26 research outputs found
Patient involvement in resident assessment within the Competence by Design context: a mixed-methods study
Background: Patients can contribute to resident assessment in Competence by Design (CBD). This study explored the extent, nature, as well as the facilitators and hindrances of patient involvement in resident assessment within and across Canadian specialty/sub-specialty/special programs that are transitioning or have transitioned to CBD.     Methods: We used a two-phase sequential explanatory mixed-methods design. In Phase 1, we surveyed program directors (PDs). In Phase 2, we interviewed PDs from Phase 1.Results: In Phase 1, 63 (62.4%) respondents in the CBD preparation stage, do not know if patients will be involved in resident assessment, 21 (20.8%) will involve patients, and 17 (16.8%) will not involve patients. Of those in the field-testing or implementation stages, 24 (72.7%) do not involve patients in resident assessment, five (15.2%) do involve patients, and four (12.1%) do not know if they involve patients. In Phase 2, 12 interviewees raised nine factors that facilitate or hinder patient involvement including, patientsâ interests/abilities, guidelines/processes for patient involvement, type of Entrustable Professional Activities, type of patient interactions in programs, and support from healthcare organizations.Conclusion: Patient involvement in resident assessment is limited. We need to engage in discussions on how to support such involvement within CBD
The Promise of Participatory Evaluation in Family-Centered Rehabilitation Settings: A Qualitative Study
Background: Family-centered service philosophy (FCS) is an important contextual aspect of many pediatric rehabilitation programs. It recognizes the importance of supporting family relationships and the benefits of active family participation in all aspects of programming. Unfortunately, many professionals often overlook FCS philosophy when designing and implementing evaluations. Given the emphasis that participatory evaluation places on collaboration and the engagement of stakeholders, it appears to be theoretically compatible with FCS philosophy. Â Purpose: To explore parentsâ and staff membersâ perceptions of participatory program evaluation, including its congruence with family-centered service (FCS) philosophy, as well as the feasibility and practicality of using participatory program evaluation within pediatric rehabilitation centers.Setting: The study was conducted at two urban pediatric rehabilitation centers in Ontario, Canada.Intervention: Not applicable.Design: Qualitative exploration.Data Collection and Analysis: The study included qualitative interviews, focus groups and a thematic analysis. Â Findings: Participants described how participatory evaluation, in congruence with FCS philosophy, would increase the relevance of program evaluations for families, help support program interventions, assist in the development of clinician-parent relationships, and facilitate the empowerment of families. They also described how a lack of time, funding, and training, as well as variations in the priorities and interests of families presented challenges for using participatory evaluation within their centers
Références aux patients dans les référentiels de compétences CanMEDS 2005 et 2015
Background: Patient involvement in postgraduate medical education (PGME) can help residents improve their communication, professionalism, and collaboration. The CanMEDS Framework defines such competencies for physicians and informs teaching and assessment activities in PGME. However, it is unclear how patients are referenced in the CanMEDS Framework and if these references encourage the active involvement of patients in PGME. To inform how patients are referenced in the revisions of the CanMEDS Framework, scheduled for publication in 2025, our aim was to determine how patients are referenced in each the 2005 and 2015 CanMEDS Frameworks.
Methods: We used document analysis to examine how the term âpatient(s)â is referenced in the 2005 and 2015 CanMEDS Frameworks.
Results: Several 2005 and 2015 CanMEDS Roles include patients in the descriptions but do not reference them in the competencies. Others do not reference patients in the descriptions or competencies, potentially detracting from the importance of involving patients. As it stands, the 2015 Health Advocate is the only Role that describes and references patients working with physicians as partners in care, facilitating potential opportunities for patient involvement in PGME.Â
Conclusion: There are inconsistencies in how patients are described and referenced as potential partners in PGME throughout past and present CanMEDS Frameworks. Understanding these inconsistencies can inform the revision of CanMEDS that is scheduled for publication in 2025.Contexte : La participation des patients dans la formation mĂ©dicale postdoctorale (FMPD) peut aider les rĂ©sidents Ă amĂ©liorer leur professionnalisme et leurs compĂ©tences en matiĂšre de communication et de collaboration. Le rĂ©fĂ©rentiel CanMEDS dĂ©finit les compĂ©tences des mĂ©decins et oriente les activitĂ©s dâenseignement et dâĂ©valuation dans la formation mĂ©dicale postdoctorale. Cependant, la maniĂšre dont les patients sont dĂ©crits dans le rĂ©fĂ©rentiel CanMEDS nâest pas claire et il nâest pas certain que cette description encourage la participation active des patients dans la FMPD. Pour Ă©clairer la description des patients dans les rĂ©visions du rĂ©fĂ©rentiel CanMEDS, dont la publication est prĂ©vue en 2025, notre objectif Ă©tait dâexaminer comment ils sont prĂ©sentĂ©s dans les rĂ©fĂ©rentiels CanMEDS de 2005 et 2015.
MĂ©thodes : Nous avons utilisĂ© lâanalyse de documents pour examiner les rĂ©fĂ©rences au terme «âpatient(s)â» dans les rĂ©fĂ©rentiels CanMEDS 2005 et 2015.
RĂ©sultats : Dans les rĂ©fĂ©rentiels CanMEDS de 2005 et 2015, les patients sont mentionnĂ©s dans la description de certains rĂŽles, mais ils ne le sont pas dans la description des compĂ©tences qui y sont associĂ©es. Dans dâautres cas, ni la description du rĂŽle ni celle des compĂ©tences correspondantes ne font rĂ©fĂ©rence aux patients, ce qui peut minimiser lâimportance de la participation de ces derniers. Actuellement, le rĂŽle de promoteur de la santĂ© dans le rĂ©fĂ©rentiel de 2015 est le seul qui comprend une description et une rĂ©fĂ©rence aux patients comme travaillant avec le mĂ©decin Ă titre de partenaires de soins, et qui favorise ainsi la possibilitĂ© de faire participer les patients dans la FMPD.Â
Conclusion : Les référentiels CanMEDS passés et présents contiennent des incohérences quant à la description des patients comme partenaires potentiels dans la FMPD. La compréhension de ces incohérences peut éclairer la révision de CanMEDS, dont la publication est prévue en 2025
Lâutilisation dâoutils fondĂ©s sur les donnĂ©es probantes et la littĂ©rature en Ă©ducation mĂ©dicale par les directeurs de programmes postdoctoraux au Canada dans lâenseignement et lâĂ©valuation des rĂŽles CanMEDS
Background: Researchers have shown that clinical educators feel insufficiently informed about how to teach and assess the CanMEDS roles. Thus, our objective was to examine the extent to which program directors utilize evidence-based tools and the medical education literature in teaching and assessing the CanMEDS roles.
Methods: In 2016, the authors utilized an online questionnaire to survey 747 Canadian residency program directors (PDâs) of Royal College of Physicians and Surgeons of Canada (RCPSC) accredited programs.
Results: Overall, 186 PDâs participated (24.9%). 36.6% did not know whether the teaching strategies they used were evidence-based and another third (31.9%) believed they were ânot at allâ or âto a small extentâ evidence-based. Similarly, 31.8% did not know whether the assessment tools they used were evidence-based and another third (39.7%) believed they were ânot at allâ or âto a small extentâ evidence-based. PDâs were aware of research on teaching strategies (62.4%) and assessment tools (51.9%), but felt they did not have sufficient time to review relevant literature (72.1% for teaching and 64.1% for assessment).
Conclusions: Canadian PDâs reported low awareness of evidence-based tools for teaching and assessment, implying a potential knowledge translation gap in medical education research.Contexte : La recherche montre que les Ă©ducateurs en mĂ©decine se sentent insuffisamment informĂ©s sur la façon dâenseigner et dâĂ©valuer les rĂŽles CanMEDS. Notre objectif Ă©tait donc dâexaminer dans quelle mesure les directeurs de programmes utilisent des outils fondĂ©s sur les donnĂ©es probantes et la littĂ©rature en Ă©ducation mĂ©dicale pour enseigner et Ă©valuer les rĂŽles CanMEDS.
Méthodes : En 2016, les auteurs ont utilisé un questionnaire en ligne pour interroger 747 directeurs de programmes de résidence (DP) agréés par le CollÚge royal des médecins et chirurgiens du Canada (CRMCC).
RĂ©sultats : Parmi les 186 (24,9 %) DP qui ont participĂ© au sondage, 36,6 % ne savaient pas si les stratĂ©gies dâenseignement quâils utilisaient Ă©taient fondĂ©es sur des donnĂ©es probantes et un tiers (31,9 %) estimaient quâelles nâĂ©taient « pas du tout » fondĂ©es sur des donnĂ©es probantes ou quâelles ne lâĂ©taient que « dans une faible mesure ». De surcroĂźt, 31,8 % ne savaient pas si les outils dâĂ©valuation quâils utilisaient Ă©taient fondĂ©s sur des donnĂ©es probantes et un tiers (39,7 %) estimait quâils lâĂ©taient « dans une faible mesure » ou quâils ne lâĂ©taient « pas du tout ». Les DP ont dĂ©clarĂ© quâils Ă©taient au courant de lâexistence dâĂ©tudes sur les stratĂ©gies dâenseignement (62,4 %) et sur les outils dâĂ©valuation (51,9 %), mais quâils manquaient de temps pour se familiariser avec la documentation pertinente (72,1 % pour lâenseignement et 64,1 % pour lâĂ©valuation).
Conclusions : Les DP au Canada sont peu familiers avec les outils dâenseignement et dâĂ©valuation fondĂ©s sur les donnĂ©es probantes, ce qui suggĂšre un transfert des connaissances lacunaire de la recherche Ă lâĂ©ducation mĂ©dicale.
 
Ălargir les mandats de responsabilitĂ© sociale Ă la recherche biomĂ©dicale dans les facultĂ©s canadiennes
Background: Social accountability (SA), as defined by Boelen and Heck, is the obligation of medical schools to address the needs of communities through education, research and service activities. While SA is embedded within health profession education frameworks in medicine, they are rarely taught within graduate-level (MSc/PhD) education.
Methods: As these programs train future medical researchers, we invited first-year graduate students enrolled in a mandatory professionalism class at our institution (n = 111) to complete a survey on their perceptions of the importance of SA in their research, training, and future careers.
Results: Over 80% (n = 87) of respondents agreed that SA is relevant and felt committed to integrating it into their future research activities, only a limited number of students felt confident and/or supported in their abilities to integrate SA into their research.
Conclusions: Specific SA training in graduate education is necessary for students to effectively incorporate elements of SA into their research, and as such support the SA mandates of their training institutions. We posit that awareness of SA principles formalizes the professional standards for biomedical researchers and is thus foundational for developing a professionalism curriculum in graduate education programs in medicine. We propose an expansion of the World Health Organization (WHO) partnership pentagon to include partners within the research ecosystem (funding partners, certification bodies) that collaborate with biomedical researchers to make research socially accountable.Contexte : La responsabilitĂ© sociale (RS), telle que dĂ©finie par Boelen et Heck, est l'obligation pour les facultĂ©s de mĂ©decine de rĂ©pondre aux besoins des communautĂ©s par lâentremise de l'Ă©ducation, de la recherche et des activitĂ©s de service. Bien que la responsabilitĂ© sociale soit intĂ©grĂ©e dans les cadres de formation des professionnels de santĂ© en mĂ©decine, elle est rarement enseignĂ©e au niveau des Ă©tudes supĂ©rieures (MSc/PhD).
MĂ©thodes : Ătant donnĂ© que ces programmes forment les futurs chercheurs mĂ©dicaux, nous avons invitĂ© les Ă©tudiants de premiĂšre annĂ©e inscrits Ă un cours obligatoire sur le professionnalisme dans notre Ă©tablissement (n = 111) Ă participer Ă une enquĂȘte sur leurs perceptions de l'importance de la RS dans leur recherche, leur formation et leur future carriĂšre.
Résultats : Plus de 80 % (n = 87) des répondants ont reconnu la pertinence de la RS et se sont engagés à l'intégrer dans leurs futures activités de recherche, mais seul un nombre limité d'étudiants se sont sentis confiants et/ou soutenus dans leurs capacités à intégrer la RS dans leur recherche.
Conclusions : Une formation propre à la RS dans le cadre des études supérieures est nécessaire pour que les étudiants puissent intégrer efficacement des éléments de la RS dans leur recherche, et ainsi promouvoir les mandats de RS de leurs établissements de formation. Nous estimons que la sensibilisation aux principes de la RS formalise les normes professionnelles des chercheurs biomédicaux et qu'elle est donc fondamentale pour l'élaboration d'un programme de professionnalisme dans les programmes d'études supérieures en médecine. Nous proposons d'élargir le pentagone du partenariat de l'Organisation mondiale de la santé (OMS) pour y inclure les partenaires de l'écosystÚme de la recherche (partenaires financiers, organismes de certification) qui collaborent avec les chercheurs biomédicaux pour rendre la recherche socialement responsable
Une étude qualitative des perspectives des patients et des aidants sur la formation des prestataires de soins de santé
Background: Patients/caregivers can be actively involved in the education of healthcare providers (HCPs). The purpose of this study was to explore patients'/caregivers' perspectives on their involvement and roles in the education of HCPs.
Methods: We invited patients/caregivers to participate in one-on-one semi-structured interviews. We analyzed the interview data using conventional content analysis to identify themes.
Results: In terms of patient/caregiver involvement in the education of HCPs, we identified that patients/caregivers perceive that it: (a) is challenging because of power-differentials between themselves and HCPs; (b) requires patient training; (c) needs to start early in HCPsâ education processes; (d) can improve patient-HCP partnerships, and (e) requires compensation for patients. With regards to the roles that patients can play in educating HCPs, we found that patients/caregivers want to: (a) teach HCPs about patientsâ expectations, experiences and perspectives through case studies, storytelling, and educational research; (b) provide direct feedback to HCPs, and (c) advise on curricula development and admission boards for HCPs.
Conclusions: Understanding patientsâ/caregiversâ perspectives on this topic can help educational leaders and HCPs improve active patient/caregiver involvement in the education of HCPs. We need to listen to patientsâ/caregiversâ voices in order to make effective changes in current and future health professions education.Contexte : Les patients et les aidants peuvent participer activement Ă la formation des prestataires de soins de santĂ© (PSS). Lâobjectif de cette Ă©tude Ă©tait dâexplorer le point de vue des patients et des aidants sur leur participation et leur rĂŽle dans la formation des professionnels de la santĂ©.
MĂ©thodes : Nous avons invitĂ© des patients et des aidants Ă participer Ă des entretiens individuels semi-structurĂ©s. Nous avons dĂ©gagĂ© les thĂšmes Ă lâaide dâune analyse de contenu classique des donnĂ©es des entretiens.
RĂ©sultats : DâaprĂšs les patients et les aidants, leur implication dans lâĂ©ducation des professionnels de la santĂ© : (a) est un dĂ©fi en raison du dĂ©sĂ©quilibre de pouvoir entre eux et les professionnels de la santĂ©; (b) nĂ©cessite une formation des patients; (c) doit commencer tĂŽt dans le processus de formation des professionnels de la santĂ©; (d) peut amĂ©liorer les partenariats entre les patients et les professionnels de la santĂ©; et (e) suppose que les patients soient indemnisĂ©s. En ce qui concerne les rĂŽles que les patients peuvent jouer dans lâĂ©ducation des professionnels de la santĂ©, nous avons constatĂ© que les patients et les aidants veulent : (a) enseigner aux professionnels de la santĂ© les attentes, les expĂ©riences et les points de vue des patients par le biais dâĂ©tudes de cas, de rĂ©cits et de recherche en Ă©ducation; (b) fournir une rĂ©troaction directe aux professionnels de la santĂ©; et (c) donner des conseils pour le dĂ©veloppement decursus et les comitĂ©s dâadmission pour les professionnels de la santĂ©.
Conclusions : Comprendre le point de vue des patients et des aidants sur ce sujet peut aider les Ă©ducateurs en poste de gestion et les professionnels de la santĂ© Ă mieux intĂ©grer la participation active des patients Ă la formation des soignants. En Ă©coutant la voix des patients et des aidants, nous serons en mesure dâapporter des changements efficaces Ă la formation actuelle et future des professions de la santĂ©
Patient references in the 2005 and 2015 CanMEDS frameworks
Background: Patient involvement in postgraduate medical education (PGME) can help residents improve their communication, professionalism, and collaboration. The CanMEDS Framework defines such competencies for physicians and informs teaching and assessment activities in PGME. However, it is unclear how patients are referenced in the CanMEDS Framework and if these references encourage the active involvement of patients in PGME. To inform how patients are referenced in the revisions of the CanMEDS Framework, scheduled for publication in 2025, our aim was to determine how patients are referenced in each the 2005 and 2015 CanMEDS Frameworks.Methods: We used document analysis to examine how the term âpatient(s)â is referenced in the 2005 and 2015 CanMEDS Frameworks.Results: Several 2005 and 2015 CanMEDS Roles include patients in the descriptions but do not reference them in the competencies. Others do not reference patients in the descriptions or competencies, potentially detracting from the importance of involving patients. As it stands, the 2015 Health Advocate is the only Role that describes and references patients working with physicians as partners in care, facilitating potential opportunities for patient involvement in PGME.Conclusion: There are inconsistencies in how patients are described and referenced as potential partners in PGME throughout past and present CanMEDS Frameworks. Understanding these inconsistencies can inform the revision of CanMEDS that is scheduled for publication in 2025.Contexte : La participation des patients dans la formation mĂ©dicale postdoctorale (FMPD) peut aider les rĂ©sidents Ă amĂ©liorer leur professionnalisme et leurs compĂ©tences en matiĂšre de communication et de collaboration. Le rĂ©fĂ©rentiel CanMEDS dĂ©finit les compĂ©tences des mĂ©decins et oriente les activitĂ©s dâenseignement et dâĂ©valuation dans la formation mĂ©dicale postdoctorale. Cependant, la maniĂšre dont les patients sont dĂ©crits dans le rĂ©fĂ©rentiel CanMEDS nâest pas claire et il nâest pas certain que cette description encourage la participation active des patients dans la FMPD. Pour Ă©clairer la description des patients dans les rĂ©visions du rĂ©fĂ©rentiel CanMEDS, dont la publication est prĂ©vue en 2025, notre objectif Ă©tait dâexaminer comment ils sont prĂ©sentĂ©s dans les rĂ©fĂ©rentiels CanMEDS de 2005 et 2015.MĂ©thodes : Nous avons utilisĂ© lâanalyse de documents pour examiner les rĂ©fĂ©rences au terme «âpatient(s)â» dans les rĂ©fĂ©rentiels CanMEDS 2005 et 2015.RĂ©sultats : Dans les rĂ©fĂ©rentiels CanMEDS de 2005 et 2015, les patients sont mentionnĂ©s dans la description de certains rĂŽles, mais ils ne le sont pas dans la description des compĂ©tences qui y sont associĂ©es. Dans dâautres cas, ni la description du rĂŽle ni celle des compĂ©tences correspondantes ne font rĂ©fĂ©rence aux patients, ce qui peut minimiser lâimportance de la participation de ces derniers. Actuellement, le rĂŽle de promoteur de la santĂ© dans le rĂ©fĂ©rentiel de 2015 est le seul qui comprend une description et une rĂ©fĂ©rence aux patients comme travaillant avec le mĂ©decin Ă titre de partenaires de soins, et qui favorise ainsi la possibilitĂ© de faire participer les patients dans la FMPD.Conclusion : Les rĂ©fĂ©rentiels CanMEDS passĂ©s et prĂ©sents contiennent des incohĂ©rences quant Ă la description des patients comme partenaires potentiels dans la FMPD. La comprĂ©hension de ces incohĂ©rences peut Ă©clairer la rĂ©vision de CanMEDS, dont la publication est prĂ©vue en 2025
The h-index in medical education: an analysis of medical education journal editorial boards
Abstract Background: Disciplines differ in their authorship and citation practices, thus discipline-specific h-index norms are desirable. Thus the goal of this study was to examine the relationship between the h-index and academic rank in the field of medical education, and the differences in the h-index between MDâs and PhDâs in this field. Methods: Due to the absence of a formalized registry of medical educators, we sampled available editorial board membership (considered a proxy for identifying âcareerâ medical educators) to establish h-index values. These were determined using Web of Science (WoS) and Google Scholar (GS), and internet searching was used to determine their academic rank. The correlation between authorsâ h-indices derived from WoS and GS was also determined. Results: 130 editors were identified (95 full professors, 21 associate professors, 14 assistant professors). A significant difference was noted between the h-indices of full professors and associate/assistant professors (p < .001). Median h-indices equaled 14 for full professors (Interquartile range [IQR] =11); 7 for associate professors (IQR =7) and 6.5 for assistant professors (IQR = 8). h-indices of MDâs and PhDâs did not differ significantly. Moderate correlation between GS and WOS h-indices was noted R = 0.46, p < .001. Conclusions: The results provide some guidance as to the expected h-indices of a select group of medical educators. No differences appear to exist between assistant professor and associate professor ranks or between MDâs and PhDâs
Digital storytelling in health professions education: a systematic review
Abstract Background Digital stories are short videos that combine stand-alone and first-person narratives with multimedia. This systematic review examined the contexts and purposes for using digital storytelling in health professions education (HPE) as well as its impact on health professionalsâ learning and behaviours. Methods We focused on the results of HPE studies gleaned from a larger systematic review that explored digital storytelling in healthcare and HPE. In December 2016, we searched MEDLINE, EMBASE, PsycINFO, CINAHL, and ERIC. We included all English-language studies on digital storytelling that reported at least one outcome from Levels 2 (learning) or 3 (behaviour) of The New World Kirkpatrick Model. Two reviewers independently screened articles for inclusion and extracted data. Results The comprehensive search (i.e., digital storytelling in healthcare and HPE) resulted in 1486 unique titles/abstracts. Of these, 153 were eligible for full review and 42 pertained to HPE. Sixteen HPE articles were suitable for data extraction; 14 focused on health professionalsâ learning and two investigated health professionalsâ learning as well as their behaviour changes. Half represented the undergraduate nursing context. The purposes for using digital storytelling were eclectic. The co-creation of patientsâ digital stories with health professionals as well as the creation and use of health professionalsâ own digital stories enhanced learning. Patientsâ digital stories alone had minimal impact on health professionalsâ learning. Conclusions This review highlights the need for high-quality research on the impact of digital storytelling in HPE, especially on health professionalsâ behaviours. PROSPERO registration number CRD42016050271