Réflexions des directeurs de programme sur les réformes des politiques nationales en matière d’éducation médicale : regards portés sur la prise de décision, l’agrément et le cadre CanMEDS

Background: Outcomes of national policy change impact all levels of the organizational hierarchy. The medical education literature is sparse on how reflections from program directors (PDs) on past large-scale policy changes can inform future policy initiatives. To fill this gap, we conducted a national survey on PDs’ perceptions of, and reflections on, decision-making in medical education, accreditation procedures, and the CanMEDS framework implementation. Methods: The survey was distributed to former Canadian specialty medicine PDs (N = 684). Descriptive analysis was performed on quantitative data, thematic analysis was performed on qualitative comments, and comparisons between the quantitative and qualitative findings were performed to identify areas of convergence and/or divergence. Results: A total of 265 (38.7%) former PDs participated. Quantitative analysis revealed that 52.8% of respondents did not feel involved in decision-making regarding policy changes, 45.1% of respondents did not feel prepared to assess the CanMEDS Roles, and PDs were divided on the reasonableness of accreditation documentation. Qualitative analysis produced four themes: communication, resources, expectations of outcomes, and buy-in. Nine sub-themes were also identified. A high level of convergence was identified across the content, with only four areas of divergence identified. Conclusions: Our findings have the potential to inform future policy and/or accreditation changes. Without the lens of those charged with overseeing the implementation, policy evaluation and quality improvement will remain uninformed. PDs, therefore, bring unique insights into our understanding of national policy changes, and without the voices of these frontline implementers, the true success of policy change implementation will be hindered.Contexte: Les effets des changements apportés aux politiques nationales se font sentir à tous les niveaux de la hiérarchie organisationnelle. La littérature traite peu du fait que l’opinion des directeurs de programme (DP) concernant les réformes d’envergure intervenues dans les politiques sur l'éducation médicale par le passé peut servir à éclairer les révisions de politiques futures. Afin de combler cette lacune, nous avons mené une enquête nationale pour sonder les DP sur leurs perceptions et réflexions quant à la prise de décision dans l'éducation médicale, aux procédures d'agrément et à la mise en œuvre du cadre CanMEDS. Méthodes: Le sondage a été distribué aux anciens DP en médecine spécialisée du Canada (N = 684). Les données quantitatives ont fait l'objet d'une analyse descriptive, les commentaires qualitatifs d'une analyse thématique, et une comparaison entre les résultats quantitatifs et qualitatifs a été effectuée pour repérer les domaines de convergence et de divergence. Résultats: Un total de 265 (38.7%) anciens DP ont participé au sondage. L'analyse quantitative a révélé que 52.8% des répondants ne se sentaient pas inclus dans la prise de décision en matière de changements de politiques, que 45.1% des répondants ne se sentaient pas en mesure d’évaluer les rôles CanMEDS, et qu’ils étaient partagés sur la question du caractère raisonnable des documents d'agrément. L'analyse qualitative a permis de dégager quatre thèmes: la communication, les ressources, les attentes en matière de résultats et l'adhésion. Neuf sous-thèmes ont également été définis. Nous avons constaté un niveau élevé de convergence sur l'ensemble du contenu, des divergences n'apparaissant que dans quatre domaines. Conclusions: Nos conclusions peuvent servir à orienter les changements futurs en matière de politiques et d'agrément. Sans le regard de ceux qui sont chargés de superviser leur mise en œuvre, l'évaluation des politiques et l'amélioration de la qualité demeureront mal fondées. La perspective unique des DP est essentielle à notre compréhension des révisions des politiques, et sans la contribution de ces responsables de première ligne de leur application, les réformes ne pourront être mises en œuvre de façon optimale

From good to great: learners’ perceptions of the qualities of effective medical teachers and clinical supervisors in psychiatry

Background: The shift in postgraduate medical training towards a competency-based medical education framework has inspired research focused on medical educator competencies. This research has rarely considered the importance of the learning environment in terms of both setting and specialty-specific factors. The current study attempted to fill this gap by examining narrative comments from psychiatry faculty evaluations to understand learners’ perceptions of educator effectiveness.   Methods: Data consisted of psychiatry faculty evaluations completed in 2015-2016 by undergraduate and postgraduate learners (N= 324) from McMaster University. Evaluations were provided for medical teachers and clinical supervisors in classroom and clinical settings. Narrative comments were analyzed using descriptive qualitative methodology by three independent reviewers to answer: “What do undergraduate and postgraduate medical learners perceive about educator effectiveness in psychiatry?” Results: Narrative comments were provided on 270/324 (83%) faculty evaluation forms. Four themes and two sub-themes emerged from the qualitative analysis. Effective psychiatry educators demonstrated specific personal characteristics that aligned with previous research on educator effectiveness. Novel themes included the importance of relationships and affective factors, including learner security and inspiration through role modeling Conclusion: Contemporary discussions about educator effectiveness in psychiatry have excluded the dynamic, relational and affective components of the educational exchange highlighted in the current study. This may be an important focus for future educational research

Program directors’ reflections on national policy change in medical education: insights on decision-making, accreditation, and the CanMEDS framework

Background: Outcomes of national policy change impact all levels of the organizational hierarchy. The medical education literature is sparse on how reflections from program directors (PDs) on past large-scale policy changes can inform future policy initiatives. To fill this gap, we conducted a national survey on PDs’ perceptions of, and reflections on, decision-making in medical education, accreditation procedures, and the CanMEDS framework implementation.Methods: The survey was distributed to former Canadian specialty medicine PDs (N = 684). Descriptive analysis was performed on quantitative data, thematic analysis was performed on qualitative comments, and comparisons between the quantitative and qualitative findings were performed to identify areas of convergence and/or divergence.Results: A total of 265 (38.7%) former PDs participated. Quantitative analysis revealed that 52.8% of respondents did not feel involved in decision-making regarding policy changes, 45.1% of respondents did not feel prepared to assess the CanMEDS Roles, and PDs were divided on the reasonableness of accreditation documentation. Qualitative analysis produced four themes: communication, resources, expectations of outcomes, and buy-in. Nine sub-themes were also identified. A high level of convergence was identified across the content, with only four areas of divergence identified.Conclusions: Our findings have the potential to inform future policy and/or accreditation changes. Without the lens of those charged with overseeing the implementation, policy evaluation and quality improvement will remain uninformed. PDs, therefore, bring unique insights into our understanding of national policy changes, and without the voices of these frontline implementers, the true success of policy change implementation will be hindered.Contexte : Les effets des changements apportés aux politiques nationales se font sentir à tous les niveaux de la hiérarchie organisationnelle. La littérature traite peu du fait que l’opinion des directeurs de programme (DP) concernant les réformes d’envergure intervenues dans les politiques sur l'éducation médicale par le passé peut servir à éclairer les révisions de politiques futures. Afin de combler cette lacune, nous avons mené une enquête nationale pour sonder les DP sur leurs perceptions et réflexions quant à la prise de décision dans l'éducation médicale, aux procédures d'agrément et à la mise en œuvre du cadre CanMEDS.Méthodes : Le sondage a été distribué aux anciens DP en médecine spécialisée du Canada (N = 684). Les données quantitatives ont fait l'objet d'une analyse descriptive, les commentaires qualitatifs d'une analyse thématique, et une comparaison entre les résultats quantitatifs et qualitatifs a été effectuée pour repérer les domaines de convergence et de divergence.Résultats : Un total de 265 (38.7%) anciens DP ont participé au sondage. L'analyse quantitative a révélé que 52.8% des répondants ne se sentaient pas inclus dans la prise de décision en matière de changements de politiques, que 45.1% des répondants ne se sentaient pas en mesure d’évaluer les rôles CanMEDS, et qu’ils étaient partagés sur la question du caractère raisonnable des documents d'agrément. L'analyse qualitative a permis de dégager quatre thèmes: la communication, les ressources, les attentes en matière de résultats et l'adhésion. Neuf sous-thèmes ont également été définis. Nous avons constaté un niveau élevé de convergence sur l'ensemble du contenu, des divergences n'apparaissant que dans quatre domaines.Conclusions : Nos conclusions peuvent servir à orienter les changements futurs en matière de politiques et d'agrément. Sans le regard de ceux qui sont chargés de superviser leur mise en œuvre, l'évaluation des politiques et l'amélioration de la qualité demeureront mal fondées. La perspective unique des DP est essentielle à notre compréhension des révisions des politiques, et sans la contribution de ces responsables de première ligne de leur application, les réformes ne pourront être mises en oeuvre de façon optimale

Efficacy of DBT in treating adult mental disorders

Systematic Review evaluating the effectiveness of dialectical behavior therapy (DBT) on treating adult mental disorder

Using Flipped Classroom Modules to Facilitate Higher Order Learning in Undergraduate Organic Chemistry.

In an ongoing effort to incorporate active learning and promote higher order learning outcomes in undergraduate organic chemistry, a hybrid (flipped) classroom structure has been used to facilitate a series of collaborative activities in the first two courses of the lower division organic chemistry sequence. An observational study of seven classes over a five-year period reveals there is a strong correlation between performance on the in-class activities and performance on the final exam across all classes; however, a significant number of students in these courses continue to struggle on both the in-class activities and final exam. The Activity Engagement Survey (AcES) was administered in the most recent course offering included in this study, and these preliminary data suggest that students who achieved lower scores on the in-class activities had lower levels of emotional and behavioral/cognitive engagement and were less likely to work in collaborative groups. In total, these findings suggest that if students can be guided to engage more successfully with the in-class activities, they are likely to be more successful in carrying out the higher order learning required on the final exam. In addition to the analyses of student performance and engagement in the in-class activities, the implementation of the flipped classroom structure and suggestions for how student engagement in higher order learning might be improved in future iterations of the class are described herein

Overview Of The Canadian Clinician Investigator Trainees’ Research Presented At The 2020 CSCI-CITAC Joint Meeting

The 2020 Annual General Meeting (AGM) and Young Investigators’ Forum of the Canadian Society for Clinical Investigation / Société Canadienne de Recherches Clinique (CSCI/SCRC) and Clinician Investigator Trainee Association of Canada/Association des Cliniciens-Chercheurs en Formation du Canada (CITAC/ACCFC) was the first meeting to be hosted virtually. The theme was “Navigating Uncertainty, Embracing Change and Empowering the Next Generation of Clinician-Scientists”, and the meeting featured lectures and workshops that were designed to provide knowledge and skills for professional development of clinician investigator trainees. The opening remarks were given by Jason Berman (President of CSCI/SCRC), Tina Marvasti (President of CITAC/ACCFC) and Nicola Jones (University of Toronto Clinician Investigator Program Symposium Chair). Dr. Michael Strong, President of the Canadian Institutes of Health Research, delivered the keynote presentation titled “CIHR’s COVID-19 Response and Strategic Planning”. Dr. John Bell (University of Ottawa) received the CSCI Distinguished Scientist Award, Dr. Stanley Nattel (Université de Montréal) received the CSCI-RCPSC Henry Friesen Award (RCPSC; Royal College of Physicians and Surgeons of Canada) and Dr. Meghan Azad (University of Manitoba) received the CSCI Joe Doupe Young Investigator Award. Each scientist delivered talks on their award-winning research. The interactive workshops were “Developing Strategies to Maintain Wellness”, “Understanding the Hidden Curriculum: Power and Privilege in Science and Medicine”, “Hiring a Clinician Scientist Trainee: What Leaders Are Looking For” and “COVID-19: A Case Study for Pivoting Your Research”. The AGM included presentations from clinician investigator trainees nationwide. Over 70 abstracts were showcased, most are summarized in this review, and six were selected for oral presentations

Using Flipped Classroom Modules to Facilitate Higher Order Learning in Undergraduate Organic Chemistry

In an ongoing effort to incorporate active learning and promote higher order learning outcomes in undergraduate organic chemistry, a hybrid (“flipped”) classroom structure has been used to facilitate a series of collaborative activities in the first two courses of the lower division organic chemistry sequence. An observational study of seven classes over a five-year period reveals there is a strong correlation between performance on the in-class activities and performance on the final exam across all classes; however, a significant number of students in these courses continue to struggle on both the in-class activities and final exam. The Activity Engagement Survey (AcES) was administered in the most recent course offering included in this study, and these preliminary data suggest that students who achieved lower scores on the in-class activities had lower levels of emotional and behavioral/cognitive engagement and were less likely to work in collaborative groups. In total, these findings suggest that if students can be guided to engage more successfully with the in-class activities, they are likely to be more successful in carrying out the higher order learning required on the final exam. In addition to the analyses of student performance and engagement in the in-class activities, the implementation of the flipped classroom structure and suggestions for how student engagement in higher order learning might be improved in future iterations of the class are described herein

Using Flipped Classroom Modules to Facilitate Higher Order Learning in Undergraduate Organic Chemistry

In an ongoing effort to incorporate active learning and promote higher order learning outcomes in undergraduate organic chemistry, a hybrid (“flipped”) classroom structure has been used to facilitate a series of collaborative activities in the first two courses of the lower division organic chemistry sequence. An observational study of seven classes over a five-year period reveals there is a strong correlation between performance on the in-class activities and performance on the final exam across all classes; however, a significant number of students in these courses continue to struggle on both the in-class activities and final exam. The Activity Engagement Survey (AcES) was administered in the most recent course offering included in this study, and these preliminary data suggest that students who achieved lower scores on the in-class activities had lower levels of emotional and behavioral/cognitive engagement and were less likely to work in collaborative groups. In total, these findings suggest that if students can be guided to engage more successfully with the in-class activities, they are likely to be more successful in carrying out the higher order learning required on the final exam. In addition to the analyses of student performance and engagement in the in-class activities, the implementation of the flipped classroom structure and suggestions for how student engagement in higher order learning might be improved in future iterations of the class are described herein

Using Flipped Classroom Modules to Facilitate Higher Order Learning in Undergraduate Organic Chemistry

In an ongoing effort to incorporate active learning and promote higher order learning outcomes in undergraduate organic chemistry, a hybrid (“flipped”) classroom structure has been used to facilitate a series of collaborative activities in the first two courses of the lower division organic chemistry sequence. An observational study of seven classes over a five-year period reveals there is a strong correlation between performance on the in-class activities and performance on the final exam across all classes; however, a significant number of students in these courses continue to struggle on both the in-class activities and final exam. The Activity Engagement Survey (AcES) was administered in the most recent course offering included in this study, and these preliminary data suggest that students who achieved lower scores on the in-class activities had lower levels of emotional and behavioral/cognitive engagement and were less likely to work in collaborative groups. In total, these findings suggest that if students can be guided to engage more successfully with the in-class activities, they are likely to be more successful in carrying out the higher order learning required on the final exam. In addition to the analyses of student performance and engagement in the in-class activities, the implementation of the flipped classroom structure and suggestions for how student engagement in higher order learning might be improved in future iterations of the class are described herein