Robert Maudsley Fellowship for Studies in Medical Education

2022

Victoria David, MD, MSc, FRCPC

Victoria David, MD, MSc, FRCPC
Clinical Scholar, Division of Hematology & Thromboembolism
McMaster University

Understanding the Competencies Required to Provide an Effective Consultation

Effective consultative technique is an important skillset for physicians. Currently, there is no specific curriculum to teach residents how to effectively provide a consultation. In addition, staff physicians are expected to assess and give feedback to trainees in their ability to provide a consultation. However, it is unclear what supervisors think are the key skills required to provide a consultation. The purpose of this study is to understand the critical skills required to carry out an effective consultation and use the resulting data to develop a framework to educate residents on how to provide an effective consultation. This study also aims to examine supervisors’ preparedness to assess consultative skills and provide feedback, and to assess trainees' perceptions on the value of the coaching they receive.

Justin Lam, MD, FRCPC

Justin Lam, MD, FRCPC
Pediatrics Resident, Clinician Investigator Program, University of Toronto
Research Fellow, Wilson Centre

Exploring Systemic Discrimination in Medical Learning Environments

Despite equity, diversity, and inclusion (EDI) reform efforts across North American residency training programs, reports of harassment and evidence of systemic discrimination in medical education are still widespread. If such issues are left unaddressed, they will continue to impact healthcare burnout and patient care. While interventions have largely focused on individual level discrimination, the effects of systemic discrimination in medical training have been less addressed. Developing a mechanism for early detection of all forms of discrimination is critical if educational training programs are to achieve their stated EDI priorities.

By focusing on routine educational activities such as bedside teaching, assessment, and clinical work we hope to a) understand how current common practices associated with preparing learners to be competent physicians might unintentionally reinforce structural discrimination, and b) develop recommendations for integrating EDI through program and policy reform as part of ongoing quality improvement of training programs. Our findings will contribute to reducing systemic discrimination in the learning environment, and make training fairer for all trainees.

Brandon Tang, MD, MSc

Brandon Tang, MD, MSc
General Internal Medicine Subspecialty Resident (PGY-4), University of Toronto

Linking patient outcomes to resident performance using resident-sensitive quality measures: The General Medicine Inpatient Initiative Medical Education Database (GEMINI MedED) Cohort Study

The ultimate goal of medical education is to train physicians to provide high quality care. However, current assessment approaches in postgraduate education infrequently incorporate patient outcomes. Emerging evidence demonstrates that physician-level variation in patient outcomes is influenced by the quality of care delivered in their training environment. Thus, residency represents a critical period when targeted feedback could improve both educational and patient outcomes. This work explores how clinical performance measures, including resident-sensitive quality measures (RSQMs) and patient outcomes, can be integrated into medical education. Senior internal medicine residents will be linked to clinical data from patients they cared for on-call, using existing clinical information from the GEMINI database and 10 years of resident call schedules. This will enable characterization of resident-level variation in clinical care processes and patient outcomes, as a first step toward aligning assessment and feedback in residency education with high quality patient care.

2021

Jessica Trier, MD, FRCPC, CSCN Diplomate (EMG)

Jessica Trier, MD, FRCPC, CSCN Diplomate (EMG)

Cultivating psychologically safe learning environments: Residents’ experiences of risk-taking in postgraduate medical education

Psychological safety is a belief that a work environment is a safe place to take interpersonal risks. In postgraduate medical education, residents work and learn in environments where they are required to take interpersonal risks every day. However, educators might not understand these risks and their potential consequences the same way residents do; things that feel risky for residents might not feel risky for clinical teachers and educators. If psychological safety in the clinical learning environment hinges on the ability for residents to take interpersonal risks, then educators must appreciate what is required for residents to feel safe taking risks during their training. This study will seek to better understand how residents experience interpersonal risk-taking in the clinical learning environment. This knowledge will help educators design and implement psychologically safe learning environments in which resident growth and development, and ultimately patient safety, can thrive.

Amanda Roze des Ordons, MD, FRCPC, MMEd

Amanda Roze des Ordons, MD, FRCPC, MMEd

Trauma-Informed Medical Education: Exploring Experiences and Developing Resources for Support

Throughout the course of medical education, learners are exposed to situations that have the potential to trigger psychological trauma. The emotional and behavioural consequences may interfere with patient care, academic success, personal relationships and well-being. Through a mixed methods approach, my research will explore learners’ experiences of traumatization in the clinical learning environment, including the scope and impact of trauma, and ways in which it might be mitigated. A greater understanding of how trauma impacts learning, interpersonal interactions, professional and personal identity and mental health will inform future approaches to medical education and learner support.

Julien Bernatchez, MD, FRCSC

Julien Bernatchez, MD, FRCSC

Multidisciplinary curriculum in wound care and amputation prevention

This work is important to medical education because it aims to provide evidence of the efficacy of online learning in the fields of health sciences and medicine. Currently available research looking at the influence of e-learning on medical education concentrates most of its efforts on demonstrating differences in test scores or appreciation of the learning experience between users and non-users. This study will add to this body of literature but most importantly, also aims to test the outcomes of e-learning on a higher level of learning evaluation by studying behaviour change. This project is also important because it consists in designing high-quality online curriculums, based on learning theories and evidence-based teaching strategies, to teach wound care and amputation prevention principles to a multitude of health care workers from different careers and specialties in the hope to improve the quality of care for this growing patient population.

2020

Quinten Paterson, MD

Emergency Medicine PGY-4, University of Saskatchewan

Quinten Paterson, MD

Utilization of the theoretical domains framework to improve EPA acquisition for emergency medicine residents

This work is important to medical education because within the new Competency by Design paradigm, the coaching and feedback interaction between the teacher and student is paramount to learner success; therefore, barriers and facilitators to this interaction must be uncovered and identified so ensure residents and teachers are experiencing the full benefits of these crucial interactions. As these encounters are enhanced by promoting enabling strategies and addressing barriers, learners can progress and excel in their residency education.

Catherine Patocka, MDCM, MHPE, FRCPC

Clinical Assistant Professor, Department of Emergency Medicine and Doctoral student, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary

Catherine Patocka, MDCM, MHPE, FRCPC

Outlining the transition to precision performance feedback

Although physicians are receiving more and more feedback on their clinical performance through audit and feedback interventions, our understanding of the use of feedback to support growth and facilitate learning in the context of continuing professional development remains limited. In particular, our current conceptualization of feedback as a generic and well-defined entity that can be prescriptively enacted as a precise set of universal best practices irrespective of context may be problematic and misguided. This research is exploring how conceptualizations of feedback vary and how these variations alter the practices of feedback, with the goal of identifying key features of feedback that can be used to appraise and guide performance feedback systems for physicians across the continuum.