Resident selection in residency programs, while aiming to be equitable, may be influenced negatively by policies designed for operational improvements and mitigating medico-legal dangers, which can end up giving an unexpected benefit to CSA. To cultivate an equitable selection process, discerning the reasons behind these potential biases is required.
The COVID-19 pandemic progressively amplified the complexities of readying students for workplace-based clerkships and fostering their professional development. Clerkship rotations, previously structured, underwent a complete transformation and reinvention in the wake of COVID-19's impact, with a surge in e-health and technology-enhanced learning adoption. Despite this, the practical merging of learning and teaching activities, and the implementation of well-conceived foundational principles in pedagogy within higher education, remain difficult to enact during this pandemic. This paper details the implementation of our clerkship rotation, exemplified by the transition-to-clerkship (T2C) course, and analyzes the challenges faced by various stakeholders, drawing on practical insights gained.
The focus of competency-based medical education (CBME) is the development of a curriculum that ensures graduates are able to competently handle and meet the needs of their patients. Key to CBME's efficacy is resident engagement, however, few studies have investigated trainee experiences within the context of CBME implementation. By examining the experiences of residents within Canadian training programs that had adopted CBME, we aimed to gain insights.
Exploring resident experiences with CBME, we conducted semi-structured interviews with 16 residents enrolled in seven Canadian postgraduate training programs. A fair allocation of participants was made, with half assigned to family medicine and half to specialty programs. Constructivist grounded theory principles were instrumental in discerning the themes.
Residents' initial support for CBME's objectives waned upon encountering significant hurdles, specifically regarding assessment and feedback practices. Performance anxiety was a frequent consequence for residents subjected to a substantial administrative burden and rigorous assessment process. Assessments, at times, were deemed meaningless by residents, as supervisors concentrated on cursory check-box exercises rather than supplying focused and detailed observations. Beyond that, they habitually voiced frustration with the subjective and inconsistent evaluation process, notably when assessments were used to delay progress towards greater self-sufficiency, prompting attempts to manipulate the system. Methylation inhibitor Resident experiences with CBME benefited from enhanced faculty engagement and support.
While residents appreciate the potential of CBME to enhance educational quality, assessment, and feedback mechanisms, the current implementation of CBME may not always meet these goals consistently. The authors advocate for multiple initiatives designed to improve residents' perceptions of CBME assessment and feedback mechanisms.
While residents appreciate CBME's promise to improve the quality of education, assessment, and feedback, the current application of CBME may not consistently reach these objectives. Several initiatives are proposed by the authors to enhance resident experiences during assessment and feedback in CBME.
Medical schools have a duty to foster students who understand and champion the needs of the surrounding community. While clinical learning objectives are important, the social determinants of health are not always a central concern. By providing a structured approach to reflection, learning logs effectively engage students in clinical encounters and support their focused skill acquisition. Learning logs, despite their demonstrated efficacy, are largely applied within medical education to cultivate biomedical knowledge and procedural proficiency. In this vein, students' ability to effectively address the psychosocial problems within the scope of comprehensive medical interventions may be limited. Third-year medical students at the University of Ottawa were given experiential social accountability logs to tackle and counteract the effects of social determinants of health. This initiative, as evidenced by student quality improvement surveys, proved beneficial to their learning and fostered greater clinical confidence. The flexibility of experiential logs in clinical training allows them to be applied across medical schools, further customized to meet the distinct community needs and priorities of each respective institution.
A concept central to professionalism encompasses various attributes and involves a significant feeling of commitment and responsibility toward patient care. Limited knowledge exists concerning the emergence of this concept's embodiment in the early stages of clinical education. This qualitative study aims to investigate the evolution of patient care ownership during the clerkship experience.
A qualitative descriptive approach was utilized in conducting twelve, one-on-one, semi-structured interviews with the final-year medical students of a single university. The trainees were prompted to articulate their understanding and convictions on patient care ownership and the mechanisms through which these cognitive models were cultivated during the clerkship, emphasizing the conditions conducive to their development. Using a qualitative descriptive approach to methodology, the data were inductively analyzed, with professional identity formation acting as a sensitizing theoretical framework.
The development of ownership of patient care in students is a consequence of professional socialization, which includes the impact of role models, self-assessment, the learning environment, healthcare and curriculum frameworks, the attitudes and interactions of others, and growing proficiency. The resulting ownership of patient care translates into an understanding of patient needs and values, active participation of patients in their care, and consistent accountability for patient outcomes.
An examination of the development of patient care ownership during early medical training, and its accompanying enabling forces, suggests ways to enhance this vital skill. This includes strategies like enriching curricula with longitudinal patient interaction, establishing a positive learning environment with clear role models, assigning responsibilities explicitly, and providing deliberate autonomy.
An awareness of how ownership of patient care is established in early medical training and the contributing elements, can suggest approaches for enhancing this process, including curricula that integrate greater longitudinal patient encounters, a supporting learning environment including positive role models, clear assignment of duties, and intentionally granted decision-making authority.
In residency education, the Royal College of Physicians and Surgeons of Canada has recognized Quality Improvement and Patient Safety (QIPS) as crucial, however, the discrepancy among previously created curricula presents a constraint to wider implementation. A longitudinal, resident-led patient safety curriculum, which incorporated relatable real-life patient safety incidents and an analytical framework, was developed. Its implementation was straightforward, well-received by residents, and significantly improved resident knowledge, skills, and attitudes concerning patient safety. Our pediatric residency program's curriculum fostered a culture of patient safety (PS), encouraging early engagement in quality improvement processes (QIPS) and addressing a deficiency in the existing curriculum.
The link between physician characteristics like education and demographics, and their practice patterns, such as rural practice, is noteworthy. By comprehending the Canadian angle of these affiliations, one can improve medical school admissions and health workforce decisions.
The goal of this scoping review was to describe the nature and extent of research investigating the relationship between physicians' characteristics in Canada and their clinical practices. Research studies were incorporated that showed relationships between the educational qualifications and socioeconomic characteristics of Canadian physicians or residents, and their practice behaviors, including career choices, practice locations, and patient demographics.
Our search for quantitative primary studies encompassed five electronic databases: MEDLINE (R) ALL, Embase, ERIC, Education Source, and Scopus. Furthermore, we conducted a thorough review of the reference lists of identified studies to uncover any additional relevant studies. The data were extracted, facilitated by a standardized data charting form.
Our search process produced a substantial collection of 80 research studies. Sixty-two students, divided into equal groups of undergraduate and postgraduate, undertook examinations of education. germline epigenetic defects A study of fifty-eight physicians was undertaken to investigate their attributes, a large portion of which involved analyzing their sex/gender considerations. The overwhelming majority of the research focused on the results engendered by the practice setting. A comprehensive literature review uncovered no examination of race/ethnicity and socioeconomic status.
Our review showcased positive associations in multiple studies between rural training or rural background and rural practice locations, and the location of physician training and the subsequent practice location, in accordance with previous literature. A complex and variegated relationship between sex/gender and workforce demographics emerged, implying that this metric might hold less predictive power in workforce planning or recruitment initiatives designed to address imbalances in healthcare provision. Antiretroviral medicines To better understand the relationship between characteristics, such as race/ethnicity and socioeconomic standing, and career choices made, alongside the populations being served, additional research is needed.
Positive associations were frequently observed in our reviewed studies, linking rural training or rural backgrounds to rural practice. This association, related to physicians' origin and practice location, mirrors findings in earlier studies.