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Medical Education Research Grant — Recipients

2020

Gisèle Bourgeois-Law, MD, MEd, FRCSC

Remediation as experience by practicing physicians

Gisèle Bourgeois-Law
Gisèle Bourgeois-Law, MD, MEd, FRCSC
Clinical Professor, Department of Obstetrics and Gynecology, UBC
CHES-IMP Liaison, UBC

This work is important to medical education because…

As an increasing number of Canadian provinces implement Physician Practice Improvement (PPI) initiatives, the number of physicians who will be identified as needing some form of remediation will likely increase. While remediation in practice shares similarities with remediation in postgraduate training, one might also expect qualitative differences when an external agent removes an individual’s professional autonomy to a lesser or greater degree. We know that remediation in practice can entail significant logistical challenges. What we don’t know is how remediation, meant to be a positive process to support a physician in bringing their practice up to the expected standard, is actually experienced by those physicians undergoing remediation. Understanding the remediation process from the remediatee point of view might lead to better ways to support physicians, increased individual buy-in, and higher rates of both short-term achievement of learning/remediation objectives and long-term sustained practice change.

Paula Rowland, PhD

Exploring tensions in the clinical learning environment: A qualitative study of policies and practices related to trainees involved in safety events In academic teaching hospitals

Paula Rowland, PhD
Paula Rowland, PhD
Scientist, Wilson Centre and Post MD, Faculty of Medicine University of Toronto and University Health Network
Assistant Professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto

This work is important to medical education because…

Clinical learning environments (CLE) have a dual mandate: provide safe patient care and provide health professions education. Developing an understanding of the organization of CLEs will provide much needed insight into how CLEs might be positively influenced towards both better care and better learning. We argue that negotiations around “when things go wrong” reveal organizational dynamics that impact the CLE. In this study, we focus on how organizations negotiate policies around errors, accidents, and unexpected events. This will be a qualitative research project, exploring how policies and practices related to students and/or trainees involved in care events are negotiated, sustained, and/or resisted by (a) hospital-based stakeholders and (b) university-based stakeholders. Our objective is to develop a conceptual framework to help educators understand, assess, and negotiate these organizational dynamics. This framework will be relevant for all medical educators concerned with the CLE, including post graduate medical education and continuing professional development.

Jonathan Sherbino, BSc MD MEd FAcadMEd DRCPSC(Clin Ed)

Consultation or Crowd Sourcing?: Exploring the diagnostic accuracy of individual and group diagnosis

Jonathan Sherbino
Jonathan Sherbino, BSc MD MEd FAcadMEd DRCPSC(Clin Ed)
Professor, Department of Medicine, McMaster University
Assistant Dean, McMaster Education Research, Innovation and Theory (MERIT) program

How can clinicians reduce diagnostic error?

This study is important because it will test the influence of collective intelligence (the wisdom of crowds) to improve diagnostic accuracy.

Sophie Soklaridis, PhD

Beyond “mini-me” and #MeToo: Building physician’s leadership capacity to support the success of people with diverse needs and experiences

Sophie Soklaridis
Sophie Soklaridis, PhD
Senior Scientist, The Centre for Addiction and Mental Health
Associate Professor, Departments of Psychiatry and Family and Community Medicine, University of Toronto
Scientist, Wilson Centre, University of Toronto, Faculty of Medicine and University Health Network

This work is important to medical education because mentorship is an essential component of career development. However, most individuals tend to mentor and advocate for the development of mentees who are most like them. As a result, women and other minority physicians have a difficult time entering the white male-dominated ranks of top hospital management and continue to occupy only a small portion of executive positions with the greatest power and authority. Physician leaders are not necessarily trained to consider approaches to gender and diversity to redress health inequities. The objectives of this research are to explore physicians’ perceived connections among leadership, mentorship and diversity; transform these experiences and what is known in the academic literature into an educational curriculum that engages physicians in complicated conversations that lead to transformative learning; and ensure an optimal learning experience for increasing physicians’ capacity to lead diverse healthcare teams.

Anneke van Enk , PhD

The Use of Previously Undocumented Data in Competence Committees of Competency-Based Medical Education Training Programs

Image of Anneke van Enk
Anneke van Enk , PhD
Scientist, Centre for Health Education Scholarship, Faculty of Medicine, University of British Columbia

This work is important to medical education because…

Previously undocumented data (PUD) plays a potentially significant role in competence committee (CC) decision making, but we know little about its forms, uses, and management in deliberations. While CCs in some countries appear to permit the use of PUD, other countries discourage its use, perhaps on assumptions that PUD will distort assessment, and that the increased documentation called for by CBME will ultimately eliminate any need for it. Yet, documentation of clinical performance is limited, and we may not be able to rely on it exclusively. Moreover, there is evidence that PUD contributes to richer assessments. It appears worthwhile, then, to revisit its place in assessment, even as we acknowledge concerns about fairness, coherence, and transparency. Our analysis will help CCs to better understand the value and potential risks of PUD in defensible decision making and to craft sounder guidelines for whether, when, and how it might best be used.

2019

Sarah Burm, PhD

Non-Indigenous Medical educators and trainees Engagement with the Truth and Reconciliation’s Calls to Action: A Narrative Study

Sarah Burm, PhD
Sarah Burm, PhD
Assistant professor, Faculty of Medicine, Continuing Professional Development and Medical Education, Dalhousie University

Across Canada, faculties of medicine are operationalizing their response to the Truth and Reconciliation Commission’s (TRC) mandate and although considerable progress has been made, there is still so much work to be done. Medical schools have an obligation to ensure everyone across their faculty, Indigenous and non-Indigenous, are equipped and committed to fulfilling their social accountability mandates with respect to Indigenous health. However, to create a community of non-Indigenous advocates who can confidently and respectfully contribute to these efforts, we first need to understand the experiences of those currently involved in advancing Indigenous health initiatives and the ways they navigate their roles and responsibilities across medical education. This qualitative research project will explore the pathways taken by some non-Indigenous peoples engaging in activities whose stated aims include advancing the TRC’s Calls to Action around Indigenous health. We want to better understand how non-Indigenous faculty and trainees enter into and navigate the complexities of this work, including engagement in critically confronting their positionality and the impact this learning has had on their personal and professional identities. The results of this study will be relevant to all medical schools striving to engage meaningfully in reconciliatory efforts.

Samantha Halman, MD, FRCPC, MMED

Focus on faculty evaluation: informing continuing professional development in a meaningful way

Samantha Halman, MD, FRCPC, MMED
Samantha Halman, MD, FRCPC, MMED
Assistant professor of medicine, University of Ottawa General internist, Department of Medicine, The Ottawa Hospital

Rigorous assessments and constructive feedback about all aspects of performance should drive learning and professional development, but this may not be the case for faculty in independent practice. Although most evaluation processes focus on care provision and teaching abilities, much more is expected of clinical faculty. To be successful, they must also be excellent researchers, mentors, administrators and leaders; faculty receive limited, if any, formal and constructive feedback about these domains. While problematic for all faculty, for those who are prone to self-doubt, lack of meaningful evaluations and credible feedback may hinder their career advancement and impact wellness. We aim to explore faculty members’ perspectives about the role evaluations and feedback currently play in their professional development, and how they obtain the insights necessary for performance improvement across multiple professional activities. This will hopefully provide opportunities to render evaluations more meaningful and impactful to faculty in practice.

Aliya Kassam, BSc (Hons), MSc, PhD

A National Initiative to help ease the Transition from Medical School to Residency: The Learner Education Handover Pilot Project (LEaPP)

Aliya Kassam, BSc (Hons), MSc, PhD
Aliya Kassam, BSc (Hons), MSc, PhD
Research lead, Office of Postgraduate Medical Education, and assistant professor, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary

Current literature suggests that medical learners feel inadequately prepared for residency, particularly in terms of clinical experience, knowledge and skills. Faculty are often able to pinpoint where improvements are needed to help ease the transition; however, these are heavily based on technical deficits that need improvement and not in other competency domains. By receiving advance notice (post resident matching but pre-entry) of specific educational, personal or accommodation needs, residency programs can proactively begin to plan and Learner Education Handover (LEH) collaborate with incoming self-identified learners to achieve a more expeditious and effective learner program for them.

Sandra Monteiro, BSc, MD, PhD

Evaluating rapid exemplar processing to improve diagnostic expertise

Sandra Monteiro, BSc, MD, PhD
Sandra Monteiro, BSc, MD, PhD
Assistant professor, Department of Health Research Methods, Evidence and Impact, McMaster University Director, Research and Analysis, Touchstone Institute

Medicine is increasingly complex, with exposure to representative patient encounters occurring in an ad hoc manner. The proposed approach takes a systematic line to building efficiency into the system. Rapid exemplar learning serves as a theoretical approach to change the delivery of medical education that is largely unchanged for the last century. To date, the only way to acquire enough exemplars to develop expert-level performance is through years of formal medical school curricula followed by informal training through ‘seeing more patients.’ This study applies modern theories of human visual statistical learning to evaluate a more time efficient method for learning to categorize diagnostic images. We believe this approach can better prepare health professions’ trainees to apply the skill of medical diagnosis.

Hatem Salim, MD, FRCPC

Is there more to it than reading around the case? A mixed methods study of resident workplace preparation habits

Hatem Salim, MD, FRCPC
Hatem Salim, MD, FRCPC
Assistant professor, Division of General Internal Medicine, Department of Medicine Associate program director, Internal Medicine, Western University/ London Health Sciences Centre

Intuitively, it is believed that better preparation habits would make for better resident performance; however, there is a paucity of research that documents how residents prepare, let alone evidence to confirm a causal relationship. The results of this study are important as many programs are undertaking major educational change initiatives. Predominantly associated with the competency-based movement, programs are being asked to personalize learning without much in the way of guidance. Many programs struggle to figure out how best to help trainees prepare and learn in the workplace. Thus this study will fill this need not only from an academic perspective, it will also serve to support programs in being able to better identify preparation habits of trainees to customize learning activities and ensure continued progress.

Lynfa Stroud, MD, Med, FRCPC

How academic advisors and residents develop learning relationships and make meaning of assessment data over time

Lynfa Stroud, MD, Med, FRCPC
Lynfa Stroud, MD, Med, FRCPC
Associate Professor, Department of Medicine, University of Toronto Staff Physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre

Competence by Design (CBD) has increased the number and frequency of low-stakes, formative assessments during residency training. To help residents synthesize and use the greater amount of assessment data and feedback, the Royal College of Physicians & Surgeons of Canada has recommended ‘coaching over time’, leading many residency programs to create the Academic Advisor (AA) role, or similar coaching roles. However research has yet to focus on the experience and impact of this new role. This work aims to better understand how AAs and residents interpret assessment data and how they use the data together to plan learning trajectories, what language AAs use to document these encounters, and how both AAs and residents perceive their relationship over time. The outcomes of this study will further inform CBD implementation and provide a greater understanding of longitudinal coaching relationships in residency training.

2018

  • Elif Bilgic, PhD
  • Tristen Gilchrist, MD, FRCPC (MHPE Student, Maastricht University)
  • Anna MacLeod, PhD
  • Tracy Moniz, PhD
  • Heather Waters, MD, CCFP, FCFP
  • Timothy J. Wood, PhD

2017

  • Ryan Brydges, PhD and Jeffrey J.H. Cheung, PhD(c)
  • Vicki Leblanc, PhD
  • Carmen L. Mueller, BSc(H) MD FRCSC MEd FACS
  • Geoffrey Norman, PhD
  • Nha Voduc, MD, FRCPC