A Tale of Four Programs: How Residents Learn About Quality Improvement during Postgraduate Medical Education at the University of Calgary

2020 ◽  
pp. 1-17
Author(s):  
Allison Brown ◽  
Kayla Atchison ◽  
Kent Hecker ◽  
Aliya Kassam
Keyword(s):  
Medical Education ◽  
Quality Improvement ◽  
Postgraduate Medical Education ◽  
University Of Calgary ◽  
The University

63. Developing a program for resident wellness at the postgraduate medical education office, University of Torontos

2007 ◽  
Vol 30 (4) ◽  
pp. 63 ◽  
Author(s):  
S. Edwards ◽  
S. Verma ◽  
R. Zulla
Keyword(s):  
Mental Health ◽  
Medical Education ◽  
Stress Management ◽  
Residency Training ◽  
Medical Training ◽  
Postgraduate Medical Education ◽  
Program Directors ◽  
University Of Toronto ◽  
Resident Wellness ◽  
The University

Prevalence of stress-related mental health problems in residents is equal to, or greater than, the general population. Medical training has been identified as the most significant negative influence on resident mental health. At the same time, residents possess inadequate stress management and general wellness skills and poor help-seeking behaviours. Unique barriers prevent residents from self-identifying and seeking assistance. Stress management programs in medical education have been shown to decrease subjective distress and increase wellness and coping skills. The University of Toronto operates the largest postgraduate medical training program in the country. The Director of Resident Wellness position was created in the Postgraduate Medical Education Office to develop a systemic approach to resident wellness that facilitates early detection and intervention of significant stress related problems and promote professionalism. Phase One of this new initiative has been to highlight its presence to residents and program directors by speaking to resident wellness issues at educational events. Resources on stress management, professional services, mental health, and financial management have been identified and posted on the postgraduate medical education website and circulated to program directors. Partnerships have been established with physician health professionals, the University of Toronto, and the Professional Association of Residents and Internes of Ontario. Research opportunities for determining prevalence and effective management strategies for stress related problems are being identified and ultimately programs/resources will be implemented to ensure that resident have readily accessible resources. The establishment of a Resident Wellness Strategy from its embryonic stags and the challenges faced are presented as a template for implementing similar programs at other medical schools. Earle L, Kelly L. Coping Strategies, Depression and Anxiety among Ontario Family Medicine Residents. Canadian Family Physician 2005; 51:242-3. Cohen J, Patten S. Well-being in residency training: a survey examining resident physician satisfaction both within and outside of residency training and mental health in Alberta. BMC Medical Education; 5(21). Levey RE. Sources of stress for residents and recommendations for programs to assist them. Academic Med 2001; 70(2):142-150.

scholarly journals Educating vocationally trained family physicians: a survey of graduates from a postgraduate medical education programme

2016 ◽  
Vol 8 (2) ◽  
pp. 115 ◽  
Author(s):  
Wayne K. Cunningham ◽  
Susan M. Dovey
Keyword(s):  
Medical Education ◽  
General Practice ◽  
General Practitioners ◽  
Personal Growth ◽  
Medical Training ◽  
Care Delivery ◽  
Postgraduate Medical Education ◽  
Free Text ◽  
Intellectual Stimulation ◽  
The University

Abstract INTRODUCTION Since 1991 the University of Otago, Dunedin, New Zealand has offered postgraduate qualifications specifically designed to educate general practitioners (GPs) about their unique work environment. AIM To determine motivations and impacts of postgraduate education for practising GPs. METHODS Survey of the 100 graduates of the University of Otago, Dunedin postgraduate general practice programme. Ninety five living graduates were approached and 70 (73.7%) responded. Quantitative data about disposition of respondents before enrolling and after completion of the programme were analysed using chi-square and paired t-tests. Free text responses about motivations, impacts and outcomes of the program were thematically analysed. RESULTS 64 GPs graduated with a postgraduate diploma and 36 with a masters degree in general practice. Although the mean number of graduates was 3.5 and 2.0 (respectively), annual enrolments averaged 25.1. Most graduates (60.9%) were aged in their 40s when they started studying and most (94.3%) had a spouse and/or children at home. Intellectual stimulation and challenge motivated study. Outcomes included perceived improvement of medical care delivery; development of critical thinking about medical epistemology, education, and research; and personal growth. Graduates increased engagement in academic and advisory roles, published papers, and some completed doctoral studies. Respondents valued scholarship and enjoyed the learning environment, but felt their qualification had low perceived value within the profession. Cost and a perception of time commitment were important barriers to study. DISCUSSION This voluntary postgraduate medical education complements traditional medical training but has low external value despite personal, practising and professional benefits. Graduates valued engagement above completion of a qualification. KEYWORDS Medical education; general practitioners; scholarship; professionalism

scholarly journals LO093: A national needs assessment survey for the development of a quality improvement and patient safety curriculum for Canadian emergency medicine residents

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S62-S62 ◽  
Author(s):  
L.B. Chartier ◽  
S. Vaillancourt ◽  
M. McGowan ◽  
K. Dainty ◽  
A.H. Cheng
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
Patient Safety ◽  
Quality Improvement ◽  
Needs Assessment ◽  
Residency Training ◽  
Royal College ◽  
Assessment Tool ◽  
Postgraduate Medical Education ◽  
Clinical Scenarios

Introduction: The Canadian Medical Education Directives for Specialists (CanMEDS) framework defines the competencies that postgraduate medical education programs must cover for resident physicians. The 2015 iteration of the CanMEDS framework emphasizes Quality Improvement and Patient Safety (QIPS), given their role in the provision of high value and cost-effective care. However, the opinion of Emergency Medicine (EM) program directors (PDs) regarding the need for QIPS curricula is unknown, as is the current level of knowledge of EM residents in QIPS principles. We therefore sought to determine the need for a QIPS curriculum for EM residents in a Canadian Royal College EM program. Methods: We developed a national multi-modal needs assessment. This included a survey of all Royal College EM residency PDs across Canada, as well as an evaluative assessment of baseline QIPS knowledge of 30 EM residents at the University of Toronto (UT). The resident evaluation was done using the validated Revised QI Knowledge Application Tool (QIKAT-R), which evaluates an individual’s ability to decipher a systematic quality problem from short clinical scenarios and to propose change initiatives for improvement. Results: Eight of the 13 (62%) PDs responded to the survey, unanimously agreeing that QIPS should be a formal part of residency training. However, challenges identified included the lack of qualified and available faculty to develop and teach QIPS material. 30 of 30 (100%) residents spanning three cohorts completed the QIKAT-R. Median overall score was 11 out of 27 points (IQR 9-14), demonstrating the lack of poor baseline QIPS knowledge amongst residents. Conclusion: QIPS is felt to be a necessary part of residency training, but the lack of available and qualified faculty makes developing and implementing such curriculum challenging. Residents at UT consistently performed poorly on a validated QIPS assessment tool, confirming the need for a formal QIPS curriculum. We are now developing a longitudinal, evidence-based QIPS curriculum that trains both residents and faculty to contribute to QI projects at the institution level.

6. CanMEDSification: The role of postgraduate medicine office in supporting the learning and teaching of CanMEDs Roles

2007 ◽  
Vol 30 (4) ◽  
pp. 30
Author(s):  
S. Glover Takahashi ◽  
S. Verma ◽  
L. Muharuma ◽  
R. Zulla
Keyword(s):  
New York ◽  
Medical Education ◽  
Faculty Development ◽  
San Francisco ◽  
Professional Competence ◽  
Postgraduate Medical Education ◽  
University Of Toronto ◽  
Development Initiatives ◽  
The University ◽  
Postgraduate Medicine

The Postgraduate Medical Education Office at the University of Toronto has implemented a range of faculty development initiatives targeted at supporting the full implementation of CanMEDS roles and competencies in the day to day learning, teaching and evaluation of residents across the highly distributed postgraduate medicine training programs. In October 2005, the Royal College of Physicians and Surgeons of Canada (RCPSC) released a revised version of the CanMEDS roles. In June 2006, the RCPSC accreditation standards for postgraduate medicine changed some standards which result in an increased expectation of implementation of the CanMEDS roles in teaching and evaluation of residency programs. From 2005 to 2007, there have been numerous initiatives by the Postgraduate Medical Education Office to support the understanding and implementation of the CanMEDS roles into the learning, evaluation and outcomes of postgraduate training at the University of Toronto. The PGME Office supported the ‘CanMEDSification’ or integration of the CanMEDS framework by: 1) Supporting the development of teacher/faculty teaching and evaluation resources; 2) Providing faculty development in the understanding of these competencies; 3) Providing explicit program feedback through the Internal Review process The CanMEDS roles have been widely integrated into teaching and evaluation at the University of Toronto. The high attendance rates at workshops and positive workshop evaluations indicate the value of centralized faculty development initiatives and also indicate an increasing confidence in using CanMEDS. The workshop evaluations also indicate a need for additional faculty development in evaluating the non Medical Expert roles. Shorter E. Oxford English Dictionary (5th ed.). Oxford, UK: Oxford University Press, 2002. Harris, IB. Deliberative inquiry: The arts of planning. in E.C. Short (ed.), Forms of curriculum inquiry. Albany: State University of New York Press, 1991; 285-307. Harris, IB. New expectations for professional competence. In L. Curry & J. F. Wergin (Eds.), Educating professionals: Responding to new expectations for competence and accountability. San Francisco: Jossey-Bass, 1993; 17-52.

scholarly journals Evaluation of a Quality Improvement Experience for Family Medicine Clerkship Students

2021 ◽  
Vol 53 (10) ◽  
pp. 882-885
Author(s):  
Geoffrey Mills ◽  
Samantha Kelly ◽  
Denine R. Crittendon ◽  
Amy Cunningham ◽  
Christine Arenson
Keyword(s):  
Medical Education ◽  
Quality Improvement ◽  
Family Medicine ◽  
Postgraduate Medical Education ◽  
Group Discussion ◽  
School Curriculum ◽  
Self Directed Learning ◽  
Medicine Clerkship ◽  
Novel Approach ◽  
Directed Learning

Background and Objectives: There is emphasis on systems-based practice competencies and quality improvement (QI) training in postgraduate medical education. However, we lack effective approaches to provide experiences in these areas during undergraduate medical education. To address this, we developed a novel approach to providing didactic and experiential learning experiences in QI during a third-year family medicine clerkship. Methods: We implemented and evaluated a QI curriculum combining self-directed learning with real-world experience to increase knowledge and confidence in the plan-do-study-act (PDSA) process for family medicine clerkship students. Students collaborated and presented their change ideas in a “Shark Tank” format for practice leaders at the end of their rotation. We used pre- and postcurriculum surveys to assess knowledge of and comfort with completing QI projects. Results: Three hundred eighty-nine students completed precurriculum surveys and 242 completed postcurriculum surveys. Pre- and postlearning evaluations revealed an increase in agreement or strong agreement with self-reported understanding of specific QI topic areas of 50%. Almost all (91.3%) reported feeling confident or reasonably confident in their ability to create change in health care after exposure to the curriculum, compared with 66.3% in the precurriculum survey. One-third of students (34%) reported intent to complete the Institute for Healthcare Improvement Open School curriculum in QI. Conclusions: Self-directed learning about QI, combined with practice observation, small-group discussion and presentation in a Shark Tank format was effective and engaging for learners. Students had limited preexisting knowledge of QI principles, suggesting a need for preclinical exposure to this topic. The family medicine clerkship provides an ideal environment for teaching QI.

A realist synthesis of quality improvement curricula in undergraduate and postgraduate medical education: what works, for whom, and in what contexts?

2020 ◽  
pp. bmjqs-2020-010887 ◽  
Author(s):  
Allison Brown ◽  
Kyle Lafreniere ◽  
David Freedman ◽  
Aditya Nidumolu ◽  
Matthew Mancuso ◽  
...  
Keyword(s):  
Medical Education ◽  
Quality Improvement ◽  
Clinical Outcomes ◽  
Postgraduate Medical Education ◽  
Grey Literature ◽  
Realist Synthesis ◽  
Programme Theory ◽  
Protected Time ◽  
What Works ◽  
Competency Area

BackgroundWith the integration of quality improvement (QI) into competency-based models of physician training, there is an increasing requirement for medical students and residents to demonstrate competence in QI. There may be factors that commonly facilitate or inhibit the desired outcomes of QI curricula in undergraduate and postgraduate medical education. The purpose of this review was to synthesise attributes of QI curricula in undergraduate and postgraduate medical education associated with curricular outcomes.MethodsA realist synthesis of peer-reviewed and grey literature was conducted to identify the common contexts, mechanisms, and outcomes of QI curricula in undergraduate and postgraduate medical education in order to develop a programme theory to articulate what works, for whom, and in what contexts.Results18854 records underwent title and abstract screening, full texts of 609 records were appraised for eligibility, data were extracted from 358 studies, and 218 studies were included in the development and refinement of the final programme theory. Contexts included curricular strategies, levels of training, clinical settings, and organisational culture. Mechanisms were identified within the overall QI curricula itself (eg, clear expectations and deliverables, and protected time), in the didactic components (ie, content delivery strategies), and within the experiential components (eg, topic selection strategies, working with others, and mentorship). Mechanisms were often associated with certain contexts to promote educational and clinical outcomes.ConclusionThis research describes the various pedagogical strategies for teaching QI to medical learners and highlights the contexts and mechanisms that could potentially account for differences in educational and clinical outcomes of QI curricula. Educators may benefit from considering these contexts and mechanisms in the design and implementation of QI curricula to optimise the outcomes of training in this competency area.

Development and implementation of a postgraduate medical education-wide initiative in quality improvement and patient safety

2021 ◽  
pp. postgradmedj-2021-140261
Author(s):  
David Bowes ◽  
Cindy Shearer ◽  
Trisha Daigle-Maloney ◽  
John Dornan ◽  
Andrew Lynk ◽  
...  
Keyword(s):  
Medical Education ◽  
Patient Safety ◽  
Quality Improvement ◽  
Needs Assessment ◽  
Task Force ◽  
Postgraduate Medical Education ◽  
Task Force Report ◽  
Road Map ◽  
Assessment Survey ◽  
Needs Assessment Survey

BackgroundQuality improvement and patient safety (QIPS) have been assigned a higher profile in CanMEDS 2015, CanMEDS–Family Medicine 2017 and new accreditation standards, prompting an initiative at Dalhousie University to create a vision for integrating QIPS into postgraduate medical education.ObjectiveThe purpose of this study is to describe the implementation of a QIPS strategy across residency education at Dalhousie University.MethodsA QIPS task force was formed, and a literature review and needs assessment survey were completed. A needs assessment survey was distributed to all Dalhousie residency programme directors. 12 programme directors were interviewed individually to collect additional feedback. The results were used to develop a ‘road map’ of recommendations with a graduated timeline.ResultsA task force report was released in February 2018. 46 recommendations were developed with a timeframe and responsible party identified for each. Implementation of the QIPS strategy is underway, and evaluation and challenges faced will be described.ConclusionsWe have developed a multiyear strategy that is available to provide guidance and support to all programmes in QIPS. The development and implementation of this QIPS framework may serve as a template for other institutions who seek to integrate these competencies into residency training.

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