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Brown A, La J, Keri MI, Hillis C, Razack S, Korah N, Karpinski J, Frank JR, Wong B, Goldman J. In EPAs we trust, is quality and safety a must? A cross-specialty analysis of entrustable professional activity guides. MEDICAL TEACHER 2024:1-9. [PMID: 38527417 DOI: 10.1080/0142159x.2024.2323177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/21/2024] [Indexed: 03/27/2024]
Abstract
PURPOSE The inclusion of quality improvement (QI) and patient safety (PS) into CanMEDS reflects an expectation that graduating physicians are competent in these areas upon training completion. To ensure that Canadian postgraduate specialty training achieves this, the translation of QI/PS competencies into training standards as part of the implementation of competency-based medical education requires special attention. METHODS We conducted a cross-specialty, multi-method analysis to examine how QI/PS was incorporated into the EPA Guides across 11 postgraduate specialties in Canada. RESULTS We identify cross-specialty variability in how QI/PS is incorporated, positioned, and emphasized in EPAs and milestones. QI/PS was primarily referenced alongside clinical activities rather than as a sole competency or discrete activity. Patterns were characterized in how QI/PS became incorporated into milestones through repetition and customization. QI/PS was also decoupled, conceptualized, and emphasized differently across specialties. CONCLUSIONS Variability in the inclusion of QI/PS in EPAs and milestones has important implications considering the visibility and influence of EPA Guides in practice. As specialties revisit and revise EPA Guides, there is a need to balance the standardization of foundational QI/PS concepts to foster shared understanding while simultaneously ensuring context-sensitive applications across specialties. Beyond QI/PS, this study illuminates the challenges and opportunities that lie in bridging theoretical frameworks with practical implementation in medical education, prompting broader consideration of how intrinsic roles and emergent areas are effectively incorporated into competency-based medical education.
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Affiliation(s)
- Allison Brown
- Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Julie La
- Graduate Program in Health Quality, Queen's University, Kingston, Canada
- Department of Surgery, Queen's University, Kingston, Canada
| | | | - Chris Hillis
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Saleem Razack
- Faculty of Medicine, University of British Columbia, Kelowna, Canada
| | - Nadine Korah
- Faculty of Medicine, McGill University, Montreal, Canada
| | | | - Jason R Frank
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Brian Wong
- Centre for Quality Improvement and Patient Safety, Toronto, Canada
- Faculty of Medicine, University of Toronto Temerty, Toronto, Canada
| | - Joanne Goldman
- Centre for Quality Improvement and Patient Safety, Toronto, Canada
- Faculty of Medicine, University of Toronto Temerty, Toronto, Canada
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Rodríguez-Monforte M, Fernández-Jané C, Bracha M, Bartoszewska A, Kozakiewicz M, Leclerc M, Nimani E, Soanvaara P, Jarvinen S, Van Sherpenseel M, van der Velde M, Alves-Lopes A, Handgraaf M, Grüneberg C, Carrillo-Alvarez E. Defining a competency framework for health and social professionals to promote healthy aging throughout the lifespan: an international Delphi study. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024:10.1007/s10459-024-10316-4. [PMID: 38441827 DOI: 10.1007/s10459-024-10316-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 02/04/2024] [Indexed: 03/27/2024]
Abstract
The promotion of healthy aging has become a priority in most parts of the world and should be promoted at all ages. However, the baseline training of health and social professionals is currently not adequately tailored to these challenges. This paper reports the results of a Delphi study conducted to reach expert agreement about health and social professionals' competencies to promote healthy aging throughout the lifespan within the SIENHA project. Materials and methods: This study was developed following the CREDES standards. The initial version of the competence framework was based on the results of a scoping review and following the CanMEDS model. The expert panel consisted of a purposive sample of twenty-two experts in healthy aging with diverse academic and clinical backgrounds, fields and years of expertise from seven European countries. Agreement was reached after three rounds. The final framework consisted of a set of 18 key competencies and 80 enabling competencies distributed across six domains. The SIENHA competence framework for healthy aging may help students and educators enrich their learning and the academic content of their subjects and/or programs and incentivize innovation.
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Affiliation(s)
- Míriam Rodríguez-Monforte
- Global Research on Wellbeing (GRoW), Blanquerna School of Health Sciences - Ramon Llull University, Barcelona, Spain
| | - Carles Fernández-Jané
- Global Research on Wellbeing (GRoW), Blanquerna School of Health Sciences - Ramon Llull University, Barcelona, Spain.
- Departament deSalut, Universitat Pompeu Fabra, Tecnocampus, Mataró-Maresme, Barcelona, Spain.
| | - Marietta Bracha
- Department of Geriatrics, Nicolaus Copernicus University, Torun, Poland
| | | | | | | | | | | | - Sari Jarvinen
- JAMK University of Applied Sciences, Jyvaskyla, Finland
| | | | - Miriam van der Velde
- Research Group Innovation of Human Movement Care, Research Center for Healthy and Sustainable Living, HU University of Applied Sciences, Utrecht, The Netherlands
| | | | | | | | - Elena Carrillo-Alvarez
- Global Research on Wellbeing (GRoW), Blanquerna School of Health Sciences - Ramon Llull University, Barcelona, Spain
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Kim S, Rochette A, Ahmed S, Archambault PS, Auger C, Battaglini A, Freeman AR, Kehayia E, Kinsella EA, Larney E, Letts L, Nugus P, Raymond MH, Salbach NM, Sinnige D, Snider L, Swaine B, Tousignant-Laflamme Y, Thomas A. Creating synergies among education/research, practice, and policy environments to build capacity for the scholar role in occupational therapy and physiotherapy in the Canadian context. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2023:10.1007/s10459-023-10298-9. [PMID: 38015277 DOI: 10.1007/s10459-023-10298-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 10/22/2023] [Indexed: 11/29/2023]
Abstract
Scholarly practice (SP) is considered a key competency of occupational therapy and physiotherapy. To date, the three sectors-education/research, practice, and policy/regulation-that support SP have been working relatively independently. The goals of this project were to (a) understand how representatives of the three sectors conceptualize SP; (b) define each sector's individual and collective roles in supporting SP; (c) identify factors influencing the enactment of SP and the specific needs of how best to support SP; and (d) co-develop goals and strategies to support SP across all sectors. We used interpretive description methodology. Consistent with an integrated knowledge translation approach, partners representing the three sectors across Canada recruited individuals from each sector, developed the content and questions for three focus groups, and collected and analyzed the data. Inspired by the Consolidated Framework for Implementation Research, we developed the questions for the second focus group. We analyzed the data using an inductive thematic analysis method. Thirty-nine participants from the three sectors participated. Themes related to participants' conceptualization of SP included (a) ongoing process, (b) reflective process, (c) broad concept, and (d) collective effort. Themes describing factors influencing and supporting SP were (a) recognition, (b) appropriate conceptualization, (c) social network, (d) accessibility to resources, and (e) forces outside of practitioners' effort. Goals to support SP included (a) further recognizing SP, (b) sustaining SP competency, and (c) ensuring access to information. SP requires collaborative and integrated intersectoral support and further recognition of its importance through the collaboration of multiple stakeholders.
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Affiliation(s)
- Sungha Kim
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Annie Rochette
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Sara Ahmed
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
- Clinical Epidemiology, Center for Outcome Research and Evaluation (CORE), McGill University Health Center Research Institute, Montréal, QC, Canada
| | - Philippe S Archambault
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Claudine Auger
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
- Institut universitaire sur la réadaptation en déficience physique de Montréal, Montréal, QC, Canada
| | - Alex Battaglini
- Directorate of University Teaching and Research, CISSS de Laval, Laval, QC, Canada
- l'École de Santé Publique de l'Université de Montréal, Montréal, QC, Canada
| | - Andrew R Freeman
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Québec, QC, Canada
- VITAM: Centre de Recherche en Santé Durable, Québec, QC, Canada
| | - Eva Kehayia
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Elizabeth Anne Kinsella
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Elinor Larney
- Association of Canadian Occupational Therapy Regulatory Organizations and College of Occupational Therapists of Ontario, Toronto, ON, Canada
| | - Lori Letts
- School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Peter Nugus
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Marie-Hélène Raymond
- Institut National d'Excellence en Santé et en Services Sociaux, Montréal, QC, Canada
| | - Nancy M Salbach
- Department of Physical Therapy, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- The KITE Research Institute, University Health Network, Toronto, ON, Canada
| | - Diana Sinnige
- Canadian Alliance of Physiotherapy Regulators, Toronto, ON, Canada
| | - Laurie Snider
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
| | - Bonnie Swaine
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada
- Institut universitaire sur la réadaptation en déficience physique de Montréal, Montréal, QC, Canada
| | - Yannick Tousignant-Laflamme
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Aliki Thomas
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada.
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montréal, QC, Canada.
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada.
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LaDonna KA, Kahlke R, Scott I, van der Goes T, Hubinette M. Grappling with key questions about assessment of the Health Advocate role. CANADIAN MEDICAL EDUCATION JOURNAL 2023; 14:80-89. [PMID: 36998507 PMCID: PMC10042793 DOI: 10.36834/cmej.73878] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Introduction Although the CanMEDS framework sets the standard for Canadian training, health advocacy competence does not appear to factor heavily into high stakes assessment decisions. Without forces motivating uptake, there is little movement by educational programs to integrate robust advocacy teaching and assessment practices. However, by adopting CanMEDS, the Canadian medical education community endorses that advocacy is required for competent medical practice. It's time to back up that endorsement with meaningful action. Our purpose was to aid this work by answering the key questions that continue to challenge training for this intrinsic physician role. Methods We used a critical review methodology to both examine literature relevant to the complexities impeding robust advocacy assessment, and develop recommendations. Our review moved iteratively through five phases: focusing the question, searching the literature, appraising and selecting sources, and analyzing results. Results Improving advocacy training relies, in part, on the medical education community developing a shared vision of the Health Advocate (HA) role, designing, implementing, and integrating developmentally appropriate curricula, and considering ethical implications of assessing a role that may be risky to enact. Conclusion Changes to assessment could be a key driver of curricular change for the HA role, provided implementation timelines and resources are sufficient to make necessary changes meaningful. To truly be meaningful, however, advocacy first needs to be perceived as valuable. Our recommendations are intended as a roadmap for transforming advocacy from a theoretical and aspirational value into one viewed as having both practical relevance and consequential implications.
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Affiliation(s)
| | | | - Ian Scott
- University of British Columbia, British Columbia, Canada
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Barbour-Tuck E, Mutter T, O’Brien JM, Girling L, Choo E, Gamble J. Benchmarking a Canadian Anesthesiology Resident Research Program against national norms using a logic model framework: a quality improvement study. CANADIAN MEDICAL EDUCATION JOURNAL 2023; 14:108-116. [PMID: 36998486 PMCID: PMC10042791 DOI: 10.36834/cmej.75306] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Background Canadian specialty training programs are expected to deliver curriculum content and assess competencies related to the CanMEDS Scholar role. We evaluated our residency research program and benchmarked it against national norms for quality improvement purposes. Methods In 2021 we reviewed departmental curriculum documents and surveyed current and recently graduated residents. We applied a logic model framework to assess if our program's inputs, activities, and outputs addressed the relevant CanMeds Scholar competencies. We then descriptively benchmarked our results against a 2021 environmental scan of Canadian anesthesiology resident research programs. Results Local program content was successfully mapped to competencies. The local survey response rate was 40/55 (73%). In benchmarking, our program excelled in providing milestone-related assessments, research funding, administrative, supervisory, and methodologic support, and requiring a literature review, proposal presentation, and local abstract submission as output. Acceptable activities to meet research requirements vary greatly among programs. Balancing competing clinical and research responsibilities was a frequently reported challenge. Conclusions The logic model framework was easily applied and demonstrated our program benchmarked well against national norms. National level dialogue is needed to develop specific, consistent scholar role activities and competency assessments to bridge the gap between expected outcome standards and education practice.
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Affiliation(s)
- Erin Barbour-Tuck
- Department of Anesthesiology, Perioperative Medicine and Pain Management, College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Thomas Mutter
- Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, University of Manitoba, Manitoba, Canada
| | - Jennifer M O’Brien
- Department of Anesthesiology, Perioperative Medicine and Pain Management, College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Linda Girling
- Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, University of Manitoba, Manitoba, Canada
| | - Eugene Choo
- Department of Anesthesiology, Perioperative Medicine and Pain Management, College of Medicine, University of Saskatchewan, Saskatchewan, Canada
| | - Jonathan Gamble
- Department of Anesthesiology, Perioperative Medicine and Pain Management, College of Medicine, University of Saskatchewan, Saskatchewan, Canada
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Tellier PP, Ataman R, Zaccagnini M, Gore G, Rodriguez C. Adolescent medicine training in postgraduate family medicine education: a scoping review. Int J Adolesc Med Health 2023; 35:119-129. [PMID: 36584348 DOI: 10.1515/ijamh-2022-0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/07/2022] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Adolescents and young adults require age-appropriate healthcare services delivered by clinicians with expertise in adolescent medicine. However, resident family physicians report a low perceived self-efficacy and under-preparedness to deliver adolescent medical care. We conducted a scoping review to map the breadth and depth of the current evidence about adolescent medicine training for family medicine residents. CONTENT We followed Arksey and O'Malley's framework and searched seven electronic databases and key organizations' webpages from inception to September 2020. Informed by the CanMEDS-FM, we analyzed the extracted data concerning basic document characteristics, competencies and medical topics using numerical and qualitative content analysis. SUMMARY We included 41 peer-reviewed articles and six adolescent health competency frameworks (n=47). Most competencies taught in family medicine programs were organized under the roles of family medicine expert (75%), communicator (11.8%), and professional roles (7.9%). Health advocate and leader were rarely included (1.3%), and never scholar. OUTLOOK The omission of multiple competency roles in family medicine resident education on adolescents is insufficient for family physicians to deliver optimal care to adolescents. The combined efforts of family medicine stakeholders to address adolescent medicine competency gaps may positively impact the perceived competence reported by family medicine residents.
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Affiliation(s)
| | - Rebecca Ataman
- The School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada.,The Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Laval, QC, Canada
| | - Marco Zaccagnini
- The School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada.,The Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Laval, QC, Canada
| | - Geneviève Gore
- McGill Schulich Library of Physical Sciences, Life Sciences and Engineering, McGill University, Montréal, QC, Canada
| | - Charo Rodriguez
- Department of Family Medicine, McGill University, Montréal, QC, Canada.,The Institute of Health Sciences Education, McGill University, Montréal, QC, Canada
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Zaccagnini M, Bussières A, Mak S, Boruff J, West A, Thomas A. Scholarly practice in healthcare professions: findings from a scoping review. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2022:10.1007/s10459-022-10180-0. [PMID: 36456756 DOI: 10.1007/s10459-022-10180-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 10/16/2022] [Indexed: 06/17/2023]
Abstract
Scholarly practitioners are broadly defined as healthcare professionals that address critical practice problems using theory, scientific evidence, and practice-based knowledge. Though scholarly practice is included in most competency frameworks, it is unclear what scholarly practice is, how it develops and how it is operationalized in clinical practice. The aim of this review was to determine what is known about scholarly practice in healthcare professionals. We conducted a scoping review and searched MEDLINE, EMBASE, CINAHL from inception to May 2020. We included papers that explored, described, or defined scholarly practice, scholar or scholarly practitioner, and/or related concepts in healthcare professionals. We included a total of 90 papers. Thirty percent of papers contained an explicit definition of scholarly practice. Conceptualizations of scholarly practice were organized into three themes: the interdependent relationship between scholarship and practice; advancing the profession's field; and core to being a healthcare practitioner. Attributes of scholarly practitioners clustered around five themes: commitment to excellence in practice; collaborative nature; presence of virtuous characteristics; effective communication skills; and adaptive change ethos. No single unified definition of scholarly practice exists within the literature. The variability in terms used to describe scholarly practice suggests that it is an overarching concept rather than a definable entity. There are similarities between scholarly practitioners and knowledge brokers regarding attributes and how scholarly practice is operationalized. Individuals engaged in the teaching, research and/or assessment of scholarly practice should make explicit their definitions and expectations for healthcare professionals.
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Affiliation(s)
- Marco Zaccagnini
- School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montréal, QC, H3G 1Y5, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, QC, Canada
| | - André Bussières
- School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montréal, QC, H3G 1Y5, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, QC, Canada
- Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Susanne Mak
- School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montréal, QC, H3G 1Y5, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, QC, Canada
- Institute of Health Sciences Education, McGill University, Montréal, QC, Canada
| | - Jill Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montréal, QC, Canada
| | - Andrew West
- The Canadian Society of Respiratory Therapists, Saint John, NB, Canada
| | - Aliki Thomas
- School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler, Montréal, QC, H3G 1Y5, Canada.
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Montréal, QC, Canada.
- Institute of Health Sciences Education, McGill University, Montréal, QC, Canada.
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Slavin S, D’Eon MF. Overcrowded curriculum is an impediment to change (Part A). CANADIAN MEDICAL EDUCATION JOURNAL 2021; 12:1-6. [PMID: 34567300 PMCID: PMC8463236 DOI: 10.36834/cmej.73532] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- Stuart Slavin
- Accreditation Council for Graduate Medical Education, Michigan, USA
| | - Marcel F D’Eon
- Educational Innovation Institute of the Medical College of Georgia, Augusta University, Georgia, USA
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