OSMERC 2021 Abstracts

Ontario Student Medical Education Research Conference (OSMERC)

Published online: 25 March 2021

Abstracts for Oral Presentations

Surgical resident workload and the impact of interruptions on educational activities

Chris J Zhang¹, Eric Walser², Anna Mierzwa¹, Michael Ott^1,2,3,4
¹Schulich School of Medicine, Western University, London ON.
²Division of General Surgery, Department of Surgery, Schulich School of Medicine, Western University, London ON.
³Center for Education Research and Innovation, Schulich School of Medicine, Western University, London ON.
⁴Department of Oncology, Faculty of Medicine, Schulich School of Medicine, Western University, London ON.
Corresponding Author: Chris J Zhang, email czhan343@uwo.ca

Abstract

Introduction: The complex workflow of surgical residents makes interruptions an unavoidable aspect of learning in a clinical environment. Interruptions are known to affect cognitive load, surgical performance, and medical error.
Research Question: What are the effects of interruptions on surgical resident education?
Methods: Junior General Surgery residents were observed by 2 trained observers using time-motion methodology between September 2018-August 2019. Interruptions were identified and coded based on predefined criteria. We captured key features of interruptions including frequency, duration, task interrupted, outcome, and educational value.
Results: 278.2 hours of resident workflow were observed, and 229 interruptions were recorded. Interruptions account for 57.9 minutes/day of a surgical resident. Time spent on interruptions are greater on an Acute Care Surgical service compared to an elective service (91.7 mins/day vs 21.0 minutes/day, p=0.003). Overall, interruptions do have educational value; however, tasks of higher educational value were frequently interrupted by tasks of lower educational value. Interruptions occur at a frequency of 0.82 interruptions/hour. 40% of interruptions that occur during informal teaching disrupt the teaching and continuation rarely occurs after the interruption is addressed.
Discussion: Interruptions are common for the surgical learning and frequently affect high value components of resident workload. The impact of interruptions on education must be considered in a context specific manner. Depending on the original task, an interruption may add or subtract educational value. We identified informal teaching as a valuable educational activity that is disproportionately impacted by interruptions. Efforts that have been shown to be effective in protecting formal teaching time from interruptions should be extended to informal teaching to ensure activities of high educational value are adequately protected from interruptions.

Emotional contagion and the surgeon leader

H. Lia ¹, F. Rudzicz ^2,3,4, C.A. Moulton^5,6
¹Temerty Faculty of Medicine
²Department of Computer Science, University of Toronto
³Unity Health Toronto
⁴Vector Institute
⁵Department of Surgery, University of Toronto
⁶Wilson Centre
Corresponding Author: Hillary Lia, email hillary.lia@mail.utoronto.ca

Abstract

Communication and teamwork skills are considered key patient safety factors. In surgery, communication failures are associated with significant increases in intraoperative adverse events. Communication failures are common, occurring in up to 30% of team exchanges. These failures increase cognitive load and emotional tension which perpetuate further communication failure. Although all team members play a role in effective communication, attending surgeons are viewed by other staff as “tone-setters” whose responsibility it is to create an emotional climate that promotes positive team interaction. Attending surgeons who create a constructive emotional climate express gratitude and enthusiasm, regulate outward expression of stress, and promote open discussion. Though there is significant literature describing the role of the attending surgeon as tone-setter, surgeons are largely unaware of this role. In the organizational behaviour literature, the phenomenon of intentional and unintentional tone-setting is known as ‘emotional contagion’. This is the process whereby the attitudes, moods, and behaviours of a group or individuals influence that of another group or individual. Effective emotional contagion can be leveraged as a leadership tool. Leaders who leverage emotional contagion increase cooperation and better motivate their team during times of stress. Though emotional contagion has not been studied in the operating room, this phenomenon may generalize to this context. Surgeons who are perceived as effective tone-setters may intentionally or unintentionally create a productive team environment by mechanism of emotional contagion. We propose that by examining the surgeon leader through the lens of emotional contagion, we may better understand operating room team dynamics. This understanding can be applied to surgeon leadership training to help surgeons leverage emotional contagion and create a safer operating room environment. 

Data source prioritization among novice raters in competence committee decision making

R. Mann^1,2, A. Acai^1,2, R. R. Sonnadara^2,3
¹Department of Psychology, Neuroscience & Behaviour, McMaster University
²Office of Education Science, Department of Surgery, McMaster University
³Department of Surgery, University of Toronto
Corresponding Author: Ruby Mann, email rubyyymann@gmail.com

Abstract

 Introduction
Competence committees (CCs) make judgments about trainees’ progression towards competence using different data sources. However, the relative weighting of these data sources remains unclear, making member training and data curation a challenge. This study investigated data source prioritization in CC decision making using a sample of novice raters.
Methods
Fifty-eight undergraduate students were presented with 32 simulated resident portfolios and made decisions about whether or not to promote each resident based on their portfolio. Each portfolio was composed of five data sources indicating strong or weak performance in various combinations: numeric entrustable professional activity (EPA) data, narrative EPA data, numeric multisource feedback (MSF) data, narrative MSF data, and numeric examination data. To determine the relative weight of each source, the promotion rate of each resident was compared with the positive control portfolio, where all data sources were strong.
Results
Participants weighted EPA and MSF numeric scores more heavily than EPA and MSF narrative comments. Only 29% of participants promoted a resident whose EPA and MSF numeric scores were weak but whose other data indicated strong performance. Conversely, 90% of participants chose to promote a resident with a similar portfolio except with weak narrative EPA and MSF data.
Conclusion
Novice raters prioritized numeric data over narrative comments, potentially reflecting their perceived “objectivity” and ease of interpretation. This may have implications for understanding the decision-making processes of new CC members and member training, although further study using a sample of clinicians is required in order to build on these exploratory findings.

Exploring Medical Students’ Experiences with an Innovative Curriculum Supplement for Teaching Gross Anatomy

N. J. Katz¹, K. Kolomitro^1,2, L. W. MacKenzie², B. Zevin³
¹Office of Professional Development and Education Scholarship, Queen's University
²Department of Biomedical and Molecular Sciences, Queen's University
³Department of Surgery, Kingston General Hosptial, Queen's University
Corresponding Author: Nathan J. Katz, email nathan.katz@queensu.ca

Abstract

Background
Graduating medical students’ knowledge of gross anatomy is clinically insufficient, creating an educational imperative to maximize the efficacy of anatomy teaching. Gross anatomy is best taught using a multi-modal approach, in which sufficient preparation for cadaver labs is critically important and currently inadequate. 3D-Visualization Software (3DVS) is a powerful but underutilized resource in Undergraduate Medical Education (UGME). Thus, developing a method to deliver gross anatomy teaching via 3DVS that is well-received by students may improve UGME anatomy educational outcomes.
Hypothesis
Teaching gross anatomy via a lecture-style presentation employing guided instruction of 3DVS constitutes a novel teaching method that may uniquely benefit medical students’ preparation for cadaver labs.
Methods
We created a prototype program that operates in conjunction with a commercially available 3DVS, providing additional functionality by allowing the instructor to guide students through a ‘fly-by’ of digitally dissected anatomical structures. Using this approach, six modules that paralleled curricular cadaver lab content were created and delivered to 1st year medical students at Queen’s University, during optional lunch-time sessions. Pre- and post-surveys explored the value of the sessions to students.
Results
All (n=21) students reported that the sessions were helpful for learning anatomical structures. Most students strongly agreed that the sessions helped preparation for cadaver labs, and aided their understanding of 3D relationships between structures. 9/10 students recommended the sessions to future 1st-year medical students. Narrative comments included: “seeing it in 3D, in relation to everything else made the lab go more smoothly” and “[helpful for] visualizing… anatomical relationships [and] making connections between structures and how they interact.”
Conclusions
Providing pre-programmed but real-time instructor-guided exploration of curated 3D content represents a novel method for teaching gross anatomy that exploits the potential of 3DVS. Incorporating this teaching method in pre-lab preparation may provide a meaningful supplement to current UGME anatomy curricula.

Innovations in Patient-Centred Care: A Longitudinal Design-Thinking Experience for Medical Students

Y. Ahmed, BMSc, MD(c)¹, J. Herman, BMSc, MD(c)¹, S. Litwin, MB BCh BAO, MDes²
Corresponding Author: Yousuf Ahmed, email yousuf.ahmed@mail.utoronto.ca

Abstract

Background:
Design thinking is a structured framework for identifying needs within a population and creating practical, user-centered solutions. This approach enables physicians to effectively engineer patient-centric solutions within a dynamic healthcare environment. As medical students’ patient care strategies are primarily derived from exposures during their medical education, it is imperative that medical education integrates the design thinking approach.
Hypothesis:
A longitudinal design thinking program constitutes a novel approach for medical students to develop a focus on patient-centred approaches to clinical care.
Methods:
Established in collaboration with medical experts in design thinking, ‘Prototype’ involves teams of medical students working directly with physician mentors on a patient-centred design project throughout the course of the year. An ancillary curriculum of workshops was also developed to support students in the formal development of design thinking skills as they work on their projects. Pre- and post-surveys explored the value of the program across a number of measures. Thematic analysis was performed to draw out key themes across responses.
Results:
All (n=12) students stated that they will apply lessons learned through this program throughout their careers as physicians. At program onset, most participants were unfamiliar with the design thinking approach and were unprepared to engage in medical innovation. Motivations to participate included an interest in innovation and entrepreneurship, exposure to a new perspective in medicine, and prior involvement in similar programs. Participants valued mentors with design-thinking experience, exposure to medical innovators, and collaborative groups with peers. The primary challenges faced was balance with a busy medical school curriculum.
Discussion:
‘Prototype’ demonstrates the value of a longitudinal design thinking program for medical students and serves to inform educators of the importance of teaching innovation within medical education. Specifically, ‘Prototype’ demonstrates a role for integrating teaching surrounding patient-centred design principles with community-based service learning programs.

Resilience Curriculum – A theory-based evaluation

Juehea Lee¹, Ben Shachar¹, Joanne Leo^1,2, Shayna Kulman-Lipsey^1,2, David Rojas Gualdron^1,3,4
¹University of Toronto Faculty of Medicine, Toronto, ON, Canada
²University of Toronto Faculty of Medicine, Office of Health Professions Student Affairs, Toronto, ON, Canada
³Centre for Ambulatory Care Education, Women’s College Hospital, Toronto, ON, Canada
⁴The Wilson Centre, University Health Network, Toronto, ON, Canada.
Corresponding Author: Juehea (Lucia) Lee, email juehea.lee@mail.utoronto.ca

Abstract

Background: Medical students experience high levels of stress and are at increased risk of developing depression and burnout. Resilience has been suggested as a teachable skill that prevents burnout and promotes student mental health. As such, the University of Toronto developed and embedded a 4-year integrative Resilience Curriculum (RC) into the undergraduate Doctor of Medicine program to equip students with tools to increase their resilience. Previous evaluations captured students' perceived value of the RC. This study aims to explore how the RC has unfolded to date, including its strengths and areas for improvement, from the perspective of its stakeholders: the developers, defined as those who led the development of the RC, and the implementers, defined as those who facilitated resilience workshops.
Methods: Two focus groups, comprising of developers (n = 6) and implementers (n = 5), were facilitated. An inductive thematic analysis was conducted. Codes were categorized to establish preliminary themes. Iterative discussions yielded final themes.
Results: Both groups identified the integration of the RC into the core curriculum and changes implemented as a response to student feedback as strengths of the curriculum. Limited training for implementers was identified as a shortcoming.
Conclusion: Findings from this work can be considered when developing and implementing a medical education-based resilience curriculum. The themes in this study may be applied to inform the creation of an innovative tool that assesses the impact of RC on the resilience and well-being of medical students.

Abstracts for Poster Presentations

Enhancing financial literacy for medical students

Mateen Akhtar (M. Akhtar)
Corresponding Author: Mateen Akhtar, email mateen1akhtar@gmail.com

Abstract

Introduction:
The total amount of medical student debt has been steadily rising and is often cited as a major source of stress for medical students. This, coupled with the fact that many medical trainees are not financially literate, could be contributing to the burnout crisis within medicine. Fortunately, research indicates that a financially literate medical student is more likely to become a financially independent physician that is more resilient against burnout. Here are answers to some common financial questions regarding the flow of money, investments and investment accounts to help support students' financial literacy and planning for the future.
Body paragraphs will explore the following financial questions commonly asked by medical students:
What is a medical professional corporation? What is tax-deferred growth in an MPC? Why are investments important? What is evidence-based investing? What's the difference between an RRSP, TFSA, and a non-registered investment account? and etc.
Conclusion:
As medical students, we often neglect our financial well-being until we finish residency and start making “doctor money.” This approach assumes that physicians are immune to financial hardships and can achieve financial independence without any planning, which is simply not the case. With escalating student debt, mental health issues and burnout, it is imperative that everyone does their part to address the lack of financial literacy that is prevalent throughout medicine.

Reproductive Endocrinology and Infertility Fellowship Program Website Assessment

M. Jain¹, J.Rodrigues BSc¹, N.Sood BSc MSc², D. Karol MD³, E.Hu⁴, F.Khosa MD MBA⁴
¹Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
²Faculty of Medicine, Memorial University, St. John’s, Newfoundland, Canada
³Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada
⁴Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.
Corresponding Author: Julia Rodrigues, email jrodr015@uottawa.ca

Abstract

Objective: To assess the comprehensiveness of Reproductive Endocrinology and Infertility (REI) fellowship program websites in Canada and the United States (US).
Design: All active Canadian and US REI fellowship program websites (as of May 2020) were evaluated and compared using a 72-point criteria checklist. Fellowship programs without websites were excluded from the study. Program website information availability was compared by geographic region.
Setting: Program website
Patients/ Animals: N/A
Intervention(s): Online American and Canadian REI program websites were individually assessed using a 72-point criteria checklist that was adapted from previous studies employing similar methodology and criteria to assess fellowship websites in various medical specialties. Program websites were grouped based on geographic location.
Main outcome measure(s): The scoring criteria consisted of a total of 72 items with the following subcategories: recruitment, fellow information, faculty information, research and education, procedural learning, clinical work, work benefits, wellness and environment.
Results: We identified 49 REI fellowship programs in the US and 9 in Canada. 100% of the Canadian programs and 95.9% of the US programs had an accessible website. The mean score across all American websites was 61.47% and 47.68% for the Canadian websites, which is significantly lower (p<0.000). The “wellness” subcategory had the highest prevalence of criteria (85.33%) across all program websites, whereas the ‘fellow information’ subcategory had the lowest score (20.0%).
Conclusion: Canadian and US REI fellowship websites overall lacked content relevant to prospective applicants. Program websites can improve sections on clinical work, current fellows and details on research requirements and opportunities to increase applicant engagement and recruitment.

Exploring lessons learned by medical students in a pediatric oncology buddies program

A. Goodbaum¹, J.Do¹, C. Nayman¹, K. Eady², K. Moreau³
¹Faculty of Medicine, University of Ottawa
²CHEO Research Institute
³Faculty of Education, University of Ottawa
Corresponding Author: Alexa Goodbaum, email agood067@uottawa.ca

Abstract

Introduction/Background: Pediatric oncology patients and their families must adjust to several stressors when faced with a cancer diagnosis. One of many support avenues is one-on-one partnership programs between patients and volunteer students. The “CHEO Buddies” program at the University of Ottawa’s Faculty of Medicine fosters nurturing relationships between pediatric oncology patients and medical students. Students gain useful insight into the intricacies of patient care and hands-on experiences important to the development of humanistic skills required in comprehensive medical care.
Hypothesis/Question: We explored medical students’ experiences over the course of the program to gain insightful evidence that can be applied to medical school curriculum development. We aimed to answer the following question: What is the lived experience of the medical students who participate in the CHEO Buddies program?
Methods: Transcendental longitudinal phenomenology, based on Moustakas’ approach, served as the foundation for this study, allowing for the exploration of the medical students’ evolving experience. Interviews were conducted with medical students at three time points: before meeting his/her buddy (pre-interview), four months after being with his/her buddy (mid-interview), and at end of his/her partnership (post-interview).
Results: Fifteen students participated. In the pre-interview, students predicted: 1) providing a supporting role; 2) developing empathy and drawing on prior experiences; and 3) anticipating emotionally charged and logistically challenging interactions with their buddies. Themes were similar in mid- and post-interviews, where students: 1) confirmed their supporting role; 2) explained the program was challenging but rewarding; 3) affirmed the tremendous learning opportunity; and 4) stated the experience was persistently emotionally charged.
Discussion/Conclusion: This study provides an in-depth understanding of what medical students experience in a pediatric buddy program. Tailored, one-on-one partnerships between medical students and pediatric oncology patients play an important role in the medical student’s life and future practice.

Quality Improvement Implementation Model in Care Gap Analysis and Development of Care Pathway to Optimize Management of Early Pregnancy Complications

K. Jean Chen^1,2, Anita Pozgay^1,2, Samuel Wilson², Celina DeBiasio², Mathieu McKinnon², Glenda Clapham^1,3, Samantha Calder-Sprackman^1,2,3, Jessica Dy^2,4, Edmund Kwok^1,2,3
¹Department of Emergency Medicine, The Ottawa Hospital, Ottawa, ON, Canada
²Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
³Quality Improvement, Department of Emergency Medicine, The Ottawa Hospital, Ottawa, ON, Canada
⁴Department of Obstetrics and Gynecology, The Ottawa Hospital, Ottawa, ON, Canada
Corresponding Author: Mathieu McKinnon, email mmcki097@uottawa.ca

Abstract

Background
Quality improvement (QI) implementation is essential in health care centres to provide care along best practice guidelines. In order to conduct a critical quality assurance project, researchers must; define the quality standards of care, determine if care gaps are present and develop a Clinical-Care Pathway Model (CPM). This model for QI implementation is best described by analyzing CPM development for Early Pregnancy Complications (EPC) at The Ottawa Hospital (TOH)
Methods
Quality standards in EPC were updated In 2019 by Health Quality Ontario (HQO). A retrospective chart review was performed on ED EPC encounters at TOH. 504 encounters were included for data analysis. Following data analysis, a CPM was developed by a team of nursing educators, social workers, patient advocates, emergency physicians and obstetrician/gynecologists. The development process used focus group interviews with patient advocacy representatives and written summaries from patient complaints. Nursing directives and physician ordering recommendations were revised to reflect best practices.
Results
22 (4%) patients received initial pain management. One (< 1%) patient received screening for sexually transmitted infections or intimate partner violence. 420 (83%) patients received an appropriate medical work up. Psychosocial support referrals were not offered for ectopic pregnancies. Preliminary analysis highlights care gaps between HQO Quality Standards and TOH ED EPC care. The development process of CPM addressed these quality gaps. Nursing triage directives and CPM were devised. An education booklet was revised to reflect the inter-professional nature of the CPM.
Conclusions
Our study at TOH highlights an effective methodology for a QI implementation project using a multidisciplinary approach. All medical learners would benefit from learning QI implementation procedures as this process is essential for actively identify care gaps at our health centres and to further encourage the use of evidence-based medicine in daily practice.

Perceived Stress Levels of Northern Ontario School of Medicine (NOSM) Medical Students and Use of Mindfulness as a Tool for Stress Reduction

J. Hammell, S. Tadwalkar
Corresponding Author: Jennifer Hammell, email jehammell@nosm.ca

Abstract

Introduction: Medical training is a stressful time for medical students. There is little consensus within the literature as to what is the best solution to reduce stress and burnout to improve wellness. This purpose of this study was to determine perceived stress levels of Northern Ontario School of Medicine (NOSM) students, determine interest/use of mindfulness and obtain wellness program suggestions.
Methods: Medical students in all four years of the undergraduate medical education program were recruited via emails and social media to complete an online survey via Survey Monkey. Participants completed the online survey including demographic information, the perceived stress scale (PSS) questionnaire, interest/use of mindfulness and provided wellness program suggestions. Data analysis was conducted using quantitative methods to compare PSS scores and qualitative methods for theme analysis of typed responses.
Results: Statistically significant differences between mean PSS scores were discovered when comparing scores between gender and years of study with higher stress scores reported amongst females and first and fourth year medical students. No correlation was found between age and mean PSS scores. Majority of students were familiar with the concept of mindfulness (98.1%) yet only 35.2% of students practice mindfulness.
Discussion: Participants who practice mindfulness did not have significantly lower levels of perceived stress. Students who do not practice mindfulness had significantly higher mean PSS scores suggesting these students may benefit from the implementation of a mindfulness program. Students indicated wellness programs focusing on political and curriculum changes would be most helpful to improve student wellbeing.

Identifying Strategies to Support Developing Health Promoting Learning Environments in Medical School

Y. Liu^1,2, J. Mincer^2,3, R. Far^2,4, J. Talia^2,5, V. Do^2,6
¹Michael G. DeGroote School of Medicine^2,3, McMaster University Medical School
²Canadian Federation of Medical Students
³Dalhousie University
⁴Cumming School of Medicine, University of Calgary
⁵Schulich School of Medicine, Western University
⁶University of Alberta
Corresponding Author: April (YiChen) Liu, email april.liu@medportal.ca

Abstract

Background: Medical students have disproportionately higher rates of mental illness relative to the general population. The Canadian Federation of Medical Students (CFMS) previously developed documents with guiding principles for improving student wellbeing; however, an updated document reflecting current evidence is needed. In an effort to implement a standardized framework for a health promoting learning environment (HPLE) across Canadian medical schools, a concise, actionable, and up-to-date charter document is suggested.
Objective: To identify key components required for effective facilitation of a HPLE across Canadian medical schools.
Methods: A CFMS working group, comprised of Canadian undergraduate medical students, was assembled. The group examined three past CFMS position papers on medical student wellbeing and conducted an abbreviated literature review of recent publications focusing on medical student wellness strategies. Key themes required to facilitate a HPLE were identified and organized by (1) individual- versus systems-targeted strategies and (2) time point: preclerkship, transition to clerkship, clerkship, and transition to residency.
Results: There were common themes of medical student wellness that traversed all stages of training. Individual-level strategies included self-regulated learning, mentorship, and educational programs on wellness behaviours. Systems-level strategies included standardized accommodation policies, timely career counselling, and further research. Preclerkship-centered interventions included increased faculty training on student wellbeing, pass-fail grading, and active solicitation of student feedback. In transitioning to clerkship, longitudinal electives and transition courses helped promote student wellbeing. Clerkship-targeted strategies included accurately defining students’ scope of practice, addressing student mistreatment disclosures, and offering financial support. For students approaching residency, wellness-supporting strategies included improving the transparency of the residency matching process.
Discussion/Conclusions: This charter document offers an updated, evidence-based approach to improving Canadian medical students’ wellbeing. It has been designed to help the CFMS advocate for a HPLE and work alongside Canadian medical schools to establish a standardized approach to student wellness.

Comparing the Ottawa Emergency Department Shift Observation Tool (O-EDShOT) to the traditional Daily Encounter Card (DEC) – Measuring the quality of documented assessments

Kaitlin Endres BSc¹; Nancy Dudek MD, MEd²; Meghan McConnell PhD^3,4; Warren J. Cheung MD, MMEd⁵
1Faculty of Medicine, The University of Ottawa
²Department of Medicine (Division of Physical Medicine & Rehabilitation) and The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
³Department of Innovation in Medication Education (DIME), University of Ottawa
⁴Department of Anesthesiology and Pain Medicine, University of Ottawa
⁵Department of Emergency Medicine, University of Ottawa
Corresponding Author: Kaitlin Endres, email kendr071@uottawa.ca

Abstract

Introduction: The Ottawa Emergency Department Shift Observation Tool (O-EDShOT) is a workplace-based assessment (WBA) designed to assess a trainee’s performance across an entire shift. It was developed in response to validity concerns with traditional end-of-shift WBAs, such as the daily encounter card (DEC). The O-EDShOT previously demonstrated strong psychometric characteristics; however, it remains unknown whether the O-EDShOT facilitates measurable improvements in the quality of documented assessments compared to DECs.
Methods: Three randomly selected DECs and three O-EDShOTs completed by 24 faculty were scored by two raters using the Completed Clinical Evaluation Report Rating (CCERR), a previously published 9-item quantitative measure of the quality of a completed WBA. Automated-CCERR (A-CCERR) scores, which do not require raters, were also calculated. Paired sample t-tests were conducted to compare the quality of assessments between O-EDShOTs and DECs as measured by the CCERR and A-CCERR.
Results: CCERR scores were significantly higher for O-EDShOTs (mean(SD)=25.6(2.6)) compared to DECs (21.5(3.9); t(23)=5.2, p<0.001, d=1.1). A-CCERR scores were also significantly higher for O-EDShOTs (mean(SD)=18.5(1.6)) than for DECs (15.5(1.2); t(24)=8.4, p<0.001). CCERR items 1, 4 and 9 were rated significantly higher for O-EDShOTs compared to DECs.
Conclusion: The O-EDShOT yields higher quality documented assessments when compared to the traditional end-of-shift DEC. Our results provide additional validity evidence for the O-EDShOT as an assessment tool for capturing trainee on-shift performance that can be used as a stimulus for actionable feedback, and as a source for high-quality WBA data to inform decisions about emergency medicine trainee progress and promotion.

Impacts of COVID-19 Curricular Changes on Medical Student Wellness

R. Trites², A. Le Roux², C. Suart^3,, T. Suart², R. Fitzpatrick^1,2.
Corresponding Author: Anique Le Roux, email aleroux@qmed.ca

Abstract

Introduction:
COVID-19 altered medical student education, including a shift to remote learning for pre-clerks and removal from hospital duties for clerks. Pre-clerkship curriculum remains largely online and changes often, contributing to ongoing student stress. Our study assessed the effect of curricular changes made in response to COVID-19 on medical student mental health and wellness.
Hypothesis:
Curricular changes caused by COVID-19 created significant stress for medical students.
Methods:
This was a prospective study of students in Queen's School of Medicine in the cohorts graduating 2021-2023. We created an online questionnaire using Qualtrics that included the Perceived Stress Questionnaire as well as questions assessing stressors that accompanied remote learning. Data was analyzed using mixed-methods on NVivo and SPSS.
Results:
We received 93 respondents out of a potential 318. There were 20, 34 and 39 respondents from the 2021, 2022 and 2023 cohorts respectively. Thematic analysis revealed that (1) the top stressor amongst students was uncertainty about curriculum, career and CaRMS; (2) isolation was the aspect of remote learning students disliked the most; and (3) students’ greatest worry about COVID-19’s effect on their future surrounded residency, electives and CaRMS. In response to “I am worried that I will be less competitive as a CaRMS applicant due to curricular change”, the mean response was 5.19 out of 7 on level of agreement and the mode was 7/7. Comparing cohorts revealed 2022s and 2023s have significantly more worry about curricular changes compared to 2021s.
Discussion/Conclusions:
Medical students experienced stress due to COVID-19 curricular changes. Fears about inadequacy in education and readiness for residency emerged as major themes. These results will be the focus of our interventions with Undergraduate Medical Education going forward. We hope to deliver this questionnaire to students across Canada to expand its impact.

Optimizing Case-Based Learning: An evaluation of tutor and first year MD student perceptions of group size and format variations

M. Kerr¹, J. Lee¹, A. McLeod^1,2, J. Nyhof-Young^3,4
¹MD Program, University of Toronto, Ontario, Canada
²Department of Medicine, University of Toronto, Ontario Canada
³Office of Assessment and Evaluation, MD Program, University of Toronto, Toronto, Ontario, Canada
⁴Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
Corresponding Author: Meghan Kerr, email meghan.kerr@mail.utoronto.ca

Abstract

Introduction: In 2016, Case-based Learning (CBL) was integrated into the first two years of the University of Toronto’s MD Program. Since then, iterative CBL delivery revisions have included variable CBL group sizes: small (8-10 students) and intermediate (46-60 students), and variable CBL formats: patient-narratives (detailed written dialogues between patients and medical students eliciting histories and physical exam findings) and case-reports (succinct patient history and physical examination summaries). First-year medical student and physician tutor experiences with these CBL formats and group sizes were explored to gain insight into their strengths and limitations for clinical skills training.
Methods: A modified, mixed-methods developmental evaluation approach using surveys, focus groups, and interviews was employed. Survey responses were reported as means and standard deviations. Descriptive thematic analysis was conducted for narrative data. Tutor and student focus group, survey, and interview data were triangulated.
Results: Thirty-eight first-year medical students (14% response rate) and twelve physician tutors (15% response rate) completed surveys. Four student focus groups (n=28) were conducted. Three physician tutors participated in interviews. Students and tutors felt small-group CBL superseded intermediate-group CBL in fostering safe and engaging learning environments. Both groups appeared to benefit from combined CBL formats, recommended use of patient-narratives during early months of training, and highlighted the role of tutor continuity in fostering a safe and tailored learning environment.
Conclusions: Study results have useful implications for health profession education programs such as ours developing CBL curricula; recommendations can help promote safer and more effective CBL learning and teaching experiences.

Diagnostic Imaging: The Past, Present, and Future Paragon of Mechanical Objectivity in Medicine

M. Kerr¹, P. Bryden^2,3, E. Nguyen^2,4.
¹MD Program, University of Toronto, Ontario, Canada
²Faculty of Medicine, University of Toronto, Ontario, Canada
³Department of Psychiatry, University of Toronto, Ontario, Canada
⁴Department of Medical Imaging, University of Toronto, Ontario, Canada
Corresponding Author: Meghan Kerr, email meghan.kerr@mail.utoronto.ca

Abstract

Background: Before the advent of automatism in image-making practices, scientists, anatomists, and physicians artistically depicted simplified images for scientific atlas making. This technique conferred subjectivity to a supposedly objective scientific process, sparking confrontations between anatomists regarding accuracy that heralded a new concept in the late 19th century – mechanical objectivity – that would revolutionize scientific knowledge and the field of medicine.
Objectives: The purpose of this health history research study is to trace the evolution of mechanical objectivity from empirical studies of early anatomists in the 19th century to the advent of x-ray technology, digitization of imaging, and disruptive technological innovations such as artificial intelligence, while simultaneously unveiling the challenges of mitigating human bias, despite advancements in medical imaging practices.
Methods: This narrative literature review was conducted using the Scopus® database under the guidance of both medical historians and practicing physicians to ensure its applicability and historical accuracy.
Conclusion: Despite a century-long quest for optimizing mechanical objectivity in diagnostic imaging to more accurately and efficiently interpret medical images, human bias remains an important factor. This historical review describes the development of medical imaging technologies over the last century with emphasis on the role played by human bias and subjectivity in a rapidly expanding field of medical imaging technology including artificial intelligence.
This article was published in Academic Radiology, Meghan V. Kerr, Pier Bryden, Elsie T. Nguyen, Diagnostic Imaging and Mechanical Objectivity in Medicine, Copyright Elsevier (2021).

Culture as a Continuum: How to Evoke Cultural Awareness in Health Sciences

J. Sung¹, M. Yao², S. Mehndiratta², M. Zubairi³
¹Michael G. DeGroote School of Medicine, McMaster University
²Faculty of Health Sciences, McMaster University
³Division of Developmental Pediatrics, Department of Pediatrics, Faculty of Health Sciences, McMaster University
Corresponding Author: Jihyun Sung, email jihyun.sung@medportal.ca

Abstract

Intro: In our increasingly globalized world, health professionals are frequently exposed to patients and caregivers who hold different values, beliefs, and histories than themselves. To address this key element of clinical practice, numerous healthcare programs have begun incorporating cultural awareness education into the curricula, with varying degrees of success.
Question: This study explores how a cultural education casebook that encourages critical reflection and reflexivity can be utilized in fostering a sense of cultural awareness and critical perspective on equity, diversity and inclusion (EDI) frameworks. This casebook frames cultural awareness as a continuously ongoing process to build on, rather than a skill that can be conclusively acquired after a formalized training program.
Methods: We are recruiting a group of students at an urban university in Ontario that are pursuing education in health professions (medicine, nursing, physiotherapy, occupational therapy) and will apply the training detailed in our casebook through a 2 hour session. Collected data will consist of qualitative observations made during the training session, interviews with students conducted 2-4 weeks afterwards, and a survey sent to students 3 months later. This will be an exploratory qualitative study using a situational analysis approach to evaluate the utility of the casebook in facilitating continuous cultural awareness.
Results: Thematic analysis will be drawn from data such as the students’ thoughts on the concepts explored in the casebook, their thoughts on the execution of the training session, any contradictions between the casebook and their clinical experiences, shifts in their perspective of the different cultural models, opinions on how cultural awareness education should be implemented, and any changes in their clinical practice after the session.

Initial Impact of COVID-19 on Postgraduate Pediatric Trainees: What We Know So Far.

M. Schneeweiss¹, E. Bassilious², M. Zubairi²
¹McMaster University, Faculty of Health Sciences
²McMaster University, Department of Pediatrics, Faculty of Health Sciences
Corresponding Author: Michelle Schneeweiss, email michelle.schneeweiss@medportal.ca

Abstract

Introduction/Background:
The COVID-19 pandemic has impacted medical education in various ways, including increased reliance on virtual consults and the requirements for physician distancing of at least 6 ft. for in-person settings.
Hypothesis/Question:
We sought to understand how the early changes brought on by COVID-19 affected postgraduate trainees in three ways: trainees’ ability to (i) connect with patients and their families; (ii) meet their learning objectives; and (iii) feel supported by staff.
Methods:
An exploratory web-based questionnaire consisting of 15 questions was sent to postgraduate trainees within the Department of Paediatrics at McMaster University. The survey was designed as a quality improvement initiative. Survey results were summarized, including the use of descriptive analysis.
Results:
We collected 77 responses. 71.4% of responses were from core paediatric residents, with the remainder a combination of subspecialty fellows, neurology and physiatry residents. The majority of respondents felt their learning goals were either ‘definitely met’ (48.1%) or ‘somewhat met’ (48.1%) despite COVID-19 related changes. Common barriers that affected learning were technical issues (49.4%), and scheduling challenges (29.9%). Trainees expressed that low patient volumes and lack of physical exam practice hindered their learning. Some trainees found that PPE hindered verbal communication, and it was challenging not to physically connect with patients.
Discussion/Conclusions:
Though most trainees felt their learning goals were met despite abrupt program changes, a number of challenges were identified. Recognition of these may help curriculum developers adapt educational programs and mitigate disruptions of COVID-19. Moving forward, we hope to use this data as a launching point for a discussion surrounding COVID-19 related implications on medical education, and ultimately develop a community of practice (CoP) which can help map out changes in our education delivery, and discover solutions to the problems we have identified.

Applied Theatre within Undergraduate Medical Education: A Scoping Literature Review

Bronte Johnston BHSc. MSc. Candidate^1,2, Hartley Jafine BA MA¹
¹Bachelor’s of Heath Sciences (Honours Program): McMaster University
²Master of Health Sciences Education Program: McMaster University
Corresponding Author: Bronte Johnston, email brontej@sympatico.ca

Abstract

Introduction: Applied theatre has been integrated within various undergraduate medical education programs within North America to improve students’ clinical skills and empathetic behaviours in future physicians. For the purposes of this project, we are defining applied theatre as the use of drama skills within educational practice. Currently, several medical schools across Canada and the United States incorporate a variation of applied theatre within their curriculums.
Research Questions: As there currently is no compilation of current publications regarding applied theatre and undergraduate medical education; what is the currently literature discussing about theatre and undergraduate medical education. How can we further understand the benefits of the intersections of drama and health education and how applied theatre initiatives and outcomes can aid undergraduate medical education.
Methods: Twelve publications were obtained from online databases including: Pubmed, OVID, Web of Science, and ERIC; a specific keyword search was employed: “medical education" and “theatre” (or applied drama or theater), and “North America”(Canada and the USA), and “drama”, and "medical students." The articles were critically appraised by the type of applied theatre activities, feedback, future applications of applied theatre initiatives, and qualitative and quantitative results from the studies.
Results: The current literature demonstrates the positive benefits of incorporating applied theatre within undergraduate medical education based on a variety of applied theatre initiatives. Three major themes presented in the data were centred around education, personal development and communication as well as clear connections to all pillars of the CanMEDS framework.
Conclusion: The results highlighted the diversity and importance of applied theatre initiatives within medical education and how it should be further incorporated in curricula in institutions across Canada. Therefore, it is essential that applied theatre become a core in undergraduate medical education as all students will have the opportunity to uncover what applied theatre means to them.

A Novel 3-Session Treatment Intervention for Anxiety and Depression with Transitional-Aged Youth (with clinical applications for virtual psychotherapy in Canada)

J McGuinty¹, A Li¹, A Carlson²
¹Health Sciences, Queen's University, Kingston, Ontario
²Independent Researcher, North Bay, Ontario
Corresponding Author: Jazlyn McGuinty, email 19jlm14@queensu.ca

Abstract

Introduction: Prevalence rates for anxiety and depression have increased with the onset of the pandemic creating a community mental health need. Our research poster presents a new short-term treatment intervention (Externalizing Metaphors Therapy/EMT). EMT is an ongoing research project with both the neurotypical population and high-functioning autism. This poster presents the novel model for conference attendees together with existing evidence across 4 Ontario universities and 2 ongoing pilot projects that continue its clinical evaluation potentially leading to a mental health best-practice.
Hypothesis/Question: If children, youth and transitional-aged youth receive the EMT novel treatment intervention then it will result in a decrease of dysphoria.
Methods: Two pilot studies were run simultaneously with a convenience sample of transitional-aged youth across 4 Ontario university student counselling centres. Data was compiled into a randomized control trial/RCT using two self-report measures of dysphoria (DASS-21, STAI). Additionally, 2 pilot studies are currently underway in a Children’s Mental Health Ontario agency, and a virtual pilot study in Porto, Portugal with transitional-aged youth.
Results: The RCT yielded significant reductions in self-reported stress, depression, and anxiety after only 3 counselling sessions. Differences on the DASS-21 revealed significant reductions in stress, t(47) = 3.99, p < .001, d = 0.58, depression, t(47) = 3.22, p = .002, d = 0.43, and anxiety, t(47) = 3.45, p = .001, d = 0.56. Further, there was a significant and large reduction in trait anxiety on the STAI, t(45) = 6.17, p < .001, d = 0.95. No results are currently available with the 2 pilot studies as they are expected to conclude end of 2021.
Conclusions: Preliminary evidence suggests that the new short-term model may be an effective treatment for anxiety and depression. Its empirical evaluation continues highlighting the need for fewer sessions which are cost-efficient to deliver (including its online application).

Do “Teddy Bear Hospital Project School Visits” improve pre-clerkship students’ comfort explaining medical concepts to children?

*H. Kis¹, *K. Endres¹, A. Karwowska^1,2, M. Harrison^1,2, S. Lau¹, O. Lemire¹, M. Zucker^1,2
*Co-First Authors
¹The University of Ottawa, Faculty of Medicine
²The University of Ottawa, Department of Pediatric Medicine
Corresponding Author: Stephanie Lau, email slau065@uottawa.ca

Abstract

Introduction: The Teddy Bear Hospital Project (TBHP) is an international initiative aimed at reducing children’s fears associated with healthcare visits by modelling these interactions using teddy bears. uOttawa’s program has outlined an additional objective: increasing pre-clerkship medical students’ comfort communicating medical topics to children.
Objective: Although a previous analysis found that the majority of pre-clerkship volunteers agreed that the program met this objective, this study aimed to assess for a significant change in comfort communicating medical concepts to children using a pre- and post- visit survey.
Methods: 25 pre-clerkship volunteers participated in 10 kindergarten/grade one classroom visits during Fall 2019. Each visit consisted of four stations (Handwashing/Immunizations; X-ray/MRI; Well-Child; and Casting/Bone Health). Likert scale data from pre- and post-visit surveys were analyzed using paired t-tests.
Results: 80.0% (20/25) of volunteers participated in the study, of which 6 were excluded for not completing the surveys sequentially. Overall, there was no significant difference in volunteers’ pre- and post-visit rating of their comfort interacting with children in a clinical setting (p=0.0851) or in their comfort communicating medical topics to children (p=0.1205). However, 12/14 (85.7%) of volunteers agreed or strongly agreed that the TBHP improved their ability to communicate medical knowledge to a young child.
Discussion: Although we found no significant difference in volunteers’ pre- and post-survey scores, the majority of participants reported a positive change in their comfort levels. Small sample size, ceiling effect and possible participant over reporting of pre-TBHP comfort levels, may have affected the results and will be addressed in subsequent data collection. Additionally, in the future, we aim to explore whether returning volunteers show a significant improvement in their comfort levels between their first and last visit.

“The Scholar Found Within The Medical Expert - Uncovering Hidden Feedback in Postgraduate Field Notes"

G. Kazevman, J. L. Marshall, B. Shachar, M. Slater, PhD, F. Leung, MD, C. B. Guiang, MD
Corresponding Author: Gill Kazevman, email gill.kazevman@mail.utoronto.ca

Abstract

Background:
CanMEDS specifically describes that as a ‘scholar’, a physician must uphold four key scholarly roles: Lifelong learner, Evidence-informed decision-maker, Teacher, and Researcher. Yet, the CanMEDS Scholar role remains one of the most neglected and difficult to assess roles in medical education literature, and one of the least appreciated by postgraduate learners. Our study analyzes 'field notes' - frequent formative written feedback in postgraduate family medicine, and attempts to explore in which situations the scholar role is evaluated. In particular, the analysis attempts to uncover hidden scholarly feedback within the most central and integrative role - Medical Expert.
Hypothesis:
Whether the Scholar role feedback can be found hidden within the feedback for the Medical Expert role.
Methods:
A deductive analysis was conducted on field notes generated by resident preceptors in the Department of Family and Community Medicine (DFCM) at the University of Toronto (UofT) between April 2017 and July 2017. We focused on Medical Expert role feedback. Scholarly roles derived from the CanMEDS Scholar role description were used to identify Scholar role feedback in these field notes.
Results
1809 FNs providing feedback to the Medical expert role were analyzed. Of these, 7.6% definitely described scholarly feedback. Two scholarly roles were often reported as Medical expert roles - Evidence-based decision-maker and Lifelong learner.
Conclusion
This study highlights aspects of the Scholar role that can overlap with Medical expert role feedback. To address this overlap, feedback tools should allow learners to receive comprehensive feedback in their learning encounters. Moreover, more attention should be given to better prepare preceptors to evaluate and categorize these roles in the clinical setting.

The self-feedback of overconfident and underconfident medical residents: a qualitative analysis

M. Bagherzadeh¹, H. Braund², T. Chaplin^1,3
¹Faculty of Medicine, Queen's University
²Faculty of Health Sciences, Queen's University
³Department of Emergency Medicine, Queen's University
Corresponding Author: Maryam Bagherzadeh, email Bagherzadeh.m@queensu.ca

Abstract

Background: Self-assessment is a core component of competency-based medical education that draws on different sources to reflect on one’s own skills and abilities. Self-confidence is an important element in the process of self-assessment, although the relationship between these variables is poorly understood. We sought to explore the qualitative themes provided in the self-assessment rationale between overconfident and underconfident residents in the context of a simulation-based summative OSCE.
Methods: Following the completion of a simulation-based resuscitation course in 2017, 41 junior residents completed a 4-scenario summative OSCE. After each scenario, both self-assessment and assessment by an attending physician was completed and involved an entrustment score and narrative rationale. Learners were assigned to a confidence group based on the difference between the faculty-assigned and self-assessment scores for each scenario. Ten residents were assigned to each group and their narrative rationales were thematically coded for differences in content and quality of feedback.
Results: The content of the self-feedback differed between the two groups. Overconfident residents highlighted areas of speed and broad situational management, while underconfident residents commented on lack of support, and a need to improve communication, diagnosis, and code blue management. Further differences were noted in the quality of self-feedback. While both groups highlighted areas of investigation, management, and treatment, the underconfident residents documented higher quality comments that were detailed and granular.
Conclusion: The findings of this study provide insight into the areas of focus and quality of self-feedback between learners with different levels of confidence. This can have valuable implications for debriefing and curriculum design within the CBME curricula. Additionally, the lack of granularity and inattention to details in the overconfident residents’ self-assessment may not be an efficient approach to continuous, lifelong learning. Residents should be encouraged to provide high-quality feedback when engaging in the process of self-assessment.

Better Transitions from Healthcare Students to Working Professionals of Tomorrow

L. D. Lee^1,2, S. Conroy²
¹University of Calgary Cumming School of Medicine
²University of Alberta Faculty of Nursing
Corresponding Author: Lauren D. Lee, email lauren.lee@ucalgary.ca

Abstract

Introduction
Healthcare students experience longer studying hours and consequently less leisure time and higher stress. Students will transition into working professionals who will face emotional, stressful work and are at risk of burnout. Despite the relevance, one can rarely find stress management and self-care incorporated in the healthcare curriculum.
Question
This project is purposed to answer: how can healthcare programs better equip their students to manage stress to help them become healthier professionals of tomorrow? And, what innovative changes are needed in the school curriculums to promote this?
Methods
We conducted a literature overview and sought examples of innovative changes in healthcare programs that helped students to handle stress better. We also brainstormed alternative ways stress management could be integrated into the curriculum.
Results
The literature overview suggested that healthcare programs work on students’ physical well-being, health promotion, effective coping mechanism, and social support network to better manage stress. Lifestyle that includes proper sleep, exercise, and eating habits are linked to better stress management by students. One study allotted time out of students’ clinical practice for health promotion. This yielded significant improvements in leading a healthier lifestyle, including better coping with stress. Another study observed that teaching students about appropriate coping mechanisms helped students to feel more capable of handling stress. Social support network was found to contribute to reduced anxiety in students and increased capability to manage stress.
Conclusion
The literature identifies gaps in the healthcare curriculum in preparing their students to manage stress. This report suggests innovative changes that faculty can implement to encourage students to become healthier working professionals of tomorrow. With the rewarding but highly stressful profession such as nursing and medicine, schools need to do more to ensure their students are prepared to meet the challenges of the profession.

Eliciting the Student Perspective on the Northern Ontario School of Medicine's Effectiveness with the Implementation of the Social Accountability Mandate

E. C. Goddard¹, C. Truyens², D. Roy², 4 , H. O'Grady², G. Adams-Carpino³
¹Faculty of Medicine, Northern Ontario School of Medicine, Laurentian University, Sudbury, Ontario, Canada
²School of Human Kinetics, Faculty of Health Sciences, Laurentian University, Sudbury, Ontario, Canada
³Division of Human Sciences, Northern Ontario School of Medicine, Laurentian University, Sudbury, Ontario, Canada
⁴School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
Corresponding Author: Emma Goddard, email egoddard@nosm.ca

Abstract

BACKGROUND: Social accountability (SA) is required to achieve quality, equity, relevance and effectiveness in medicine. Evaluating implementation of SA will inform curricular development to educate socially accountable physicians.
PURPOSE: Elicit perspectives of Undergraduate Medical Education (UME) students at the Northern Ontario School of Medicine (NOSM) about the implementation of the SA mandate in order to inform curriculum reform.
METHODS: Data was collected using a cross-sectional voluntary response survey with Likert-scale and short-answer questions. Frequency analysis and thematic analysis were used.
RESULTS: Survey showed ≥80% positive response when describing if practical placements allowed engagement with priority populations (PP) and if the mandate inspired involvement in the communities and evaluation of their specialist/generalist needs. There was 60-79% positive response when evaluating if curriculum reflects community needs, responsiveness to needs, if educators reflect the PP, if there are health promotion opportunities, and if the curriculum prepared students to engage with PP clinically. Conversely, <60% positive response that curriculum provides engagement with all PP, the student body reflects PP, or that educators had expertise with PP. The qualitative themes that emerged were the expansion of the SA mandate to include other marginalized populations prevalent in Northern Ontario, increasing the representation of PP, and areas for curriculum reform.
DISCUSSION: To improve SA, inclusion of LGBTQ+ individuals, immigrants, and refugees in the SA mandate is recommended, as well as populations suffering from mental health and substance abuse, housing insecurity, and low socioeconomic status (SES). Implementation of an acceptance stream for low SES students, active recruitment in rural/remote communities, and filling faculty positions individuals representing PP for representative student body/faculty. Students suggested curricular change to include lectures and educational resources directed towards identified PP. Finally, students expressed a need for practical health promotion and advocacy, including advocacy projects or inter-professional student-led clinics.

Chronic Pain in Undergraduate Medical Education at McMaster University: An Assessment of Medical Student Knowledge & Development of Pain-Centered Curricula

L. Latchupatula¹, M. Benayon¹, A. S. Naidu²
¹Michael G. DeGroote School of Medicine, McMaster University
²Division of Physical Medicine and Rehabilitation, McMaster University
Corresponding Author: Lekhini Latchupatula, email Lekhini.Latchupatula@medportal.ca

Abstract

Introduction/Background:
The Canadian Pain Task Force has highlighted the insufficiencies in pain curricula in undergraduate medical education (UGME). This is devastating considering that 1 in 5 Canadians suffer from chronic noncancer pain (CNCP) and 40-80% of patients with CNCP are misdiagnosed.
Question/Objective:
This study’s objective is to quantify McMaster medical students’ perception of CNCP learning opportunities and confidence in managing CNCP-related pathologies, in order to inform additions to the existing UGME curriculum.
Methods:
A Google Forms survey was distributed through email and social media to 618 McMaster undergraduate medical students in all three years of training. Data were analyzed with descriptive statistics.
Results:
168 (27%) responses were collected from first (N=53), second (N=62), and third (N=53) year medical students. 140 (83%) students rated their satisfaction with the pre-clerkship CNCP curriculum as 3 or below on a scale ranging from 1 (None at all) to 5 (Very Satisfied). On average, first, second, and third year students rated their confidence in CNCP pathologies as 0.9, 2.6, and 3.1, respectively on a scale of 1 (Poor) to 7 (Excellent). Additionally, 96% of all students foresee interacting with patients with CNCP in their medical practices. When asked how CNCP education should be delivered, the majority of students preferred online modules (85%) compared to workshops (54%) or improving existing curriculum components (47%).
Discussion/Conclusions:
These results are highly indicative of the existing shortcomings in the current pain-specific McMaster UGME curriculum. Improvements to the curricula can be made by incorporating online modules to address topics such as stigmatization of patients with CNCP and virtual workshops to participate in interactive multi-disciplinary CNCP team experiences. By reproducing this survey in all 17 Canadian medical schools and improving UGME nationwide, future physicians will be better equipped to diagnose and manage patients with CNCP, and improve their health outcomes.

TOWARDS VIRTUAL MEDICAL OBSERVERSHIPS: PILOTING WEARABLE LIVE STREAMING TECHNOLOGY

Authors: M. Issa¹, M. W. Nelms¹, Y. Jeyakumar¹, D. Teitelbaum¹, L. Wintraub¹, M. Xie¹, M. Otremba^1,2, G. Sirianni^1,3,4, F. H. Leung^1,3,6, K. Prucnal^1,3, J. Nyhof-Young^3,5
¹Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
²Division of General Internal Medicine, Mount Sinai Hospital, Ontario, Canada
³Department of Family and Community Medicine, University of Toronto, Ontario, Canada
⁴Sunnybrook Health Sciences Centre, Ontario, Canada
⁵Office of Assessment and Evaluation, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
⁶Department of Family and Community Medicine, St. Michael’s Hospital, Ontario, Canada
Corresponding Author: Mariam Issa, email mariam.issa@mail.utoronto.ca

Abstract

The current coronavirus pandemic has had a substantial impact on medical education. Although many aspects of pre-clinical education have transitioned smoothly into virtual environments, career exploration has been cancelled due to physical distancing requirements. This study is designed to evaluate the implementation of a point-of-view technology (POV) live streaming technology for career exploration among medical students at the Temerty Faculty of Medicine, University of Toronto. Physicians, medical students, and patients will participate in this pilot education study to assess the practicality, utility, and efficacy of the technology.
Seven physicians practicing at the Michael Garron Hospital will be recruited to participate. Fourteen second-year medical students will be recruited and randomized into observership pods, either independently, with another student, or with a group of 4 other students. Each observership pod will be matched with a physician who will don a chest-mounted camera allowing POV livestreaming of their patient visits. Students, physicians, and patients will provide informed consent prior to participating in the study. All participants will be invited to complete a survey and participate in individual or group semi-structured interviews. Basic descriptive statistics will be used to examine quantitative data. Thematic classifications that delineate major opinions and beliefs held by participants on the practicality, utility, and efficacy of the new learning aid will be formed based on the individual and group interviews. Using these categories, feedback patterns across stakeholder groups will be identified and these patterns will be triangulated between groups and into themes. If successful, this virtual educational platform can be adopted by the MD Program, and other educational institutions and health disciplines, to provide students adequate exposure to the real-life practice of medicine in situations requiring physical distancing.

Evaluating the impact of an online educational platform in developing leadership skills of recent graduates from Canadian Occupational Therapy programs.

Gobika Sithamparanathan, HBSc, MScOT Candidate ’21¹, Meera Premnazeer, HBSc, MScOT Candidate ’21¹, and Andrea Duncan, BScOT, MBA, OT Reg. (Ont), PhD Candidate¹

¹Department of Occupational Science & Occupational Therapy, Faculty of Medicine, University of Toronto
Corresponding Author: Gobika Sithamparanathan, email gobika.sithamparanathan@mail.utoronto.ca

Abstract

Introduction: Leadership is a key competency in Occupational Therapy to ensure best practice when working as part of an interprofessional team (Copolillo et al., 2010). For continued professional development, it is fundamental that entry level occupational therapists (OTs) have opportunities to develop leadership skills to navigate resources for best practice (Brown et al., 2014). There is yet to be a comprehensive study that evaluates the impact of online methods of teaching on developing leadership skills specific for OTs (Richardson et al., 2008).
Question: The purpose of the study is to understand and accumulate evidence on if and how an online leadership educational platform contributes to the development of leadership skills in recently graduated OTs.
Methods: An online platform, Massive Open Online Course (MOOC), is designed to develop leadership skills targeted to Master of Science in Occupational Therapy (MScOT) Class of 2020 cohort in Canada. The study will consist of participants who are enrolled into the four-week MOOC and expressed interest in participating in the optional research study. The study will utilize a quasi-experimental design with two intervention groups and a time-series delay with participants completing questionnaires at three time points. Data will be examined using correlational analysis.
Results: The findings will contribute to exploring enablement of leadership competency of entry level practitioners and provide opportunities to advocate for the importance of utilizing OTs in novel roles beyond traditional practice settings.
Conclusions: This study will provide insights on if and how an online teaching method can help improve leadership skills in recent Canadian MScOT graduates.

Improving Junior Pediatric Residents Satisfaction & Confidence with Making Autonomous Clinical Decisions during Admissions from the Emergency Department to the Clinical Teaching Unit at the Alberta Children’s Hospital

J. Milenkovic^1,2, R. Suppiah^1,2, L. Davies¹, M. Bailey¹
¹Alberta Children's Hospital, Department of Pediatrics
²University of Calgary, Post Graduate Medical Education
Corresponding Author: Jovana Milenkovic, email jovana.milenkovic@albertahealthservices.ca

Abstract

Background:
Residency programs strive to provide residents adequate training for independent practice. The University of Calgary Pediatrics Residency Program has a senior resident (SR) led admission process for patients admitted from the emergency department (ED) to the clinical teaching unit (CTU) at the Alberta Children’s Hospital (ACH). Residents have identified that Junior Residents (JR) could be better positioned to hone clinical decision-making skills in this process.
Objectives/Questions:
Can implementing changes to the admission process from the ACH ED to CTU during August 2019 to June 2020 help JRs become more satisfied with their role and more confident in clinical decision-making during admissions?
Methods:
Using quality improvement methodology, interventions were implemented into the ACH ED to CTU admission process from August 2019 to June 2020. Surveys administered to JRs assessed baseline, midway and final time point levels of satisfaction with their role and confidence in their ability to make clinical decisions during admissions. Additional data was collected using two other survey modalities to assess process and balancing measures.
Results and Findings:
JRs satisfied with their role in the admission process increased from 60% at baseline to 100% at the final time point. JR confidence in making autonomous clinical decisions increased from 27% to 45%. SR satisfaction with time efficiency and safety increased from 20% to 62%, and 60% to 70%, respectively.
Conclusions and Significance:
Interventions implemented into the ACH ED to CTU admission process helped improve JR satisfaction with their role in the admission process and JR confidence in clinical decision making. Perceived patient safety and efficiency of the admission process were not sacrificed. Residency training programs elsewhere can apply similar interventions to enhance clinical decision-making opportunities for residents.

Profiling Medical Specialties and Informing Aspiring Physicians: A Data-Driven Approach

M. Balas¹, R. Scheepers², Z. Zador¹, C. D. Witiw¹
¹Division of Neurosurgery, St. Michael’s Hospital, Toronto, Ontario, Canada
²School of Medicine, Trinity College Dublin, Dublin, Ireland
Corresponding Author: Michael Balas, email 1michaelbalas@gmail.com

Abstract

Introduction/Background: To be competitive for residency matching, medical students require adequate preparation and work devoted to their field(s) of choice. However, students can face challenges selecting a specialty at an early stage in order to accumulate the appropriate research and/or extracurricular activities. Previous research has focused on what medical students perceive to be the characteristics of a given specialty; instead, this work assesses what they actually are from a data-driven perspective.
Hypothesis/Question: How do medical specialties characterize into distinct profiles that can help inform medical student career choice decision-making?
Methods: We merged publicly available, aggregate databases into a single rich dataset containing demographic, working environment and payment information for physicians across Canada. This data was collected from the Canadian Institute for Health Information, the Canadian Medical Association, and the Institute for Clinical Evaluative Sciences, primarily in 2018-2019. The merged dataset includes 25 unique medical specialties, each with 37 indicator variables. Latent Profile Analysis (LPA) was used to group specialties into distinct clusters.
Results: The Bayesian Information Criterion revealed an optimal distribution of seven latent profiles. The Kruskal-Wallis test identified 20 out of 37 indicator variables that significantly differed between the seven profiles. These variables included income and overhead, proportion of males and Canadian graduates, different work settings, payment styles and time spent performing different tasks. Variables that did not significantly vary between profiles included total hours worked, professional satisfaction and work-life balance satisfaction.
Discussion/Conclusions: The 25 analyzed medical specialties were grouped in an unsupervised manner into seven profiles via LPA. These profiles correspond to expected and meaningful groups of specialties that share a common theme and set of indicator variables (e.g. procedurally-focused, clinic-based practice, etc.). These profiles can help aspiring physicians narrow down and guide specialty choice. Despite the many differences between profiles, satisfaction rates remain consistent among all.

Supporting Evidence-Based Medicine and Critical Appraisal Skills: Educators Perceptions of medical student training in Health Sciences Research

D. M. Ferri¹, C. Moore¹, K. J. Mun¹, A. Chen¹, D. K. Katzman^1,2, J. Nyhof-Young^1,3,4
¹Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
²Department of Pediatrics, The Hospital for Sick Children and University of Toronto, Ontario, Canada
³Office of Assessment and Evaluation, MD Program, University of Toronto, Ontario, Canada
⁴Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
Corresponding Author: Dario Ferri, email dario.ferri@mail.utoronto.ca

Abstract

Introduction: Evidence-based medicine (EBM) allows physicians to integrate the best current evidence, clinical experience, and patient values into clinical-decision making. EBM functions as an invaluable component of physicians’ clinical toolkits and represents an important skill for medical students to master as they learn to provide optimal patient care. Therefore, EBM has been regularly incorporated into undergraduate medical education curricula, with an emphasis on literature critical appraisal (CA). The MD Program at the University of Toronto has incorporated small group tutorials to facilitate EBM and CA teaching in its Health Sciences Research (HSR) curriculum. Previous research indicates medical students feel HSR is effective in teaching CA to enhance care; however, little research has focused on educator perceptions of EBM effectiveness in teaching CA skills in our context.
Hypothesis/question: What are HSR tutor perceptions regarding HSR tutorial effectiveness in teaching EBM and CA skills?
Methods: A 15-item, on-line questionnaire surveyed 56 HSR tutors. Likert scale and free-response questions evaluated EBM and CA skills teaching in HSR tutorials. Quantitative data was analyzed using descriptive statistics and qualitative data using descriptive content analysis.
Results: Data analysis from 14 tutors (25% response rate) indicated HSR tutorials were effective in teaching EBM (85.7%, 12/14) and CA (92.8%, 13/14). The most effective teaching modalities included: research proposals, tutorials, assignments (literature searches, proposal updates) and critical appraisal presentations. Three themes emerged i) difficult time constraints, ii) heterogeneity of student experience/interest, and iii) desire for continued course review.
Conclusions: While HSR educators perceive the curriculum as effective in teaching EBM and CA, room exists for improvement in delivery and content tailoring to account for student diversity in research experience. This study may also inform other medical schools with EBM-based curricula about teaching modalities worth integrating or evaluating to further improve EBM and CA teaching.

Take a Breath: Investigating the Effect of Box-Breathing on Residents’ Stress, Cognitive Load, and Performance in a Simulation-Based Resuscitation OSCE

S. Van Heer¹, G Gutiérrez¹, A. Szulewski^2,3, T. Chaplin²
¹School of Medicine, Queen's University.
²Department of Emergency Medicine, Queen's University.
³Department of Psychiatry, Queen's University.
Corresponding Author: Shyan Van Heer, email svanheer@qmed.ca

Abstract

Background: Patient resuscitation can be overwhelming for junior residents. Cognitive load theory suggests the inherent complexity and stress of resuscitations (intrinsic cognitive load, ICL) and off-task distractions (extraneous cognitive load, ECL) can overload cognitive capacity and impair performance. Box Breathing (BB) can mitigate this stress response and maintain performance.
Question: To investigate the effect of BB on residents’ stress, cognitive load, and performance.
Methods: Thirty-nine (n=39) PGY1 residents from 14 specialties participating in a simulation-based resuscitation OSCE were randomized to perform either BB or colour naming (CN) task for 20 seconds prior to each of 4 OSCE stations. Residents completed the STAI-6 and a modified Leppink cognitive load questionnaire after each station. Faculty assessors observed and assigned entrustment (EPA) scores. Intervention arms and measured outcomes were compared with unpaired student’s t-test and linear regression models.
Results: The BB group reported non-significantly lower stress (13.8 vs 14.5, p=0.1452), lower total cognitive load (6.47 vs 6.99, p=0.249), and higher EPA scores (4.12 vs 4.01, p=0.4028). BB group reported significantly lower ICL than the CN group (4.03 vs 4.86, p=0.0011). BB had a significant effect (p=0.019) on the relation between the ICL and the EPA scores, such that higher ICL amongst the CN group was associated with decreased EPA scores (b=-0.149, p=0.0177), but the BB group’s EPA scores were not associated with ICL. Amongst all participants, STAI-6 scores were associated positively with total cognitive load (b=0.277, p=0.0003), and negatively with EPA scores (b=-0.074, p=0.0005).
Conclusions: Residents using BB had significantly lower ICL and increased tolerance for ICL without declining EPA scores. Suggesting that the psychophysiological changes promoted by BB are protective against cognitive overload by excessive ICL, which would otherwise impair performance. Additionally, higher stress was associated with higher cognitive load and lower EPAs. Future work will explore BB’s use in resuscitation training.

Differences in Cognitive Load and Processes during Chest Radiograph Interpretation in the Emergency Department across the Spectrum of Expertise

M. Morra¹, H. Braund², A.K. Hall^3,, A Szulewski ^3,4.
¹School of Medicine, Queen’s University
²Office of Professional Development and Educational Scholarship, Queen’s University
³Department of Emergency Medicine, Queen’s University
⁴Department of Psychology, Queen’s University
Corresponding Author: Michael A Morra, email mmorra@qmed.ca

Abstract

Introduction/Background
In the emergency department (ED), chest radiographs (CXRs) provide essential information for clinical diagnostic reasoning. Errors in interpretation are known to lead to negative patient outcomes. Emergency physicians need be proficient in CXR interpretation to identify important pathologies. Gaining understanding of the differences in cognitive processes and cognitive load (CL) in CXR interpretation along the spectrum of expertise in emergency medicine (EM) is warranted.
Methods
This study adopted a mixed methods research design. Participant groups included medical students (M), junior (J) and senior (S) EM residents, and attending EM physicians (P) at a tertiary care academic hospital. A cognitive task analysis was performed for each participant, which consisted of a think aloud CXR interpretation of one of their patients while on shift in the ED. Interviews were audio recorded, transcribed, and coded for themes, and followed by a questionnaire measuring CL, stress and confidence.
Results
Questionnaire data between groups were compared using Mann-Whitney U tests which revealed decreased levels of CL (M vs. S and M vs. P: p=.002, J vs. S: p=.004, J vs. P: p=.005) and stress as experience level increased, and higher confidence levels with increased experience. Analysis of cognitive processes revealed four themes during CXR interpretation: checking behaviour, information reduction, pattern recognition vs. systematic viewing, and recognizing scope of practice.
Discussion/Conclusions
More experienced participants commonly utilized checking behaviours such as comparison to past radiographs, and effectively deprioritized irrelevant data such as verbalizing fewer possible pathologies than learners. Experts also utilized a general overview technique as their initial viewing approach as opposed to a systematic approach, and they better recognized an EM physicians’ priorities of interpretation. This study characterizes the differences in CL and cognitive processes in EM personnel of varying levels of expertise during CXR interpretation, gaining insight into expertise development in this critical task.

Preparing Community-Responsive Physicians Strengthening the Future of Healthcare

M. Gera¹, U. Rathod², A. Karra-Aly^3,, and Dr. A. Abraham⁴
¹H.BA, MPH - Public Health professional and partner at ETIO Public Health Consultants, Mississauga, Ontario, Canada.
²H.BSc, MMASc - Global Health professional, University of Western Ontario, Schulich School of Medicine & Dentistry, London, Ontario, Canada; ORCID: https://orcid.org/0000-0002-6578-9319
³BA, MMASc - Global Health professional, University of Western Ontario, Schulich School of Medicine & Dentistry, London, Ontario, Canada; ORCID: https://orcid.org/0000-0003-2773-105X
⁴BDS, MPH, MPEd, DPH(c), CCRA - Adjunct Clinical Professor, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada. Assistant Professor (Honorary), Pushpagiri College of Dental Sciences, Kerala University of Health Sciences, India; ORCID: https://orcid.org/0000-0002-0872-6856
Corresponding Author: Urvashi Rathod, email urathod@uwo.ca

Abstract

Introduction:
Problem-based learning (PBL) has been widely used in medical education since the 1960s. In recent years, Team-based learning (TBL) has gained popularity and has been applied in various medical and other professional institutions around the world.
Hypothesis/Question:
The hypothesis of this systematic review was to identify which teaching pedagogy, TBL or PBL, is more effective in delivering medical education.
Methods:
A systematic literature search was conducted using University of Western Ontario Library systems with adherence to PRISMA framework guidelines. The authors searched PsycNet, ERIC and PubMed databases for articles on TBL and PBL in regards to medical education, published between 2002 and 2020. The articles were selected and reviewed by the PRISMA framework guidelines.
Results:
The authors identified 15 articles after full-text screening that satisfied their inclusion criteria. Of the 15 articles, 12 incorporated a modified TBL format, while 3 described classic PBL.
Conclusions:
Overall, majority of the articles demonstrated a positive learning experience of TBL programs, specifically a better understanding of medical concepts. There are pros and cons to both TBL and PBL. The advantages for both pedagogies include promoting critical thinking and fostering collaboration, while disadvantages are lack of motivation and poor clinical problem solving. In the future, finding a way to merge both of these teaching methods might optimize learning experiences in medical education.

The Problem of Trustworthy AI in Medicine

P. Istasy^1,2 B. Chin-Yee^2,3
¹Schulich School fo Medicine and Dentistry
²Rotman Institute of Philosophy
³London Health Sciences Centre
Corresponding Author: Paul Istasy, email pistasy@uwo.ca

Abstract

This paper argues that under a patient-centered model of care, the notion of trustworthy artificially intelligent systems is inherently misconstrued. Trust is an essential component of the physician-patient relationship. Current models of the clinical encounter focus on shared decision-making, whereby physicians develop management plans with patients and actively elicit and integrate patients’ values and preferences into clinical decisions. With the increasing use of artificial intelligence (AI) in medicine, there is a growing concern about how this will influence the physician-patient relationship. While the majority of the relevant literature examines the dynamics of human-machine relationships, the influence that these machines have on human-human relationships remains an understudied topic. The trust in physician-patient relationships is determined by the competence and integrity of a physician—the former is self-evident, and the latter is required for identification-based trust, which is a type of trust whereby a physician identifies with and incorporate a patient’s values in medical decision-making. We provide an analysis of the physician-patient trust relationship in light of the introduction of medical AI. We demonstrate that even if artificially intelligent systems show superior competence to physicians in certain tasks, they will ultimately fail to display integrity and thereby, eliminate any possibility of identification-based trust between the patient and the physician. To this end, medical AI systems cannot be considered the epistemic authority in a medical setting and if introduced without philosophical scrutiny it may adversely affect the physician-patient trust relationship.

Emergency Airway Management: Practice Makes Perfect (Automatic)

J.P. Raleigh², J. Newbigging¹, R. McGraw¹, F. Gilic¹, E. Blackmore¹, & W. Lam¹
¹Queen's University
²Schulich School of Medicine & Dentistry
Corresponding Author: James Raleigh, email jraleigh2022@meds.uwo.ca

Abstract

Background: Emergency airway management (EAM) requires competency in technical and non-technical skills for use in a complex and time-sensitive clinical setting. EAM teaching often relies on part-task training in one-off seminars, combined with practice in the controlled setting of the operating room. This approach does not necessarily prepare residents for the complexity and high cognitive load inherent to EAM.
The four-component instructional design (4C/ID) model is a proven approach to teaching complex cognitive skills with varying real-world contexts and settings. The 4C/ID model asserts that four interrelated components are essential for complex learning: learning tasks, supportive information, just-in-time information, and part-task practice.
Hypothesis: It was hypothesized that participants in a simulation-based curriculum designed using the 4C/ID model would achieve proficiency and automation of skills and experience decreased cognitive load during complex clinical tasks.
Methods: 10 members of the CFPC-Emergency Medicine program at Queen’s University participated in a curriculum designed using the 4C/ID model. Phase I of the curriculum included 3 teaching modules which incorporated advance learning of supportive theoretical information, followed by high volume part-task practice where residents received just-in-time feedback for increasingly complex airway problems. Only when the required level of performance for a particular task class had been reached did the learner proceed, thus encouraging automation prior to advancing to subsequent tasks.
Results: 100% of participants reached the Objective Structured Assessment of Technical Skills milestones for intubation prep, direct and video laryngoscopy, supraglottic device use and surgical cricothyrotomy with 100% accuracy, and achieving at least 4/5 (superior) rating on the Global Assessment Scale. Residents also reported a reduction in cognitive load when approaching EAM tasks in the clinical setting, despite minimal actual clinical experience to influence this.
Conclusions: Preliminary evidence suggests that a 4C/ID-based EAM curriculum may reduce the cognitive load experienced by residents during complex clinical tasks.

Supporting the Caregiver: Evaluation of a Novel Education Model for Parents of Children with Medical Complexity

C. N. Kang¹, J. van Warmerdam¹, S. Moolla¹, A. Volpe¹, S. Chu², S. Adams^{3, 4, 6, 7}, J. Orkin^3-6.
¹Faculty of Medicine, University of Toronto, Toronto, ON, Canada
²Connected Care, The Hospital for Sick Children, Toronto, ON, Canada
³Complex Care Program, The Hospital for Sick Children, Toronto, ON, Canada
⁴Division of Paediatric Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
⁵Department of Paediatrics, University of Toronto, Toronto, ON, Canada
⁶Child Health Evaluation Sciences, SickKids Research Institute, Toronto, ON, Canada
⁷Lawrence S. Bloomberg Faculty of Nursing, University of Toronto
Corresponding Author: Cindy (Na-Young) Kang, email nayoung.kang@mail.utoronto.ca

Abstract

Introduction/Background
Hospital-to-home transition remains a challenge and source of caregiver anxiety. Historically, training was non-centralized and teaching content varied with clinician experience and expertise. The Connected Care Program provides centralized, standardized caregiver teaching for children being discharged home with new medical technology (e.g., enteral tube feeding, tracheostomy care, and suctioning). This abstract evaluates a new caregiver education program with a prospective descriptive survey.
Hypothesis/Question
To understand the perspectives of a new centralized education model for family caregivers being discharged from hospital-to-home with new medical technology.
Methods
Caregivers of children who received new medical technology were recruited from a large paediatric centre between February 2018-2019. Caregivers completed a Likert Scale survey to evaluate the centralized discharge education program.
Results
Caregivers (n=152/180, 84.4% response rate) were trained to use nasogastric tubes (n=54), gastrostomy/gastro-jejunostomy/jejunostomy tubes (n=55), enteral feeding (n=48), subcutaneous injections(n=15), central venous lines (n=18), oxygen saturation monitoring (n=6), tracheostomy care(n=7), and other technologies (n=5).
Majority of respondents strongly agreed on the following: 1) one-on-one teaching sessions were beneficial (96.1%, µ=4.88±0.65); 2) sessions provided opportunities to ask homecare-related questions (93.9%, µ=4.86±0.67); 3) sessions were an appropriate length of time (87.8%, µ=4.88±0.68). However, the following were highlighted as areas requiring improvement with a smaller proportion of respondents who strongly agreed: 1) practicing with mannequins and equipment was effective (85.3%, µ=4.76±0.74); 2) resources given were useful to learning (85.3%, µ=4.75±0.75); 3) the space provided distraction-free learning (79.5%, µ=4.76±0.76).
Written feedback was provided by 39 caregivers (25.7%). Consistent themes included: increasing room size (18%), more realistic environment (13%), and options to train with the patient rather than models (5%).
Discussion/Conclusion
Overall, caregivers valued one-on-one teaching and the opportunity to ask homecare-related questions. Further improvements included incorporating a distraction-free, spacious, and realistic learning environment. This informed a novel home-simulated education room for which future evaluation will follow.

Bridging The Gap In Clinical Skills: A Pilot Study Investigating the Use of Clinical Respiratory Examination Skills in Practice.

Sophia Kerzner¹†, Randi Q. Mao¹†, Janhavi N. Patel¹†, Shreyas Sreeraman¹†, Jason Profetto^1,2
¹Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Canada;
²Department of Family Medicine, McMaster University, Hamilton, Canada
†First Authorship
Corresponding Author: Janhavi Nikhil Patel, email janhavi.patel@medportal.ca

Abstract

Background: The transition to clinical settings represents a source of anxiety for medical students. Many students feel underprepared for clinical rotations, citing the theory-practice gap and a perceived lack of clinical skills knowledge as stressors. Having an understanding of clinically relevant examination skills may better focus studying, increase preparedness, and ease student anxiety. Due to a paucity of existing literature, we aim to address this gap and highlight to students which skills are clinically relevant.
Methods: We disseminated a 10-minute online anonymized survey to residents and physicians using an open recruitment strategy with convenience and snowball sampling. This survey focused on determining the practical use of respiratory exam skills in the McMaster Clinical Skills guide (4th edition). We conducted basic quantitative analysis to determine the percentage of respondents that found a skill useful and a descriptive content analysis for short-answer questions.
Results: From a total of 161 physician and resident respondents, 148 individuals completed the entire survey. The majority of respondents found all 12 inspection skills to be useful in practice. Tracheal deviation was the only palpation skill found useful (68.63%). No percussion or auscultation skills were seen as useful by a majority of respondents, except for auscultating for breath sounds (100% useful). In qualitative analysis, the major theme was that skills should continue to be taught despite minimal use as they help teach disease pathophysiology, help in limited resource settings, and have use in particular situations, such as in traumas or different specialties.
Conclusions: There is a discordance between the clinical skills taught to students and the ones actually used in practice. Despite this fact, there is still utility in teaching these skills to medical students. Highlighting what skills are commonly used while retaining all aspects of the curriculum could help students better prepare for clinical settings.

A Look at the Flipside: Positive Experiences in Surgical Practice

S. M. Jiang^1,2,3, S. McQueen^3,4, A. McParland^3,4, M. Hammond Mobilio³, R. Sonnadara³, C. Moulton^3,4.
¹Queen's University, School of Medicine
²Kingston Health Sciences Centre, Department of Cardiac Surgery
³Toronto General Hospital, The Moulton Lab
⁴University of Toronto, School of Medicine
Corresponding Author: Stephanie Jiang, email mijiang@qmed.ca

Abstract

INTRODUCTION
Epidemic levels of stress and burnout are negatively impacting surgeons (and physicians more broadly), evidenced by leaves of absence and early retirement. Yet many surgeons continue to thrive. Few studies have examined the factors that support flourishing among surgeons. Renewed attention on positive experiences in surgical practice may provide critical insights for understanding how to keep surgeons in the field and help them flourish. This study sought to understand the positive contributors to surgeon experience through a holistic and multidimensional lens.
METHODS
Semi-structured interviews were conducted with staff surgeons affiliated with UofT. A constructivist grounded theory methodology guided all stages of data collection and analysis. Interview questions explored different positive experiences in surgical practice from a multidimensional perspective.
RESULTS
19 staff surgeons with 3-32 years of experience from various specialties participated. A conceptual framework was co-constructed with participants to describe contributors to positive experiences. Five major components were identified: 1) Mastery, 2) Meaning, 3) Flow, 4) Institution, and 5) Relationships. Participants reported that their careers positively impacted their lives in several ways, from the objective (e.g. developing technical mastery) to the existential (giving meaning to their life). As one surgeon recounted; “I don’t think there are many things that you can do with your life that can get you closer to living a life worth trying to make sense of all of this than medicine. What we do is soaked with meaning.” (P15)"
CONCLUSION
Positive contributors to the surgical experience included individual and institutional factors. Individually, surgeons found their careers to afford ample opportunity for meaning, growth, and challenge, such as through the intrinsically rewarding nature of the work and ability to help patients. On the institutional level, key factors, such as positive team and operative cultures, teaching opportunities, and support within the surgical community, promoted positive experiences.

Development and Implementation of a Novel Leadership Program in Pre-Clerkship Undergraduate Medical Education

Michael Aw BHSc*1; Ahmed Shoeib BSc*¹; Craig Campbell MD FRCPC¹; Charles Su MD CCFP(EM), FCFP¹
¹University of Ottawa Faculty of Medicine.
*Joint first authorship
Corresponding Author: Michael Aw, email maw092@uottawa.ca

Abstract

Background: Leadership is intrinsic to medicine. The current uOttawa MD program provides didactic lectures based on the LEADS framework. Given the potential to enhance students’ engagement through experiential learning, we developed the Foundations in Leadership program (20-hour elective), which encourages student participation through self-learning; small group exercises; role play and simulation-based education. Our objectives are to assess student reception of the program and knowledge application via Simulated Objective Structured Clinical Examinations (OSCEs).
Methods: Sixteen uOttawa first year medical students were selected based on their willingness to commit to the full program. At baseline, students self-assessed their leadership competencies. Student feedback was solicited after each session using anonymous surveys. Students will participate in video recorded OSCE leadership stations, once at the beginning of the program and again at the end. OSCE stations were developed in collaboration with experts to challenge students’ communication and problem-solving skills. Blinded third-party evaluators will receive all video recording simultaneously at the end of the study period.
Preliminary Results: Currently, students have completed 4 of 8 sessions. Student feedback has been overwhelmingly positive. Using a 5-point Likert scale, a mean 95% (range: 80-100%) of participants described individual sessions to be good or excellent; 95% (86-100%) of participants agreed or strongly agreed that they had a positive learning experience and 97.5% (90-100%) recommended the continuation of sessions. At baseline, on a 7-point Likert scale, students self-reported a mean score of 4.8 (range: 3-7) amongst all measured 10 leadership skills. Specifically, the lowest rated skills were influence & impact, team leadership and initiative. Moving forward, students will engage in OSCE assessment.
Conclusion: Currently, our interim findings suggest the launching of the Foundations in Leadership program has been well received. Next steps include assessing knowledge application through simulated learning and evaluating post-program changes to student’s perceived acquisition of leadership competencies.

Title: To lead or not to lead: understanding the qualities, competencies and leadership strategies of exemplary team leaders during high stakes interventions in the emergency department (ED)

M. Hacker Teper¹, L. Notario², N. Kester-Greene²
¹University of Toronto, Faculty of Medicine
²Emergency Services, Troy Trauma Program, Sunnybrook Health Sciences Centre
Corresponding Author: Matthew Hacker Teper, email Matthew.HackerTeper@mail.utoronto.ca

Abstract

INTRODUCTION: In emergency departments (EDs) around the world, some of the most intense moments of patient care are those times when ED teams act in rapid and synchronized efforts to preserve the lives of deteriorating patients. Given the time-sensitive, stressful, complex and emotional nature of these high stakes scenarios, leadership is required to coordinate a team response that will lead to a successful intervention. While the impact of leadership on patient outcomes is well-defined, analyses of this phenomenon in the real-world setting of the ED (i.e. not trauma bay or operating room) are rare. Specifically, there remains a dearth of understanding of how exemplary leaders foster high teamwork in high stakes ED environments.
QUESTION: How do exemplary leaders foster effective teamwork in high stakes situations in emergency departments (EDs)?
METHODS: Qualitative descriptive study with thematic analysis. Semi-structured interviews will be completed with two participant groups. First, interprofessional team members will be asked about important qualities of excellent ED leaders in high stakes scenarios. Second, exemplary team leaders, as identified by their colleagues, will be asked to describe their leadership approaches and techniques to leading teams during high stakes interventions.
RESULTS: Results will outline specific competencies and strategies that exemplary ED leaders employ to better foster teamwork and optimal patient care during high stakes moments. Our project is currently beginning the data collection phase, and we anticipate having preliminary results to share by the date of the conference.
DISCUSSION: This research represents a first attempt to develop an understanding of how exemplary ED leaders think, say and do during high stakes situations to best care for ailing patients. These findings may be used to create subsequent professional development trainings that develop strong leaders who are better equipped to help patients in life threatening scenarios.

Immersive virtual reality (iVR) improves procedural duration, task completion, and accuracy in surgical trainees: a systematic review

R.Q. Mao¹, L. Lan¹, J. Kay², R. Lohre³, O.R. Ayeni², D.P. Goel³, D. de SA²
¹Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario
²Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario
³Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia
Corresponding Author: Randi Q. Mao, email randi.mao@medportal.ca

Abstract

Background
Immersive virtual reality (iVR) simulators provide accessible, low cost, realistic adjuncts in time and financially constrained training programs. With increasing utilization of this technology, its effect on global skill acquisition should be clarified. This systematic review examines the current literature on the effectiveness of iVR for surgical skills training.
Methods
A literature search was performed on MEDLINE, EMBASE, CENTRAL, Web of Science and PsycInfo for primary studies published between January 1, 2000 and May 13, 2020 on the use of iVR to develop technical surgical skills. Two reviewers independently screened titles, abstracts, and full texts, extracted data, and assessed quality and strength of evidence using the Medical Education Research Quality Instrument (MERSQI) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Results were qualitatively synthesized, and descriptive statistics were calculated. Where possible, standardized mean differences (SMD) were calculated using a random effects model.
Results
The literature search yielded 8,939 citations, with 13 articles included for qualitative synthesis. Immersive VR-trained groups performed 18% to 43% faster on procedural time to completion compared to control (pooled SMD =-1.11 [95% CI=-1.66 to -0.57, I2 =1%, p<0.0001]). Two of four controlled trials that used task-specific checklists found iVR groups completed significantly more steps than control post-intervention. Four studies reported on implant placement accuracy. In two studies by Xin et al., iVR groups placed significantly more successful grade I/A pedicle screws compared to controls (89.6% vs. 60.4%, and 69.6% vs. 55.4%). The mean MERSQI score was 11.88±1.60.
Conclusion/Recommendations
Immersive VR incorporation into surgical training programs is supported by high-quality, albeit heterogeneous, studies demonstrating improved procedural times, task completion, and accuracy, positive user ratings, and cost-effectiveness.

The Pearly Bird Gets the Worm: A Qualitative and Quantitative Analysis of the Geriatrics Update: Clinical Pearls Course

P. Hoang¹, L. Torbiak², Z. Goodarzi^1,3, H. Schmaltz¹
¹. Department of Medicine, Cumming School of Medicine, University of Calgary
²Department of Medicine, University of Manitoba
³Hotchkiss Brain Institute and O’Brien Institute of Public Health, University of Calgary
Corresponding Author: Peter Hoang, email peter.hoang@albertahealthservices.ca

Abstract

Background: The University of Calgary Cumming School of Medicine Annual Geriatrics Update: Clinical Pearls Course (Geriatrics Update) is a one-day, Continuing Medical Education (CME) program designed to enhance geriatrics competency for family physicians (FPs), given increasing population age and complexity.
Hypothesis: How does the Geriatrics Update course meet family physician’s perceived and unperceived learning needs and what modifications can better support FPs?
Methods: Descriptive data from 2018-2019 course evaluation surveys including demographic data, evaluations, and narrative feedback from participating FPs. Semi-structured phone and video-conferenced interviews with FPs were thematically analyzed each year.
Results: Fifty-two (61%) and thirty-nine (58%) FPs completed the survey in 2018 and 2019. Eighty-four percent (2018) and 82% (2019) of FP respondents intended to make practice changes. FPs were significantly (p=0.001) more confident on course objectives after the course in both years. All interviewees (n=20) described fulfilled perceived and unperceived learning needs and planned to return. The Geriatrics Update course is the primary source of Geriatrics CME for 60% of interviewees.
Conclusions: Iterative evaluation of Geriatrics Update identified that the course is well received, and often FPs primary source of geriatric CME. Interviews provided additional context and descriptive feedback to improve course delivery and better meet FP learning needs.

Using Parallaxic Praxis as an Arts-Based Methodology for Understanding Social Accountability in a Medical Education Context during COVID-19

M. Waugh¹, B. Beaudry¹, E. Cameron¹, H. Fleming 1
Corresponding Author: Miranda Waugh, email mwaugh@nosm.ca

Abstract

The arts in medical education have been studied in a variety of ways to enhance student confidence, strengthen empathetic reasoning and positively contribute to the development of medical students with heightened human interaction and self-reflection. This study will explore how arts-based research (ABR) methods can be applied to medical education to further the understanding of what it means to be socially accountable as a community member, health care provider, medical learner or stakeholder during the unprecedented times of the COVID-19 pandemic. Social accountability is highly embodied in medical education; however, its definition and its applicability to everyday practices are challenging to identify.
With the partnership of international sites, this project will be a high yield and informative study around local and global ideas of social accountability during this time of crisis. The result of this project will be a large body of artistic works aimed at deepening the understanding of the similarities and the differences of what it means to be socially accountable during these times through a unique methodology titled parallaxic praxis. The methodological framework utilizes artistic creations as data to thoroughly interpret a concept or make sense of a complex topic. To date, there is no current research that utilizes parallaxic praxis as a research method in medical education and more specifically speaks to an essential theme, like social accountability, in medical education during challenging times. The concept of parallaxic praxis includes guiding recruited participants through visual art workshops or phone interviews for data collection. Data analysis involves translating the created art and transcripts into common themes. Finally, the renderings include making new art out of these themes to further uncover new meaning of social accountability.

A synchronous motion-tracking and video-capture system for objective assessment and training in ureteroscopy

J. Trac¹, B. Carrillo, M. Farcas^2,3,4
¹Department of Medicine, University of Toronto
²St. Michael’s Hospital, Department of Surgery, Division of Urology
³Li Ka Shing Knowledge Institute, St. Michael's Hospital
⁴Department of Surgery, University of Toronto
Corresponding Author: Jessica Trac, email jessica.trac@mail.utoronto.ca

Abstract

BACKGROUND
Hand/instrument motion-tracking in surgical simulation provides valuable data to improve psychomotor skills, and can serve as a more formative evaluation tool. Although motion analysis has been well studied in laparoscopic surgery, it has been poorly studied in endoscopic surgery. There are essentially no studies looking at motion tracking for flexible ureteroscopy (fURS), a surgical procedure that requires significant hand dexterity.
OBJECTIVE
Our goal was to design an open-source, synchronized motion-tracking and video-capture system for flexible ureteroscopy. The aim is to provide trainee feedback and to collect metrics for use in objective skills assessment/examinations.
METHODS
Position and orientation data of the ureteroscope handle and lever (used to manipulate the tip) was collected with a motion tracking system (PolhemusTM), off-the-shelf inertial measurement units (IMUs) and optical sensors. Video data of the surgeon’s hands was captured with a Raspberry Pi camera. Video data of the scope view was collected from the video tower with an off-the-shelf USB video grabber. Open source Python software was written to control and integrate the sensors and cameras with a Raspberry Pi 4.
RESULTS
A preliminary prototype of the system was assembled with the PolhemusTM sensor, IMUs and Raspberry Pi. A 10-minute trial demonstrated successful, synchronized data collection of the position and orientation of the instrument handle and lever, and video data of the hands. Average CPU utilization went from an 8% baseline to 33% during data collection.
CONCLUSIONS
We are building an open-source data collection system capable of gathering synchronized motion-tracking and video data in fURS. The data pool can be utilized by surgeons and engineers to improve and standardize objective assessment and simulation training for endoscopic surgery. Our next steps include integration of optical sensors for insertion point tracking, and a sensor for scope tip tracking.

Artificial Intelligence in Undergraduate Medical Education: A Scoping Review

Juehea (Lucia) Lee¹, Annie Siyu Wu¹, David Li², and Kulamakan (Mahan) Kulasegaram^3,4.
¹University of Toronto, Temerty Faculty of Medicine
²University of Ottawa Faculty of Medicine
³University of Toronto Department of Family and Community Medicine
⁴The Wilson Centre
Corresponding Author: Juehea (Lucia) Lee, email juehea.lee@mail.utoronto.ca

Abstract

Purpose:
Artificial intelligence (AI) is a rapidly growing phenomenon poised to instigate large-scale changes in medicine. However, medical education has not kept pace with the rapid advancements of AI. Despite several calls to action, the adoption of teaching on AI in undergraduate medical education (UME) has been limited. This scoping review aims to identify key concepts in the peer-reviewed literature on AI training in UME.
Methods:
The scoping review was informed by Arksey and O'Malley's methodology. 8 electronic databases including MEDLINE and EMBASE were searched for articles discussing the inclusion of AI in UME between January 2000 and July 2020. 1750 articles were independently screened by three co-investigators and 22 full-text articles were included. Data was extracted using a standardized checklist. Themes were identified using iterative thematic analysis.
Results:
The literature addressed: 1) a need for an AI curriculum in UME, 2) recommendations for AI curricular content including machine learning literacy and AI ethics, 3) suggestions for curriculum delivery, 4) an emphasis on cultivating 'uniquely human skills' such as empathy in response to AI-driven changes, and 5) challenges with introducing an AI curriculum in UME. However, there was considerable heterogeneity and poor consensus across studies regarding AI curricular content and delivery.
Conclusion:
Despite a large volume of literature, there is little consensus on what and how to teach AI in UME. Further research is needed to address these discrepancies and create a standardized framework of competencies that can facilitate greater adoption and implementation of a standardized AI curriculum in UME.

Infographic Evaluation: What to Look For

S. Dolatabadi¹, S. Wicklum^2,3, M. Kelly²
¹Cumming School of Medicine, University of Calgary
²Department of Family Medicine, Cumming School of Medicine, University of Calgary
³O’Brien Institute for Public Health, Cumming School of Medicine University of Calgary
Corresponding Author: Samin Dolatabadi, email samin.dolatabadi@ucalgary.ca

Abstract

Introduction/Background: Infographics are graphic visual representations that present complex information quickly and clearly to an audience. They are commonly being used in various disciplines such as law to explain complex legal matters to clients to strengthen the attorney-client relationship. Infographics are also an invaluable tool in education as they can explain complex topics in a visually appealing format. There is also evidence that students prefer infographics to other formats as they find that this format is more engaging and allows them to retain information more effectively. Although an infographic can transfer knowledge about a topic faster and more effectively than pure text (picture superiority effect), enhance patient’s decision-making capabilities, and improve the physician-patient communication, learning to make effective infographics is not commonly taught in medical school.
Hypothesis/Question: What are the characteristics of effective infographics that increases data cognition, supports knowledge translation and physician-patient communication?
Methods: MEDLINE (OVID), EMBASE, CINAHL, Library and Information Science Source, Library and Information Science Abstracts, ERIC, and Communication Mass Media Complete were searched using a structured search. Descriptive data and key features of effective infographics were tabulated on a custom-made data extraction form and summarised descriptively.
Results: 10 articles meeting the inclusion criteria were selected. Five key features of an effective infographic were identified: clarifying the purpose and message; targeting the message towards the audience by taking their characteristic into account, balancing design and visual complexity, ensuring accurate textual content, and organizing the content in a logical manner.
Discussion/Conclusions: This literature review identified five major themes on infographic evaluation. Not only can these results be used by instructors to guide students through designing an effective infographic, they can also be used for evaluation purposes. In addition, the results can be used by learners to evaluate infographics that they encounter on social media or academic platforms.

Exercise Based Virtual Anatomy Review Classes: A Novel Method of Curriculum Delivery for Medical Students During COVID-19

Nadeesha Samarasinghe¹, Taniya Napgal², Michele Barbeau^1,3, Charys Martin^1,3
¹Schulich School of Medicine and Dentistry, Western University
²Faculty of Health Sciences, University of Ottawa
³Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University
Corresponding Author: Nadeesha Samarasinghe, email nsamarasinghe2022@meds.uwo.ca

Abstract

Introduction:
As a result of COVID-19 related facility closures, medical students face the challenge of learning complicated anatomy curricula through virtual teaching methods, with restricted access to cadaveric specimens. It has been suggested that non-traditional learning environments can be used to reinforce anatomical concepts and that this teaching is best delivered in a multimodal format. Through offering virtual exercise-based review sessions, we sought to explore the use of physical activity as an adjunct teaching method to reinforce musculoskeletal (MSK) anatomy course material prior to examinations.
Hypothesis:
We hypothesize that students who participate in the applied learning experience will report improved understanding of MSK anatomy concepts, increased physical activity motivations and positive well-being.
Methods:
Virtual group fitness classes were run with second year medical students at the Schulich School of Medicine and Dentistry at Western University during which various resistance and Yoga exercises were performed targeting different muscle groups. Key concepts were highlighted during the execution of each exercise and students were prompted to recall this information at various points during the session. Surveys were distributed to students who participated in these sessions.
Results:
A qualitative study aiming to formally evaluate student perceptions of these exercise-based review sessions has been approved by Western’s Research Ethics Board and is currently underway.
Discussion:
There is growing evidence to support the efficacy of teaching anatomy through exercise, which is especially significant when considering that most medical students do not meet the recommended levels of physical activity. In addition, the positive impacts of exercise, along with the ‘group fitness’ nature of the virtual classes, can potentially foster a sense of community and reduce anxiety surrounding the pandemic. In conducting this initiative, we hope to provide recommendations on enhancing medical student wellbeing and integrating exercise-based learning into undergraduate medical curriculum beyond the current pandemic situation.

Piloting a curricular innovation for point of care ultrasound education during the COVID-19 pandemic

E. Tang RN BScN.¹, R. Daniel BSc.¹, L. Wintraub BSc.¹, M. W. Nelms MSc.¹, D. D. Cho MD MSc. FRCPC^2,3
¹Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
²Division of Emergency Medicine, University of Toronto
³Emergency Department, University Health Network, Ontario, Canada
Corresponding Author: Evan Tang, email evan.tang@mail.utoronto.ca

Abstract

Background: There has been increasing interest and enthusiasm in point-of-care ultrasound (POCUS) as an aide to traditional examination techniques. POCUS education has been traditionally taught though in-person sessions, however, the COVID-19 pandemic has resulted in this training shifting to online platforms. While virtual lectures can provide POCUS theory, it falls short of providing the contextual information that is the foundation of POCUS utilization. We aim to assess the feasibility and efficacy of a live streamed ultrasound scan.
Methods: We conducted a pilot study of medical students which utilized a wireless probe during a POCUS teaching session alongside lecture slides. The wireless probe was utilized along with the lecturer’s camera to provide real-time positioning and scanning to supplement the materials of the lecture. Participants completed an optional feedback form following the session.
Results: 30 participants attended the teaching session with 11 participants completing the post-session feedback. All respondents felt engaged and identified that the session fostered a positive and interactive learning environment. 10 (91%) felt that their understanding of POCUS improved after the session. 5 (45%) strongly agreed and 4 (36%) agreed that they were able to visualize the maneuvers performed with this teaching method.
Discussion: This pilot project demonstrated the feasibility of the live streamed ultrasound scan as an adjunct to the traditional didactic lecture. Future work will aim to compare the efficacy of this approach to virtual lecture alone or hands on training and explore the viability of implementation into the virtual medical curriculum.

Assessing engagement and attrition of medical students in research education interventions: a scoping review

J.W.i Zhu¹, C.L. Gonsalves¹, L. Thabane², M.C. Samaan³
¹Michael G. DeGroote School of Medicine, Master University
²Department of Clinical Epidemiology and Biostatistics, McMaster University
³Department of Pediatrics, McMaster University
Corresponding Author: Clarelle Gonsalves, email clarelle.gonsalves@medportal.ca

Abstract

Introduction: Research programs are considered to be essential components of contemporary undergraduate medical education, with the goal of promoting interest in research and equipping medical students with the skills to perform research. Despite their importance, the level of engagement and attrition among students for programs designed to teach basic research competencies is widely unknown.
Question: To assess engagement and attrition rates in structured research education interventions for medical students. Secondary objectives included identifying: i) the various types of research education offered to medical students, ii) factors promoting enhanced engagement, and iii) barriers or difficulties that promoted disengagement and attrition
Methods: A literature search was performed in April 2020 according to PRISMA guidelines through PubMed, Embase, CINAHL, Web of Science, and ERIC. Quantitative findings were pooled and analyzed using a meta-analysis and a thematic analysis was used for qualitative findings.
Results: The literature search resulted in 7558 articles, of which 35 articles included in this review. There were four main types of research interventions: (i) special programs, (ii) elective research courses, (iii) elective student run series, and (iv) online modules. None of the studies reported data pertaining to dropout rates among participating students. Perceived useful skills included increased knowledge of research methodology, critical appraisal, and scholarly communication. Factors promoting interest and engagement were faculty mentorship, immersive course design, and ability to conduct independent research projects. Barriers promoting disengagement and attrition were time constraints, lack of teaching of statistics and data analysis, lack of formal course structure, and lack of supervisor support.
Conclusion: Faculty mentorship and immersive program design were the factors most commonly reported among medical students to promote interest. Insufficient time to conduct research and low confidence in statistics were the most commonly cited barriers regarding research education interventions and these should be considered when designed research education interventions.

Exploring resident and faculty perspectives on the impact of transitioning to virtual care on clinical exposure, teaching, and assessment during the COVID-19 pandemic.

Jessica S.S. Ho MSc¹, Rebecca Leclair¹, Heather Braund PhD², Sara Awad MD^1,3, Stephen Mann MD MMed^1,4, Boris Zevin MD PhD^1,4
¹Queen’s University, School of Medicine
²Faculty of Education, Queen's University, Kingston, Canada
³Department of Medicine, Queen's University, Kingston, Canada
⁴Department of Surgery, Queen's University, Kingston, Canada
Corresponding Author: Jessica Ho, email jho@qmed.ca

Abstract

Introduction/Background:
The COVID-19 pandemic has resulted in a decline of in-person clinical care, and an increase in virtual care. This transition may have also resulted in diminished opportunities for clinical teaching, learning, and assessment for post-graduate trainees within the competency-based medical education model.
Hypothesis/Question:
How has the transition from in-person to virtual ambulatory care during the COVID-19 pandemic affected post-graduate trainees’ teaching, learning and assessment at Queen’s university?
Methods:
Post-graduate trainees and faculty in the Departments of Medicine and Surgery [Faculty (n= 17), residents (n=18, recruitment ongoing)] are recruited to participate in this mixed-methods phenomenological study (qualitative interviews and focus groups, with quantitative analysis of assessment and feedback data). Participants are asked to reflect on their experiences with the transition to virtual ambulatory care in relation to clinical learning, teaching and assessment. Quantitative resident-level data is being collected to identify changes in clinical encounters and feedback received before and after the transition. Data will be coded to identify themes that emerge focusing on lived experiences.
Results:
Preliminary findings show that virtual care has changed many facets of teaching and learning, requiring significant changes for faculty and post-graduate trainees. There are significant barriers such as technology infrastructure, lack of space and lack of guidelines for virtual care. While assessments of entrustable professional activities (EPAs) for trainees have not changed, the absence of specific feedback EPAs focused on virtual care- has limited the ability to assess the skills unique to virtual patient interactions. Recommendations for institutions to improve resident education during the COVID pandemic are coming to light, including appropriate resources, support and education around virtual care.
Discussion/Conclusions:
We seek to understand the experiences of residents and faculty who transitioned from in-person to virtual patient care to inform new strategies of engaging residents in virtual care and provide more beneficial learning experiences.

McMaster Medical Student Professional Identity Development in the COVID-19 Era

R. Akbary, K. Hamann, J. Yu, A. Jones, I. McPherson
Waterloo Regional Campus, Michael G. DeGroote School of Medicine, McMaster University
Corresponding Author: Roya Akbary, email roya.akbary@medportal.ca

Abstract

Background:
Community and clinical exposure are critical components of how medical students develop their professional identity. In response to the COVID-19 pandemic, McMaster’s Michael G. DeGroote School of Medicine pulled pre-clerkship medical students from all clinical and in-person learning environments in March 2020. For the class of 2022 pre-clerkship students, the curriculum rapidly shifted: all components were moved online and in-person pre-clerkship electives and clinical skills sessions were temporarily cancelled. The impact of online learning and lack of clinical exposure on students’ socialization in medicine and development of a professional identity is not well characterized. We aimed to explore how medical students have perceived and adapted to the new online curriculum, and how the lack of in-person experiences have impacted pre-clerk medical students’ professional identity development.
Methods:
An anonymous and voluntary online survey was distributed to McMaster medical students in the class of 2022 (n = 203). Data underwent descriptive analysis for major themes.
Results:
A total of 75 students participated in the survey. Overall, most students felt the pandemic negatively impacted their learning, with emphasis on the limitations of online learning and interactions. Since the pandemic, students have felt increased pressure from their social responsibility as future physicians, and are more aware of the ethical and moral responsibilities of physicians. In addition, most are willing to return to the clinical environment despite acknowledgement of COVID-19 risks. Lastly, students identified areas for improvement in McMaster’s curriculum for maintaining students’ connection to medicine and professional identity development.
Conclusion:
The shift to online learning and suspension of clinical activities has negatively impacted students’ perception of their learning and competency. However, it has also increased students’ awareness of the professional responsibilities of a physician. These gaps in McMaster’s curriculum are opportunities for medical educators to better support students’ professional identity development.

Bringing the Patient Voice to Professionalism in Medical Education

S. Haney^1,2, R. Brydges^1,2,3,5, A. Kuper^1,3,4, P. Rowland^1,6,7,8, S. Ginsburg^1,2,3,9.
¹The Wilson Centre
²University or Toronto, Institute of Medical Science
³The Department of Medicine, University of Toronto
⁴Sunnybrook Health Sciences Centre, Toronto
⁵Allan Waters Family Simulation Centre, St. Michael’s Hospital, Toronto
⁶University Health Network, Toronto
⁷University of Toronto, Institute of Health Policy Management and Evaluation
⁸Department of Occupational Science and Occupational Therapy, University of Toronto
⁹Mount Sinai Hospital, Toronto
Corresponding Author: Simon Haney, email simon.haney@mail.utoronto.ca

Abstract

Introduction/Background: Research has acknowledged the value of patients as an essential stakeholder group in education, yet medicine has failed to incorporate patients’ perspectives into a discourse they are surely expert in: professionalism.
Purpose: Our purpose was to explore patients’ perceptions of professional behaviour in medical learners as a first step to considering patients’ potential roles in assessing professionalism.
Methods: Using a constructivist grounded theory approach we interviewed 19 patients, recruited from one urban hospital. Each participant watched 5 video scenarios that depict common professionally challenging situations faced by medical students. After each video, participants were asked what they thought the student should (or shouldn’t) do in the scenario, along with their rationale.
Results: Participants’ responses largely echoed those of medical students and faculty. They referenced principles of professionalism, the student’s affect or internal factors, and potential implications of actions when discussing what they felt was correct behaviour. Patients conveyed an understanding of the multiple competing factors students must balance (e.g., providing optimal care while maximizing educational opportunities) and expressed empathy regarding some of the pressures students face. Participants also identified principles not previously raised by students or faculty, including the importance of respecting privacy and of not showing disagreement among professionals in front of a patient.
Discussion/Conclusions: Knowing what patients perceive as important will allow educational and assessment efforts to be refined to reflect their values. Our work begins the process of understanding how best to include patients in the assessment of medical learners.

Addressing Weight Bias in the Medical School Curriculum: A Review of Literature 

M. Saad¹, A. Aziz Rizk², M. Saad²
¹Memorial University of Newfoundland
²University of Ottawa
Corresponding Author: Meena Saad, email mts772@mun.ca

Abstract

Introduction
Obesity has been described as a worldwide epidemic affecting the physical, mental and social health of approximately 39% of adults globally, according to the World Health Organization (WHO). Despite the prevalence of this chronic disease, significant implicit and explicit bias are consistently being reported amongst physicians and medical students.
Question
The purpose of this paper was to explore and discuss the efficacy of numerous interventions that are targeted towards weight bias among medical students throughout various stages of their undergraduate medical education.
Methods
The databases PUBmed, PsychINFO and EMBASE were used to find articles that met the inclusion criteria of 1) addressing implicit weight bias/stigma, 2) explicit weight bias/stigma, 3) targeted towards medical students and 4) discussed intervention strategies. Overall, eleven articles were found that met the criteria.
Results
Weight bias amongst medical students may arise due to exposure to certain derogatory behaviors and attitudes from faculty towards people with obesity. Various interventions were targeted towards these biases, most with little efficacy. It was found that most interventions were short in duration and failed to provide any long-term changes in implicit or explicit bias. While a long-term (continued throughout the four years of medical education) intervention showed a decrease in explicit weight bias, there were no significant changes in implicit bias from any of the proposed interventions.
Discussion
Overall, it can be seen that weight bias among medical students remains prevalent with the majority of interventions providing short-term solutions. The lack of long-term efficacy seen may be due to the brief duration of the interventions. It is therefore recommended that medical school interventions targeting weight bias be offered continuously throughout the medical education. In addition, the findings could be due to skewed or ineffective weight bias measuring tools which could be overcome by the utilization of multiple measuring strategies.

Implementing Trauma Informed Care into Undergraduate Medical Education

Author List: M. Y. Liepert¹, H. J. Byles¹, T. Killam^1,2
Affiliations:
¹Cumming School of Medicine, University of Calgary
²Riley Park Maternity Clinic
Corresponding Author: Maya Liepert, email maryah.liepert@ucalgary.ca

Abstract

Introduction:
Trauma Informed Care (TIC) is an approach to patient interactions which recognizes the serious adverse effects of trauma and adverse childhood experiences. It works to acknowledge the ways in which the healthcare system can potentially contribute to these negative impacts and ensure that interactions with the healthcare system do not re-traumatize individuals, but rather empower them to have control over their care. Unfortunately, despite its importance, there is not much focus on TIC in medical education. Prior studies have used lectures, online modules and group discussions as formats for implementing TIC education in healthcare settings. This study will assess the efficacy of an easily-accessible one-page resource in implementing TIC education in a medical communications course by examining medical student and preceptor perspectives on the resource.
Methods:
We created a one-page resource on TIC based on four pillars; What is TIC, Why is it important, How can you incorporate TIC into a History and Physical Examination, and How to Manage a Trauma Response. These pillars were chosen based on review of TIC resources found in existing literature as well as consultation with medical experts. We created four questionnaires total, two for students and two for preceptors; they will be sent before and after the completion of the communications course. Each questionnaire includes 6 questions regarding TIC knowledge, understanding and comfort. Students and preceptors are asked to rate their agreement on a 5 point scale from strongly disagree (1) to strongly agree (5). The TIC resource will be available in the teaching rooms throughout the course and the preceptors will be encouraged to implement this resource in their teaching.
Hypothesis:
We hypothesize that the implementation of a one-paged resource in a medical teaching setting will improve TIC knowledge, understanding, and comfort for both students and preceptors following completion of the course.

Development and Evaluation of an Online Simulation Curriculum for Interdisciplinary Medical Teams at Electronic Dance Music Festivals

A. V. Seto¹, A. Vorobeichik², L. Haynes², A. Hussein^3,, W. Kennedy⁴
¹Department of Family Medicine, University of Calgary
²Undergraduate Medical Education, University of Calgary, Cumming School of Medicine
³University of Calgary
⁴Department of Medicine, University of Saskatchewan
Corresponding Author: Allen Vorobeichik, email allen.vorobeichik@ucalgary.ca

Abstract

Introduction/Background: Electronic Dance Music (EDM) festivals present unique challenges to patient care, including resource limitations, loud music, crowded environments, and working with ad hoc teams to manage uncommon clinical cases. Hypothesis: We created an online, interdisciplinary simulation curriculum and predict that it will increase healthcare providers’ self-efficacy for, and knowledge in managing life-threatening medical cases at EDM festivals. Methods: Healthcare providers/trainees from various backgrounds (e.g., medicine, nursing, paramedicine) participated in three consecutive online simulations (cardiac arrest, serotonin toxicity, and toxin-induced seizure) in teams of 4-5. Two simulation facilitators managed case progression through a screen-share of Google Forms via Zoom video conferencing. Participants completed quantitative self-efficacy and knowledge assessments one week pre- and post-session, as well as a qualitative survey immediately post-session, reflecting on teamwork, take-home learning points, and curriculum quality. Results: Mean self-efficacy ratings (n=18) increased pre- vs post-session (one-tailed repeated-measures t-test) for cardiac arrest (3.80 to 4.31/5.00; p<0.01), serotonin toxicity (2.60 to 4.13/5.00; p<0.001), and seizure (2.70 to 3.83/5.00; p<0.001). Mean knowledge quiz scores (n=18) increased pre- vs post-session (one-tailed repeated-measures t-test) for all subsections (p<0.001): cardiac arrest (67% to 80%), serotonin toxicity (65% to 83%), and seizure (54% to 76%). Participants’ post-session reflections identified collaborative decision-making and communication as teamwork strengths. Commonly reported take-home learning points were related to pharmacology/toxicology, clinical approaches, and differential diagnoses. Mean program satisfaction rating (n=22) was 4.36/5.00. Discussion/Conclusions: The online simulation curriculum increased participants’ self-efficacy and knowledge on tailored learning objectives one week post-session. Online simulation can be an effective and satisfying training experience for festival medical teams and offers several benefits: i) serves as an icebreaker for teams prior to arriving at events, ii) eliminates physical distractions (e.g., loud music, crowding) to focus on clinical knowledge and approaches, and iii) offers convenience and cost-savings.

ADVOCATING FOR MINORITY FRENCH COMMUNITIES: A CASE STUDY OF DEVELOPING FRANCOPHILE MEDICAL LEARNERS

Tatiana Yeuchyk¹(pres.), Melanie Elhafid¹(pres.), Joyce Nyhof-Young², Brett Schrewe³
¹Faculty of Medicine, University of Toronto
²Department of Family & Community Medicine, Faculty of Medicine, University of Toronto
³Department of Pediatrics, Faculty of Medicine, University of British Columbia
Corresponding Author: Tatiana Yeuchyk, email t.yeuchyk@mail.utoronto.ca

Abstract

INTRODUCTION: 22.8% of Canadians speak French as a first language, with over 1 million people living in official language minority communities (OLMC) outside of Québec. Healthcare availability in French is often limited or absent, leading to reduced access and quality of care, and variations in health outcomes. It is imperative to address this gap in health equity and increase French service availability. One strategy is to support Francophone/Francophile medical students at Anglophone faculties of medicine. FrancoDoc was established in 2015 by the Association of Faculties of Medicine of Canada to equip learners to deliver linguistically appropriate care to OLMCs.
QUESTION: We seek to understand drivers of medical student dedication to skill development required to respond to the needs of OLMCs, and how FrancoDoc has affected their perception of French-language practice. In analyzing these phenomena, we will better support their professional development towards this goal. These results and proposed modifications will be presented FrancoDoc developers for its next chapter.
METHODS: A qualitative case study is underway using constructivist grounded theory and an exploratory approach. Semi-structured interviews will be conducted with 10-12 medical students involved in FrancoDoc activities, such as the national Ambassadocteurs leadership forum and medical French club chapters. Interviews will be transcribed and analyzed using a constant comparative approach until concept saturation is attained.
RESULTS: Preliminary findings suggest a strong motivation to improve fluency, an appreciation for FrancoDoc opportunities and resources, and deep recognition for language as a social determinant of health. Constraints of time and coordination between faculties of medicine, FrancoDoc, and local groups appear to be barriers in achieving target competencies.
DISCUSSION: These findings will allow us to propose concrete changes to FrancoDoc to better align learner support. In so doing, Anglophone faculties of medicine are better positioned to deliver social accountability to patients and OCLMs they serve.

Virtual Workshop in Interpretation for Multilingual Medical Students

Darya Naumova, MSc¹; Kenzy Abdelhamid¹; Xinyu Ji, BSc¹; Bertrand Lebouché, MD PhD^2,3,4
¹Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
²Center of Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre (MUHC)-Research, Montreal, Canada
³Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
⁴Canadian Institutes of Health Research Strategy for Patient-Oriented Research (CIHR/SPOR) Mentorship Chair in Innovative Clinical Trials in HI, Montreal, Canada
Corresponding Author: Darya Naumova, email darya.naumova@mail.mcgill.ca

Abstract

Background: Language barriers pose serious obstacles to healthcare service delivery, especially in multicultural urban centers of countries such as Canada. Multilingual medical students could play a role in addressing language barriers by acting as interpreters when the service of professional interpreters is unavailable. However, they must first receive adequate training in interpretation. Presently, no formal interpretation training is offered at Canadian medical schools.
Objectives: To evaluate the effectiveness of a virtual interpretation workshop on medical students’ knowledge, self reported qualification, and confidence in serving as interpreters in clinical settings.
Methods: The workshop targeted multilingual medical students and included a one-hour didactic lecture and one-hour interactive role plays. Ten identical workshops were hosted via ZOOM. Each workshop consisted of a theoretical, practical and feedback session, engaging >12 students with 2 moderators. Anonymously and voluntarily participants complete online pre- and post-workshop questionnaires to evaluate knowledge of the basics of medical interpretation, as well as the change in self-perceived comfort and qualification with taking this role. Secondary outcomes included acceptability, appropriateness, and adoption of the workshop.
Results: 74 students registered and 68 attended a workshop in July 2020. 49 completed both pre- and post-questionnaires. Study participants declared fluency in 23 languages other than French or English (official Canadian languages). The workshop resulted in a significant improvement in the participants’ mean knowledge score (increase of 4.29/17; p<0.005), along with a significant increase in their comfort and self reported qualification in performing interpretation in the clinical setting. The workshop was rated highly on acceptability and appropriateness and had a 92% adoption rate.
Conclusion: A two-hour virtual interpretation training is effective in improving multilingual medical students’ level of knowledge on the basics of interpretation, allowing them to become more comfortable with the role and perceive themselves as more qualified in performing medical interpretation in the clinical setting.

Trauma 101: A virtual case-based trauma conference as an adjunct to medical education

T. Amir¹, L. Lan¹, S. Farquharson¹, E. Y. Liu¹, R. Q. Mao¹, J. Yan², K. Singh^3,, A. Allard-Coutu⁴
¹Michael G. DeGroote School of Medicine, McMaster University.
²Department of Surgery, University of British Columbia.
³Department of Internal Medicine, University of Toronto.
⁴Department of General Surgery, McMaster University.
Corresponding Author: Takhliq Amir, email takhliq.amir@medportal.ca

Abstract

Introduction/Background
COVID-19 has impacted medical curricula, limiting simulation-based trauma education and surgical rotations. Virtual learning has been integrated as an alternative; however, its effectiveness for teaching critical concepts in trauma has not been validated. Small-group sessions are an effective pedagogical model, yet it is unclear how they translate to online learning.
Methods
Medical students were invited to attend a two-day virtual trauma conference organized by student interest groups at McMaster University and promoted on social media. 360 students from over 17 medical schools in five countries registered. The event included nine interactive presentations by physicians and residents in five specialties, followed by small-group case discussions. A peak of 167 simultaneous connections during presentations and 68 connections during small-group discussions was recorded. A best-match algorithm assigned students to preferred small-group sessions. Participants completed pre- and post-conference testing and feedback questionnaires. Results were analyzed using paired t-tests and descriptive content analysis.
Results
131 students (36%) completed the pre-test with a mean score of 3.4/10 (SD=2.04). 86 (24%) completed the post-test, with a mean score of 6.3/10 (SD=2.3, p<0.001). 73 students (20%) completed both tests. Paired t-test analysis revealed improvement by 2.7/10 (SD= 2.3, 95% CI=2.17 to 3.23, p<0.001). No correlations between education/school attended and performance were found.
Social media engagement resulted in 147 posts. 37.4% were participant-generated. Live polling and moderated chats improved participation. 74% of participants agreed sessions were interactive. 95.2% agreed the online platform was effective and 78.3% endorsed the conference as helpful preparation for clerkship. 58.8% (40/68) completed the feedback for small-group sessions. 42.5% (17/40) reflected favourably on group interaction. 92.7% rated small-group discussions as effective.
Conclusion
With participant satisfaction and significantly improved post-test results, this model for trauma education is an effective pedagogical adjunct. Small-group case-based discussions and social media enhanced participant engagement.

Explaining Mental Illness Stigma in Canadian Medical Students: A Nationwide Study

M. L. Glass¹, R. Voth², A. J. Canty³
¹ Michael G. DeGroote School of Medicine, McMaster University
² Department of Family Medicine, McMaster University
³Department of Mathematics and Statistics, McMaster University
Corresponding Author: Rebecca Voth, email rebecca.voth@medportal.ca

Abstract

Background:
Mental illness is ubiquitous and accounts for a substantial portion of the global disease burden. Unfortunately, negative stereotypes (stigma) about people with mental illness are common among health care professionals and students, which can decrease the quality of patient care. While some fixed factors such as gender and age have been examined, it is not yet clear which specific beliefs and experiences establish stigma prior to training. This study aimed to describe and explain mental illness stigma in the first nationwide sample of incoming Canadian medical students.
Method:
Over the course of 2 months, 262 survey responses were collected from first-year medical students across the 14 English-language Canadian medical schools. Total scores from the validated Mental Illness: Clinicians’ Attitudes (MICA-2) scale were used to measure stigma.
Results:
Greater mental illness stigma was predicted by male gender, less mental illness exposure, less subjective knowledge about mental health, greater distrust/skepticism toward people with mental illness, and stronger belief that people with mental illness cannot meaningfully contribute to society. Exposure (p = 1.86E-3), knowledge (p = 4.98E-3), distrust/skepticism (p = 9.34E-9), and perceived inability to contribute (p = 8.93E-6), cumulatively explained 31.7% of the variability in MICA-2 stigma score. Neither future specialty of interest (family medicine, surgery, or other) nor believed etiology of mental illness predicted participants’ stigma scores.
Discussion/Conclusions:
This study characterized mental illness stigma in the first nationwide sample of incoming Canadian medical students and identified modifiable predictors of this stigma. These offer clear targets for future antistigma educational interventions.

Impacts of poor financial literacy among Ontario medical students and implications for undergraduate medical training - A narrative review

I. Aggarwal¹, M. A. Scaffidi 1.
¹Queen's University
Corresponding Author: Ishita Aggarwal, email iaggarwal@qmed.ca

Abstract

Introduction: Pursuing a medical education, especially in Ontario, is a costly endeavour. The average cost of medical school tuition in Ontario is $24,151 and the average education debt of Canadian medical graduates has increased significantly from $72,000 in 2014 to $160,000 in 2019.
Question: In this narrative review, we aimed to explore the level of financial literacy among Ontario medical students, as well as identify any salient interventions.
Methods: We consulted PubMed, EMBASE, and PsycINFO to identify literature highlighting systemic and personal impacts of poor financial literacy on medical trainees.
Results: A review of over two dozen studies revealed that poor financial literacy impacts medical school demographics, academic and clinical performance, career selection, and overall work/life satisfaction. First, high tuition costs and debt disproportionately affect trainees coming from lower-income and/or rural backgrounds, which may dissuade or bar certain students from pursuing careers in medicine. Second, low financial competence and high debt were found to have negative effects on students’ academic performance, contributing to lower scores on examinations and poorer evaluations. Third, numerous studies demonstrated that increased debt burden influences specialty choice, driving students away from primary care and toward higher-paying fields. Finally, there was considerable evidence indicating that poor finances result in higher anxiety/stress levels, negatively affecting students’ mental health and reducing future job and life satisfaction. These impacts on physician well-being may lead to decreased quality of care and poorer health outcomes for patients in the long-term.
Discussion: Despite a large number of medical trainees considering personal financial literacy a priority, Ontario medical schools devote little time to its direct/indirect teaching. Moving forward, undergraduate medical curricula should introduce and/or increase training on borrowing and debt management, billing practices and insurance, investing, and retirement plans. More opportunities for financial extracurriculars and counseling is needed. A future systematic review is recommended.

Toward evidence-informed gender-affirming medicine CPD: An evaluation of a free online education tool

G. Enxuga^1,2, D. Rojas Gualdron^3,4,5, S. L. Ng⁶, J. Owen J^7,8, Y. Krakowsky⁹, K. R. MacKinnon¹⁰.
¹Master of Social Work Student - School of Social Work, McGill University.
²Research Assistant - Centre for Ambulatory Care Education (CACE), Women’s College Hospital.
³Assistant Professor - Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Toronto.
⁴Evaluation Scientist - Centre for Ambulatory Care Education (CACE), Women’s College Hospital.
⁵Evaluation Scientist - Office of Assessment and Evaluation, MD Program, University of Toronto.
⁶Director of Research - Centre for Faculty Development, St. Michael’s Hospital.
⁷Family Physician - St Michael’s Hospital.
⁸Assistant Professor - Department of Family and Community Medicine, University of Toronto’s Faculty of Medicine.
⁹Urologist and Medical Director - Transition-Related Surgery Clinic, Women’s College Hospital.
¹⁰Assistant Professor - Faculty of Social Work, York University.
Corresponding Author: Gabriel Enxuga, email gabriel.enxuga@mail.mcgill.ca

Abstract

Introduction
Current approaches to gender-affirming medicine (GAM) focus on ‘one-size-fits-all' eligibility assessments. These prevailing practices can obstruct patient-centered care to trans and non-binary patients. The Path to Patient-Centred Care (PPCC), a digital continuing professional development tool, teaches clinicians an alternative model of GAM: the informed consent model. However, implementation of this model requires evidence-informed education and knowledge mobilization. We analyzed the use of the PPCC with diverse post-graduate medical learners.
Methods
Between July and October 2020, we recruited physicians (total n=29) from a range of clinical specialities and experience levels to test and provide feedback on the PPCC tool. 29 participants tested the PPCC and provided feedback on its impact. From this sample, 13 participants completed a semi-structured 30-minute interview about the tool’s strengths and weaknesses.
Results
The PPCC tool increased self-perceived knowledge about the informed consent model and how to tailor the dominant approach of gender-affirming medicine for the purpose of addressing trans patients’ access inequities. The implementation guide, information about malpractice and transition regret, and the articulation of a model of patient-centered GAM were all endorsed as strengths. However, data showed that participants self-perceived capacity to implement GAM did not increase after using the tool.
Discussion
The PPCC increased clinician self-perceived knowledge on a range of topics relevant to patient-centred care with trans patients. However, it did not influence the self-perceived capacity to implement GAM. The lack of a formal curricula and scientific evidence on patient outcome were identified as barriers to GAM. Recommendations for future work include compiling a wider set of GAM resources addressing medical risks and benefits, and resources for clinical application.

“The Airwayve Podcast”: a novel, medical student-led anesthesia podcast for distance learning

G. Martin¹, A. Caldwell¹, P. Panchal¹, S. Xia^1,2, J. Albaum^1,2, N. Timmerman^1,2, G. Lovsted¹, A. Nair¹, A. Ajay¹, D. Cordovani²
¹Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
²Department of Anesthesia, McMaster University, Hamilton, ON, Canada
Corresponding Author: Grace Martin, email grace.martin@medportal.ca

Abstract

Introduction: Medical students remain underexposed to anesthesiology before clerkship. There is a lack of accessible educational materials in anesthesia geared towards students and the COVID-19 pandemic has compounded this issue by restricting clinical access to anesthesia. “The Airwayve Podcast” teaches fundamental anesthetic concepts using succinct, student-generated episodes that are reviewed by senior students, residents, and staff physicians. Episodes explore core topics in anesthesia, the scope of practice, and tips for learners. For episodes and summaries, visit www.airwayvepodcast.com.
Hypothesis: Student-generated anesthesia podcasts are a promising tool for promoting career exploration and teaching fundamental clinical content.
Methods: Six medical students, three residents, and one faculty member have collaborated on the podcast. Each episode undergoes a three-step editorial process, is recorded to a hosting platform, and is distributed via podcast apps. Anonymous survey data on episode content, listener preferences, and knowledge retention are being collected to improve podcast content and student outreach.
Results: 12 episodes across two series (“Introduction to Anesthesia” and “General Anesthesia”) have been released, and have received over 1000 downloads across five continents since September 2020. 73% of listeners access episodes from mobile devices. Listeners most commonly accessed episodes via the free online player on the podcast website (20%), Spotify (19%), and Apple Podcasts (15%). Airwayve has been endorsed by the McMaster University Department of Anesthesia and shared nationally with medical schools with commitments for distribution.
Discussion: The Airwayve Podcast is the first faculty-endorsed anesthesia podcast geared towards medical students. While the podcast has been well received thus far, ongoing explorations of user preferences and knowledge retention will optimize this educational tool for medical students in the current distance-learning era.

Program Website Evaluation of Canadian OB/GYN Residency and Fellowship Programs

M. Jain¹, A. Misra, BHSc (Hons.)¹, N. Sood, BSc, MSc², R. Varguise^3,, D. Karol, MD⁴, J. Y. Hu^3,, A. B. Alwazzan, MD⁵, F. Khosa, MD, MBA³
¹Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
²Faculty of Medicine, Memorial University, St. John’s, Newfoundland, Canada
³Department of Radiology, Vancouver General Hospital, Vancouver, British Columbia, Canada.
⁴Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada
⁵Department of Obstetrics and Gynecology, King Abdulaziz University, Faculty of Medicine, Jeddah, Saudi Arabia
Corresponding Author: Avika Misra, email amisr063@uottawa.ca

Abstract

Objective: The purpose of this investigation is to assess the comprehensiveness of obstetrics and gynecology residency and fellowship websites in Canada to understand the quality of information available to prospective students and make recommendations if needed.
Methods: All active Canadian residency and fellowship websites an (as of May, 2020) were evaluated and compared using a 72-point criteria in the following domains: Recruitment, Faculty, Current Residents/ Fellows, Research and Education, Surgical Procedures, Clinical Work, Benefits and Incentives, Wellness, and Environment. Fellowship programs without websites were excluded from the study. Program website information availability was compared by geographic region.
Results: Out of the identified 80 residency and fellowship programs, 68.75% (n=55/80), while, 6.25% (n=5/80) were from Atlantic Canada and 25% (n=20/80) from Western Canada. The mean score of residency websites was 35.28% (n= 25.4 ± 7.59), and the subcategory with the highest rate of inclusion was research and education (46.3% criteria complete); the subcategory with the lowest rate of inclusion was information on current residents (16.2% criteria complete). The mean score of fellowship websites was 38.75% (n= 27.9 ± 8.89). Wellness had the highest rate of inclusion (66.0% criteria complete) on fellowship websites; current fellows had the lowest rate of inclusion (13.2% criteria complete). Overall, fellowship program websites scored higher than residency websites (Fellowship: 27.9 ± 8.89 out of 72 criteria; Residency: 25.4 ± 7.59 out of 72 criteria).
Conclusion: Based on the results of this study, overall residency and fellowship websites can consider adding details on current residents and fellows, respectively.

Assessing the Effectiveness of Virtual Near-peer Teaching in Clinical Reasoning

M. Huroy, S. Ramdani, Y. Zhong, A. Cheung, E. Leveille, A. Ni, L. Shum-Tim, N. Haghandish, A. Shen, C. Caron, S. Lubarsky
Corresponding Author: Menal Huroy, email menal.huroy@mail.mcgill.ca

Abstract

Background: COVID-19 pandemic has brought many changes to the medical school curriculum. Clinical reasoning, often taught by faculty experts, has been limited due to reduced clinical exposure. E-Digesting Cases is a virtual case-based initiative with the goal of preparing medical students for clinical rotations using near peer teaching (NPT). NPT allows for better understanding of the student’s learning objectives while providing a safe space via cognitive and social congruence. However, there exists a paucity of literature for NPT in teaching clinical reasoning.
Hypothesis: This research aims to look at the effectiveness of near peers in teaching clinical reasoning as compared to faculty experts.
Methods: Pre-clerkship students will be invited to attend a case-based session and randomized into small groups that will be led either by a faculty expert facilitator or a near-peer facilitator. Facilitators receive the same case broken down in segments to guide participants through a typical clinical case. Participants receive a quiz prior and after the session to assess their clinical reasoning skills. Mirroring the session’s objectives through analytical complex questions that test higher levels of cognition, the questionnaire will also evaluate their confidence in their clinical reasoning skills.
Results: The average number of participants over 5 sessions was 20 students. The sessions were well rated with an average rating of 4.8 on a 5-point Likert scale. Out of 16 respondents, 62% reported a preference for peer-led teaching compared to didactic teaching.
Discussion/Conclusion: Given their support and acceptability of our model, a study is underway to assess the direct effectiveness of NPT compared to faculty members. We aim to shed light on the use of NPT and its potential integration in the medical curriculum.

A pilot Wellness and Academic near-peer mentor program for first year medical students during virtual learning.

H.F. Koury¹, L. Palmer¹, S. George¹, C. Hutchison¹
¹Department of Undergraduate Medical Education, University of Calgary Cumming School of Medicine
Corresponding Author: Hannah Koury, email hannah.koury@ucalgary.ca

Abstract

Introduction/Background: Online learning results in a loss of in-person connections that are crucial to overcoming routine challenges in the transition to medical school. Second-year medical students have established relationships and supports developed over a year of in-person classes that can assist in overcoming these challenges. The proposed program provides a structure for regular feedback from incoming medical students and support from senior students in order to prevent negative outcomes associated with online learning in medical school both for student wellness and academics vias structured wellness and academic peer mentorship.
Hypothesis/Question: The authors hypothesize that the proposed program will a)facilitate transition into medical school and online learning for incoming medical students, b)increase wellness and satisfaction of first-year medical students compared to second-year students who did not access the program, and c) increase professionalism, communication and leadership skills in second-year peer mentors.
Methods: The program includes 1 first-year representative from each of the case-based learning (CBL) small groups (n=14), 2-3 second-year peer mentors assigned to each CBL group (n=30). All first year representatives engage in biweekly meetings with second year Wellness and Academic Leaders. All second year peer mentors conduct wellness check-ins for first-year CBL groups after summative evaluations. Three qualitative surveys will be administered after 6 months of the program to first-years, second-year mentors, and second-year non-mentors. The second-year non-mentor data will capture students’ experiences transitioning to online medical school without this program and will be compared to the first-year students’ experience of beginning medical school online with access to the program for support. Descriptive statistical analysis will be completed on both first-year and second-year mentor primary outcomes.
Results: Data collection is currently underway.
Discussion/Conclusions: Results could support implementation of a similar program into other medical schools to support student wellness and professionalism.

TOWARDS VIRTUAL MEDICAL OBSERVERSHIPS: PILOTING WEARABLE LIVE STREAMING TECHNOLOGY

Authors: M. Issa¹, M. W. Nelms¹, Y. Jeyakumar¹, D. Teitelbaum¹, L. Wintraub¹, M. Xie¹, M. Otremba^1,2, G. Sirianni^1,3,4, F. H. Leung^1,3,6, J. Nyhof-Young^3,5, K. Prucnal^1,3.
¹Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
²Division of General Internal Medicine, Mount Sinai Hospital, Ontario, Canada
³Department of Family and Community Medicine, University of Toronto, Ontario, Canada
⁴Sunnybrook Health Sciences Centre, Ontario, Canada
⁵Office of Assessment and Evaluation, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada
⁶Department of Family and Community Medicine, St. Michael’s Hospital, Ontario, Canada
Corresponding Author: Mariam Issa, email mariam.issa@mail.utoronto.ca

Abstract

The current coronavirus pandemic (COVID-19) has had a substantial impact on medical education. Although many aspects of pre-clinical education have transitioned smoothly into virtual environments, career exploration has been cancelled due to physical distancing requirements. This study is designed to evaluate the implementation of a point-of-view (POV) live streaming technology for career exploration among medical students at the Temerty Faculty of Medicine, University of Toronto. Physicians, medical students, and patients will participate in this pilot education study to assess the practicality, utility, and efficacy of the technology.
Seven physicians practicing at the Michael Garron Hospital will be recruited to participate. Fourteen second-year medical students will be recruited and randomized into observership pods, either independently, with another student, or with a group of 4 other students. Each observership pod will be matched with a physician who will don a chest-mounted camera allowing POV live streaming of their patient visits. Students, physicians, and patients will provide informed consent prior to participating in the study. All participants will be invited to complete a survey and participate in individual or group semi-structured interviews. Basic descriptive statistics will be used to examine quantitative data. Thematic classifications that delineate major opinions and beliefs held by participants on the practicality, utility, and efficacy of the new learning aid will be formed based on the individual and group interviews. Using these categories, feedback patterns across stakeholder groups will be identified and these patterns will be triangulated between groups and into themes. If successful, this virtual educational platform can be adopted by the MD Program, and other educational institutions and health disciplines, to provide students adequate exposure to the real-life practice of medicine in situations requiring travel or physical distancing.

Pilot Project: A Peer-Led BLS Training Program for UBC Medical Students

H. Kapur¹, S. L. Douglas¹, K. Shi¹
¹University of British Columbia Faculty of Medicine
Corresponding Author: Hannah Kapur, email hkapur20@student.ubc.ca

Abstract

Introduction/Background
Canadian medical students are required to be trained in Basic Life Support (BLS). Students obtain certifications through private organizations, providing challenges with course cost and availability. Peer-led BLS training has been piloted in medical schools outside Canada, showing benefits in effectiveness, accessibility, cost, knowledge retention, and student engagement, while providing teaching opportunities, a core physician competency.
Hypothesis/Question
We hypothesized that a peer-led BLS program could be implemented for UBC medical students that substantially reduced costs, while increasing levels of engagement, relevance, and exposure to simulation labs.
Methods
Two second-year UBC medical students completed a two-day Heart and Stroke Foundation (HSF) BLS Instructor Course. The peer-instructors volunteered to organize and teach full-length and renewal BLS courses to medical students. The course cost $10 per student, covering HSF registration and instructor fees. Courses were taught at university-affiliated simulation centres with high-fidelity manikins and common medical equipment students use during clinical rotations. A ‘Code Blue’ team-based simulation was incorporated to add relevance. A post-course survey was delivered for quality improvement.
Results
Since July 2019, 8 courses were taught, training 41 students total. The first-time pass-rate was 100%. Students paid about 88% below professional-led courses. 37% of students completed the post-course survey. Compared to professional-led courses, students reported that peer-instructors increased engagement levels and the use of high-fidelity mannequins in a simulation room improved practicality. 100% of students agreed the program should continue.
Discussion/Conclusions.
Peer-led BLS certification for medical students is a cost-effective program that students find relevant and valuable. Barriers to creating a sustainable program include costs to train new instructors and purchase equipment. Stability of the program is provided by a faculty academic physician to oversee the program long-term. Future research should focus on the benefit to peer-instructors and the practicality of BLS-courses to increase curriculum exposure to simulations.

THE IMPACT OF THE COVID-19 PANDEMIC ON FAMILY MEDICINE RESIDENCY TRAINING AT THE UNIVERSITY OF TORONTO: A MIXED-METHODS STUDY

L. Diamond¹(pres.), M. Kulasegaram^1,2,3, M. Forte^{1,2 1}.
Corresponding Author: Laura Diamond, email laura.diamond@mail.utoronto.ca

Abstract

BACKGROUND: The COVID-19 pandemic posed severe disruption to medical education globally. Understanding the impact of COVID-19 on the training of Family Medicine residents (FMR) at the University of Toronto is critical to inform curricular changes and future crisis response.
OBJECTIVES: To identify how entering and exiting FMR experienced changes to their education during the COVID-19 pandemic.
METHODS: The Family Medicine Longitudinal Survey – an existing, validated national survey instrument – was modified to query COVID-19-related impact. Items included 5-point Likert-scale questions, as well as open-ended, short answer questions. Distribution was via email to 167 FMR graduating in Spring 2020 and 163 FMR beginning residency in Fall 2020.
Likert-scale responses were reported as summary statistics. Short answer responses were categorized into themes and subthemes inductively.
RESULTS: Survey response rates were 87% and 74% for entering and exiting FMR, respectively. Significant themes for both cohorts included: reduced access to clinical environments, reduced patient volumes, and lack of exposure to procedural skills.
While the graduating cohort indicated they felt confident to begin practicing family medicine, they described being significantly impacted by the loss of a tailored learning environment, including cancelled/altered electives.
In contrast, incoming residents reported on the loss of core skills, such as physical exam skills. In addition, they were impacted by the loss of face-to-face communication, rapport and relationship building.
DISCUSSION: Based on our results, residency programs can specifically tailor solutions and modifications to address common themes across cohorts in order to facilitate optimal learning environments in these pandemic times.

Exploring clinical reasoning between prescribing pharmacists and family physicians

V. Chiang^1,2, K.G. Hecker^1,2,3, A. L. Warren^2,3 S. J. Anderson¹
Corresponding Author: Vincent Chiang, email vincent.chiang@ucalgary.ca

Abstract

Background: Prescribing is part of the expanded scopes of practice for pharmacists in Alberta. Given the responsibilities associated with prescribing, the ability to reason through and apply clinical information becomes essential for pharmacists. However, the study of clinical reasoning has been limited in the field of pharmacy. Given there is reasonable overlap in the outpatient presentations seen by both family physicians and pharmacists, an opportunity exists to study clinical reasoning processes between these professions.
Objectives: The objective of the research is to understand the similarities and differences in the clinical decision-making of prescribing pharmacists and family physicians
Methods: This research consists of two phases. Phase 1 will use an online survey to capture an overview of the diagnostic and therapeutic patterns demonstrated by both groups. Phase 2 will use integrated, psycho-physiological tools (EEG and eye-tracking) to gain a deeper understanding of the processes underlying the decisions made by both groups.
Findings: This research is a current work in progress, preliminary data from Phase 1 will be reported in the final poster
Conclusions and Significance:
The results of this research could provide foundational knowledge regarding the decision-making processes within and between these groups of health professions, leading to a greater understanding of how to train learners in diagnostics and treatment selection.

Community Physician Retention in South Western Ontario: Perceptions of Longstanding and Recently-Recruited Physicians

G. Kim, D. Kim, E. Liu, A. Rocha
Corresponding Author: Alexandra Rocha, email arocha2022@meds.uwo.ca

Abstract

Introduction
Rural communities in Ontario are disproportionately underserved by physicians – 9% of practicing physicians in the province serve 21% of the population. While this disparity has been observed since 1996, successful efforts to increase physician recruitment to community sites have not been met with long term retention. Newly recruited rural physicians were most likely to leave their practice locations within the first 5 years of practice, whereas physicians practicing longer than 5 years tended to stay. Factors influencing physician retention in distributed sites are not well understood. This study aims to elucidate whether perspectives on physician recruitment and retention differ between recently recruited physicians and long-standing physicians in distributed sites.
Hypothesis
Long-standing physicians were predicted to be influenced by different motivators and barriers for recruitment and retention compared to newly recruited physicians.
Methods
Semi-structured telephone interviews were conducted with physicians practicing in distributed sites using a qualitative approach. Participants were categorized as recently recruited (0-4 years of practice) or long-standing (5+ years). Interviews were transcribed and coded using immersion and crystallization.
Results
Six broad themes influencing retention and recruitment emerged from analysis: professional, personal, family, incentives and compensation, education, and community. Recently recruited physicians valued their educational experience and transition into practice as motivators for remaining long-term. Long-standing physicians valued integration within the community and flexibility in their practice as key motivators for retention.
Discussion
Universal themes identified for both groups included; scope of practice, workplace collegiality, and family support as factors promoting recruitment and retention. Engaging medical students in community rotations is important to recruit physicians to community sites. Newly recruited physicians need to be supported with a breadth of resources during transition into practice. To retain physicians, communities should be equipped with support networks for both physicians and their family members to feel integrated.

Home-Based Pediatric Cancer Care: Perspectives and Improvement Suggestions from Children, Family Caregivers, and Clinicians

T. Masama², L. Jibb^1,2, D. Johnston^3,4, J. Chartrand^3,4, R. Balasa⁴, E. Patry⁴, M. Lamont⁴, R. Morin⁴, J. Choueiry⁴
¹The Hospital for Sick Children
²Lawrence S. Bloomberg, Faculty of Nursing, University of Toronto
³Children's Hospital of Eastern Ontario
⁴University of Ottawa
Corresponding Author: Tatenda Masama, email t.masama@mail.utoronto.ca

Abstract

"Background: Pediatric cancer care can be a taxing endeavor for families, with negative impacts that span psychological, physical, social and financial health. It has been suggested that home-based cancer care (HBCC), where appropriate, may help alleviate some negative aspects of the cancer experience. However, little is known about the opinions of key informants related to HBCC, which is needed to improve home care services.
Question: What are the opinions of children with cancer, their caregivers, as well as clinicians on the current model of home-based pediatric cancer care, including associated benefits, challenges, and modifications?
Methods: Children with cancer, their caregivers, and clinicians who provide care at a tertiary pediatric care center or the community participated in semi-structured interviews in English and French, which were then audio recorded by trained personnel. Interviews were transcribed and coded using NVivo 10 by a research assistant using a line-by-line approach. Codes were grouped into categories based on between-code relationships and then further grouped into themes.
Results: Thirteen children, 20 family caregivers, and 22 clinicians participated. Home-based care was endorsed as a means to better child health, alleviate family social and financial constraints, and improve system-level outcomes. The success of a home-based model is built on care that addresses child and family informational, treatment/care, material, and psychosocial needs. Suggestions for improving care include enhanced homecare agency-hospital- family communication, training for homecare nurses in pediatric cancer care, standardizing treatment protocols between hospital and home care agencies, and an expansion of home-based services. Child-, family-, and system-related factors affect the delivery of optimal home-based care
Conclusion: Overall, participants advocated for HBCC and the holistic approach to care it provides. Insight from these key informants is of paramount importance and should be integrated when developing best practice guidelines as they relate to pediatric home-based cancer care."

Climate Wise: a longitudinal solution to weave climate action into pre-clerkship medical training.

Celia Walker¹, Tyler Warnock¹, Nicole Mancini¹, Kavya Anchuri¹, Dr. Andrea Hull¹, Dr. Sonja Wicklum¹, Dr. Clark Svrcek¹
¹Cumming School of Medicine
Corresponding Author: Celia Walker, email celia.walker@ucalgary.ca

Abstract

Background:
The intersection of climate crisis and health is lacking from Canadian medical curricula. The 2020 Lancet Countdown on Health and Climate Change laments the marked rise of climate-induced pathologies over recent decades, highlighting the grave necessity of equipping medical trainees to treat disease manifestations of climate crisis among their patients. Climate Wise will systematically introduce climate-related etiologies and management of existing disease presentations within the undergraduate medical education (UME) curriculum at the Cumming School of Medicine.
Objectives/ Questions:
1. Educate medical students about climate crisis’ impacts on health
2. Equip medical students to manage climate-related etiologies of disease
3. Inform medical students about climate-friendlier healthcare practices, technologies
Methods:
Modeled after Choosing Wisely Canada, Climate Wise will create PowerPoint slides and problem-based small group learning material on the intersections of climate crisis and health to integrate into pre-existing lecture and small group material across the UME curriculum - enabling lecturers to seamlessly draw connections between disease presentations they already teach and their climate-related etiologies. For example, to accompany a pre-existing lecture on asthma in the course on respirology, Climate Wise has created a slide educating on asthma exacerbations due to increased incidence of wildfires in western Canada. All Climate Wise materials will be reviewed by expert physicians and systematically evaluated for their pedagogical utility by stakeholders (lecturers, medical students) using pre-post survey modalities. We will be testing the preliminary slide on asthma in February 2021 and will present the remainder of the material in 2021-2022 for the graduating class of 2024.
Results and Findings:
Findings expected in spring 2021 from a preliminary pedagogical evaluation of the Climate Wise pilot for the Respirology course within the UME curriculum. Subsequent results are expected in spring 2022 for the remainder of Climate Wise slide material integration.
Conclusions and Significance:
Producing a new generation of physicians with acute knowledge of ever-worsening ramifications of climate crisis on the health of their patients, and how to manage these.

Applying EDUCATE to Medical Student Intimate Partner Violence Training (mEDUCATE)

M. Leslie¹, K. Lienhard¹, N. Bradley², S. Sprague¹, P. S. Schneider³
¹University of Calgary, Cumming School of Medicine.
²University of Alberta, Faculty of Medicine and Dentistry.
³McMaster University, Department of Surgery
Corresponding Author: Kaitlyn Dillabough, email kaitlyn.dillabough@ucalgary.ca

Abstract

Background: Healthcare providers (HCPs) report lack of comfort in identifying and assisting patients experiencing intimate partner violence (IPV). Yet, there are no practical educational opportunities for medical trainees to learn how to identify IPV or access resources. We developed and implemented a novel multi-modal IPV educational program for medical trainees (mEDUCATE) to address this knowledge gap.
Objectives/Questions: Program aimed to increase medical trainee knowledge and comfort identifying/assisting patients with IPV.
Methods: Mixed-methods qualitative and quantitative assessments are being utilized to evaluate program utility. The Physician Readiness to Manage IPV Survey (PREMIS) was administered to participants pre-, post-, and 6 weeks-post educational symposium. Responses are being scored to evaluate change in trainee IPV comfort and knowledge. Semi-structured interviews with participants (n=8) have been completed. Interviews were analyzed using parallel deductive coding methods and Middle-Range Theory to seek consensus amongst analysts to consolidate themes and key findings. The content and delivery of mEDUCATE will be iteratively modified based on this critical appraisal.
Results and Findings: mEDUCATE was held December 2019. Major themes identified included that practical training and social worker presence was integral, comfort in difficult conversations increased, training enhanced education and trainees desire to learn from patients and HCPs of diverse backgrounds. Preparations to deliver the symposium virtually, at multiple institutions are being made. Quantitative PREMIS assessment will be completed by January 2021.
Conclusions and Significance: IPV is a public health issue all HCPs and trainees should be equipped to address, especially in the setting of COVID-19. mEDUCATE has been well-received and early results support value of IPV training in medical education.

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