scholarly journals LO15: Not a hobby anymore: Establishment of the Global Health Emergency Medicine organization at the University of Toronto to facilitate academic careers in global health for faculty and residents

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S32
Author(s):  
C. Hunchak ◽  
L. Puchalski Ritchie ◽  
M. Salmon ◽  
J. Maskalyk ◽  
M. Landes
Keyword(s):  
Emergency Medicine ◽  
Global Health ◽  
Academic Career ◽  
Critical Mass ◽  
Practice Research ◽  
University Of Toronto ◽  
Academic Benefits ◽  
Seed Funding ◽  
Academic Plan ◽  
The University

Introduction/Innovation Concept: Demand for training in global health emergency medicine (EM) practice and education across Canada is high and increasing. For faculty with advanced global health EM training, EM departments have not traditionally recognized global health as an academic niche warranting support. To address these unmet needs, expert faculty at the University of Toronto (UT) established the Global Health Emergency Medicine (GHEM) organization to provide both quality training opportunities for residents and an academic home for faculty in the field of global health EM. Methods: Six faculty with training and experience in global health EM founded GHEM in 2010 at a UT teaching hospital, supported by the leadership of the ED chief and head of the Divisions of EM. This initial critical mass of faculty formed a governing body, seed funding was granted from the affiliated hospital practice plan and a five-year strategic academic plan was developed. Curriculum, Tool, or Material: GHEM has flourished at UT with growing membership and increasing academic outputs. Five governing members and 9 general faculty members currently run 18 projects engaging over 60 faculty and residents. Formal partnerships have been developed with institutions in Ethiopia, Congo and Malawi, supported by five granting agencies. Fifteen publications have been authored to date with multiple additional manuscripts currently in review. Nineteen FRCP and CCFP-EM residents have been mentored in global health clinical practice, research and education. Finally, GHEM’s activities have become a leading recruitment tool for both EM postgraduate training programs and the EM department. Conclusion: GHEM is the first academic EM organization in Canada to meet the ever-growing demand for quality global health EM training and to harness and support existing expertise among faculty. The productivity from this collaborative framework has established global health EM at UT as a relevant and sustainable academic career. GHEM serves as a model for other faculty and institutions looking to move global health EM practice from the realm of ‘hobby’ to recognized academic endeavor, with proven academic benefits conferring to faculty, trainees and the institution.

Pregraduate Training in Emergency Medicine

1993 ◽  
Vol 8 (1) ◽  
pp. 69-75 ◽  
Author(s):  
Louis Binder ◽  
Desmond Colohan ◽  
Wolfgang Dick ◽  
Bernard Nemitz ◽  
Yoel Donchin ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Undergraduate Education ◽  
Medical Center ◽  
Disaster Medicine ◽  
World Congress ◽  
Medical Organization ◽  
University Of Toronto ◽  
Texas Tech University ◽  
The University ◽  
Seventh World

AbstractA panel session on undergraduate education in Emergency Medicine from a worldwide perspective was conducted at the Seventh World Congress of Emergency and Disaster Medicine in Montreal, in May, 1991. Desmond Colohan MD, of the University of Toronto (Canada) was the panel moderator. Panel speakers were: Louis Binder MD, Texas Tech University Health Services Center (USA); Wolfgang Dick MD, University of Mainz (Germany); Bernard Nemitz MD, Faculty de Medicine d'Ameins (France); Yoel Donchin MD, Hadassa Medical Organization (Israel); and Noriyoshi Ohashi MD, Tsukuba Medical Center (Japan).

scholarly journals MP18: Addressing unrealistic expectations: a novel transition to discipline curriculum in emergency medicine

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S48
Author(s):  
L. Costello ◽  
N. Argintaru ◽  
A. Wong ◽  
R. Simard ◽  
M. Chacko ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Clinical Exposure ◽  
Professional Activities ◽  
University Of Toronto ◽  
Airway Trauma ◽  
Self Assessments ◽  
Simulation Session ◽  
Interactive Workshop ◽  
The University ◽  
Spaced Repetition

Innovation Concept: Emergency medicine (EM) programs have restructured their training using a Competence by Design model. This model emphasizes entrustable professional activities (EPAs) that residents must fulfill before advancing in their training. The first EPA (EPA 1) for the transition to discipline (TTD) stage involves managing the unstable patient. Data from the University of Toronto (U of T) program suggests residents lack enough exposure to these patient presentations during TTD – creating a disconnect between anticipated clinical exposure and the expectation for residents to achieve competence in EPA 1. Methods: To overcome this gap, U of T EM faculty specifically targeted EPA 1 while designing the TTD curriculum. Kern's six-step approach to curriculum development in medical education was used. This six-step approach involves: problem identification, needs assessment, goals and objectives, education strategies, implementation and evaluation. To maximize feasibility of the new curriculum, existing sessions were mapped against EPAs and required training activities to identify synchrony where possible. Residents were scheduled on EM rotations with weekly academic days that included this novel curriculum. Curriculum, Tool or Material: Didactic lectures, procedural workshops and simulation were closely integrated in TTD to address EPA 1. Lectures introduced approaches to cardinal presentations. An interactive workshop introduced ACLS and PALS algorithms and defibrillator use. Three simulation sessions focused on ACLS, shock, airway, trauma and the altered patient. A final simulation session allowed spaced-repetition and integration of these topics. After the completion of TTD, residents participated in a six-scenario simulation OSCE directly assessing EPA 1. Conclusion: The curriculum was evaluated using a multifaceted approach including surveys, self-assessments, faculty feedback and OSCE performance. Overall, the curriculum achieved its goal in addressing EPA 1. It was well-received by faculty and residents. Residents rated the sessions highly, and self-reported improved confidence in assessing unstable patients and adhering to ACLS algorithms. The simulation OSCE demonstrated expected competency by residents in EPA 1. One limitation identified was the lack of a pediatric simulation session which has now been incorporated into the curriculum. Moving forward, this innovative curriculum will undergo continuous cycles of evaluation and improvement with a goal of applying a similar design to other stages of CBD.

scholarly journals WHAT IS ENGINEERING SCIENCE? DEFINING A DISCIPLINE THROUGH A CROSS-INSTITUTIONAL COMPARISON AND A MULTI-INSTITUTIONAL WORKSHOP

2020 ◽  
Author(s):  
Lisa Romkey ◽  
Nikita Dawe ◽  
Rubaina Khan
Keyword(s):  
Academic Discipline ◽  
Grey Literature ◽  
The State ◽  
Academic Programs ◽  
Engineering Science ◽  
Science And Engineering ◽  
University Of Toronto ◽  
Academic Plan ◽  
Internal And External Factors ◽  
The University

The Division of Engineering Science at the University of Toronto offers a complex, multidisciplinary undergraduate program, commonly known as "EngSci”. We are in the first of a multi-year project titled ROLE (Realigning Outcomes with Learning Experiences), designed to proactively realign curriculum, pedagogy, students, and brand with our program goals. The first step in this process is to understand the state of Engineering Science as an academic discipline more broadly, and to better understand its role in the broader engineering and science landscape.  To better understand the discipline, we have used the academic plan model to compare eight engineering science programs from around the globe. The academic plan model supports the identification of internal and external factors that shape academic programs and frames the academic plan itself as seven related components that make up curriculum. Utilizing public-facing documentation such as websites and grey literature, we compared the IESC (International Engineering Science Consortium) programs and found differences in fundamental curriculum content, sub-disciplinary foci, organizational structure, and sources of external influence.  Concurrently, we conducted a workshop with members from the IESC to facilitate dialogue on the state of the discipline. This workshop resulted in a number of interesting artifacts, documenting the perspective of the participants. Some key themes that emerged included a strong focus on fundamentals and first principles; a focus on non-traditional and rapidly developing sub-disciplines, using the notion that Engineering Science can act as an “incubator” for new disciplines; and a diversity of views on the relationship between science and engineering within Engineering Science programs.  Finally, the paper paves a way forward for the next phase of the work, which involves interviewing program faculty and alumni to further understand perceptions of the discipline and the positioning of the discipline in the broader science and engineering landscape. 

scholarly journals P023: Development of a Canadian Global Health Emergency Medicine (GHEM) Certificate Program based on established best practices

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S72-S73
Author(s):  
R. Stefan ◽  
J. Maskalyk ◽  
L. Puchalski Ritchie ◽  
M. Salmon ◽  
M. Landes
Keyword(s):  
Emergency Medicine ◽  
Best Practices ◽  
Global Health ◽  
Addis Ababa ◽  
Phase 1 ◽  
Lessons Learned ◽  
Certificate Program ◽  
University Of Toronto ◽  
Fellowship Programs ◽  
Multi Phase

Innovation Concept: Global health fieldwork is valuable for Canadian residents, but is often trainee-organized, short-term, unsupervised, and lacking in preparation and debriefing. In contrast, we have developed a Certificate Program which will be offered to University of Toronto (UofT) emergency medicine (EM) trainees in their final year of residency. This 6-month Program will complement the Transition to Practice stage for residents interested in becoming leaders in GHEM. Methods: We completed a multi-phase needs assessment to inform the structure and content of a GHEM Certificate Program. Phase 1 consisted of 9 interviews with Program Directors (PDs), Assistant PDs, and past fellows from existing GH fellowships in Canada and USA to understand program structure, curriculum, fieldwork and funding. In Phase 2 we interviewed 4 PDs and fellows from UofT fellowship programs to understand local administrative structures. In Phase 3 we collected feedback from 5 UofT residents and 7 faculty with experience in global health to assess interest in a local GHEM Program. All interview data was reviewed and best practices and lessons learned from key stakeholders were summarized into a proposed outline for a 6-month GHEM Certificate Program. Curriculum, Tool, or Material: The Program will comprise of 1) 3 months of preparatory work in Toronto followed by 2) 3 months of fieldwork in Addis Ababa, Ethiopia. Fieldwork will coincide with activities under the Toronto-Addis Ababa Academic Collaboration in Emergency Medicine (TAAAC-EM). The GHEM trainee's work will support TAAAC-EM activities. Preparatory months will include training in specific competencies (POCUS, teaching, tropical medicine, QI) and meetings between the trainee and a UofT mentor to design an academic project. During fieldwork, the trainee will do EM teaching (75% of time) and complete their academic project (25% of time). A UofT supervisor will accompany, orient and supervise the trainee for their first 2 weeks in Addis. Throughout fieldwork, the trainee will be required to debrief with their UofT mentor weekly for academic and clinical mentoring. One AAU faculty member will be identified as a local supervisor and will participate in all evaluations of the trainee during fieldwork. Conclusion: This Program will launch with a call for applications in July 2021, expecting the first trainee to complete the Program in 2022-23. We anticipate that this Program will increase the number of Canadian EM trainees committed to global health projects and partnerships throughout their career.

scholarly journals Emergency medicine preclerkship observerships: evaluation of a structured experience

CJEM ◽  
2009 ◽  
Vol 11 (03) ◽  
pp. 235-239 ◽  
Author(s):  
Rick Penciner
Keyword(s):  
Emergency Medicine ◽  
Medical Students ◽  
Medical School ◽  
Role Models ◽  
Online Survey ◽  
Career Decisions ◽  
Convenience Sample ◽  
University Of Toronto ◽  
Perceptions And Attitudes ◽  
The University

ABSTRACT Objective: Medical students are expected to make residency and career decisions early in their undergraduate medical education. In medical school curricula, there is limited exposure to emergency medicine (EM) in the preclerkship years. The purpose of this study was to evaluate a structured EM observership program for preclerks by surveying the students’ perceptions and attitudes about the program following their participation. Methods: A structured observership program was developed and implemented at the University of Toronto Medical School in February 2007. All first- and second-year students were eligible to participate on a voluntary basis. Nine emergency department (ED) teaching sites were enlisted, with each site recruiting interested preceptors. The observership consisted of two 4-hour shifts with 1 preceptor at 1 site. Specific expectations were provided to the students at the start of the observership. A convenience sample was used for the period between Feb. 26 and Nov. 4, 2007, to conduct an anonymous online survey about the students' experience after the ob servership. Results: During the study period, 82 students completed 99 observerships at 9 sites with 54 different preceptors. Of the 82 students who completed the observerships, 70 students completed the survey. Overall, all the students (70/70) found the experience to be worthwhile. Most students (68/70) viewed the preceptors as good role models. As a result of the observership, 47 of 70 students reported that their attitudes about and interest in EM had changed and most (59/70) planned on exploring other opportunities in EM (e.g., electives). Conclusion: Structured EM observerships are viewed by medical students to be worthwhile. These observerships can change attitudes about and interest in EM and allow students to make more informed career choices.

scholarly journals MP21: Global emergency medicine fellowship: establishing a global EM training program at Queen’s University

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S47-S48
Author(s):  
A. Collier ◽  
S. A. Bartels ◽  
D. Messenger
Keyword(s):  
Public Health ◽  
Emergency Medicine ◽  
Global Health ◽  
Academic Career ◽  
Clinical Work ◽  
The United States ◽  
International Emergency Medicine ◽  
Master Of Public Health ◽  
Medicine Research ◽  
Training Opportunities

Introduction: Global Emergency Medicine (Global EM) is growing rapidly as an academic niche in Canada. An increasing number of Canadian emergency physicians work internationally as part of their practice, and trainees consistently seek out international projects and electives. For the most part however, residents have had to create their own training opportunities as formal Global EM fellowship training has been lacking in Canada. To address this identified need, Queens University established a Global EM fellowship, the first of its kind in the country. Methods: The fellowship is designed to provide the skills necessary for an academic career in Global Emergency Medicine. Curriculum and objectives are modeled on similar well-established fellowships in the United States. Areas of expertise include emergency medicine systems development, humanitarian medicine, disaster response, public health, tropical medicine, research, administration and education. Fellows have the opportunity to tailor their training according to their specific interests within these domains. Importantly, the fellowship provides direct mentorship from academic global EM and public health physicians, and networking opportunities within the global health sphere. Results: The two-year fellowship curriculum is divided between: 1) coursework to complete a Master of Public Health (MPH) Degree 2) fieldwork 3) relevant international emergency medicine training courses and 4) clinical work in the emergency departments at the Kingston Health Sciences Center. The Queens Global EM fellowship admitted its first fellow in August 2017. To date, the inaugural fellow has completed the MissionCraft Leadership in Disaster Relief course as well as a Humanitarian U Disaster and Response course, in addition to submitting a research grant as a co-principal investigator, starting coursework for an MPH degree and giving several invited lectures on humanitarian medicine. The fellow also travelled to Lebanon to support research in collaboration with aid organizations responding to the Syrian crisis. Upcoming fieldwork involves teaching at a newly established emergency medicine residency program in Haiti as well as a humanitarian crisis deployment. Conclusion: In response to a lack of formal international emergency medicine training opportunities in Canada, Queens University has established a Global Emergency Medicine fellowship. The fellowship aims to provide protected time, access to field opportunities and dedicated mentorship to develop the skills necessary to succeed as an academic Global EM physician. We believe it provides a unique opportunity to significantly expand fellows experiences in global health fieldwork, education and research while continuing to practice in a Canadian tertiary emergency department.

scholarly journals MP25: The quality improvement and patient safety curriculum for emergency medicine residents at the University of Toronto: results from the first cohort

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S49-S50
Author(s):  
A. H Y. Cheng ◽  
S. Vaillancourt ◽  
M. McGowan ◽  
A. Verma ◽  
A. McDonald ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Patient Safety ◽  
Quality Improvement ◽  
Practical Skills ◽  
Absolute Increase ◽  
Educational Methods ◽  
University Of Toronto ◽  
Curriculum Changes ◽  
The University ◽  
The Impact

Introduction: The 2015 CanMEDS framework requires all residency programs to increase their focus on Quality Improvement and Patient Safety (QIPS). We created a longitudinal (4-year), modular QIPS curriculum for FRCP emergency medicine residents at the University of Toronto (UT) using multiple educational methods. The curriculum addresses three levels of QIPS training: knowledge, practical skills at the microsystem level, and practical skills at the organization level. Aim Statement: To increase the UT FRCP emergency medicine residents absolute score on the QIKAT-R (Quality Improvement Knowledge Application Tool Revised) by 10% after the completion of the QIPS curriculum. Methods: Physicians and other healthcare professionals with QI expertise collaboratively designed and taught the curriculum. We used the QIKAT-R as the outcome measure to evaluate QI knowledge and its applicability. The QIKAT-R is a validated measure that assesses an individuals ability to decipher a QI issue within the healthcare context, and propose a change initiative to address it. The first cohort of residents completed the QIKAT-R prior to the first session in 2014 (pre) and at the completion of the curriculum in 2017 (post). Each response was anonymized and scored by physicians with QI expertise. The QIKAT-R scores and comments from course evaluations are used to make yearly iterative curriculum changes. Results: The QIPS curriculum was implemented in September 2014. All nine residents in the first cohort completed the curriculum; they demonstrated an absolute increase of 19.6% (5.3/27) in the mean QIKAT-R score (13.0 +/− 3.3 pre vs. 18.3 +/− 3.8 post, p=0.001). Of the pre-test responses, 26% were categorized as poor, 70% as good, and 4% as excellent, whereas of the post-test 11% of responses were categorized as poor, 37% as good, and 52% as excellent (p<0.001). Two iterative curriculum changes were made at the end of each academic year since 2014: (1) The time between sessions were decreased to promote knowledge retention, and (2) different PGY3 QI practical project options were provided to suit residents individual QI interests. QIKAT-R scores and resident feedback were used to evaluate the impact of the curriculum changes. Conclusion: A collaborative, modular, longitudinal QIPS curriculum for UT FRCP emergency medicine residents that met CanMEDS requirements was created using multiple educational methods. The first resident cohort that completed the curriculum demonstrated an absolute increase in QI knowledge and its applicability (as measured by the QIKAT-R) by 19.6%. Two PDSA cycles were completed to improve the curriculum with the change ideas generated from resident feedback. Ongoing challenges include limited staff availability to teach and supervise resident QI projects. Future directions include incentivising staff participation and providing mentorship for residents with a career interest in QI beyond what is offered by the curriculum.

scholarly journals P079: Transition to practice: evaluating the need for formal training in supervision and assessment techniques among senior emergency medicine residents and new to practice emergency physicians

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S84-S85 ◽  
Author(s):  
S. Kilbertus ◽  
K. Pardhan ◽  
G. Bandiera ◽  
J. Zaheer
Keyword(s):  
Emergency Medicine ◽  
Structured Interview ◽  
Formal Training ◽  
Independent Practice ◽  
Formal Curriculum ◽  
University Of Toronto ◽  
Constructive Feedback ◽  
Interview Guide ◽  
The University ◽  
Mcmaster University

Introduction: Final year emergency medicine residents may be transitioning to practice with little to no training on how to effectively supervise and assess trainees. It remains unclear how comfortable final year residents and new-to-practice physicians are with these competencies. The goal of our study was to examine physician comfort with supervision and assessment, whether there was a perceived need for formal training in these areas, and what gaps, barriers and enablers would exist in implementing it. Methods: Qualitative data were collected in two phases during September 2016-November 2017 through interviews of PGY5 emergency residents and new-to-practice staff at the University of Toronto and McMaster University in Ontario, Canada. A semi-structured interview guide was developed and used during the first round of interviews at the University of Toronto during phase one. Results from phase one were used to refine the interview guide, to be used in phase two, to ensure that all potential areas of thematic generation were touched upon. Phase two occurred at the University of Toronto and McMaster University using the refined interview guide. All transcripts were coded, analyzed, and collapsed into themes. Data analysis was guided by a constructivist grounded theory based in a relativist paradigm. Results: Thematic analysis revealed five themes. Residents and staff alike described acquiring the skills of supervision and assessment passively, primarily through modeling the behaviours of others; the training that is available in these areas is variably used, creating a diversity of physician comfort levels within these two competencies; the many competing priorities in the emergency department represent significant barriers to improving supervision and assessment; providing negative feedback is universally difficult and often avoided, sometimes resulting in struggling trainees not being identified until late in residency; the move towards competency based education (CBE) will act as an impetus for more formal curriculum being required in these areas. Conclusion: As residency programs transition to a CBE model, there will be a greater need for formal training in supervision and assessment to achieve a standard level of comfort and competence among senior residents physicians in independent practice. These competencies will also need an emphasis on how to identify struggling trainees, and how to approach negative and constructive feedback.

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