Canadian medical education journal最新文献

Background: Equity-deserving groups are communities marginalized from institutional power by oppressive forces (e.g., racism, sexism, homophobia, ableism). Dear MD to Be is a medical-student-led podcast created to interview physicians of intersectional backgrounds about their institutional experience. This study aims to evaluate the podcast as a tool for knowledge, mentorship, and psychological safety for equity-deserving listeners.

Methods: Between February and March 2022, we recruited medical students across all levels of training from English-speaking Canadian medical schools using email listservs and social media. We disseminated a cross-sectional questionnaire assessing demographics, knowledge gained from podcast engagement, attitudes towards podcasts as a tool for mentorship, and psychological/emotional gains from the podcast content. We conducted descriptive and frequency analyses of quantitative data and applied thematic analysis to qualitative data.

Results: Thirty-eight individuals completed the entire survey from all levels of training, with 97% self-identifying with at least one equity-deserving group. 100% agreed that the Dear MD to Be podcast was an accessible form of mentorship; participants appreciated self-pacing mentorship and interacting with many narratives. Listeners gleaned lessons about wellness, advocacy work, allyship, cultural imposter syndrome, and navigating discrimination. Furthermore, most listeners felt represented, empowered, and legitimized by podcast content.

Conclusions: Podcasts can serve as a medium for accessible equity-centred mentorship. By disseminating multiple underrepresented narratives in medicine, the Dear MD to Be podcast serves as a source of EDI knowledge while contributing to learner safety.

Implication Statement The Psychiatry Information Card (PIC) offers a practical, structured concise resource to enhance medical students' confidence, knowledge, and self-reflection during psychiatry rotations. Its utility lies in providing targeted support for students navigating the transition from classroom learning to clinical practice, and addressing specific challenges encountered during this critical phase of medical education. By offering accessible and relevant information aligned with rotation objectives, the PIC increased knowledge pre and post rotation, and enhanced the learning experience. The PIC's acceptability is demonstrated by the high recommendation rate (90%) among participants, who endorsed its integration into the rotations. Additionally, the low cost and ease of distribution make the PIC a cost-effective resource, further supporting its feasibility for widespread implementation. Therefore, we recommend formal integration into the curriculum.

Background: The purpose of this study was to investigate the effect of word choice on the quality of narrative feedback in ophthalmology resident trainee assessments following the introduction of competency-based medical education at Queen's University.

Methods: Assessment data from July 2017-December 2020 were retrieved from Elentra^TM (Integrated Teaching and Learning Platform) and anonymized. Written feedback was assigned a Quality of Assessment for Learning (QuAL) score out of five based on this previously validated rubric. The correlation between QuAL score and specific coaching words was determined using a Spearman's Rho analysis. Independent samples t-tests were used to compare the QuAL score when a specific word was used, and when it was absent.

Results: A total of 1997 individual assessments were used in this analysis. The number of times the identified coaching words were used within a comment was significantly and positively associated with the total QuAL score, with the exception of "next time" (rho=0.039, p=0.082), "read" (rho = 0.036, p = 0.112), "read more" (rho = -0.025, p = 0.256) and "review" (rho = -0.017, p = 0.440). The strongest correlations were for "continue" (rho = 0.182, p < 0.001), "try(ing)" (rho = 0.113, p < 0.001) and "next step" (rho = 0.103, p < 0.001). The mean value of the QuAL score increased when coaching words were used vs. not used with the largest mean difference of 1.44 (p < 0.001) for "reflect". A clear positive relationship was demonstrated between word count and QuAL score (rho = .556, p < 0.001).

Conclusions: The use of certain coaching words in written comments may improve the quality of feedback.

Background and objective: Virtual patient simulations are cost-effective methods for training health professionals. Yet, this teaching method is rarely used with clinicians who work or plan on working with people with substance use disorders. This scoping review summarizes the current state of the literature concerning virtual substance use disorder patient simulations in health professionals' training and provides suggestions for future directions.

Methods: Online databases were searched for peer-reviewed articles published between January 2010 and June 2024.

Results: Twelve studies were included. The development, administration, and evaluation of performance of the simulations are diverse. Most simulations aim to develop screening, brief interventions or referring skill, they target a variety of health professionals' disciplines and report positive learning outcomes. Virtual simulations have good acceptance rates from learners.

Conclusions: Enhancing the diversity of clinical skills and patient populations portrayed in simulations, alongside adherence to best practices in simulation development and implementation is suggested to optimize training outcomes in this critical area of healthcare education.

Background: Though there are more family physicians in Canada than ever before, and residency programs are expanding, gaps in access to comprehensive care remain. This study aimed to describe and understand the role residency training experiences played in shaping practice choices, including the provision of comprehensive community-based care, among early career family physicians.

Methods: A secondary analysis of sixty-three (63) qualitative interviews was conducted on data from a larger mixed method study on practice patterns and choices of early career Canadian family physicians. We utilized Braun and Clarke's six phases of reflexive thematic analysis on portions of transcripts concerning residency training experiences.

Results: Participants described positive residency training experiences that shaped practice choice with respect to preceptors and mentorship, experiences of longitudinal care, breadth of exposure, and preparedness for comprehensive clinical practice. Woven through these four domains were "points of tension" and "hidden truths". Points of tension included: i) the promotion of an idealized professional identity and practice that was difficult to uphold, ii) lack of representation among faculty/preceptors with respect to age and gender, at some sites, and iii) frustration about the lack of opportunities for interprofessional collaborative practices that reflected training experiences. Hidden truths included: i) lack of preparation to run a business, ii) high administrative workload, iii) realities of payment models, and iv) the range of roles available for family physicians beyond the provision of comprehensive care.

Conclusions: Findings highlight opportunities for educational reform supporting the transition from residency to practice alongside the importance of addressing systemic factors beyond training which impact physicians' choices regarding comprehensive care.

Background: Extended reality technology (XR) in simulation-based medical education is becoming more prevalent. This study examined Canadian simulation centre directors' perceptions toward XR and their self-reported adoption of XR within their centres.

Methods: We conducted a national, cross-sectional survey study to examine five kinds of XR: Immersive Virtual Environments, Screen-based Virtual Worlds, Virtual Simulators, Immersive Augmented Reality, and Non-immersive Augmented Reality. An electronic survey with multiple-choice, Likert scales, and open-ended questions were developed to identify the current use, degree of satisfaction, and experienced and foreseen challenges with each XR technology. We used the Checklist for Reporting Results of Internet E-Surveys checklist to describe and justify our survey development. All twenty-three Royal College-accredited Canadian simulation centres were invited based on their Royal College membership to complete the survey. Directors and representatives of seventeen (74%) centres participated.

Results: Each XR has been used for research or simulation education by about half of the simulation centres, at minimum. The degree of satisfaction among directors with XR ranged from 30% to 45%. Directors frequently cited logistical and fidelity challenges, along with concerns over maintenance. Cost and lack of evidence, and unclear needs were cited as foreseen challenges with the future implementation of XRs.

Conclusions: This survey summarizes the status of XR in Canadian simulation centres. The pattern of use, satisfaction levels, and challenges reported by simulation centre directors varied depending on the types of XR.

Competency Based Medical Education (CBME) is pushing the medical profession to be more accountable in our standards of assessment. This has led us to focus our efforts at the top of Miller's pyramid, where we aim to see what the trainee 'does' in the clinical environment. In Canadian Royal College specialty training, this has come in the form of workplace-based supervision of trainees performing Entrustable Professional Activities (EPAs). This is unfamiliar territory for many residents and faculty, and implementation of an additional assessment process into already busy clinical practice has been particularly challenging. Because EPA assessments serve as significant contributors in new programs of assessment, failure to collect high quality EPA assessments threaten the validity of this new system. Understanding the barriers to and enablers of EPA acquisition can inform faculty development initiatives to ensure success. Based on our previous work studying early experiences of EPA assessment acquisition in Emergency Medicine, we have identified eight key concepts to guide faculty development initiatives, namely: the rationale for CBME, the 'behind the scenes' of CBME, how to construct rich narrative comments, effective use of supervision scales, the tension of EPA assessments being both formative and summative, the importance of a shared responsibility between residents and faculty for EPA assessment completion, familiarity with the suite of EPAs, and tips and tricks for incorporating EPA assessment completion into busy clinical practice. These key concepts can be integrated into an overall faculty development strategy for building this now essential skill set.