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CanMEDS Resource Stewardship Curriculum Toolkit Series

 

As leaders in the health care system, physicians regularly engage in the stewardship of health care resources. In a complex system with competing priorities and demands, resource stewardship is often challenging. Fortunately, the competencies required for good stewardship can be learned and with the introduction of CanMEDS 2015, these competencies will soon be a part of every trainee’s toolkit.

As a busy clinician teacher, you recognize the importance of stewardship in your practice and in the system every day. You may be wondering though how you will ever find “extra” time to prepare your residents for the challenges associated with stewardship? The good news is that a group of physicians and residents, the College of Family Physicians, Choosing Wisely Canada and the Royal College have done the heavy lifting for you.

Introducing three new toolkits to help you teach residents the foundations of resource stewardship. Designed for you to use with as much or as little adaptation as you choose; the toolkits include things like modifiable power point slide decks, annotated bibliographies, how-to guides, etc. Use your time wisely: take 5 minutes now to save yourself hours down the road.

Use these free Resource Stewardship toolkits in your resident training programs.
These toolkits are available as a free downloadable digital resource.
Where possible, content is available in a modifiable format so that users can easily customize to fit their needs

Want to receive notice whenever we update a toolkit or add new resources? Click here to send us an email

Resource Descriptions

Foundations Toolkit

Foundations of Resource
Stewardship


Provides faculty and trainees with a foundational knowledge of resource stewardship principles and the ability to recognize opportunities in daily practice to apply resource stewardship concepts through clinical care, teaching and assessment.

 
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Foundations Toolkit

 

This toolkit covers the concepts that are foundational to resource stewardship and help learners identify opportunities to apply resource stewardship concepts in daily practice.

Designed as a teaching resource this toolkit includes :

 

PowerPoint Presentation:

There are five versions of the PowerPoint available; each tailored for specialty-specific, target-audience relevance. Disclaimer: the alternate slide decks do not have speciality-specific cases for all subspecialties; if your specialty is not represented, please use the cases as a guide from which to build your own customized case.

Pre-developed cases:
  1. Medicine/Emergency Medicine – unnecessary investigations for acute kidney injury due to urinary retention, resulting in treatment of asymptomatic bacteriuria
  2. Pediatrics/Primary Care – unnecessary use of H2 blocker therapy in infant with reflux leading to medication side-effect
  3. Psychiatry/Primary Care – unnecessary benzodiazepine use in the elderly for insomnia, leading to fall
  4. Surgical/Primary Care – unnecessary investigations and management of minimally symptomatic inguinal hernia
  5. Surgical/Anesthesia/Internal Medicine/Primary Care – unnecessary pre-operative investigations leading to incidentaloma and surgical delay

 

This document contains a preamble to the toolkit and has been created to facilitate use of the slide deck and to assist the user in preparing themselves to present the PowerPoint presentation. It has a more in depth discussion of the slides notes available in the PowerPoint presentation.


 

Contains helpful resources relating to Resource Stewardship for those wishing to learn more. Each reference contains a brief summary of the study, relevance of the study and its relationships to other studies in the field; an evaluation of the research methodology (if applicable) and our article conclusions.

Resource Descriptions

Projects Toolkit

Undertaking a Resource Stewardship Project During Postgraduate Training


Resource stewardship and quality improvement are growing domains of research and many residents now choose to undertake scholarly projects in this field. This toolkit is designed for faculty who have limited experience in the planning, supervision and assessment of resource stewardship projects.

 
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Projects Toolkit

 

For faculty supervising resident scholarly projects. Will assist faculty in the planning, supervision and assessment of resource stewardship projects. If you’re new to this domain, or if you’re looking for some fresh ideas, check out this toolkit, which consists of:

 

This 24 page document outlines the key steps in conducting a resource stewardship project and walks users through the steps of five different types of resource stewardship projects. Each module is accompanied by real-life examples from residents across Canada.

Also included within the Roadmap:

 

To reflect the specific skill set of resource stewardship, these projects should be assessed and evaluated differently from other research and health care projects. This assessment tool can be used to assess competencies related to the ability to undertake resource stewardship projects.

 

A list of tips for supervising a successful resource stewardship project.

Resource Descriptions

Communication Toolkit

Communicating with Patients and Families About Resource Stewardship


Focussed on communication skills, this toolkit provides a framework that you can use to teach your residents how to communicate with patients and families that request a medically unnecessary test/treatment.

 
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Communication Toolkit

Teaches communication skills associated with resource stewardship and provides a framework for how to communicate with patients and families that are requesting a medically unnecessary test/treatment .

 

Use this to teach a communication framework to your residents. You can use this slide deck as is, but you may also want to modify the material to be more relevant to your discipline and/or practice environment.


 

Depending on your level of experience in teaching this content, you may find this document helpful as you prepare to present the material to your residents. It includes a more in depth discussion of the slide notes, included in the PowerPoint presentation


 

A short guide to creating your own role play scenarios. Includes a convenient checklist.


 

This document contains two rating scales that can be used for formative/summative evaluations of residents speaking with patients regarding resource stewardship communication both in formal settings (e.g., OSCE scenario) and in informal settings (e.g., ward-based evaluations). The assessment tools are based on the communication framework that was taught in the communication toolkit slide deck. They are meant to help in the assessment of communication around resource stewardship and can be adapted to the assessment goals.


 

Two family medicine/emergency medicine focused OSCEs on resource stewardship and patient communication. Following the outline of each station is a set of suggestions for ways to modify the station for other specialties based on the Choosing Wisely Canada recommendations.

Document 1: Unnecessary Antibiotics
Document 2: Unnecessary MRI for lower back pain

 

Contributors

FOUNDATIONS TOOLKIT

Series Editor
Chris Hillis, MD, MSc (QI/PS), FRCPC
Department of Oncology
McMaster University
Hamilton, Ontario

Editor
Jennifer Ngo, MD MSc (QI/PS) FRCPC
Department of Medicine
University of Calgary
Calgary, Alberta

Contributors
Faiza Khurshid, MBBS, FCPS
Department of Pediatrics
Queen's University
Kingston, Ontario

Kwadwo Mponponsuo, MD
Department of Internal Medicine
University of Calgary
Calgary, Alberta

Jessica Otte, MD, CCFP
Department of Family Practice
University of British Columbia
Vancouver, British Columbia

Natasha Qureshi, BSc, MD
Department of Internal Medicine
University of Calgary
Calgary, Alberta

Denyse Richardson, MD, MEd, FRCPC
Department of Medicine
University of Toronto
Toronto, Ontario

Seth J. Stern, MSc, MD
Department of Internal Medicine
McMaster University
Hamilton, Ontario

Brian M. Wong, MD, FRCPC
Department of Medicine
Sunnybrook Health Sciences Centre
University of Toronto
Toronto, Ontario


Reviewers
Karen Born, MSc, PhD
Knowledge Translation
Choosing Wisely Canada
Institute of Health Policy, Management and Evaluation
University of Toronto
Toronto, Ontario

Nancy Fowler, MD, CCFP, FCFP
Academic Family Medicine
The College of Family Physicians of Canada
Mississauga, Ontario

 
PROJECT TOOLKIT

Series Editor
Chris Hillis, MD, MSc (QI/PS), FRCPC
Department of Oncology
McMaster University
Hamilton, Ontario

Editor
Jerome Leis, MD, MSc (QI/PS), FRCPC
Division of Infectious Diseases
Sunnybrook Health Sciences Centre
Department of Medicine
University of Toronto
Toronto, Ontario


Contributors
Julie Gilmour, MBChB, MSc HQ, FRCPC
Department of Endocrinology
University of Toronto
Toronto, Ontario

Heather Johnson, MD
Department of Internal Medicine
Queen's University
Kingston, Ontario

Neil Kalra, MD
Department of Diagnostic Radiology
University of Saskatchewan
Saskatoon, Saskatchewan

Michael Lamb, MBBS
Department of Internal Medicine
University of Toronto
Toronto, Ontario

Michel A. Taylor, MD, FRCSC
Department of Orthopaedic Surgery
Queen's University
Kingston, Ontario

Jennifer Ngo, MD MSc (QI/PS) FRCPC
Department of Medicine
University of Calgary
Calgary, Alberta

Mina Tohidi, MD
Department of Orthopaedic Surgery
Queen's University
Kingston, Ontario

Penny Yin, MD FRCPC
Division of General Internal Medicine
University of Toronto
Toronto, Ontario

Reviewers
Stacy Ackroyd-Stolarz, BSc(OT), PhD
Department of Emergency Medicine
Dalhousie University
Halifax, Nova Scotia

Anees Bahji, MD
Department of Psychiatry
Queen's University
Kingston, Ontario

Nancy Fowler, MD, CCFP, FCFP
Academic Family Medicine
The College of Family Physicians of Canada
Mississauga, Ontario

Christopher Moriates, MD
Department of Internal Medicine
The University of Texas at Austin
Austin, Texas

Martina Trinkaus, MD, FRCPC
Division of Hematology and Medical Oncology
University of Toronto
Toronto, Ontario

Brian M. Wong, MD, FRCPC
Department of Medicine
Sunnybrook Health Sciences Centre
University of Toronto
Toronto, Ontario

Michelle Zeller, MD, FRCPC, MHPE, DRCPSC
Division of Hematology and Thromboembolism
McMaster University
Hamilton, Ontario

 
COMMUNICATION TOOLKIT

Series Editor
Chris Hillis, MD, MSc (QI/PS), FRCPC
Department of Oncology
McMaster University
Hamilton, Ontario

Editors
Geetha Mukerji, MD, MSc, FRCPC
Division of Endocrinology & Metabolism
Women’s College Hospital
Institute of Health Policy, Management and Evaluation
University of Toronto
Toronto, Ontario

Adina Weinerman, MD, FRCPC
Department of General Internal Medicine
Sunnybrook Health Sciences Centre
Toronto, Ontario

Contributors Samantha Buttemer, MD, CCFP
Department of Family Medicine
Queen's University
Kingston, Ontario

Ming-Ka Chan MD, MHPE, FRCPC
Department of Pediatrics and Child Health
University of Manitoba
Winnipeg, Manitoba

Constance LeBlanc, CCFP (EM), MAEd, CCPE
Department of Emergency Medicine
Dalhousie University
Halifax, Nova Scotia

Jennifer Russell, MD, FRCPC
Division of Cardiology within the Department of Paediatrics
Hospital for Sick Children
University of Toronto
Toronto, Ontario

Brian M. Wong, MD, FRCPC
Department of Medicine
Sunnybrook Health Sciences Centre
University of Toronto
Toronto, Ontario

Reviewers
Nancy Fowler, MD, CCFP, FCFP
Academic Family Medicine
The College of Family Physicians of Canada
Mississauga, Ontario

Brian M. Wong, MD, FRCPC
Department of Medicine
Sunnybrook Health Sciences Centre
University of Toronto
Toronto, Ontario

Do you have feedback for us?

Royal College Fellows, please contact us at: canmeds@royalcollege.ca

Family physicians*, please contact the College of Family Physicians of Canada (CFPC) at: academicfm@cfpc.ca

* More information for family physicians will be available in the coming months.

A Royal College joint initiative with: