Disruption and Dissonance: Exploring Constructive Tensions Within Research in Medical Education

The academic medicine community has experienced an unprecedented level of disruption in recent years. In this context, the authors consider how the disruptions have impacted the state of research in medical education (RIME). The articles in this year\u27s RIME supplement reflect several constructive tensions that provide insight on future for the field. In this commentary, the authors discuss themes and propose a framework for the future. Recommendations include: normalizing help seeking during times of disruption and uncertainty, contextualizing the application of complex approaches to assessment, advancing and problematizing innovation, and recognizing the deeply embedded and systemic nature of inequities

The current utility and future use of the medical student performance record: A survey of perceptions across Canada

Introduction: The MSPR is a Canada wide tool that provides aggregate information on MD students’ performance during training and used widely as part of PG admissions. This survey study elicits the perceptions of PG admissions stakeholders on the current use and future utility of the MSPR in Canada. Methods: PG admissions stakeholders across the faculties of medicine were convenience sampled for a 15-question online survey in the fall of 2018. Participants were asked how and when the MSPR is incorporated into the admissions process and perceptions and recommendations for improvement Data are summarized descriptively and thematically. Results: Responses came from 164 participants across the 17 faculties of medicine. The MSPR was widely used (92%), most commonly in the file review process (52%) for professionalism issues. The majority of responses indicated that MSPRs were not fair for all MD students (60%) and required revision (74%) with greater emphasis required on transparency, professionalism, and narrative comments. Discussion: The results indicate that though MSPRs are widely used in PG admissions their perceived value is limited to a few specific sources of information and to specific parts of the admissions process. There are significant concerns from PG stakeholders on the utility of MSPRs and future changes should align with the needs of these stakeholders while balancing the concerns of students and undergraduate programs

Six façons d’accroître le taux de réponse aux sondages : conclusions tirées d’une enquête dans le cadre de l’agrément d’une faculté de médecine au Canada

Background: Surveys are being increasingly used to gather feedback and study data in healthcare professions. However, it may be challenging to achieve high response rates in surveys administered to healthcare professionals. The aim of this paper is to report six strategies that contributed to a high response rate on the Independent Student Analysis at the University of Toronto (U of T), which can be applied to other surveys to achieve strong response rates amongst healthcare professionals. Methods: In 2019, as part of accreditation for the U of T MD Program, we conducted the Independent Student Analysis, a student-led survey examining a medical student’s experience. We review and critically evaluate the factors that contributed to a robust response rate amongst one of the largest cohorts of medical students in Canada. Results: Among 1080 students in the MD program, we achieved an unprecedented response rate of 87.2%. Six factors were identified that most contributed to our high response rate, including: faculty support, student representation, eliciting participant feedback, creating protected time for completion, offering incentives, and generating awareness. Conclusions: Eliciting high survey response rates from medical learners can be challenging. However, with careful consideration of learner feedback and effective employment of the strategies discussed in this paper, medical school faculty may better engage students in survey completion, achieving higher response rates and gathering richer insight, which can be used to more effectively enact meaningful change amongst healthcare professionals.Contexte : Les enquêtes auprès de professionnels de la santé sont de plus en plus utilisées pour recueillir et étudier des perspectives et des données, mais il peut s’avérer difficile d’obtenir des taux de réponse élevés. Cet article vise à présenter six stratégies qui ont permis de susciter une forte participation à l’enquête de l’Analyse indépendante des étudiants à l’Université de Toronto et qui peuvent être transposées à d’autres contextes de sondage auprès des professionnels du domaine. En 2019, dans le cadre du processus d’agrément du programme de doctorat en médecine de l’Université de Toronto, nous avons réalisé l’Analyse indépendante des étudiants, une enquête dirigée par les étudiants en médecine visant à examiner leur expérience. Nous passons en revue et évaluons de manière critique les facteurs qui ont contribué à l’atteinte d’un taux de réponse élevé auprès d’une des plus grandes cohortes d’étudiants en médecine au Canada. Résultats : Nous avons obtenu un taux de réponse sans précédent de 87,2 % parmi les 1 080 étudiants inscrits au programme de médecine. Les six facteurs qui ont le plus contribué à ce taux de réponse élevé sont : le soutien du corps professoral, la représentation des étudiants, leur participation à la conception de l’enquête, la création de plages horaires réservées pour remplir le questionnaire, l’offre d’incitatifs et la sensibilisation. Conclusions : Il peut être difficile de susciter une forte participation aux questionnaires chez les étudiants en médecine. Cependant, en considérant attentivement les commentaires des apprenants et en utilisant efficacement les stratégies présentées dans cet article, le corps professoral seront en mesure de mobiliser les étudiants à participer davantage aux enquêtes et de tirer profit de leur apport pour éclairer la promotion de changements pertinents chez les professionnels de la santé

Recherche interinstitutionnelle en éducation fondée sur des données : valeurs consensuelles, principes et recommandations pour guider le partage éthique des données administratives relatives à l’enseignement médical à des fins de recherche au Canada

Background: Administrative data are generated when educating, licensing, and regulating future physicians, but these data are rarely used beyond their pre-specified purposes. The capacity necessary for sensitive and responsive oversight that supports the sharing of administrative medical education data across institutions for research purposes needs to be developed. Method: A pan-Canadian consensus-building project was undertaken to develop agreement on the goals, benefits, risks, values, and principles that should underpin inter-institutional data-driven medical education research in Canada. A survey of key literature, consultations with various stakeholders, and five successive knowledge synthesis workshops informed this project. Propositions were developed, driving subsequent discussions until collective agreement was distilled. Results: Consensus coalesced around six key principles: Establishing clear purposes, rationale, and methodology for inter-institutional data-driven research a priori; informed consent from data generators in education systems is non-negotiable; multi-institutional data sharing requires special governance; data governance should be guided by data sovereignty; data use should be guided by an identified set of shared values; and best practices in research data-management should be applied. Conclusion: We recommend establishing a representative governance body, engaging a trusted data facility, and adherence to extant data management policies when sharing administrative medical education data for research purposes in Canada.Contexte : Des données administratives sont générées dans le cadre de la formation des médecins, d’octroi de permis d’exercice et de réglementation des activités professionnelles, mais ces données sont rarement utilisées au-delà de leurs objectifs prédéfinis. Il convient de créer un système de supervision réactif et sensible aux risques pour permettre le partage de données relatives à l’enseignement médical entre établissements à des fins de recherche. Méthode : Une initiative pancanadienne de recherche de consensus a été réalisée pour parvenir à un accord sur les objectifs, les avantages, les risques, les valeurs et les principes qui devraient sous-tendre la recherche interinstitutionnelle sur l’enseignement médical à l’aide des données existantes. Ce projet s’est appuyé sur une analyse de la littérature scientifique, sur des consultations avec diverses parties prenantes et sur cinq ateliers successifs de synthèse des connaissances. Des discussions ont été menées sur la base de propositions formulées préalablement jusqu’à la cristallisation d’un accord collectif. Résultats : Un consensus s’est dégagé autour de six principes clés : la création a priori d’objectifs, d’une logique et d’une méthodologie clairs pour la recherche interinstitutionnelle fondée sur les données; l’obtention, sans exception, du consentement éclairé des personnes concernées par la collecte de données dans les systèmes d’éducation; la création d’un cadre de gouvernance visant spécifiquement le partage des données entre établissements; le respect, dans ce cadre, de la souveraineté des données; l’utilisation des données fondée sur un ensemble de valeurs partagées; et l’application des meilleures pratiques en matière de gestion des données de recherche

Promouvoir la confiance, la collaboration et une culture d'amélioration continue de la qualité : appel à la transparence dans l’agrément des facultés de médecine

Medical schools provide the foundation for a physician’s growth and lifelong learning. They also require a large share of government resources. As such, they should seek opportunities to maintain trust from the public, their students, faculty, universities, regulatory colleges, and each other. The accreditation of medical schools attempts to assure stakeholders that the educational process conforms to appropriate standards and thus can be trusted. However, accreditation processes are poorly understood and the basis for accrediting authorities’ decisions are often opaque.  We propose that increasing transparency in accreditation could enhance trust in the institutions that produce society’s physicians. While public reporting of accreditation results has been established in other jurisdictions, such as Australia and the United Kingdom, North American accrediting bodies have not yet embraced this more transparent approach. Public reporting can enhance public trust and engagement, hold medical schools accountable for continuous quality improvement, and can catalyze a culture of collaboration within the broader medical education ecosystem. Inviting patients and the public to peer into one of the most formative and fundamental parts of their physicians’ professional training is a powerful tool for stakeholder and public engagement that the North American medical education community at large has yet to use

Development of Scientific Competences in Chemistry Courses

Enseñar química en los primeros años de educación universitaria es clave en la formación de futuros profesionales, puesto que, además de proveer los conocimientos que aportan las ciencias básicas, contribuye al desarrollo de competencias científicas para que el estudiante resuelva problemas reales, a partir de la búsqueda adecuada de información en fuentes confiables y su lectura, con el propósito de desarrollar habilidades analíticas, críticas y creativas. Es por esto que, como estrategia de innovación pedagógica, el Departamento de Ciencias Básicas de la Universidad de La Salle ha venido implementando desde el año 2016 la formulación de un proyecto de investigación en los cursos de química. En el marco de esta estrategia, desde el II-2018 las autoras se abocaron a la reflexión e implementación de la estrategia didáctica que propende por el desarrollo de competencias científicas en los cursos de Química General, Química Orgánica y Bioquímica desde tareas, investigación y aprendizaje de problemáticas vigentes en Colombia y en el mundo.Abstract: Teaching chemistry in the first years of university education is key in the training of future professionals since, in addition to providing the knowledge of the basic sciences, it contributes to the development of scientific skills that lead to the student to solve real problems, starting from the appropriate search of information in reliable sources and its reading with the purpose of developing analytical, critical and creative skills. Therefore, as a pedagogical innovation strategy, the formulation of a research project in chemistry courses has been implemented since 2016 by the Department of Basic Sciences of the Universidad de La Salle. Within the framework of this strategy, from II-2018 the authors focused on the reflection and implementation of the didactic strategy that depends on the development of scientific competences in the courses of General Chemistry, Organic Chemistry and Biochemistry from tasks, research and learning of current problems in Colombia or in the world

Assessment for Learning: The University of Toronto Temerty Faculty of Medicine M.D. Program Experience

(1) Background: Programmatic assessment optimizes the coaching, learning, and decision-making functions of assessment. It utilizes multiple data points, fit for purpose, which on their own guide learning, but taken together form the basis of holistic decision making. While they are agreed on principles, implementation varies according to context. (2) Context: The University of Toronto MD program implemented programmatic assessment as part of a major curriculum renewal. (3) Design and implementation: This paper, structured around best practices in programmatic assessment, describes the implementation of the University of Toronto MD program, one of Canada’s largest. The case study illustrates the components of the programmatic assessment framework, tracking and making sense of data, how academic decisions are made, and how data guide coaching and tailored support and learning plans for learners. (4) Lessons learned: Key implementation lessons are discussed, including the role of context, resources, alignment with curriculum renewal, and the role of faculty development and program evaluation. (5) Conclusions: Large-scale programmatic assessment implementation is resource intensive and requires commitment both initially and on a sustained basis, requiring ongoing improvement and steadfast championing of the cause of optimally leveraging the learning function of assessment