L’implantation d’évaluations des activités professionnelles confiables dans un programme canadien de résidence en obstétrique et gynécologie : une étude par méthodes mixtes

Background: Since the implementation of competency-based medical education (CBME) across residency training programs in Canada, there has been limited research understanding how entrustable professional activity (EPA) assessments are used by faculty supervisors and residents. Objective: This study examines how EPA assessments are used in an Obstetrics and Gynecology residency program and the impact of implementation on both groups. Methods: A mixed methods study design was used. Part one involved the aggregation of descriptive data of EPA assessment completion for postgraduate year 1 and 2 residents from July 2019 to May 2020. Part two involved a thematic analysis of semi-structured interviews of residents and faculty. Results:  There was significant uptake of EPA assessments across community and teaching hospitals with widespread contribution of assessment data from faculty. However, both residents and faculty reported that the intended design of EPA assessments as low-stakes assessments to provide formative feedback is not how EPA assessments are experienced. Residents and faculty noted the increased level of administrative burden and related perceived stress amongst the resident group.   Conclusions: The implementation of EPA assessments is feasible across a variety of sites. However, previous measurement challenges remain. Neither residents nor faculty perceive the value of EPAs to improve feedback, despite their intended nature.Contexte : Depuis l’implantation de l’éducation médicale fondée sur les compétences (EMFC) dans les programmes de résidence au Canada, peu de recherches ont été menées pour comprendre comment les évaluations des activités professionnelles confiables (APC) sont utilisées par les superviseurs et les résidents. Objectif : Cette étude examine l’utilisation des évaluations des APC dans un programme de résidence en obstétrique et gynécologie et les impacts de son implantation sur ces deux groupes. Méthodes : La première partie de cette étude à méthode mixte a consisté en l’agrégation des données descriptives sur les évaluations d’APC pour les résidents de première et deuxième année effectuées entre juillet 2019 et mai 2020. Dans un second temps, nous avons analysé thématiquement les entrevues semi-structurées de résidents et de membres du corps professoral. Résultats : Il y a eu une importante participation aux évaluations des APC dans les hôpitaux communautaires et universitaires, avec une contribution considérable de données d’évaluation de la part des professeurs. Toutefois, alors que les évaluations des APC sont considérées à faibles enjeux etvisent à fournir une rétroaction formative, ce n’est pas de cette façon qu’elles sont vécues Les résidents et le corps professoral ont tous les deux rapporté une augmentation de la charge administrative et du niveau de stress perçu chez les résidents Conclusion : L’implantation des APC est réaliste dans plusieurs sites. Malgré l’intention qui a motivé la mise en place des APC, ni les résidents ni le corps professoral ne perçoivent leur valeur comme moyen d’améliorer la rétroaction.

A national clinician–educator program: a model of an effective community of practice

Background: The increasing complexity of medical training often requires faculty members with educational expertise to address issues of curriculum design, instructional methods, assessment, program evaluation, faculty development, and educational scholarship, among others. Discussion: In 2007, The Royal College of Physicians & Surgeons of Canada responded to this need by establishing the first national clinician–educator program. We define a clinician–educator and describe the development of the program. Adopting a construct from the business community, we use a community of practice framework to describe the benefits (with examples) of this program and challenges in developing it. The benefits of the clinician–educator program include: improved educational problem solving, recognition of educational needs and development of new projects, enhanced personal educational expertise, maintenance of professional satisfaction and retention of group members, a positive influence within the Royal College, and a positive influence within other Canadian academic institutions. Summary: Our described experience of a social reorganization – a community of practice – suggests that the organizational and educational benefits of a national clinician–educator program are not theoretical, but real

Education Scholarship and its Impact on Emergency Medicine Education

Emergency medicine (EM) education is becoming increasingly challenging as a result of changes to North American medical education and the growing complexity of EM practice. Education scholarship (ES) provides a process to develop solutions to these challenges. ES includes both research and innovation. ES is informed by theory, principles and best practices, is peer reviewed, and is disseminated and archived for others to use. Digital technologies have improved the discovery of work that informs ES, broadened the scope and timing of peer review, and provided new platforms for the dissemination and archiving of innovations. This editorial reviews key steps in raising an education innovation to the level of scholarship. It also discusses important areas for EM education scholars to address, which include the following: the delivery of competency-based medical education programs, the impact of social media on learning, and the redesign of continuing professional development

Education Scholarship and its Impact on Emergency Medicine Education

Emergency medicine (EM) education is becoming increasingly challenging as a result of changes to North American medical education and the growing complexity of EM practice. Education scholarship (ES) provides a process to develop solutions to these challenges. ES includes both research and innovation. ES is informed by theory, principles and best practices, is peer reviewed, and is disseminated and archived for others to use. Digital technologies have improved the discovery of work that informs ES, broadened the scope and timing of peer review, and provided new platforms for the dissemination and archiving of innovations. This editorial reviews key steps in raising an education innovation to the level of scholarship. It also discusses important areas for EM education scholars to address, which include the following: the delivery of competency-based medical education programs, the impact of social media on learning, and the redesign of continuing professional development

JGME-ALiEM Hot Topics in Medical Education Online Journal Club: An Analysis of a Virtual Discussion About Resident Teachers.

BackgroundIn health professionals' education, senior learners play a key role in the teaching of junior colleagues.ObjectiveWe describe an online discussion about residents as teachers to highlight the topic and the online journal club medium.MethodsIn January 2015, the Journal of Graduate Medical Education (JGME) and the Academic Life in Emergency Medicine blog facilitated an open-access, online, weeklong journal club on the JGME article "What Makes a Great Resident Teacher? A Multicenter Survey of Medical Students Attending an Internal Medicine Conference." Social media platforms used to promote asynchronous discussions included a blog, a video discussion via Google Hangouts on Air, and Twitter. We performed a thematic analysis of the discussion. Web analytics were captured as a measure of impact.ResultsThe blog post garnered 1324 page views from 372 cities in 42 countries. Twitter was used to endorse discussion points, while blog comments provided opinions or responded to an issue. The discussion focused on why resident feedback was devalued by medical students. Proposed explanations included feedback not being labeled as such, the process of giving delivery, the source of feedback, discrepancies with self-assessment, and threats to medical student self-image. The blog post resulted in a crowd-sourced repository of resident teacher resources.ConclusionsAn online journal club provides a novel discussion forum across multiple social media platforms to engage authors, content experts, and the education community. Crowd-sourced analysis of the resident teacher role suggests that resident feedback to medical students is important, and barriers to student acceptance of feedback can be overcome

Implementation of Entrustable Professional Activities assessments in a Canadian obstetrics and gynecology residency program: A mixed methods study

Background: Since the implementation of competency-based medical education (CBME) across residency training programs in Canada, there has been limited research understanding how entrustable professional activity (EPA) assessments are used by faculty supervisors and residents.Objective: This study examines how EPA assessments are used in an Obstetrics and Gynecology residency program and the impact of implementation on both groups.Methods: A mixed methods study design was used. Part one involved the aggregation of descriptive data of EPA assessment completion for postgraduate year 1 and 2 residents from July 2019 to May 2020. Part two involved a thematic analysis of semi-structured interviews of residents and faculty.Results:  There was significant uptake of EPA assessments across community and teaching hospitals with widespread contribution of assessment data from faculty. However, both residents and faculty reported that the intended design of EPA assessments as low-stakes assessments to provide formative feedback is not how EPA assessments are experienced. Residents and faculty noted the increased level of administrative burden and related perceived stress amongst the resident group.  Conclusions: The implementation of EPA assessments is feasible across a variety of sites. However, previous measurement challenges remain. Neither residents nor faculty perceive the value of EPAs to improve feedback, despite their intended nature.Contexte : Depuis l’implantation de l’éducation médicale fondée sur les compétences (EMFC) dans les programmes de résidence au Canada, peu de recherches ont été menées pour comprendre comment les évaluations des activités professionnelles confiables (APC) sont utilisées par les superviseurs et les résidents.Objectif : Cette étude examine l’utilisation des évaluations des APC dans un programme de résidence en obstétrique et gynécologie et les impacts de son implantation sur ces deux groupes.Méthodes : La première partie de cette étude à méthode mixte a consisté en l’agrégation des données descriptives sur les évaluations d’APC pour les résidents de première et deuxième année effectuées entre juillet 2019 et mai 2020. Dans un second temps, nous avons analysé thématiquement les entrevues semi-structurées de résidents et de membres du corps professoral.Résultats : Il y a eu une importante participation aux évaluations des APC dans les hôpitaux communautaires et universitaires, avec une contribution considérable de données d’évaluation de la part des professeurs. Toutefois, alors que les évaluations des APC sont considérées à faibles enjeux etvisent à fournir une rétroaction formative, ce n’est pas de cette façon qu’elles sont vécues Les résidents et le corps professoral ont tous les deux rapporté une augmentation de la charge administrative et du niveau de stress perçu chez les résidentsConclusion : L’implantation des APC est réaliste dans plusieurs sites. Malgré l’intention qui a motivé la mise en place des APC, ni les résidents ni le corps professoral ne perçoivent leur valeur comme moyen d’améliorer la rétroaction

JGME-ALiEM Hot Topics in Medical Education: Analysis of a Multimodal Online Discussion About Team-Based Learning

BackgroundTeam-based learning (TBL) is an instructional method that is being increasingly incorporated in health professions education, although use in graduate medical education (GME) has been more limited.ObjectiveTo curate and describe themes that emerged from a virtual journal club discussion about TBL in GME, held across multiple digital platforms, while also evaluating the use of social media in online academic discussions.MethodsThe Journal of Graduate Medical Education (JGME) and the Academic Life in Emergency Medicine blog facilitated a weeklong, open-access, virtual journal club on the 2015 JGME article "Use of Team-Based Learning Pedagogy for Internal Medicine Ambulatory Resident Teaching." Using 4 stimulus questions (hosted on a blog as a starting framework), we facilitated discussions via the blog, Twitter, and Google Hangouts on Air platforms. We evaluated 2-week web analytics and performed a thematic analysis of the discussion.ResultsThe virtual journal club reached a large international audience as exemplified by the blog page garnering 685 page views from 241 cities in 42 countries. Our thematic analysis identified 4 domains relevant to TBL in GME: (1) the benefits and barriers to TBL; (2) the design of teams; (3) the role of assessment and peer evaluation; and (4) crowdsourced TBL resources.ConclusionsThe virtual journal club provided a novel forum across multiple social media platforms, engaging authors, content experts, and the health professions education community in a discussion about the importance, impediments to implementation, available resources, and logistics of adopting TBL in GME