1
|
Toledo-Ortiz R, González-Rojas JM, Molina-Vallejo LE, Mendoza-Velásquez JJ, Romero-Casillas Y, Cano-Collado LA, de la Rosa-Cruz SA, Juárez-Medel CA, González-Bonilla CR. [Development of the INSABI educational strategy: a lesson learned from the COVID-19 epidemic]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2023; 61:386-398. [PMID: 37216695 PMCID: PMC10437235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 11/30/2022] [Indexed: 05/24/2023]
Abstract
The Institute for Health for Well-being (INSABI according to its initials in Spanish), in collaboration with the National Institute of Medical Sciences and Nutrition Salvador Zubirán (INCMNSZ), instituted the Continuous Training on clinical management "Mexico against COVID-19" in 2020, with the purpose of training the frontline health personnel in the care for patients with COVID-19 in the context of hospital reconversion through the COVIDUTI platform. Virtual conferences were held for medical personnel from all over the country with the possibility of interacting with various specialists. In 2020, 215 sessions were held and 158 in 2021. That year educational content was expanded and included topics for other health categories, such as nursing and social work. In October 2021, it was established the Health Educational System for Well-being (SIESABI), with the aim of promoting continuous and permanent education for health workers. It currently offers face-to-face and virtual courses, permanent seminars, and telementoring, with the possibility of providing academic follow-up to its subscribers and linking priority courses that are on other platforms. The educational platform is an opportunity to unify the efforts of the health system in Mexico in the continuous and permanent education of professionals who care for people without social security and thereby contribute to the implementation of a model of care based on primary health care (PHC).
Collapse
Affiliation(s)
- Rosbel Toledo-Ortiz
- Instituto de Salud para el Bienestar, Coordinación de Formación y Capacitación de Personal de Salud, Unidad de Coordinación Nacional Médica. Acapulco, Guerrero, MéxicoInstituto de Salud para el BienestarMéxico
| | - Jessica Margarita González-Rojas
- Instituto de Salud para el Bienestar, Coordinación de Formación y Capacitación de Personal de Salud, Unidad de Coordinación Nacional Médica. Acapulco, Guerrero, MéxicoInstituto de Salud para el BienestarMéxico
| | - Luis Enrique Molina-Vallejo
- Instituto de Salud para el Bienestar, Coordinación de Formación y Capacitación de Personal de Salud, Unidad de Coordinación Nacional Médica. Acapulco, Guerrero, MéxicoInstituto de Salud para el BienestarMéxico
| | - José Javier Mendoza-Velásquez
- Comisión Nacional contra las Adicciones, Coordinación de Estrategias Nacionales. Ciudad de México, MéxicoComisión Nacional contra las AdiccionesMéxico
| | - Yesenia Romero-Casillas
- Instituto de Salud para el Bienestar, Coordinación de Formación y Capacitación de Personal de Salud, Unidad de Coordinación Nacional Médica. Acapulco, Guerrero, MéxicoInstituto de Salud para el BienestarMéxico
| | - Luz Alejandra Cano-Collado
- Instituto de Salud para el Bienestar, Coordinación de Formación y Capacitación de Personal de Salud, Unidad de Coordinación Nacional Médica. Acapulco, Guerrero, MéxicoInstituto de Salud para el BienestarMéxico
| | - Sergio Aarón de la Rosa-Cruz
- Instituto de Salud para el Bienestar, Coordinación de Formación y Capacitación de Personal de Salud, Unidad de Coordinación Nacional Médica. Acapulco, Guerrero, MéxicoInstituto de Salud para el BienestarMéxico
| | - Carlos Alberto Juárez-Medel
- Instituto de Salud para el Bienestar, Coordinación de Formación y Capacitación de Personal de Salud, Unidad de Coordinación Nacional Médica. Acapulco, Guerrero, MéxicoInstituto de Salud para el BienestarMéxico
| | - César Raúl González-Bonilla
- Instituto de Salud para el Bienestar, Coordinación de Formación y Capacitación de Personal de Salud, Unidad de Coordinación Nacional Médica. Acapulco, Guerrero, MéxicoInstituto de Salud para el BienestarMéxico
| |
Collapse
|
2
|
Ding M, Koppula S, Szafran O, Au L, Babenko O. Mindsets of Early-Career Family Physicians Trained in Competency-Based Education. PRIMER (LEAWOOD, KAN.) 2021; 5:39. [PMID: 34841214 PMCID: PMC8612592 DOI: 10.22454/primer.2021.389603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION The objective of this study was to examine the mindsets (mastery, performance approach, performance avoidance) of early-career family physicians following graduation from a competency-based education residency program. METHODS This was a longitudinal, cohort, survey study of family medicine residents at a large Canadian university. The 2015-2017 cohort of family medicine residents was surveyed at three time points: (1) at the end of residency training; (2) at 1 year in clinical practice; and (3) at 3 years in clinical practice. We used Baranik et al's instrument to measure three types of mindsets. We performed descriptive and multivariate analyses using SPSS 26.0 software. RESULTS Irrespective of the time in practice, mean scores were the highest on the mastery mindset and the lowest on the performance avoidance mindset measures (P<.001). Over time, the mastery mindset scores tended to decrease (P=.04). CONCLUSION Family physicians trained in competency-based education continued to be mastery-oriented in the first 3 years of clinical practice. This finding is reassuring given that the mastery mindset is associated with professional well-being and long-term success. Nonetheless, because mastery mindset scores appeared to decrease over time, residency programs need to ensure graduating residents are equipped with knowledge and tools to remain mastery-oriented throughout the course of their professional careers.
Collapse
Affiliation(s)
- Mao Ding
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - Sudha Koppula
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - Olga Szafran
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - Lillian Au
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - Oksana Babenko
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| |
Collapse
|
3
|
Sloychuk J, Szafran O, Duerksen K, Babenko O. Association Between Family Medicine Residents' Mindsets and In-Training Exam Scores. PRIMER : PEER-REVIEW REPORTS IN MEDICAL EDUCATION RESEARCH 2020; 4:33. [PMID: 33426482 DOI: 10.22454/primer.2020.796230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Introduction In medical practice, a mastery mindset is important for engaging in lifelong learning. The objective of this study was to examine the association between family medicine residents' scores on mindset measures and their performance on in-training examinations (ITE). Methods This was a secondary data analysis of a cohort of family medicine residents. Following ethics approval, residents' ITE scores from each of the 2 years of residency were linked with residents' responses to a mindsets survey that they had taken at the midpoint of residency training. Multiple regression analysis was used to investigate the relationship between residents' mindset scores and their ITE scores. Of 85 residents, 46 (54%) had complete data for the three data collection points. Results Residents' ITE scores in year 1 were most predictive of their ITE scores in year 2 (β=0.72; P<.001). Mastery mindset scores were negatively associated with residents' performance on the ITE in year 2 (β=-0.29; P=.004). Conclusion While the observed negative relationship between residents' mastery mindset scores and their ITE performance may be disconcerting, it is not surprising. In clinical settings, residents are individually coached by preceptors and provided with specific, actionable feedback to support their learning. With respect to formative assessments, residents likely require explicit training on how to use their assessment results (ITE scores) to support their self-directed learning. This finding has practical implications for residency programs in using ITEs as formative assessments.
Collapse
Affiliation(s)
- Janelle Sloychuk
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Olga Szafran
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Kimberley Duerksen
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Oksana Babenko
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
4
|
Babenko O, Guo Q. Measuring Self-Compassion in Medical Students: Factorial Validation of the Self-Compassion Scale-Short Form (SCS-SF). ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2019; 43:590-594. [PMID: 31396881 DOI: 10.1007/s40596-019-01095-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 07/02/2019] [Accepted: 07/28/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The primary purpose of this study was to evaluate the factorial structure of the short-form version of the self-compassion scale (SCS-SF) and validate its use with medical students. METHODS Two hundred medical students completed an electronic questionnaire containing the 12-item SCS-SF and the 16-item Oldenburg burnout inventory. The authors performed reliability and confirmatory factor analyses (CFA) to evaluate the internal consistency and factorial structure of the SCS-SF scores, and correlational analyses to examine relationships of self-compassion with student engagement and exhaustion. RESULTS The internal consistency of the SCS-SF was 0.86. Self-compassion scores were positively correlated with engagement scores (r = 0.24; p < 0.01) and negatively correlated with exhaustion scores (r = - 0.44; p < 0.001). The CFA results for the two-factor model (formed by three positive and three negative components) indicated an improved fit over the single-factor model. The positive factor (self-compassion) was positively correlated with engagement scores (r = 0.17; p < 0.05) and negatively correlated with exhaustion scores (r = - 0.32; p < 0.001). The negative factor (self-criticism) was negatively correlated with engagement scores (r = - 0.25; p < 0.001) and positively correlated with exhaustion scores (r = 0.44; p < 0.001). CONCLUSIONS The SCS-SF scores had good internal consistency and expected relations with student engagement and exhaustion. Although the single, general self-compassion factorial structure had an acceptable fit with the data, the hierarchical two-factor structure of the SCS-SF provides support for the idea that distinguishing between self-compassion and self-criticism in medical students may be important.
Collapse
Affiliation(s)
| | - Qi Guo
- University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
5
|
Babenko O, Oswald A. The roles of basic psychological needs, self-compassion, and self-efficacy in the development of mastery goals among medical students. MEDICAL TEACHER 2019; 41:478-481. [PMID: 29493363 DOI: 10.1080/0142159x.2018.1442564] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Aim: Competency-based medical education aims to foster mastery goals in learners. We examined medical students' mastery approach (beneficial) and mastery avoidance (maladaptive) goals and their associations with students' basic psychological needs, self-compassion, and self-efficacy. Methods: This was a cross-sectional study employing an online questionnaire. Two hundred medical students in all four years of the medical program completed the questionnaire, containing measures of mastery goals, basic psychological needs (autonomy, competence, relatedness), self-compassion, and self-efficacy. Regression analyses were performed. Results: Of the three basic psychological needs, the need for competence was significant in explaining both types of mastery goals. Self-efficacy and self-compassion were significant in explaining mastery approach and mastery avoidance goals, respectively. Conclusions: Creating learning environments that are supportive of students' need for competence, raising students' awareness of the value of learning from mistakes in competency acquisition, and providing opportunities for students to experience self-efficacy may foster beneficial mastery approach goals in medical students.
Collapse
Affiliation(s)
- Oksana Babenko
- a Department of Family Medicine , University of Alberta , Edmonton , Canada
| | - Anna Oswald
- b Department of Medicine , University of Alberta , Edmonton , Canada
| |
Collapse
|
6
|
Cooke LJ, Duncan D, Rivera L, Dowling SK, Symonds C, Armson H. The Calgary Audit and Feedback Framework: a practical, evidence-informed approach for the design and implementation of socially constructed learning interventions using audit and group feedback. Implement Sci 2018; 13:136. [PMID: 30376848 PMCID: PMC6208022 DOI: 10.1186/s13012-018-0829-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 10/18/2018] [Indexed: 11/10/2022] Open
Abstract
Background Audit and feedback interventions may be strengthened using social interaction. The Calgary office of the Alberta Physician Learning Program (CPLP) developed a process for audit and group feedback for physicians. This paper extends previous work in which we developed a conceptual model of physician responses to audit and group feedback based on a qualitative analysis of six audit and group feedback sessions. The present study explored the mediating factors for successfully engaging physician groups in change planning through audit and group feedback. Methods To understand why some groups were more interactive than others, we completed a comparative case analysis of the six audit and group feedback projects from the prior study. We used framework analysis to build the case studies, triangulated our observations across data sources to validate findings, compared the case studies for similarities and differences that influenced social interaction (mediating factors), and thematically categorized mediating factors into an organizing framework. Results Mediating factors for socially interactive AGFS were a pre-existing relationship between the program team and the physician group, projects addressing important, actionable questions, easily interpretable data visualization in the reports, and facilitation of the groups that included reflective questioning. When these factors were in place (cases 1, 2A, 3), the audit and group feedback sessions were dynamic, with physicians sharing and comparing practices, and raising change cues (such as declaring commitments to de-prescribing, planning educational interventions, and improving documentation). In cases 2C–D, the mediating factors were less well established and in these cases, the sessions showed little physician reflection or change planning. We organized the mediating factors into a framework linking the factors for successful sessions to the conceptual model of physician behaviors which these mediating factors drive. Conclusions We propose the Calgary Audit and Feedback Framework as a practical tool to help foster socially constructed learning in audit and group feedback sessions. Ensuring that the four factors, relationship, question choice, data visualization, and facilitation, are considered for design and implementation of audit and group feedback will help physicians move from reactions to their data towards planning for change.
Collapse
Affiliation(s)
- Lara J Cooke
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, UCMC Area 3, 3350 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.
| | - Diane Duncan
- Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - Laura Rivera
- Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - Shawn K Dowling
- Physician Learning Program, Cumming School of Medicine, University of Calgary, HSC G302, 3330 Hospital Dr. NW, Calgary, AB, T2N 4N1, Canada
| | - Christopher Symonds
- Division of Endocrinology & Metabolism, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - Heather Armson
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| |
Collapse
|
7
|
Cooke LJ, Duncan D, Rivera L, Dowling SK, Symonds C, Armson H. How do physicians behave when they participate in audit and feedback activities in a group with their peers? Implement Sci 2018; 13:104. [PMID: 30064509 PMCID: PMC6069557 DOI: 10.1186/s13012-018-0796-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 07/20/2018] [Indexed: 11/25/2022] Open
Abstract
Background Audit and feedback interventions may be strengthened using social interaction. With this in mind, the Calgary office of the Alberta Physician Learning Program developed a process for audit and group feedback for physician groups. As a part of a larger project to develop a practical approach to the design and implementation of audit and group feedback projects, we explored patterns of physician behavior during facilitated audit and group feedback sessions. Methods Six audit and group feedback sessions were recorded, transcribed, and analyzed thematically to derive a conceptual model of physicians’ behaviors during audit and group feedback sessions. Results A predictable cycle of behaviors emerged from audit and group feedback sessions. This cycle would repeat with discussion of each new data element: reacting to the data, questioning and understanding the data, justifying and contextualizing, sharing and reflecting on the data and relevant guidelines, and planning for change. “Change cues” that emerged within groups reliably pivoted the discussion towards action planning. Conclusions In audit and group feedback sessions, physicians display a predictable series of behaviors as they move towards commitment to change. Establishing the meaning and credibility of the data is a necessary precursor to reflection. Group reflection leads to “change cues” triggered by group members, which stimulate action planning.
Collapse
Affiliation(s)
- Lara J Cooke
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, UCMC Area 3, 3350 Hospital Drive NW, Calgary, AB, T2N 4N1, Canada.
| | - Diane Duncan
- Cumming School of Medicine, University of Calgary, HSC G302, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - Laura Rivera
- Cumming School of Medicine, University of Calgary, HSC G302, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - Shawn K Dowling
- Cumming School of Medicine, University of Calgary, HSC G302, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - Christopher Symonds
- Division of Endocrinology and Metabolism, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - Heather Armson
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| |
Collapse
|
8
|
Babenko O, Mosewich A, Abraham J, Lai H. Contributions of psychological needs, self-compassion, leisure-time exercise, and achievement goals to academic engagement and exhaustion in Canadian medical students. JOURNAL OF EDUCATIONAL EVALUATION FOR HEALTH PROFESSIONS 2018; 15:2. [PMID: 29307134 PMCID: PMC5847840 DOI: 10.3352/jeehp.2018.15.2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 01/08/2018] [Indexed: 05/13/2023]
Abstract
PURPOSE To investigate the contributions of psychological needs (autonomy, competence, and relatedness) and coping strategies (self-compassion, leisure-time exercise, and achievement goals) to engagement and exhaustion in Canadian medical students. METHODS This was an observational study. Two hundred undergraduate medical students participated in the study: 60.4% were female, 95.4% were 20-29 years old, and 23.0% were in year 1, 30.0% in year 2, 21.0% in year 3, and 26.0% in year 4. Students completed an online survey with measures of engagement and exhaustion from the Oldenburg Burnout Inventory-student version; autonomy, competence, and relatedness from the Basic Psychological Needs Scale; self-compassion from the Self-Compassion Scale-short form; leisure-time exercise from the Godin Leisure-Time Exercise Questionnaire; and mastery approach, mastery avoidance, performance approach, and performance avoidance goals from the Achievement Goals Instrument. Descriptive and inferential analyses were performed. RESULTS The need for competence was the strongest predictor of student engagement (β= 0.35, P= 0.000) and exhaustion (β= -0.33, P= 0.000). Students who endorsed mastery approach goals (β= 0.21, P= 0.005) and who were more self-compassionate (β= 0.13, P= 0.050) reported greater engagement with their medical studies. Students who were less self-compassionate (β= -0.32, P= 0.000), who exercised less (β= -0.12, P= 0.044), and who endorsed mastery avoidance goals (β= 0.22, P= 0.003) reported greater exhaustion from their studies. Students' gender (β= 0.18, P= 0.005) and year in medical school (β= -0.18, P= 0.004) were related to engagement, but not to exhaustion. CONCLUSION Supporting students' need for competence and raising students' awareness of self-compassion, leisure-time exercise, and mastery approach goals may help protect students from burnout-related exhaustion and enhance their engagement with their medical school studies.
Collapse
Affiliation(s)
- Oksana Babenko
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
- Corresponding
| | - Amber Mosewich
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Joseph Abraham
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Hollis Lai
- Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| |
Collapse
|