Family Medicine Residency Training Programs Research Articles

Development, Implementation, and Meta-Evaluation of a National Approach to Programmatic Assessment in Canadian Family Medicine Residency Training.

The growing international adoption of competency-based medical education has created a desire for descriptions of innovative assessment approaches that generate appropriate and sufficient information to allow for informed, defensible decisions about learner progress. In this article, the authors provide an overview of the development and implementation of the approach to programmatic assessment in postgraduate family medicine training programs in Canada, called Continuous Reflective Assessment for Training (CRAFT). CRAFT is a principles-guided, high-level approach to workplace-based assessment that was intentionally designed to be adaptable to local contexts, including size of program, resources available, and structural enablers and barriers. CRAFT has been implemented in all 17 Canadian family medicine residency programs, with each program taking advantage of the high-level nature of the CRAFT guidelines to create bespoke assessment processes and tools appropriate for their local contexts. Similarities and differences in CRAFT implementation between 5 different family medicine residency training programs, representing both English- and French-language programs from both Western and Eastern Canada, are described. Despite the intentional flexibility of the CRAFT guidelines, notable similarities in assessment processes and procedures across the 5 programs were seen. A meta-evaluation of findings from programs that have published evaluation information supports the value of CRAFT as an effective approach to programmatic assessment. While CRAFT is currently in place in family medicine residency programs in Canada, given its adaptability to different contexts as well as promising evaluation data, the CRAFT approach shows promise for application in other training environments.

Training Family Medicine Residents to Address the COVID-19 Pandemic: A National Survey of Program Directors.

Public health training became particularly important for family medicine (FM) residency training programs amid the COVID-19 pandemic; the Accreditation Council for Graduate Medical Education (ACGME IV.C.19) requires a structured curriculum in which residents address population health. Our primary goal was to understand if, and to what extent, public health interventions trainings were incorporated into FM residency training programs amid the COVID-19 pandemic. We hypothesized programs with more resources (eg, university affiliates) would be better able to incorporate the training compared to those without such resources (ie, nonuniversity affiliates). In 2021, we incorporated items addressing COVID-19 public health training competencies into the 2021 Council of Academic Family Medicine Educational Research Alliance national survey of FM residency program directors. The items addressed the type of training provided, mode of delivery, barriers to providing training, perceived importance of training, and support in delivering training. The overall survey response rate was 46.4% (n=287/619). All programs offered at least some training to residents. There were no statistically significant differences in training intensity between university and nonuniversity affiliates. The length of time an FM residency director spent in their position was positively associated with training intensity (r=0.1430, P=.0252). The biggest barrier to providing the trainings was the need to devote time to other curriculum requirements. FM residency programs were able to provide some public health interventions training during the pandemic. With increased support and resources, FM resident training curricula may better prepare FM residents now in anticipation of a future pandemic.

Supporting Community-Based Family Medicine Residency Training Programs in North Carolina and their Potential Impact on Healthy NC 2030.

North Carolina is a leader in family medicine, but a growing health care chasm exists between the state's urban centers and rural areas. Training family medicine residents in rural communities can address disparities in health care access and improve rural population health metrics for all subsets of the population, goals that align well with renewed state and national strategies.

Evaluation of the Educational Environment in in a Family Medicine Residency Training Program in Riyadh by Use of PHEEM (Postgraduate Hospital Educational Environment Measure)

Evaluation of the Educational Environment in in a Family Medicine Residency Training Program in Riyadh by Use of PHEEM (Postgraduate Hospital Educational Environment Measure)

The Impact of Resident Duty Hour Reform on Family Medicine Residency Training: Residents' Points of View

<p>目的：本研究探討家庭醫學科住院醫師自2019年適用勞動基準法規定後，對工時規範之滿意度、健康影響、學習成效、醫療品質與病人安全層面進行調查，並進一步比較不同訓練職級、不同醫院訓練容額、與不同醫院層級住院醫師在工時規定影響看法上的差異。</p> <p>方法：以2017至2019訓練年度進入家庭醫學專科醫師訓練計畫的住院醫師為對象，以問卷調查工時限制所造成的影響。結果：共有286位家庭醫學住院醫師參與研究，其中有近九成滿意目前工時限制規定，且普遍認為工時限制不會降低訓練品質。其中第一年住院醫師超時的比例較高，較資深住院醫師同意工時規定會減少教學指導與學習體驗的比例較高，但多數還是認為並不影響教學品質。超過半數第一年住院醫師認為醫療錯誤發生率會降低，資深住院醫師則多認為不變。雖然所有醫院層級的住院醫師都認為工作時疲勞情況與嗜睡程度有所改善，但地區與區域級醫院仍有少部分住院醫師認為工作時疲勞及嗜睡程度更明顯。</p> <p>結論：實施工時限制後，大部分家庭醫學科住院醫師滿意目前工時限制規定，認為工時限制不會降低訓練品質，也不需要延長受訓年限。學員普遍認為對於工時限制對住院醫師的身心健康有正向影響，對於病人受到的醫療品質與病人安全則不受影響。</p> <p> </p><p>Objective: The study assessed family medicine residents’ overall satisfaction with the resident duty hour restriction implemented in 2019 and explored their perceptions of the impacts of the restriction on their well-being, education, and patient safety. The study further compared the differences in residents’ perceptions based on the level of residency training, size of residency training program, and level of training hospital.</p> <p>Methods: Residents admitted to the family medicine residency training program by the Taiwan Association of Family Medicine from 2017 to 2019 were selected to participate in this study. A prospective anonymous questionnaire survey was administered to family medicine residents nationwide to gather their opinions and suggestions regarding the newly implemented resident duty hour reform.</p> <p>Results: A total of 286 family medicine residents responded to the questionnaire survey. Nearly 90% of the residents were satisfied with the current duty hour regulations and found the restriction unlikely to compromise the quality of residency training. First-year residents reported a greater frequency of working overtime, compared to residents of other levels. The more senior the residents, the stronger the belief that duty hour restriction reduced time for learning and faculty guidance; however, the majority of the responding residents were of the opinion that the restriction did not affect the overall quality of residence training. Over 50% of the first-year residents felt the restriction helped reduced the likelihood of medical error, while more senior residents found the likelihood unchanged. Regardless of the levels of their training hospitals, a great part of the residents found the problems of fatigue and daytime sleepiness alleviated, yet there was still a minority of residents in regional and district hospitals felt the problems aggravated.</p> <p>Conclusion: After the implementation of duty hour restriction, most family medicine residents are satisfied with the current regulations and feel no significant impact of the restriction on the quality of residency training. In their opinion, there is no need to extend the length of residency training. The duty hour reform does exert positive influences on their physical and mental health and bring about no impact on patients’ safety and quality of care.</p> <p> </p>

Effects of a Life Story Interview on the Physician-Patient Relationship with Chronic Pain Patients in a Primary Care Setting.

Introduction: Within family medicine it is generally accepted that the more we know about patients' lives, the better the care we provide. Few studies have sought to quantify this historical assumption. We wondered if knowing their chronic pain, patients' life stories would improve the physician-patient relationship in a family medicine residency training program clinic. Methods: We selected patients in chronic pain with depression and/or anxiety who were considered difficult. After a lead in period to establish stability of ratings, we obtained a life story interview for 125 such patients after administering the doctor-patient relationship questionnaire to them and their physicians. Patients completed the McGill Pain Inventory (MPQ), the Zung Anxiety Inventory, and the Center for Epidemiological Studies Depression Scale. Physicians completed the Jefferson Physicians Empathy Scale. Questionnaires were repeated every 4 months. Results: The quality of the physician-patient relationship increased significantly over the course of the year for patients (increase of 0.60, standard deviation [SD] = 0.13, 95% confidence interval [CI] = 0.57 to 0.63, p < 0.001) and for doctors (increase of 0.77, SD = 0.20, 95% CI = 0.72 to 0.81, p < 0.001). The perceived level of pain on the MPQ decreased significantly on the sensory component (71.2 ± 7.6 to 11.7 + 9.4, 95% CI = 0.589 to 9.411, p = 0.0270 and the affective component (4.2 + 3.4 to 2.1 + 4.3, 95% CI = 0.131 to 4.069, p = 0.037). Anxiety and depression ratings did not change. Physicians' empathy ratings increased significantly over the course of the year from a mean of 117.2 (SD = 10.2) to 125.1 (SD = 16.1) for a difference of 7.90, which was significant at p = 0.0273 with a 95% CI of -14.85 to -0.915. Discussion: Knowing the patient's life story improves the physician-patient relationship for both patients and physicians. When the physician-patient relationship improves, the perceived level of pain decreases. Physicians' empathy ratings increase. While the interview requires 90-120 min, it is billable, and can be done by medical students, medical assistants, social workers, or behavioral health. Conclusions: Obtaining life stories of chronic pain patients is a cost-effective way to reduce pain while simultaneously improving the physician-patient relationship and increasing physician empathy.

Implications of COVID-19 Pandemic on Family Medicine Residency Training Program and ACGME Requirements in Qatar

Implications of COVID-19 Pandemic on Family Medicine Residency Training Program and ACGME Requirements in Qatar

Medicine Residency Training Program during COVID-19: Qatari Experience.

Family medicine residency training programs should put in place COVID-19 action plan in conjunction with other clinical departments, employee health personnel, and infection control leads. Programs should develop coping strategies that balance resident and patient safety, resident wellbeing, clinical training services, and resident education.

Digital Healing: People, Information, Healthcare

Digital Healing takes the reader on an evolutionary journey focusing on the deployment of electronic health record systems across the United States from 2000 to 2018. The author, Marc Ringel, M.D., studied at the Abraham Lincoln School of Medicine in Chicago, Illinois followed by postgraduate training in pediatrics at Cook County Hospital (Chicago). He later became a general practitioner in Yuma, Colorado (population 2,000) as part of the National Health Service Corps where he fell in love with rural medicine and became Board Certified as a family physician. He has also practiced in rural Wisconsin and taught at the North Colorado Family Medicine Residency Training Program in Greeley, Colorado. He is an eloquent writer and speaker, and is dedicated to writing about rural health care, telemedicine, and continuing medical education. Dr. Ringel weaves relevant scholarly references and personal stories about his role as a family medicine physician to engage the reader in a thoughtful discussion about ways in which people are better than computers and vice versa in health care.A recurrent theme throughout the book is that no matter how sophisticated or impressive technology is, the determining factor for its successful implementation is the people involved in deploying and using the technology. Personal stories and clever examples of telemedicine applications are interwoven throughout the book in a way that draws the reader in. Dr. Ringel cleverly depicts the improvement offered by electronic health records while describing the importance of the human component of health care, focusing on patients’ stories and relationships, while using clever chapter titles such as “Left-Handed Pregnant Women,” “Everybody Wants Your Data,” and “Financial and Human Costs of EHRs.” The author commands an encyclopedic knowledge of medical history and integrates it well with the rapidly evolving digital revolution that is affecting health systems throughout the world.The central thesis of the book explores the ways in which human beings can utilize digital information and resources to improve health, while also allowing people to be more human. The author intercalates stories describing entire health systems, such as those in rural and urban centers in Colorado, with individual anecdotes that highlight the strengths and limitations of electronic health records. The author’s views, particularly advocating for rural health initiatives and reducing health services disparities, are prevalent throughout the text.As a rural practitioner, Dr. Ringel recognizes the importance of interventions that address disparities in healthcare access, particularly in remote areas of the country. All forms of telemedicine are emphasized, from phone calls to virtual consults with intensivists who offer around-the-clock expertise to clinicians in remote hospitals with limited or no access to specialists.The book is carefully organized into chapters focusing on specific areas ranging from virtual reality to artificial intelligence to clinical decision support. The author avoids jargon and aims for a balanced presentation that is accessible to medical and general readers alike. This book offers a set of perspectives on the evolution of the electronic health record system, but is not a comprehensive overview of the field. The book is available in hardback and eBook formats through a variety of services. Readers of all levels of experience will enjoy this welcome reality check in today’s digitally connected world.

Medicine Residency Training Program during COVID-19: Qatari Experience

Family medicine residency training programs should put in place COVID-19 action plan in conjunction with other clinical departments, employee health personnel, and infection control leads. Programs should develop coping strategies that balance resident and patient safety, resident wellbeing, clinical training services, and resident education.

Implicit Bias Training in a Residency Program: Aiming for Enduring Effects.

Implicit bias often affects patient care in insidious ways, and has the potential for significant damage. Several educational interventions regarding implicit bias have been developed for health care professionals, many of which foster reflection on individual biases and encourage personal awareness. In an attempt to address racism and other implicit biases at a more systemic level in our family medicine residency training program, our objectives were to offer and evaluate parallel trainings for residents and faculty by a national expert. The trainings addressed how both personal biases and institutional inequities contribute to structural racism, and taught skills for managing instances of implicit biases in one's professional interactions. The training was deliberately designed to increase institutional capacity to engage in crucial conversations regarding implicit bias. Six months after the trainings, an external evaluator conducted two separate 1-hour focus groups, one with residents (n=18) and one with program faculty and leadership (n=13). Four themes emerged in the focus groups: increased awareness of and commitment to addressing racial bias; appreciation of a safe forum for sharing concerns; new ways of addressing and managing bias; and institutional capacity building for continued vigilance and training regarding implicit bias. Both residents and faculty found this training to be important and empowering. All participants desired an ongoing programmatic commitment to the topic.

Relationship of Patient Self-Administered COPD Assessment Test to Physician Standard Assessment of Chronic Obstructive Pulmonary Disease in a Family Medicine Residency Training Program.

Assessing the global impact of chronic obstructive pulmonary disease (COPD) on a patient's life can be difficult to perform in the clinical setting due to time constraints and workflow challenges. The primary objective of this study was to compare disease impact ratings between patient self-administered COPD Assessment Test (CAT) and physician standard office assessment. This prospective study was conducted at a family medicine residency clinic in northeast Tennessee. The study included two study groups: 1) adult patients seen at the clinic during the 3-month study period with an active diagnosis of COPD, and 2) their physicians. Physicians' assessment of the impact of COPD on their patients' daily lives was compared to patients' self-administered CAT assessments. Physician assessment of COPD impact and patient assessment of CAT categories significantly differed (χ2=11.0, P=0.012). There was very poor agreement between patient and physician ratings (κ=0.003), with 42.9% of physician ratings underestimating the impact, 28.6% overestimating the impact, and 28.6% correctly estimating the impact COPD had on their patients' lives. These findings support the use of validated assessment tools to help providers understand the symptom burden for patients with COPD.

The use of Dermoscopy Following a one-day Workshop Among Family Medicine Residents

Skin cancer is the most common form of cancer in the United States. The purpose of this study is to determine if a single grand rounds workshop impacts the use of dermoscopy in a single Family Medicine Residency training program. Dermoscopy is a non-invasive tool to allow for higher magnification of skin lesions thereby increasing the ability to assess qualities which are unable to be seen by the naked eye. This study utilized a pre- and post-workshop survey questionnaire to assess participant practices in evaluation, diagnosis, and management of skin lesions. Eighteen (18) residents completed the survey prior to the grand rounds workshop. Nine (9) residents completed the follow-up survey three-months post-workshop. The results showed that the frequency of dermoscopy use increased post-workshop (Pearson’s Chi Square=8.83, p=0.012; Fischer’s Exact=0.008) and residents felt dermoscopy decreased the need to refer skin lesions (Pearson’s Chi Square=9.11, p=0.028; Fischer’s Exact=0.023). However, there was no significant change in resident comfort level when using dermoscopy post-educational workshop (Pearson’s Chi Square=5.34, p=0.255; Fischer’s Exact=0.272).

PREFACE

................ The Government of Indonesia has recently launched the nation’s postgraduate family medicine residency training programs, based in 17 universities spread across the country. For the first time, medical graduates will receive postgraduate training in comprehensive primary medical care. Formal assessment at the end of training will lead to Fellowship of the Indonesian College of Primary Care Physicians. These new graduates will lead the transformation of health care in this country............One of the main tasks of primary care doctors or family doctors is disease prevention and health promotion. Health education is a way that most take to promote public health. The research articles in this edition show us about how health education is implemented with the aim of general society such as school students, health cadres and puskesmas officers. Education and experience (experiential-based) trigger behavior changes which are then expected to improve health status1. How health education is implemented can affect the results to be achieved. For example, the interactive learning process can achieve the expected results, rather than independent learning and lectures2..............

Missed opportunities: are residents prepared to care for transgender patients? A study of family medicine, psychiatry, endocrinology, and urology residents

The transgender (trans) population faces multiple barriers in accessing health care, with knowledge deficits of health care providers contributing substantially. Trans patients report having to teach health care professionals about their own health needs. We compared perceptions of trans-care education and training across family medicine, psychiatry, endocrinology, and urology residency training programs at the University of Toronto. We surveyed residents to assess their perceptions of and attitudes towards trans-care, exposure to trans patients, knowledge of trans-specific clinical care, and the state of trans-care education within their training. We used Likert scale data to identify patterns across residency programs. We collected open-ended responses to further explain quantitative findings where appropriate. Of 556 residents approached, 319 participated (response rate = 57.4%). Nearly all endocrinology and psychiatry residents agreed that trans-care falls within their scope of practice, while only 71% and 50% of family medicine and urology residents did, respectively. Though participants were at different stages of their postgraduate training when surveyed, only 17% of all participants predicted they would feel competent to provide specialty-specific trans-care by the end of their residency and only 12% felt that their training was adequate to care for this population. Though the study revealed a willingness to serve this population, there was a lack of clinical exposure and trans-related teaching within postgraduate curricula resulting in feelings of unpreparedness to meet the health care needs of this underserved population.

From pipelines to pathways: the Memorial experience in educating doctors for rural generalist practice.

This report describes the community context, concept and mission of The Faculty of Medicine at Memorial University of Newfoundland (Memorial), Canada, and its 'pathways to rural practice' approach, which includes influences at the pre-medical school, medical school experience, postgraduate residency training, and physician practice levels. Memorial's pathways to practice helped Memorial to fulfill its social accountability mandate to populate the province with highly skilled rural generalist practitioners. Programs/interventions/initiatives: The 'pathways to rural practice' include initiatives in four stages: (1) before admission to medical school; (2) during undergraduate medical training (medical degree (MD) program); (3) during postgraduate vocational residency training; and (4) after postgraduate vocational residency training. Memorial's Learners & Locations (L&L) database tracks students through these stages. The Aboriginal initiative - the MedQuest program and the admissions process that considers geographic or minority representation in terms of those selecting candidates and the candidates themselves - occurs before the student is admitted. Once a student starts Memorial's MD program, the student has ample opportunities to have rural-based experiences through pre-clerkship and clerkship, of which some take place exclusively outside of St. John's tertiary hospitals. Memorial's postgraduate (PG) Family Medicine (FM) residency (vocational) training program allows for deeper community integration and longer periods of training within the same community, which increases the likelihood of a physician choosing rural family medicine. After postgraduate training, rural physicians were given many opportunities for professional development as well as faculty development opportunities. Each of the programs and initiatives were assessed through geospatial rurality analysis of administrative data collected upon entry into and during the MD program and PG training (L&L). Among Memorial MD-graduating classes of 2011-2020, 56% spent the majority of their lives before their 18th birthday in a rural location and 44% in an urban location. As of September 2016, 23 Memorial MD students self-identified as Aboriginal, of which 2 (9%) were from an urban location and 20 (91%) were from rural locations. For Year 3 Family Medicine, graduating classes 2011 to 2019, 89% of placement weeks took place in rural communities and 8% took place in rural towns. For Memorial MD graduating classes 2011-2013 who completed Memorial Family Medicine vocational training residencies, (N=49), 100% completed some rural training. For these 49 residents (vocational trainees), the average amount of time spent in rural areas was 52 weeks out of a total average FM training time of 95 weeks. For Family Medicine residencies from July 2011 to October 2016, 29% of all placement weeks took place in rural communities and 21% of all placement weeks took place in rural towns. For 2016-2017 first-year residents, 53% of the first year training is completed in rural locations, reflecting an even greater rural experiential learning focus. Memorial's pathways approach has allowed for the comprehensive training of rural generalists for Newfoundland and Labrador and the rest of Canada and may be applicable to other settings. More challenges remain, requiring ongoing collaboration with governments, medical associations, health authorities, communities, and their physicians to help achieve reliable and feasible healthcare delivery for those living in rural and remote areas.

Improving Resident Knowledge in Pediatric and Adolescent Gynecology: An Evaluation of the North American Society for Pediatric and Adolescent Gynecology Short Curriculum.

Resident education in pediatric and adolescent gynecology (PAG) is challenging. It encompasses patients from neonates to young adults with different disorders involving multiple subspecialties. Residents have inadequate exposure to PAG topics and report lack of knowledge in this area. The objective of this study was to determine if the North American Society for Pediatric and Adolescent Gynecology (NASPAG) Short Curriculum improves self-reported knowledge in PAG among obstetrics and gynecology (ObGyn), family medicine, and pediatric residents. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Participants were 47 US ObGyn, family medicine, and pediatric residency training programs across a 4-month study window, from September to December 2016. The NASPAG Short Curriculum was distributed to them with a request to complete a retrospective pre- and post-test survey. Primary outcome measure was improvement in self-perceived knowledge after exposure to the curriculum. Forty-eight programs responded to the study comprising a total of 1130 residents. One program was excluded because of logistical barriers to the distribution of study incentive. In total, 1080 residents were invited and 103 chose to participate (10%response rate); 68 residents completed all survey questions to be included in the final analysis. After completing the curriculum, self-reported knowledge improved in all 10 learning objectives, across all 3 specialties (47% [32/68] to 82% [56/68]; P<.01). Pre-test knowledge correlated with previous clinical exposure to PAG patients, but did not correlate with year of residency training, type of residency, or previous PAG lectures. Significant deficiencies exist regarding self-reported knowledge of core PAG topics among ObGyn, family medicine, and pediatric residents. Use of the NASPAG Short Curriculum improves self-reported knowledge in PAG trainees across all 3 specialties.

Evolution of family medicine residency training program in Dubai Health Authority: A 24-year review, challenges, and outcomes.

Introduction:It is well known that family medicine (FM) is a cornerstone for developing a community-based health-care system, and training family physicians is critical for the society. In Middle East, only 5%–10% of physicians, nurses, and health technicians are citizens. This demands more efforts toward having national FM practitioners in the country. The development of FM residency training program through the past two decades in Dubai has played a crucial rule in this aspect.Methods:The primary purpose of this study is to review the status of FM specialty training in the Emirates of Dubai throughout the past two decades.Results:The FM residency training program started since 1993 and had intake of 230 residents till 2017; out of which, 200 (87%) were female and 211 (92%) were the United Arab Emirates national. From 176 residents who are supposed to be graduated by 2017, 162 (92%) completed 4-year training, 132 (75%) has got the Arab Board certificate, and 116 (66%) qualified by the Membership of the Royal College of General Practitioners (MRCGP) international.Conclusion:The present study revealed that despite all challenges, the well-structured FM program enabled the graduates to reach high clinical, administrative, leadership, and academic positions such as consultant (40), chief executive officer (1), chief advisor for primary care (1), director (9), head of sections (9), head/deputy head of primary health center (55), head of academic affair center (1), chair of MRCGP international (1), program director of FM (4), MRCGP convener (6), MRCGP coordinator (6), and MRCGP examiner (42). However, the program is still lacking certification by an international accreditation body. This will help in reaching a better balance between education and clinical duties for all trainers and faculty; and will positively advocate support for an environment conducive to learning for residents as well as faculty members.

A ‘How-To-Guide’ for teaching and assessing Collaborator Role competencies in family medicine residency and health professional training programs

Introduction: Collaborative practice competencies are essential for safe, effective practice in today’s health care system. Providing learners with formal teaching and assessment opportunities is a requirement for accreditation in medicine and other health professional programs. However, identifying and assessing a trainee’s ability to competently collaborate in practice across educational contexts remains challenging. Further, without common assessment tools for collaborative practice teaching opportunities, ensuring comparability of collaborative practice learning experiences is difficult. To address these challenges, the College of Family Physicians of Canada tasked an interprofessional group of educators to develop a practical ‘How to Guide’ to support educators and facilitate practice change in how we assess and teach the Collaborator Role competencies. As educators, we are often required to work from a variety of educational frameworks: programmatic evaluation objectives, key and enabling competencies and clinical domains of care as examples. By leveraging specific observable behaviours of collaborative practice, the ‘How to Guide’ links these frameworks and provides practical strategies for teaching and assessing these behaviours across educational contexts. Through these practical tools and strategies for teaching and assessment we expect not only to facilitate these processes but also to encourage consistency of programming and to ensure that health professional learners are supported in the attainment of these collaborator competencies. Purpose: This interactive workshop is designed to support educators in medicine and other health professions with teaching and assessing collaborator competencies. With reference to the CanMEDS 2015, participants will reflect on how they teach and assess the collaborator role within their own contexts; compare these opportunities with collaborator role teaching and assessment strategies implemented in Canada; and consider how the ‘How to Guide’ for the Collaborator Role can support their teaching and assessment of collaborative practice competencies. Learning objectives: By the end of this workshop participants will be able to: 1. Identify opportunities to teach and assess the collaborator role in their teaching context. 2. Describe common teaching and assessment practices for collaborator role competencies 3. Access and apply the How to Guide to support their teaching and assessment of the collaborator role. Targeted Population and Stakeholders: Teachers / preceptors, program directors, health professional educators, medical residents and health professional learners, curriculum developers and assessment leads Timeline: This work took place from 2013 to 2016 to coincide with the release of the 2015 CanMEDS framework. The How-To-Guide will accompany the roll-out across Canada for the 2017 CanMEDS FM (Family Medicine) competency framework. Sustainability and Transferability: The How-To-Guide is relevant to all health professional educators in their role of preparing future health professionals to be competent to practice in integrated and interprofessional care models. The How-To-Guide was created by an interprofessional group of educators to ensure its relevancy to all health professional training programs. The guide is expected to be available for educators on an ongoing basis for the next decade. Its revision would likely coincide with the 10 year-review of the College of Physicians and Surgeons Canada CanMEDs framework in 2025. This workshop will be facilitated in both English and French.

Palliative Care Rotations in Obstetrics and Gynecology, Internal Medicine, and Family Medicine Residency Programs [14I

INTRODUCTION: To determine the number of obstetrics and gynecology, internal medicine, and family medicine residency training programs with mandatory palliative care rotations. METHODS: We included internal medicine, family medicine, and obstetrics and gynecology programs listed on the Fellowship and Residency Electronic Interactive Database. Program information such as the number of residents per year, geographic location and monthly block schedule for each program were obtained. If the block schedule explicitly mentioned mandatory palliative care rotation for at least two weeks, programs were categorized as: mandatory palliative care program. RESULTS: Overall, 12.4% (146/1,177) programs had mandatory rotation as part of the residency training. Rates of mandatory palliative care rotation were highest amongst the programs in the West-Pacific (29.2%) and lowest for the West-Mountain (3.5%) residency programs. Internal medicine programs had higher mandatory palliative care rotations compared to Family Medicine (17.6% vs 14.3%, P=.048). Obstetrics and Gynecology had the lowest rate at 0.8%. From these programs, 16.2% (2,181/13,434) of the graduating residents each year had mandatory palliative rotation exposure. CONCLUSION: Our findings highlight the lack of focus on primary palliative care training. Despite recommendations from the Institute of Medicine, based on our analysis, majority of graduate medical training programs do not incorporate palliative care in the curriculum. Incorporating palliative care training with other mandatory subspecialty trainings rotations (e.g. cardiology or oncology) would be an important step in this direction to assure the delivery of high-quality end-of-life care.