积极的、隐藏的a /H课程支持他们在培训期间保持这些性格。更多地了解这些隐藏的宝藏可以帮助整个医疗阶层培养全面发展和人文主义的医生。
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引用次数: 0
Perspectives on a virtual student-led research conference in ophthalmology 一个虚拟的学生主导的眼科研究会议的观点
Pub Date : 2023-10-02 DOI: 10.36834/cmej.77019
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.
我们分享我们组织一个为期一天的虚拟教育活动的经验,这是加拿大第一届全国学生眼科会议,以响应眼科职业探索的需要。会议包括指导居民、研究报告、主题演讲等。活动结束后,学生们表示在获得眼科指导和研究机会方面有所改善,同时他们对眼科专业的理解也有所提高。我们提供对组织框架和质量改进结果的见解,旨在帮助学生适应不同专业的类似活动。
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引用次数: 1
Pulse and passion 脉搏与激情
Pub Date : 2023-10-02 DOI: 10.36834/cmej.78130
Antonio Yaghy, Maria Yaghy
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引用次数: 1
The cornerstone of medical care 医疗保健的基石
Pub Date : 2023-10-02 DOI: 10.36834/cmej.78128
Antonio Yaghy
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引用次数: 0
A geographic-location-based medical school admissions process does not influence pre-clerkship and licensing examination academic performance 以地理位置为基础的医学院招生过程不影响实习前和执照考试的学习成绩
Pub Date : 2023-09-25 DOI: 10.36834/cmej.75532
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.
背景:选择学生进入北安大略医学院(NOSM U)医学博士学位课程,使用旨在最大限度地获得最有可能在该地区执业的人的标准,包括使用地理背景分数(GCS),该分数对那些在安大略省北部和/或农村生活过的人进行排名。本研究探讨此录取程序对医学院学业表现的影响。方法:采用回顾性队列设计,结合多元线性回归分析,探讨实习前课程和加拿大医学委员会资格考试第1部分(MCCQE1)录取分数与成绩的关系。GCS并没有显著地解释任何职前课程的表现差异,也没有解释MCCQE1,而本科的平均成绩与大多数评估分数相关。先前的本科生物医学课程的数量预测科学和临床技能的表现,特别是在一年级,但与MCCQE1分数无关。二年级课程的表现,特别是基础科学和临床技能,显著预测了MCCQE1的分数。结果:我们的数据表明,录取地理环境评分与未来的学习成绩无关。此外,先前较少的本科生物医学课程的学生可能会从早期增加的支持和/或修改的计划中受益。
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引用次数: 0
A practical model of faculty development in medical education: make it accessible, versatile, and easy to use! 医学教育师资发展的实用模式:使其易于获取、用途广泛且易于使用!
Pub Date : 2023-09-25 DOI: 10.36834/cmej.77076
Henry Moon, Marcel D'Eon
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.
教师发展计划应该提供变革性的资源,并优先考虑教师的独特需求。然而,如果教师在使用这些课程时遇到困难,这些宝贵资源的潜在影响可能会受到限制。为了缓解这个问题,我们设计了一个教师发展计划,任何人都可以在任何时间和任何配置中使用。通过允许教师从各种各样的医学教育主题中进行选择,他们可以在教学和教育领导角色中迅速应用关键概念。该计划允许教师从事个性化的专业发展,提高他们的教学实践,促进专业成长。此外,项目协调员和管理员可以无缝地将我们的资源整合到他们现有的教师发展计划中。这些资源可以作为自学材料,现有课程的补充,或具有高可访问性,多功能性和易用性的独立课程。
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引用次数: 0
Evaluation of a pre-professional pathway program: perspectives of former students in the rural pre-medicine program at Selkirk College 专业预科课程的评估:来自塞尔柯克学院农村预科课程学生的观点
Pub Date : 2023-09-19 DOI: 10.36834/cmej.76951
Sara McEwen, Jonathan Vanderhoek, Takaia Larsen
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.
背景:拥有农村背景是最终拥有农村实践的最具预测性因素之一,但来自农村地区的人在接受高等教育方面面临几个障碍。职业前农村路径倡议是一个潜在的解决方案。不列颠哥伦比亚省塞尔柯克学院的农村医学预科课程(RPM)旨在为学生提供申请医学和其他卫生专业课程所需的学分,介绍农村卫生保健问题,以及一个独特而全面的支持计划,以确保成功。方法:我们对2014年9月至2020年5月期间离开该项目的前学生进行了横断面调查,以探索项目目标实现的程度。结果:有效率为49.4%(40/81)。受访者同意该计划提高了他们的技能,他们对农村卫生保健问题的理解,并增强了他们申请卫生专业项目的竞争力。大多数人认为,该计划增加了他们未来在农村工作的意愿。受访者建议,学术规划应更加灵活,以允许更多不同的课程后途径。结论:这项调查提供了初步证据,证明RPM计划正在增加有农村亲和力的人准备成为卫生专业人员的人数。
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引用次数: 1
Exploring how immigrant international medical graduates successfully manage complex sociocultural challenges 探索移民国际医学毕业生如何成功应对复杂的社会文化挑战
Pub Date : 2023-09-19 DOI: 10.36834/cmej.76244
Azaria Marthyman, Laura Nimmon
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.
背景:虽然移民国际医学毕业生(I-IMGs)对北美的医生队伍做出了重大贡献,但研究人员强调了社会文化挑战对他们成功的负面影响。关于i - img如何有效管理社会文化挑战的复杂过程的概念性理解相对较少。为了解决这一关键的知识差距,本研究探讨了i - img作为研究生住院医师如何成功管理社会文化差异。方法:我们采访了11名来自不同背景的i- img,他们正在或最近在加拿大的一个分布式多地点研究生医学培训项目中接受培训。我们使用社会文化学习理论的镜头来深入了解i - img如何描述成功管理社会文化挑战的过程。结果:参与者的总体故事情节强调,他们的经历是谦卑的,因为他们与内心的斗争、情绪和脆弱性作斗争,同时接受不知道对他们的期望的模糊性。从他们的叙述中,以下主要主题概括了i - img如何概念化并成功管理社会文化挑战的突出过程:1)成功地引导过渡;2)抵制或改变先前社会文化规范的元素,同时接受新的;3)生活在社区中,拥有支持性的社交网络;4)勇于自我倡导,积极寻求帮助。结论:了解I-IMGs如何应对复杂的社会文化挑战的优势和积极策略对医疗培训机构具有应用价值。我们的见解表明,需要在I-IMG培训项目中提供实际、有效和持续的帮助,以更好地支持未来的学员应对社会文化挑战。
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引用次数: 0
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Canadian medical education journal
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