From vision to implementation: Building a national undergraduate paediatric curriculum

Objective There are many challenges in ensuring medical students learn paediatrics. Medical educators must develop and maintain curricula that meet learners’ needs and accreditation requirements. Paediatricians and family physicians, practicing and teaching in busy clinical environments, require Canadian-relevant curricular guidance and resources to teach and assess learners. Students struggle with curricular cohesion, clear expectations, and resources. Recognizing these challenges and acknowledging the need to address them, the Paediatric Undergraduate Program Directors of Canada (PUPDOC) created canuc-paeds, a comprehensive competency-based undergraduate curriculum that teachers and students would actually use. Methods Curriculum development included the following: utilization of best practices in curriculum development, an environmental scan, development of guiding principles, Delphi surveys, in-person meetings, and quality improvement. All Canadian paediatric undergraduate educator leaders and other stakeholders were invited to participate. Results The curriculum, based on the RCPSC CanMEDS Framework, includes 29 clinical presentations, each with key conditions, foundational knowledge objectives, and learning resources. Essential paediatric-specific physical examination and procedural skills that graduating medical students are expected to perform are identified. Objectives specific to Intrinsic Roles of Collaborator, Communicator, Professional, Leader, Health Advocate and Scholar that can be assessed in the field of paediatrics at the undergraduate level are articulated. The national curriculum has been implemented widely at Canadian medical schools. Online, open-access clinical resources have been developed and are being used world-wide. Conclusion This curriculum provides overarching Canadian-specific curricular guidance and resources for students and for the paediatricians and family physicians who are responsible for teaching and assessing undergraduate learners.

Comparative Effectiveness of OSCEs, Virtual OSCEs, and Traditional Testing Methods in Assessing Medical School Students’ Competencies: A Scoping Review Protocol

Advancements in virtual medical education, particularly the technical advancements, are immediately relevant to other types of post-graduate education and undergraduate education. As future medical experts, medical students need to demonstrate the competencies summarized in the CanMEDS framework (professional, communicator, collaborator, leader, health advocate, scholar, medical expert). This scoping review aims to understand the advantages and the shortcomings of OSCEs in assessing the CanMEDS roles, and the comparative effectiveness of virtual versus in-person OSCEs.

Not wanted on the voyage: highlighting intrinsic CanMEDS gaps in Competence by Design curricula

Background: As governing bodies design new curricula that seek to further incorporate principles of competency-based medical education within time-based models of training, questions have been raised regarding the continued centrality of existing CanMEDS competencies. Although efforts have been made to align these new curricula with CanMEDS, we don’t yet know to what extent these competencies are meaningfully integrated. Methods: A content analysis approach was used to systematically evaluate national Canadian curricula for 18 residency-training programs and determine the number of times each enabling CanMEDS competency was represented. Results: Clear trends persisted across all programs. Medical Expert and Collaborator competencies were well integrated into curriculum (81% and 86% mapped to assessment) while competencies related to the Leader, Professional, and Health Advocate roles were less frequently mapped to assessment (41%, 36%, and 40%) and were often absent from the new curricula altogether (59%, 64%, and 60%). Conclusion: Deliberate planning in curriculum development affords the early identification of gaps. These gaps can inform current assessment practice and future curricular development by providing direction for innovation. If we are to ensure that any new curricula meaningfully address all CanMEDS roles, we need to think carefully about how to best teach and assess underrepresented competencies.

Are South African anaesthesiologists fit for purpose? A comparison of opinions of graduates, teachers and examiners

Background: Anaesthesiologists must be assessed as and deemed fit for purpose (FFP) to function independently as specialists prior to their embarking on independent practice. Opinions of various stakeholders are useful in determining whether graduating specialists are prepared for practice, some of which include teachers, examiners and the graduates themselves. Methods: This descriptive quantitative study comprised recent graduates and anaesthesiology teachers and examiners from all eight national university departments of anaesthesiology. Each participant scored the preparedness of graduates’ competences deemed appropriate by national experts via an electronic survey. Nine specialist role meta-competences (medical expert, communicator, collaborator, leader, health advocate, scholar, professional, context awareness, humaneness) with their accompanying 101 component enabling competences were assessed. Participants used a 4-point Likert scale to score preparedness for each meta- and enabling competence (1– completely unprepared; 2 – somewhat prepared; 3 – prepared; 4 – completely prepared). Scores of 1 and 2 were considered as unprepared and 3 and 4 as prepared. Scores of graduates, teachers and examiners were compared. After individual group comparisons, the scores of combined teachers and examiners (seniors) were compared with those of graduates. Results: Response rates for graduates, teachers and examiners were 85%, 68% and 96% respectively. Graduates felt prepared for 7/9 roles (medical expert, collaborator, communicator, professional, scholar, context awareness and humaneness) and unprepared for the roles of health advocate and leader. Teachers’ and examiners’ scores were similar, perceiving graduates as prepared for 4/9 roles (medical expert, collaborator, context awareness and humaneness) and unprepared for the majority of their roles (communicator, scholar, professional, leader and health advocate). Leader and health advocate roles were unanimously perceived as unprepared by all three groups. Statistically significant disparate scores were evident between seniors and graduates for the roles of communicator, scholar and professional, with graduates assessing themselves as more prepared compared to the opinions of seniors. Conclusion: According to South African national anaesthesiology teachers and examiners, local graduates may not be fit for purpose, despite the contrasting perceptions of graduates. Graduates’ self-assessment may be less objective than that of experienced opinions, necessitating the need for longitudinal assessments to establish the impact of experience on subsequent graduate perceptions.

Residents’ perspectives: Does the Saudi general surgery residency training program apply CanMEDS competencies and prepare future leaders?

Background: This study investigates leadership skills and Canadian Medical Education Directives for Specialists (CanMEDS) competencies acquisition within the General Surgery Residency Training Program (GSRTP). The Saudi Commission for Health Specialties (SCFHS) incorporates the CanMEDS Competency Framework into its curriculum to prepare the resident for healthcare needs. Methods: This is a descriptive-analytical study. A questionnaire was used to collect data from 117 General Surgery residents (GS) at seven institutes in Jeddah, Saudi Arabia. Results: The GS residents reported an acceptable self-perceived level of Clinical Leadership Skills (mean ± standard deviation). The most dominant skill was working with others (1.98 ± 1.03), followed by demonstrating personal qualities (2.07 ± 0.88), the ability to manage services (2.21 ± 1.37), improving services (2.22 ± 1.84) and last, setting directions (2.39 ± 0.95). Regarding the CanMEDS competencies, the respondents showed a generally positive perception with an “agree” level (Mean = 1.83). Of the CanMEDS competency roles, Collaborator ranked first followed by Professional and then Communicator. Leader competency ranked fourth followed by Health Advocate, Medical Expert and last, Scholar. Conclusion: The GSRTP residents showed satisfactory self-assessed clinical leadership skills and acquirement of the CanMEDS competencies during their training, which will prepare them to lead in the future.

Engaging Youth Through Digital Badges to Promote Health in Underserved Communities

The CHAMPIONS NETWork program trains Chicago high school students as health advocates while preparing them to become future health professionals. We added digital badging to the curriculum in its third year of programming (2018). This article describes methods and student feedback about digital badging, allowing others to implement similar technology-driven opportunities to engage youth and promote healthy living. Program staff created seven online experiences (XPs) on health advocacy that made up a playlist. Students adopted three adults as clients and completed four XPs themselves and three with clients. Completion of all XPs resulted in a digital badge—an electronic portfolio of health advocacy experiences to be shared with employers and colleges. Following the 2019 cohort’s completion of the digital badge, we conducted two focus groups with students about their feedback on the digital badge. Results showed that students most liked the healthy eating and cardiopulmonary resuscitation XPs. They had more positive reactions to the experience than negative, and especially appreciated aspects of active learning, as well as the badge’s long-term benefits. This technology can potentially help any student with access to an electronic device become a health advocate, and could become a new tool for career development while improving population health.