Canadian medical education journal最新文献

Trigger warnings are statements provided prior to the delivery of sensitive content that aim to prepare recipients for ensuing distress. In recent years, there have been calls to incorporate trigger warnings into medical education due to the recognition that encountering sensitive content in educational settings can add to the stress experienced by medical students. The evidence for and against their use is inconsistent, and currently there is little consensus on how to, or if we should, introduce trigger warnings into educational settings. In this paper, we present seven ways to get a grip on requests for trigger warnings in medical education: consult your institution; adopt a balanced and evidence-informed approach; encourage self-awareness and help seeking; communicate realistic expectations regarding clinical practice; approach sensitive content as an educational opportunity; foster inclusivity in discussions involving sensitive content; and encourage feedback.

Patients with intellectual and developmental disabilities (IDD) do not receive quality medical care, resulting in health disparities. A key contributing factor to poor care delivery is the lack of standardized IDD curriculum in Canadian medical education. Many physicians and nurses report they do not feel confident in providing care for patients with IDD. It is imperative to design curriculum for medical and nursing students to build confidence and competency. At the University of Toronto, we delivered a 4-hour workshop that provides a framework for delivering IDD education that should be replicated at institutions Canada-wide to address this critical gap in training.

Ultrasonography has become a valuable procedural guide and diagnostic tool across many medical specialties. A 2017 descriptive cross-sectional survey at Memorial University of Newfoundland found that there was support to integrate preclinical and clinical applications of point of care ultrasound (POCUS) into the undergraduate medical anatomy curriculum. Unlike previous studies that have focused on scanning a single body system, our group utilized a station-based model that allowed medical students to scan several different body systems throughout the year. Our experience in creating the syllabus, collecting feedback, and creating multiple choice assessment questions will be useful to other educators who may wish to integrate POCUS into their curriculum.

Introduction: Objective Structured Clinical Examinations (OSCEs) are crucial in assessing clinical competencies, but their implementation varies widely across medical schools. This work examines OSCE practices across Canadian medical schools, focusing on frequency, type, and timing.

Methods: A survey was conducted among all 17 Canadian medical schools through the AFMC Clinical Skills Working Group. Data were collected during the 2023-2024 academic year. Details on OSCEs implementation during pre-clerkship and clerkship phases, categorized as formative or summative, and on the timing of final OSCEs was collected. Descriptive statistics were used to analyze the data.

Results: The median number of OSCEs per school was four, with one-third formative and two-thirds summative. Pre-clerkship assessments were split between formative and summative OSCEs, while 78% of clerkship OSCEs were summative. Timing of a program's final OSCE varied: 35% occurred before the last year, while 65% took place in the final year, predominantly in the second half. All final OSCEs were summative.

Discussion and conclusion: Variability in OSCE implementation likely reflects differing curricular approaches and institutional constraints. This work demonstrated a more balanced proportion of formative and summative assessments during pre-clerkship, indicating a desire to provide students with opportunities learn from feedback during their early training years. During clerkship, the focus shifted towards summative assessments. The later emphasis on summative OSCEs may highlight a focus on certifying competence at the cost of reduced opportunities for formative feedback. Medical schools may use these findings as guidance when building their programs of assessment.

Introduction: Current approaches to health advocate (HA) training leave many physicians feeling ill-equipped to advocate effectively. Likewise, faculty perceive the HA role as challenging to teach, role model, evaluate and assess. Progress on improving HA training is further stalled by debate over the role's importance and whether it should be considered intrinsic to medical practice. Recent graduates are well-positioned to comment on how these challenges affect HA training and preparation for practice. Therefore, our purpose was to explore the perspectives of new-in-practice physicians who are keen to be effective advocates.

Methods: Ten early-career physicians participated in semi-structured interviews exploring their perceived competence and motivation to engage in health advocacy. Constructivist grounded theory informed the iterative data collection and analysis process.

Results: Participants wished they knew during training how much they would use advocacy in practice. While training imparted adequate patient-level advocacy skills, participants felt underprepared to enact system-level advocacy-which they conceptualized as a wide-range of activities including political advocacy. In turn, participants grappled with lack of preparation, waning motivation, feelings of futility, lack of value for advocacy and need for self-preservation. For these reasons, they questioned whether system-level advocacy should be expected of all physicians.

Conclusions: Although training may adequately prepare physicians for patient-level advocacy, system-level advocacy training remains insufficient. While patient-level advocacy is integral to good care, whether system-level advocacy should be a universal expectation deserves closer consideration. Perhaps system-level health advocacy may be better conceptualized as a specialized role requiring additional training. Regardless, physician advocates' efforts need to be valued for their contributions.