2019 Recipients: Advancing Competency-based Medical Education across the Continuum

Exploring supervisors' decisions about procedural entrustment in simulation-based and workplace-based settings

This work is important to medical education because …

This research will shed light on how clinical supervisors make entrustment decisions in workplace-based and simulation-based settings. While simulation has become commonplace in procedural skills training and assessment, how supervisors engage in observational and decision-making processes (‘rater cognition’) when assessing trainees in simulation-based settings remains unclear. With the introduction of Competence By Design, it is timely to explore how rater’s cognitive processes may be similar or different in simulation-based and workplace-based assessment contexts, and what implications any similarities or differences may have for entrustment decision-making. We intend to study this using colonic polypectomy as a relevant entrustable professional activity in Gastroenterology which can be assessed in either context. The outcomes of this study will advance specialty medical education by informing when and how we use simulation in CBD-era assessments in the years to come.

Understanding the language of front-line faculty: gathering validity evidence for a construct-aligned rating of internal medicine residents

This work is important to medical education because…

Current evidence suggests that the construct of entrustment is enacted differently across specialties as clinical supervision and entrustment are grounded in specialty-specific working cultures and language. Our multi-institutional team (Andrea Gingerich [UBC], Shiphra Ginsburg and Lindsay Melvin [University of Toronto], David Taylor and Stephen Gauthier [Queen’s University]) will undertake a validity study, using Kane’s framework, to explore the specialty-specific language that captures the essence of clinical supervision in internal medicine and to develop and examine a construct-aligned rating scale based on our findings. We will gain a richer understanding of clinical supervision in internal medicine, and the language used by supervisors, which may be harnessed in service of work-based assessment. This work could also serve as a guide for other disciplines to investigate the essence of clinical supervision in their contexts and to develop the related validity arguments for their assessment tools.

Training Physicians and Learners in the use of EHR: what have we learned? A Case Study of Three Hospitals

This work is important to medical education because…

Electronic Health Records (EHR) are being adopted in multiple healthcare settings. There are many reported benefits such as improved access to patient information, reduced medical errors, and improved efficiency. Despite widespread agreement about the importance of EHR, implementation has been challenging. One of the most important barriers to implementation has been the lack of proper education and training strategies for physicians. Considering the billions of dollars spent in EHR implementation, it is notable that education research to develop effective training programs receives very little attention.

The implementation of EHRs across three academic hospitals in Ontario offers a unique opportunity to identify current challenges and successes in workplace learning. The purpose of our study is to describe and critically analyze the similarities and differences in EHR implementation and training across these sites. Lessons learned will help characterize best educational practices and resources to support sustainable long-term training programs.

Leaner Handover: What do learners think?

This work is important to medical education because…

… it has the potential to identify new insights about learner handover from the learner’s perspective.

Learner handover, the process of sharing information about the learner between faculty supervisors involved in the learner’s education, has been a source of debate mainly due to fears of introducing bias to assessments and stigmatization. However, its potential to facilitate the longitudinal assessment fundamental to CBME, often hindered by our current rotation-based system, has caused renewed interest in its practice. As such, national organizations in North America have been developing learner handover tools for the transition between undergraduate to postgraduate medical education to improve institutional preparedness for incoming learner needs, patient safety, professional development, mentorship and resident wellness. Despite the learner-centered focus, much of what we know about learner handover comes from faculty. This project has the potential to increase our understanding of learner handover from Canadian and American learners ultimately ensuring learner-centred practices as implementation becomes imminent.

Acknowledgment:
This study is a collaborative effort between the University of Ottawa and University of California, San Francisco.