Canadian medical education journal最新文献

Background: Declining numbers of family physicians (FPs) provide obstetrical care-an essential service. Exploring reasons why current family medicine obstetrics (FM-OB) clinician teachers chose this field and what motivates them to continue may inform retention strategies and inspire future family medicine learners. Our objective was to explore perspectives of academic FPs who practice FM-OB with the goal of increasing recruitment of future FM-OB practitioners and retention of those currently practicing FM-OB.

Methods: Academic FP clinician teachers from three urban multidisciplinary Canadian centers who currently practice FM-OB and deliver at one hospital participated in 60-minute, semi-structured interviews. Questions explored participant experiences providing FM-OB care. Interviews were audio-recorded, transcribed and analyzed using a constant comparison method of descriptive thematic analysis.

Results: There were 10 participants. The data revealed an overarching theme highlighting three key influences on the decision to start and continue practicing FM-OB: 1) Individual; 2) Interpersonal, and 3) Systemic influences. Early experiences with positive feedback, hands-on skills, and positive role models shaped their decisions to start. The joy derived from this work, mentorship, patient relationships, and a supportive environment fueled their commitment to continue practicing.

Conclusion: This study highlights the importance of early learning experiences, effective role models, and supportive systemic factors in encouraging trainees to practice FM-OB and retaining FPs in this field. By also identifying the sources of joy in FM-OB and promoting work-life balance, these findings can help inform programs to retain FM-OB providers and inspire future family medicine learners.

Background: With the onset of the COVID-19 pandemic, a reliance upon telehealth patient visits emerged. Many medical schools use early clinical experiences in the pre-clerkship years to provide opportunities to practice evolving clinical skills and broaden classroom learning. However, little is known about the value of telehealth visits during the pre-clerkship years. Therefore, the purpose of the current study was to determine what student learning experiences were with telehealth patient encounters during early clinical experiences.

Methods: In this qualitative study, we used a descriptive phenomenological approach. We interviewed medical students using Zoom to gather their lived experiences. We grouped key findings into themes.

Results: Seventeen medical students participated in the study. Key challenges included the loss of body language and visual cues leading to challenges with rapport building, the inability to perform physical examinations, and less involvement and independent practice of skills. However, positive aspects include good opportunities for history taking and benefits to note-taking. Mentorship with preceptors remained either positive or similar to in-person experiences.

Conclusion: Since telehealth remains an important part of healthcare, it is crucial to train learners in telehealth clinical environments alongside standard in-person environments. However, while both challenges and benefits exist with telehealth clinical visits for junior learners, active learning processes, the use of video augmentation and robust faculty development strategies remain important to increase the educational value of these visits.

Efforts to increase patient safety have increased over the past 20 years. Education in patient safety has historically targeted residents, senior physicians, and healthcare professionals. Recently, patient safety has been identified as a top priority that should be instilled in the earliest stages of medical education, targeted at medical students. This Black Ice paper is intended to help readers to get a grip on how to manage barriers associated with reporting of medical errors, analysis of patient safety incidents, and integration of patient safety education curricula into existing courses and rotations.

Background: We aimed to describe the immediate and medium-term effects of training in the role of change agent (CA) on: 1) the perceived competence to act as a CA; 2) the acquisition of skills required for the role; and 3) the anticipated and actual implementation of CA actions in real-world settings by professionals.

Methods: Using a summative evaluation design and a self-administered online questionnaire, we collected data at three time points: before the training, immediately after, and six months later. We analyzed the data using descriptive and inferential statistics.

Results: The 39 participants, aged 25 to 44, were mostly women. For both perceived competence to act as a CA and the acquisition of the required skills, the proportion of professionals responding positively increased significantly immediately after the training and decreased six months later. Although professionals intended to act as CAs right after the training, their actions had not materialized within the following six months.

Conclusion: Support measures may help sustain the effects of the training in the medium term and encourage real-world implementation of change agent actions.

Introduction: Self-explanation (SE), an individual learning strategy for the development of clinical reasoning skills, has been implemented in undergraduate medical curricula. A tool for documenting students' appropriate use of SE is needed to ensure benefit on learning. The objective of this project was to develop such a tool and report on evidence of its validity.

Methods: We used DeVellis's eight steps to develop the tool. Assessors applied the tool to 85 audio-recorded SEs. We calculated students' mean number of inferences (biomedical, clinical, monitoring) and case elements used when self-explaining to document validity evidence of content. We used interrater agreement, with intraclass correlation coefficients, to document validity evidence of response processes.

Results: Three assessors documented the students' use of SE with the tool. They found means of 13.33 to 17.76 biomedical inferences, 16.27 to 27.04 clinical inferences, 2.03 to 3.10 monitoring statements, and listed 21.77 to 26.87 case elements. Interrater reliability varied from 0.53 to 0.96.

Discussion: We developed the tool using the principles underlying SE. The way students used SE aligned with our expectations. Assessors used the tool in a consistent way. The tool could document students' use of SE in experimental or educational contexts.