Canadian medical education journal最新文献

Spirituality involves one's sense of purpose, connection with others, and ability to find meaning in life. We implemented a three-year pilot of a spiritual history taking (SHT) clinical skills session. In small groups, medical students discussed and practiced SHT with clinical scenarios and the FICA framework and received preceptor and peer feedback. Post-session focus groups and interviews demonstrated student perceptions of improved comfort, knowledge, and awareness of discussing spirituality with patients. This innovation may support improved clinical skills teaching across other health professions institutions to better prepare students to recognize patients' spiritual needs and provide more holistic, culturally competent care.

Faculty development in medical education is often delivered in an ad hoc manner instead of being a deliberately sequenced program matched to data-informed individual needs. In this article, the authors, all with extensive experience in Faculty Development (FD), present a competency-based faculty development (CBFD) framework envisioned to enhance the impact of FD. Steps and principles in the CBFD framework reflect the lessons learned from competency-based medical education (CBME) with its foundational goal to better train physicians to meet societal needs. The authors see CBFD as a similar framework, this one to better train faculty to meet educational needs. CBFD core elements include articulated competencies for the varied educational roles faculty fulfill, deliberately designed curricula structured to build those competencies, and an assessment program and process to support individualized faculty learning and professional growth. The framework incorporates ideas about where and how CBFD should be delivered, the use of coaching to promote reflection and identity formation and the creation of communities of learning. As with CBME, the CBFD framework has included the important considerations of change management, including broad stakeholder engagement, continuous quality improvement and scholarship. The authors have provided examples from the literature as well as challenges and considerations for each step.

We developed a pharmacist-led one-month teaching rotation for medical residents to learn HIV pharmacotherapy. The postgraduate-year-3 residents found this interprofessional learning experience extremely valuable to their future practice in HIV care. The overarching concept of this rotation was for the medical trainee to "become-the-pharmacist," learning to recognize, prevent, and manage drug-related issues in HIV patients. To support medical training in other highly specialized pharmacotherapeutic areas we suggest considering a pharmacist-led interprofessional learning experience.

Introduction: The purpose of this study was to identify whether the incorporation of a combined Patient as teacher (PAT) and arts-based reflection (ABR) program during a surgical clerkship rotation could influence more humanistic perceptions of surgeons, using an innovative evaluation approach.

Methods: A novel, single question evaluation tool was created. Third year medical-students were asked to "list the top 5 attributes of a surgeon, in order of perceived importance" both before and after their surgical clerkship rotations and participation in the PAT/ABR program. Attributes identified by students were coded as either "humanistic" or "non-humanistic," which were then analyzed using generalized linear regression models under a Bayesian framework.

Results: After participation in the PAT/ABR program, the predicted probability of students ranking a humanistic characteristic as the most important attribute of a surgeon had increased by 17%, and the predicted probability of students ranking a humanistic characteristic amongst their top three attributes for a surgeon had increased by 21%.

Conclusion: This innovative evaluative method suggested the success of a combined PAT/ABR program in encouraging a humanistic perspective of surgery and this approach could potentially be explored to evaluate other humanistic education initiatives.

Introduction: Previous articles have highlighted the laborious process of acquiring disability accommodations in medical education. We endeavoured to characterize the trends of test accommodations on the MCCQE Part I.

Methods: Data was obtained from the Medical Council of Canada on the number of applicants who attained test accommodations on the MCCQE Part I between 2013 and 2021. The number of test takers for the same period was obtained from the Medical Council of Canada's Annual Technical Reports; this data was not publicly available for 2013, 2014, or 2021. Prevalence rates and graphs were produced.

Results: The number of test takers who attained test accommodations ranged from 35 to 126 between 2013 and 2021. The percentage of test takers who attained test accommodations ranged from 0.89% to 2.01% between 2015 and 2020. Per correspondence with the Medical Council of Canada, no applicant who provided all required documentation was denied test accommodations during this period.

Discussion: The number and rate of test takers attaining test accommodations on the MCCQE Part I have increased substantially during this period. It is unclear whether this increase is due to greater rates of students with disabilities, or a reduction in stigma around using test accommodations.

Background: Internal Medicine (IM) residents are required to perform bedside procedures for diagnostic and therapeutic purposes. Residents' experiences with procedures vary widely, for unclear reasons.

Objective: To explore IM residents' experiences with performing bedside procedures and to identify barriers and facilitators to obtaining sufficient experience.

Methods: Using an inductive, thematic approach, we conducted five individual semi-structured interviews and one focus group with seven IM residents (12 residents in total) during the 2017-2018 academic year at a Canadian tertiary care centre. We used iterative, open-ended questions to elicit residents' experiences, and barriers and facilitators, to performing bedside procedures. Transcripts were analyzed for themes using Braun and Clarke's method.

Results: We identified four themes 1) Patient-specific factors such as body habitus and procedure urgency; 2) Systems factors such as time constraints and accessibility of materials; 3) Faculty factors including availability to supervise, comfort level, and referral preferences, and 4) Resident-specific factors including preparation, prior experiences, and confidence. Some residents expressed procedure-related anxiety and avoidance.

Conclusion: Educational interventions aimed to improve procedural efficiency and ensure availability of supervisors may help facilitate residents to perform procedures, yet may not address procedure-related anxiety. Further study is required to understand better how procedure-averse residents can gain confidence to seek out procedures.

One element to address health disparities and historical injustices of systemically excluded groups is to examine selection processes. Implicit association testing for selection committees is suggested as one intervention to address bias in selection and is used for Undergraduate Medical Education at the University of Manitoba. Our study demonstrated that implicit bias training for PDs in isolation has minimal impact on addressing bias within resident selection. This training must occur as part of a systemic institutional approach to address bias in resident selection. Programs should consider a multipronged and sustained approach when committing to diversifying postgraduate medical education programs.

Introduction: Up to 98% of practicing family physicians, and over 75% of resident physicians in Canada experience abusive incidents. Despite the negative consequences of abusive incidents, few residents report these events to their supervisors or institution. We sought to estimate the prevalence of abusive incidents experienced or witnessed by Saskatchewan family medicine residents (FMRs) and identify their responses to these events.

Methods: Anonymous survey invitations were emailed to all 110 Saskatchewan FMRs in Saskatchewan in November and December 2020. Demographic characteristics, frequency of witnessed and experienced abusive incidents, sources of incidents and residents' responses were collected. Incidents were classified as minor, major, severe, or as racial discrimination based on a previously published classification system.

Results: The response rate was 34.5% (38/110). Ninety-two percent (35/38) of residents witnessed a minor incident and 91.7% (32/36) of residents experienced a minor incident. Seventy-one percent (27/38) of residents witnessed racial discrimination while 19.4% (7/36) of residents experienced racial discrimination. Patients were the most common source of abusive incidents. Twenty-nine percent of residents reported abusive incidents to their supervisors. Most residents were aware of institutional reporting policies.

Conclusions: Most Saskatchewan FMRs experienced or witnessed abusive incidents, but few were reported. This study provided the opportunity to reassess policies on abusive incidents, which should consider sources of abuse, confidence in reporting, and education.