Canadian medical education journal最新文献

Background: Many residents report a second victim response following near-miss events during their pediatric anesthesia rotation with consequences for their mental and physical wellbeing. This study investigated the impact of a Better Resident Wellness (BREW) initiative at our tertiary pediatric centre.

Methods: We invited anesthesia residents to complete a survey at the start of their pediatric rotation. Questions included the Second Victim Experience and Support Tool (SVEST). During their rotation, residents attended weekly BREW rounds, a one-hour peer discussion facilitated by a psychologist. They provided feedback in a follow-up survey, including repeat SVEST.

Results: 33/48 (69%) invited residents completed pre- and post-surveys Oct/2021-Feb/2023: all had attended one or more BREW rounds; 32/33 (97%) considered BREW helpful, safe, and would recommend to future residents; perceived benefits included improved morale (30/33, 91%) and clinical care (23/33, 70%). SVEST indicated a second victim response for 17/32 (53%) at the start and 7/32 (22%) at the end of their rotation (odds ratio 0.25, 95% CI 0.07 to 0.82, p = 0.019), with reduced professional self-efficacy concerns (median difference -0.25, 95%CI -0.50 to 0, p = 0.029).

Conclusion: BREW offers anesthesia residents a desirable and beneficial support resource. Other residency programs should consider integrating facilitated peer discussion into their curriculum.

Problem-based learning (PBL) has become widely adopted in medical education, but its implementation presents challenges, particularly regarding decreased anatomy hours and knowledge acquisition compared to traditional methods. The Faculty of Medicine and Health Sciences Anatomy Club's near-peer teaching model demonstrates an effective, scalable solution to bridging anatomical knowledge gaps inherent in PBL curricula. By pairing virtual workshops with clinical cases and interactive quizzes, the club enhances medical students' understanding and retention of anatomy while reducing stress. Survey results suggest significant gains in knowledge and engagement, making this approach beneficial for self-directed, PBL-based settings. Institutions aiming to supplement anatomy education in PBL environments may find this model both feasible and valuable.

Objective: Physicians report high rates of delayed childbearing and are at increased risk of infertility and pregnancy loss. There are limited studies on this topic in the Canadian context, particularly for trainees. Our objective was to explore Ontario medical trainees' experiences with and knowledge of delayed childbearing, infertility, and fertility treatments.

Methods: We administered a cross-sectional survey to all residents and fellows in Ontario. Descriptive statistics, multiple regression, and thematic analysis of free text responses are used to present the findings.

Results: 460 trainees responded to the survey. Over half (57%) intentionally delayed childbearing due to medical training, with long working hours being the most cited reason (82%). Cis women were 85% more likely to delay family initiation than cis men. Rates of early pregnancy loss (17%) were similar to that of the Canadian average for this age group, while rates of infertility (14%) were slightly higher. Knowledge gaps were identified, with trainees scoring 62% on knowledge questions around age-related fertility decline and fertility treatment. The majority (73%) felt their programs were supportive of family initiation during training, with top areas for change identified as increased flexibility with working hours, and increased protected time for required extracurricular activities.

Conclusion: Trainee physicians in Ontario report high rates of delaying family initiation due to training, with greater impacts on cis women compared to cis men, and slightly higher rates of infertility. Addressing knowledge gaps is one way to empower trainees to make informed family planning decisions going forward.

Background/purpose: Medical trainee harassment is a global issue that has led to a multitude of detrimental effects. An important area of consideration is whether harassment policies are clear and available to all medical trainees globally. We aimed to develop a standardized rubric for evaluating anti-harassment policies and assess policies across Canadian medical schools and top international universities to identify strengths and areas for improvement.

Methods: We constructed a rubric by synthesizing criteria from established frameworks on harassment policy effectiveness, adapting key elements to assess clarity, accessibility, and comprehensiveness in medical school policies. On March 2023, we evaluated 58 harassment policies from 16 Canadian medical schools and 31 policies from eight of the top 10 Quacquarelli Symonds (QS)-ranked universities. Our rubric, developed from four key frameworks, scored policies across three themes: (1) Policy Foundation, (2) Complaint Procedures, and (3) Resolution and Implementation.

Results: Canadian universities performed well in foundational policy areas (average score 83.00% on Theme 1) but showed meaningful gaps in Complaint Procedures (48.75%) and Resolution and Implementation (39.38%). Top international QS-ranked universities similarly scored low in these latter themes, though they performed better on formal complaint processes. Key areas needing improvement include informal complaint procedures and timelines for response in Canadian universities, and policy revision commitments in top QS-ranked universities.

Conclusions: This study highlights the need for enhanced anti-harassment policies, particularly in complaint and resolution procedures. Our rubric provides a structured approach for policy evaluation, enabling Canadian and potentially international institutions to improve policy clarity, accessibility, and comprehensiveness, fostering safer training environments.

Instruction to the Double is a method used in work psychology. Its key interest is that it bridges the gap between real and prescribed work. From a theoretical standpoint, Instruction to the Double is embedded in Vygotskian socio-constructivism. It aims at developing the learners' power to act. In practice, learners select a practical situation from their work experience and participate in an interview where the learner presents step-by-step instructions to a facilitator as to how intervene in that situation. The facilitator must focus on the how, rather than the why. Learners subsequently access the recorded interview and transcript. The method's potential for development resides in surprising learners with the discrepancy between what they think they do, and what they say they do. Such discrepancy facilitates learner's development of their power to act. Instruction to the Double can be a promising learning method in medical education, especially for post-graduate and continuing professional development learners.

Background: Medical students in Canada report significantly higher rates of suicidal ideation, psychological stress, as well as mood and anxiety disorders, compared to age matched general population. We are still early in the process of having a comprehensive approach to learner wellbeing that centers around health promoting learning environments (HPLE) - focusing on more systemic actions as guided by the international Okanagan Charter. To move forward, we need to further understand what learners, faculty and staff view as critical components in an HPLE and explore how we can best advance efforts to create and embed HPLEs in medical education. The objectives of this study were to elucidate how medical students define an HPLE and what medical students perceive as the main barriers and facilitating factors to developing and fostering HPLEs.

Methods: We undertook an exploratory qualitative study using virtual semi-structured interviews of how medical students define an HPLE and the facilitators and barriers of this. We used thematic analysis to review all transcripts with ongoing iterative analysis. Final themes were agreed on consensus.

Results: We interviewed 14 medical students from all years at the University of Alberta. We identified four overarching themes which serve as important components of an HPLE including that HPLEs have foundational characteristics of respect, transparency, and open communication. Developing HPLEs require multi-pronged approaches that starts with ensuring basic needs are met and empowering learners to make health promoting choices. Learners identified that a culture of wellbeing is driven by wellbeing centered leadership. A safe space to take an active role in influencing their environment help learners thrive.

Conclusions: Our study focused on elucidating medical student perspectives on factors that contribute to and foster a health promoting learning environment. Our findings can inform on systemic efforts to embed wellbeing into medical education in Canada.

Background: Diversity of professionals within the healthcare system enhances patient outcomes. Existing literature indicates that Mini Medical School (MMS) Programs can increase medical school diversity by engaging youth from underrepresented backgrounds (URiM+); however, there is limited understanding of the mechanisms by which this happens. Further research could refine these programs and improve their effectiveness. Grounded in social cognitive career theory, this study evaluates the impact of a single-day MMS on URiM+ students' knowledge and confidence in pursuing medicine.

Methods: Female and gender-diverse youth were invited to urban or rural single-day MMS events organized by medical students. These MMS programs included clinical skills activities and a lecture about becoming a physician. Participants completed a pre- and post-event survey and quiz assessing their interest, knowledge, and confidence in pursuing a medical career.

Results: Participants at both MMS events reported increased confidence about pursuing a career in medicine. Both subjective and objective measures of knowledge about a career in medicine increased. Interest in pursuing a career in medicine, however, did not increase significantly in either group. A significant positive correlation was found between participants' self-confidence in becoming a physician and their perceived knowledge of how to become a physician.

Conclusions: We found that these single-day MMS programs increased participants' knowledge about the steps to pursuing a career in medicine, and their confidence in their ability to do so, but did not significantly increase their interest. When considering the impacts of MMS programs from a social cognitive career theory lens, program organizers should consider ensuring that their MMS curriculum includes practical tools for success, as this will contribute to supporting URiM+ students in viewing themselves as future physicians and contributing to the aim of diversifying the medical profession.