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Qedair J, Ezzi S, AlMadani R, Alsamin SI, Almeneif HA, Hakami AY, Alobaid A. Neurosurgery Residents' Satisfaction Toward Their Saudi Training Program: Insights from a National Survey. World Neurosurg 2024; 185:e867-e877. [PMID: 38447740 DOI: 10.1016/j.wneu.2024.02.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 02/26/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Given the high-stakes nature of their work, neurosurgery residents face constant pressure and require high-quality training to succeed. We aim to investigate the satisfaction levels of residents with their Saudi Neurosurgery Residency Training Program (SNRTP) and its influential factors. METHODS This is a nationwide, cross-sectional study that employed a questionnaire, structured based on the relevant literature, which was disseminated to neurosurgery residents, commencing from December 2021 and culminating in September 2022. RESULTS A total of 70 out of 143 neurosurgery residents were included, giving a response rate of 48.9%. Most participants (62.9%) aged 24-28 years old, 55.7% were males, and 40.0% were from the Central region of Saudi Arabia. The residents were further divided into juniors (R1-R3; 64.3%) and seniors (R4-R6; 35.7%). Approximately 13.3% of the juniors were satisfied with the SNRTP, whereas only 8.0% of the seniors were satisfied. Dissatisfaction rates over the SNRTP were significantly higher in the seniors (68.0%) compared to the juniors (28.9%; P = 0.006). The frequency of operating room sessions per week and presence of protected research time were the only 2 factors significantly associated with the junior and senior residents' satisfaction, respectively. CONCLUSIONS The SNRTP has a vision to provide the society with elite competent neurosurgeons. However, we found a degree of dissatisfaction among the residents, indicating a need for improving the SNRTP's policies. We recommend incorporating more hands-on training opportunities, implementing a mentorship model, setting tailored teaching sessions, and establishing resident wellness programs. We hope this study initiate dialogue on promoting residents' satisfaction and overall well-being.
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Affiliation(s)
- Jumanah Qedair
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah, Saudi Arabia; King Abdullah International Medical Research Center (KAIMRC), Jeddah, Saudi Arabia.
| | - Suzana Ezzi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah, Saudi Arabia; King Abdullah International Medical Research Center (KAIMRC), Jeddah, Saudi Arabia
| | - Raghad AlMadani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah, Saudi Arabia; King Abdullah International Medical Research Center (KAIMRC), Jeddah, Saudi Arabia
| | - Sarah I Alsamin
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hesham A Almeneif
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Alqassem Y Hakami
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah, Saudi Arabia; King Abdullah International Medical Research Center (KAIMRC), Jeddah, Saudi Arabia
| | - Abdullah Alobaid
- Department of Neurosurgery, National Neurosciences Institute, King Fahad Medical City, Riyadh Second Health Cluster, Riyadh, Saudi Arabia
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Frank JR, Karpinski J, Sherbino J, Snell LS, Atkinson A, Oswald A, Hall AK, Cooke L, Dojeiji S, Richardson D, Cheung WJ, Cavalcanti RB, Dalseg TR, Thoma B, Flynn L, Gofton W, Dudek N, Bhanji F, Wong BMF, Razack S, Anderson R, Dubois D, Boucher A, Gomes MM, Taber S, Gorman LJ, Fulford J, Naik V, Harris KA, St. Croix R, van Melle E. Competence By Design: a transformational national model of time-variable competency-based postgraduate medical education. PERSPECTIVES ON MEDICAL EDUCATION 2024; 13:201-223. [PMID: 38525203 PMCID: PMC10959143 DOI: 10.5334/pme.1096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 02/16/2024] [Indexed: 03/26/2024]
Abstract
Postgraduate medical education is an essential societal enterprise that prepares highly skilled physicians for the health workforce. In recent years, PGME systems have been criticized worldwide for problems with variable graduate abilities, concerns about patient safety, and issues with teaching and assessment methods. In response, competency based medical education approaches, with an emphasis on graduate outcomes, have been proposed as the direction for 21st century health profession education. However, there are few published models of large-scale implementation of these approaches. We describe the rationale and design for a national, time-variable competency-based multi-specialty system for postgraduate medical education called Competence by Design. Fourteen innovations were bundled to create this new system, using the Van Melle Core Components of competency based medical education as the basis for the transformation. The successful execution of this transformational training system shows competency based medical education can be implemented at scale. The lessons learned in the early implementation of Competence by Design can inform competency based medical education innovation efforts across professions worldwide.
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Affiliation(s)
- Jason R. Frank
- Centre for Innovation in Medical Education and Professor, Department of Emergency Medicine, Faculty of Medicine, University of Ottawa, ON, Canada
| | - Jolanta Karpinski
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Competency Based Medical Education, University of Ottawa, Ottawa, ON, Canada
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
| | | | - Linda S. Snell
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Medicine and Health Sciences Education, McGill University, Montreal, QC, Canada
| | - Adelle Atkinson
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Anna Oswald
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Competency Based Medical Education, University of Alberta, Edmonton, AB, Canada
| | - Andrew K. Hall
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Lara Cooke
- Division of Neurology, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Susan Dojeiji
- Physical Medicine and Rehabilitation, University of Ottawa, Ottawa, ON, Canada
| | - Denyse Richardson
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Department of Physical Medicine and Rehabilitation, Queen’s University, Kingston, ON, Canada
| | - Warren J. Cheung
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Rodrigo B. Cavalcanti
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- HoPingKong Centre, University Health Network, Toronto, ON, Canada
| | - Timothy R. Dalseg
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Division of Emergency Medicine, University of Toronto, Toronto, ON, Canada
| | - Brent Thoma
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Emergency Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Leslie Flynn
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Departments of Psychiatry and Family Medicine, and Co-Director Master of Health Sciences Education, Queen’s University, Kingston, ON, Canada
| | - Wade Gofton
- Department of Surgery (Division of Orthopedic Surgery), The Ottawa Hospital and University of Ottawa, Ottawa, ON, Canada
| | - Nancy Dudek
- Department of Medicine (Division of Physical Medicine & Rehabilitation) and The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Farhan Bhanji
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Brian M.-F. Wong
- Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Canada
| | - Saleem Razack
- Centre for Health Education Scholarship, University of British Columbia and BC Children’s Hospital, Vancouver, BC, Canada
| | - Robert Anderson
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Northern Ontario School of Medicine University, Sudbury, ON, Canada
| | - Daniel Dubois
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Andrée Boucher
- Department of Medicine (Division of Endocrinology), Universitéde Montréal, Montréal, QC, Canada
| | - Marcio M. Gomes
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Sarah Taber
- Office of Standards and Assessment, Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
| | - Lisa J. Gorman
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
| | - Jane Fulford
- Canadian Internet Registration Authority, Canada
| | - Viren Naik
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada
- Medical Council of Canada, Ottawa, ON, Canada
| | - Kenneth A. Harris
- Royal College of Physicians and Surgeons of Canada, Canada
- Emeritus, Western University, Canada
| | - Rhonda St. Croix
- Learning and Connecting at the Royal College of Physicians and Surgeons of Canada, Canada
| | - Elaine van Melle
- Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
- Department of Family Medicine, Queen’s University, Kingston, ON, Canada
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Miller F, Wood S, Livingston P. The lived experience of Competence by Design: Canadian resident physicians' perspectives. Can J Anaesth 2024; 71:254-263. [PMID: 38133715 DOI: 10.1007/s12630-023-02678-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/12/2023] [Accepted: 07/21/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE Canadian specialist residency programs are in the process of transitioning to a hybrid time and competence model, Competence by Design (CBD), developed by the Royal College of Physicians and Surgeons Canada. Although there is extensive literature around competency-based medical education (CBME), few studies have evaluated the experience of residents after CBME implementation. The purpose of this study was to obtain a rich perspective on the lived experience of residents. METHODS We designed a qualitative study with inductive thematic analysis of semistructured interview data. The study population was residents in CBD postgraduate training programs in anesthesiology, internal medicine, or surgery (including all surgical subspecialties) at Dalhousie University (Halifax, NS, Canada). RESULTS Residents identified the following benefits of their programs and CBD: supportive peers and clinical supervisors, a roadmap for residency, formalized feedback opportunities, and program evolution. Resident-identified drawbacks of CBD included: a lack of transparency around CBD, CBD not as advertised, a lack of buy-in, increased administrative burden, difficulties obtaining evidence for entrustable professional activities (EPAs); the onus for CBD on residents, inconsistent feedback, cumbersome technology, and significant psychological burden. Resident-suggested improvements were reducing the number of EPAs, streamlining EPA requirements, increasing transparency and communication with competence committees, providing incentives and continuous education for clinical supervisors, improving on existing electronic interfaces, and developing technology better suited to the needs of CBD. CONCLUSION This study highlights that the significant administrative and psychological burden of CBD detracts from clinical learning and enthusiasm for residency. Future research could explore whether overcoming the identified challenges will improve residents' experiences.
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Affiliation(s)
- Franziska Miller
- Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, 1276 South Park Street, Halifax, NS, B3H 2Y9, Canada.
| | - Sarah Wood
- School of Medicine, University of Dundee, Dundee, Scotland, UK
| | - Patricia Livingston
- Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
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Han SY, Lee SH, Chae H. Developing a best practice framework for clinical competency education in the traditional East-Asian medicine curriculum. BMC MEDICAL EDUCATION 2022; 22:352. [PMID: 35538517 PMCID: PMC9088070 DOI: 10.1186/s12909-022-03398-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 04/21/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND While clinical competency is crucial for traditional East-Asian medical education, available studies on the educational system for fostering clinical performance are scarce. This study aimed to review the educational system, curriculum, facilities, and management of current traditional East-Asian medicine in a well-established university of Korea and develop a Best Practice Framework (BPF) of clinical competency education. METHODS The clinical competency education system in Pusan National University School of Korean Medicine was systematically described through 5 steps of governance of the educational system, competency of the graduates, educational resources, assessment strategies and tools, and gaps in the curriculum. We also reviewed the experiences in education and the points to be improved. RESULTS The Office of Traditional Korean Medicine Education governs the development, implementation, and evaluation of the educational curriculum for cultivating students' clinical competency. Medical students have undertaken 39 modules of clinical biomedicine and 21 of traditional medicine during the clinical clerkship courses in an affiliated hospital, Clinical Skill Practice Center, clinical research center, practice lab for medical herb, and other locations. After training, 15 modules of simulated clinical training using standardized patients, students' clinical competency are evaluated by a Clinical Performance Test using a Clinical Performance Examination (CPX) and an Objective Structured Clinical Examination (OSCE) for biomedical and traditional medical skills. CONCLUSIONS A clinical competency framework is required for a qualified physician of traditional East-Asian medicine. This study reviewed the current well-organized educational system of Korean traditional medicine in detail, which can be used for the BPF of competency-based clinical education. We expect the current study to be a representative reference for establishing an educational system of traditional medicine such as acupuncture and medical herbs in other countries.
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Affiliation(s)
- Sang Yun Han
- College of Korean Medicine, Daejeon University, Daejeon, 34520, South Korea
- Department of Medical Education, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - Seung-Hee Lee
- Department of Medical Education, Seoul National University College of Medicine, Seoul, 03080, Korea
| | - Han Chae
- School of Korean Medicine, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan-si, Gyeongnam, 50612, Korea.
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Thibault LP, Bourque CJ, Luu TM, Huot C, Cardinal G, Carriere B, Dupont-Thibodeau A, Moussa A. Residents as Research Subjects: Balancing Resident Education and Contribution to Advancing Educational Innovations. J Grad Med Educ 2022; 14:191-200. [PMID: 35463172 PMCID: PMC9017267 DOI: 10.4300/jgme-d-21-00530.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/15/2021] [Accepted: 01/03/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Research in education advances knowledge and improves learning, but the literature does not define how to protect residents' rights as subjects in studies or how to limit the impact of their participation on their clinical training. OBJECTIVE We aimed to develop a consensual framework on how to include residents as participants in education research, with the dual goal of protecting their rights and promoting their contributions to research. METHODS A nominal group technique approach was used to structure 3 iterative meetings held with the pre-existing residency training program committee and 7 invited experts between September 2018 and April 2019. Thematic text analysis was conducted to prepare a final report, including recommendations. RESULTS Five themes, each with recommendations, were identified: (1) Freedom of participation: participation, non-participation, or withdrawal from a study should not interfere with teacher-learner relationship (recommendation: improve recruitment and consent forms); (2) Avoidance of over-solicitation (recommendation: limit the number of ongoing studies); (3) Management of time dedicated to participation in research (recommendations: schedule and proportion of time for study participation); (4) Emotional safety (recommendation: requirement for debriefing and confidential counseling); and (5) Educational safety: data collected during a study should not influence clinical assessment of the resident (recommendation: principal investigator should not be involved in the evaluation process of learners in clinical rotation). CONCLUSIONS Our nominal group technique approach resulted in raising 5 specific issues about freedom of participation of residents in research in medical education, over-solicitation, time dedicated to research, emotional safety, and educational safety.
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Affiliation(s)
- Louis-Philippe Thibault
- Louis-Philippe Thibault, MD, BBA, is a Student, Master's in Medical Education Program, Harvard Medical School, and a Pediatrician, Department of Pediatrics, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Claude Julie Bourque
- Claude Julie Bourque, PhD, is an Assistant Professor and a Researcher, Department of Pediatrics, Centre for Applied Health Sciences Education, Faculty of Medicine, Université de Montréal, Quebec, Canada
| | - Thuy Mai Luu
- Thuy Mai Luu, MD, MSc, is an Associate Clinical Professor, Department of Pediatrics, and Clinician-Scientist, CHU Sainte-Justine Research Center, Faculty of Medicine, Université de Montréal
| | - Celine Huot
- Celine Huot, MD, MSc, is a Full Clinical Professor and Researcher, Department of Pediatrics and CHU Sainte-Justine Research Center, Faculty of Medicine, Université de Montréal
| | - Genevieve Cardinal
- Genevieve Cardinal, LLM, is Chair of the Research Ethics Board and Manager, Research Ethics Office, CHU Sainte-Justine
| | - Benoit Carriere
- Benoit Carriere, MD, MHPE, is an Associate Professor and the Director of Medical Education, CHU Sainte-Justine, Department of Pediatrics, Faculty of Medicine, Université de Montréal
| | - Amelie Dupont-Thibodeau
- Amelie Dupont-Thibodeau, MD, PhD, is an Assistant Professor and a Researcher, Department of Pediatrics, CHU Sainte-Justine Research Center, Faculty of Medicine, Université de Montréal
| | - Ahmed Moussa
- Ahmed Moussa, MD, MMEd, is an Associate Professor, Department of Pediatrics, a Clinician-Scientist, CHU Sainte-Justine Research Center, and Director, Center for Applied Health Sciences Education, Faculty of Medicine, Université de Montréal
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Anderson HL, Kurtz J, West DC. Implementation and Use of Workplace-Based Assessment in Clinical Learning Environments: A Scoping Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:S164-S174. [PMID: 34406132 DOI: 10.1097/acm.0000000000004366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE Workplace-based assessment (WBA) serves a critical role in supporting competency-based medical education (CBME) by providing assessment data to inform competency decisions and support learning. Many WBA systems have been developed, but little is known about how to effectively implement WBA. Filling this gap is important for creating suitable and beneficial assessment processes that support large-scale use of CBME. As a step toward filling this gap, the authors describe what is known about WBA implementation and use to identify knowledge gaps and future directions. METHOD The authors used Arksey and O'Malley's 6-stage scoping review framework to conduct the review, including: (1) identifying the research question; (2) identifying relevant studies; (3) study selection; (4) charting the data; (5) collating, summarizing, and reporting the results; and (6) consulting with relevant stakeholders. RESULTS In 2019-2020, the authors searched and screened 726 papers for eligibility using defined inclusion and exclusion criteria. One hundred sixty-three met inclusion criteria. The authors identified 5 themes in their analysis: (1) Many WBA tools and programs have been implemented, and barriers are common across fields and specialties; (2) Theoretical perspectives emphasize the need for data-driven implementation strategies; (3) User perceptions of WBA vary and are often dependent on implementation factors; (4) Technology solutions could provide useful tools to support WBA; and (5) Many areas of future research and innovation remain. CONCLUSIONS Knowledge of WBA as an implemented practice to support CBME remains constrained. To remove these constraints, future research should aim to generate generalizable knowledge on WBA implementation and use, address implementation factors, and investigate remaining knowledge gaps.
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Affiliation(s)
- Hannah L Anderson
- H.L. Anderson is research associate, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; ORCID: http://orcid.org/0000-0002-9435-1535
| | - Joshua Kurtz
- J. Kurtz is a first-year resident, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Daniel C West
- D.C. West is professor of pediatrics, The Perelman School of Medicine at the University of Pennsylvania, and associate chair for education and senior director of medical education, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; ORCID: http://orcid.org/0000-0002-0909-4213
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