Canadian Training Programs Research Articles

Gender Distribution in Paediatric Cardiology Training Programs in Canada

BackgroundDespite female medical students being the majority, there are certain medical specialities that continue to have a prevalence of male trainees, such as adult cardiology. The purpose of this study is to examine gender distribution within Canadian paediatric cardiology training programs. MethodsBoth application and successful matches to core paediatric residency programs and paediatric cardiology programs were obtained through the Canadian Resident Matching Service. Analysis was performed to determine if the association between gender of paediatric residents and paediatric cardiology applicants/fellows was significant. ResultsBetween 2016 and 2024, 12% (n = 3/26) of individuals who successfully matched into a Canadian paediatric cardiology training program identified as female and 88% (n = 23/26) identified as male. Between 2013 and 2023, 78% (n = 947/1220) of individuals who successfully matched into a Canadian paediatrics residency identified as female and 22% (n = 273/1220) identified as male. There was a statistically significant difference between the gender of paediatric residents and the gender of paediatric cardiology residents (P < 0.0001). There was no significant association between applicant gender and match outcome within paediatric cardiology training programs (P < 0.23). ConclusionsThere is a gender discrepancy within Canadian paediatric cardiology training programs with a predominance of male trainees in the recent era. It appears that female under-representation in the field is due to the low number of female applicants. Although limited by sample size, there was no clear association between applicant gender and success of admission to a paediatric cardiology training program.

Is ChatGPT ready for primetime? Performance of artificial intelligence on a simulated Canadian urology board exam.

Generative artificial intelligence (AI) has proven to be a powerful tool with increasing applications in clinical care and medical education. ChatGPT has performed adequately on many specialty certification and knowledge assessment exams. The objective of this study was to assess the performance of ChatGPT 4 on a multiple-choice exam meant to simulate the Canadian urology board exam. Graduating urology residents representing all Canadian training programs gather yearly for a mock exam that simulates their upcoming board-certifying exam. The exam consists of written multiple-choice questions (MCQs) and an oral objective structured clinical examination (OSCE). The 2022 exam was taken by 29 graduating residents and was administered to ChatGPT 4. ChatGPT 4 scored 46% on the MCQ exam, whereas the mean and median scores of graduating urology residents were 62.6%, and 62.7%, respectively. This would place ChatGPT's score 1.8 standard deviations from the median. The percentile rank of ChatGPT would be in the sixth percentile. ChatGPT scores on different topics of the exam were as follows: oncology 35%, andrology/benign prostatic hyperplasia 62%, physiology/anatomy 67%, incontinence/female urology 23%, infections 71%, urolithiasis 57%, and trauma/reconstruction 17%, with ChatGPT 4's oncology performance being significantly below that of postgraduate year 5 residents. ChatGPT 4 underperforms on an MCQ exam meant to simulate the Canadian board exam. Ongoing assessments of the capability of generative AI is needed as these models evolve and are trained on additional urology content.

A310 CANADIAN GASTROENTEROLOGY RESIDENT ATTITUDES TOWARDS TREATING PATIENTS WITH DISORDERS OF GUT BRAIN INTERACTION

Abstract Background Disorders of gut brain interaction (DGBI) are common in the Canadian population. Studies show DGBI represent 30% of new referrals to gastroenterology (GI) clinics. Despite this, evidence suggests that gastroenterologists experience challenges in providing care for these patients, with a recent study from the United States indicating that this discomfort may begin early in residency training. Aims Our aim was to determine Canadian GI resident attitudes towards treating patients with DGBI, with a focus on determining underlying causes and solutions for potential negative attitudes. Methods Gastroenterology residents participating in accredited adult GI training programs in Canada were invited to participate in an online 30-item survey. This was based on similar studies in the adjacent field of chronic pain and administered using RedCap. Recruitment occurred through email invites distributed to residency program directors and QR code links presented at national GI resident meetings over one year. Results In total, 42 residents participated in the survey. Most residents reported frequent exposure to DGBI. Although most residents felt confident at diagnosing DGBI, only few felt confident in managing them. The majority reported less enjoyment and personal reward at managing DGBI than other gastrointestinal diseases, finding them frustrating to treat and expressing concern regarding the uncertainty of the diagnosis and low likelihood of successful management. Residents believed that challenges in the treatment stemmed from the following: inadequate training, uncertainty regarding the severity of symptoms that were reported, co-existing psychiatric issues, a lack of clarity on therapy and inadequate time. Residents reported that senior residents and staff both expressed negative opinions about caring for those with DGBI, and felt that displeasure for managing patients with DGBI was pervasive in the GI community. Importantly, the majority of trainees believed it was important to formally learn about the physiological underpinnings of DGBI as well as their diagnosis and management. Furthermore, understanding the impact of DGBI on a patient’s quality of life was thought to be important. Conclusions This national survey demonstrates that Canadian GI trainees are less confident and less interested in providing care for those with DGBI due to a variety of factors including inadequate training and a potential hidden curriculum. Residents believe in the importance of education in this field. The results of this study will be used to develop educational experiences to ultimately improve the care of those with DGBI. Funding Agencies None

A87 A SURVEY-BASED ASSESSMENT OF ENDOSCOPY CURRICULUM AND EDUCATION IN CANADIAN TRAINING PROGRAMS

Abstract Background Endoscopic training within Canada occurs in programs accredited by the Royal College of Physicians and Surgeons of Canada (RCPSC). Beyond national accreditation, there are no standardized endoscopic training curriculums and each program is responsible for ensuring its trainees achieve competency. There is debate in the literature regarding the minimum number of endoscopic procedures and the role of objective assessment tools in the assessment of trainee competence with no specific recommendations for these by the RCPSC. Aims The goal of our study was to characterize endoscopic training curriculums within Canadian training programs while determining the usage and perceived importance of procedure volume tracking and objective assessment tools. Methods Online surveys were sent to program directors (PD) and trainees within Adult Gastroenterology, Pediatric Gastroenterology, General Surgery and Colorectal Surgery programs within Canada. Surveys contained questions meant to characterize endoscopy training curriculums and perceived effectiveness of the curriculum while highlighting the factors important for feedback and competency assessment. Results Survey responses were obtained from 20 PDs and 83 trainees. Of all programs surveyed 53% (44/83) of trainees reported that they had a formal endoscopy curriculum compared with 75% (15/20) of PDs. PDs assessed endoscopic competence predominantly by EPAs (95%) and verbal feedback (65%) with minimal usage of objective tools (30%). Trainees reported fewer objective tool usage at 2.4% (2/83). When assessed on a 5-point Likert scale, both PDs and trainees felt that verbal feedback was the most important for assessment of competence (3.58 and 4.39 respectively). Seventy-seven percent of trainees report using a procedure log and when asked about procedure volume 37% of trainees expected to complete ampersand:003C250 colonoscopies by the end of their training. Eighty-three percent of PDs felt that all their trainees achieved endoscopic competency with only 50% of adult GI PDs reporting the same. Most PDs and trainees felt that national recommendations for objective tool usage (65% and 57% respectively) and minimum procedure volume (65% and 63% respectively) would be helpful to standardize endoscopic training. Additional results are reported in Figure 1. Conclusions Most training programs reported a standardized curriculum with a majority of trainees tracking their procedure volume, but a minority of programs incorporated objective tools. A significant portion of trainees expected to complete ampersand:003C250 colonoscopies by the end of their training and not all PDs felt that all of their trainees reach endoscopic competence. The majority of trainees and PDs felt national recommendations for procedure tracking and objective tools would be helpful, suggesting the need for more formalized endoscopic curriculums in Canada. Funding Agencies None

Trainee Evaluations of Preparedness for Clinical Trials in Medical Oncology-A National Questionnaire.

A standardized approach to the education of clinical trial investigators across Canadian medical oncology (MO) subspecialty training does not exist. With training programs transitioning to competency-based medical education (CBME), studies assessing education practices and competence are paramount to enhancing trainee education. This study aimed to determine whether current education practices in MO subspecialty training programs in Canada prepare trainees for participating in clinical trials as an investigator. From November 2021 to February 2022 a national, bilingual, online questionnaire to understand trainee experiences with self-perceived competence, preparedness, and willingness to participate in clinical trials as investigators was conducted. MO trainees, fellows, and new-to-practice physicians who completed an MO subspecialty training program in Canada were included. A total of 41 responses were received (response rate: 15%). Formal training in how to participate in clinical trials as an investigator was reported by 73% of respondents. At the end of training, 65% of respondents rated competence in clinical trials as fair/poor and 74% rated preparedness in conducting clinical trials as fair/poor. Correlation analysis determined that in-clinic teaching in clinical trials trended toward improved self-evaluations of competence and preparedness (p > 0.05). This is the first study in Canada to assess competencies in any residency training program since the establishment of CBME. Training in conducting clinical trials is highly variable across MO programs in Canada, with most trainees finding current practices not translating into self-perceived competence and preparedness. Further assessment into how to produce competent clinical trial investigators is warranted.

Occupational Stress, Correctional Officers, and Training for the Job: Probing Sources of Stress During the Correctional Service of Canada’s Correctional Training Program

Occupational stress remains a remarkable problem among correctional officers. While the scholarship on correctional services has scrutinized correctional work to identify and analyze sources and consequences of stress, correctional training has received little attention. Drawing on the literature on sources of stress in corrections work, we analyze and compare whether sources of stress on the job overlap with those of correctional training. We base our analysis on interviews with correctional officers from Canada’s federal prison system who were interviewed while completing the Correctional Service of Canada’s Correctional Training Program. Findings suggest that sources of stress in training are not consistent with those of correctional work. The training program conditions succeed in preparing recruits to manage pressure, strain, and anxiety. However, the program does not necessarily equip recruits to deal with on-the-job stress, and does little to eliminate the occupational stressors and mental health disorders that too often emerge during occupational tenure. Correctional training programs in Canada and beyond must ensure that recruits are equipped with tools to deal with the specific sources of stress and possibly eliminate such sources in the course of work.

A80 DEVELOPMENT OF COMPETENCY BASED MEDICAL EDUCATION CURRICULUM FOR INFLAMMATORY BOWEL DISEASE ADVANCED TRAINING PROGRAM IN CANADA

Abstract Background Inflammatory bowel disease (IBD) advanced training programs in Canada are heterogenous in their education, structure, and case exposure, resulting in differences in trainee experience. While competency based medical education (CBME) is becoming the primary educational framework in residency training, there is no CBME-based curriculum for IBD advanced training programs. Adopting a CBME framework for IBD fellowships may help standardize training to increase competence. Purpose The purpose of this study was to develop a CBME-based curriculum for IBD advanced training programs in Canada. Method Strategic groups consisting of 25 IBD experts were assigned to develop 15 entrustable professional activities (EPAs), which were then refined by experts in medical education and curriculum development. Acceptable EPAs were assessed using an electronically administered round-less Delphi panel. Panel members evaluated each EPA using a Likert scale, which asked participants to consider appropriateness of each EPA for an advanced IBD curriculum. A consensus strength greater than 70% was the acceptable threshold for inclusion into the final curriculum. Milestones were modelled after CanMED roles for each EPA. Result(s) Of the 15 initial EPAs, nine were recommended for the roundless Delphi panel by the selection committee: (1) identification, diagnosis, and treatment of new onset IBD; (2) assessment and treatment of outpatients with IBD; (3) the endoscopic evaluation of disease activity and the effective communication of endoscopic findings for patients with IBD; (4) provide effective inpatient management and coordinate transition to outpatient care for patients with IBD; (5) recognize and institute preventive health maintenance strategies in patients with IBD; (6) management and treatment of special populations with IBD; (7) identification, diagnosis, and treatment of the various extraintestinal manifestations of IBD; (8) Engage health care systems to improve the quality of care for patients with IBD; (9) engage in scholarly activities related to IBD. Eight of the nine EPAs achieved a consensus score greater than 70%, with the EPA, ‘engage in scholarly activities related to IBD’ failing to meet this cut-off. Associated milestones were developed for the eight final EPAs. Image Conclusion(s) This study was the first attempt to develop a CBME-based IBD curriculum in Canada. With proper funding and guidance, we hope our model can be implemented across Canada in IBD advanced training programs. These methods may also help facilitate the development of CBME curricula for other advanced training programs. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared

Factors Associated With Resident Research Success: An Analysis of Canadian General Surgery Trainees

Better understanding the research productivity of Canadian general surgery residents and factors associated with success would provide a valuable reference and help inform actions to enable success. We aimed to characterize the research productivity of Canadian general surgery residents and to evaluate factors associated with residents' research quantity and impact. A cross-sectional, observational study was performed using publicly available data evaluating Canadian General Surgery resident research productivity. Research productivity was characterized using measures including publications per postgraduate year (PGY) and CiteScore among others. Residency programs were then comparatively assessed using a multivariable logistic regression to evaluate program and resident factors associated with achieving >50th percentile research productivity. All General Surgery residents from English speaking Canadian training programs were included in this study, which was completed at the University of Alberta, a tertiary level academic center in Edmonton, Canada. A wide range of resident research productivity was observed across Canada with the median publications per PGY of 0.29, and the median sum of a resident's publication CiteScores of 2.05. The median h-index was 0.90. Graduate degree completion and publication experience prior to residency were significantly associated with higher publications per PGY (OR 2.94 and OR 2.10, respectively), as well as higher mean CiteScore (OR 3.42 and 2.24). The program factors that were assessed, including program size, research blocks, mandatory projects, or higher staff research productivity, did not show significant association with increased research output. There is a wide range in research output by general surgery residents across the country. Successful completion of graduate degrees and the experience of publication prior to residency are associated with higher research productivity and impact.

Advancing Integrated Care through Embedded Research: Early Lessons from Two Canadian Training Programs

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 2.913 (2021 JCR, received in June 2022)The IJIC 20th Anniversary Issue was published in 2021.

A qualitative study of Canadian resident experiences with Competency-Based Medical Education.

Competency-based medical education (CBME) is an outcomes-based curricular paradigm focused on ensuring that graduates are competent to meet the needs of patients. Although resident engagement is key to CBME's success, few studies have explored how trainees have experienced CBME implementation. We explored the experiences of residents in Canadian training programs that had implemented CBME. We conducted semi-structured interviews with 16 residents in seven Canadian postgraduate training programs, exploring their experiences with CBME. Participants were equally divided between family medicine and specialty programs. Themes were identified using principles of constructivist grounded theory. Residents were receptive to the goals of CBME, but in practice, described several drawbacks primarily related to assessment and feedback. For many residents, the significant administrative burden and focus on assessment led to performance anxiety. At times, residents felt that assessments lacked meaning as supervisors focused on "checking-boxes" or provided overly broad, non-specific comments. Furthermore, they commonly expressed frustration with the perceived subjectivity and inconsistency of judgments on assessments, especially if assessments were used to delay progression to greater independence, contributing to attempts to "game the system." Faculty engagement and support improved resident experiences with CBME. Although residents value the potential for CBME to improve the quality of education, assessment and feedback, the current operationalization of CBME may not be consistently achieving these objectives. The authors suggest several initiatives to improve how residents experience assessment and feedback processes in CBME.

Implementation of Entrustable Professional Activities assessments in a Canadian obstetrics and gynecology residency program: a mixed methods study.

BackgroundSince the implementation of competency-based medical education (CBME) across residency training programs in Canada, there has been limited research understanding how entrustable professional activity (EPA) assessments are used by faculty supervisors and residents.ObjectiveThis study examines how EPA assessments are used in an Obstetrics and Gynecology residency program and the impact of implementation on both groups.MethodsA mixed methods study design was used. Part one involved the aggregation of descriptive data of EPA assessment completion for postgraduate year 1 and 2 residents from July 2019 to May 2020. Part two involved a thematic analysis of semi-structured interviews of residents and faculty.ResultsThere was significant uptake of EPA assessments across community and teaching hospitals with widespread contribution of assessment data from faculty. However, both residents and faculty reported that the intended design of EPA assessments as low-stakes assessments to provide formative feedback is not how EPA assessments are experienced. Residents and faculty noted the increased level of administrative burden and related perceived stress amongst the resident group.ConclusionsThe implementation of EPA assessments is feasible across a variety of sites. However, previous measurement challenges remain. Neither residents nor faculty perceive the value of EPAs to improve feedback, despite their intended nature.

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.

Gender disparity in academic orthopedic programs in Canada: a cross-sectional study.

Background:The majority of the literature on gender disparity in orthopedic surgery is from the United States; the Canadian perspective is lacking. The objective of this study was to determine the representation of women faculty members and the proportion of women faculty in published leadership positions in academic orthopedic divisions and departments across Canada.Methods:In this cross-sectional study, we used a Web-based search strategy to identify faculty listings for all 17 academic orthopedic programs affiliated with the Association of Faculties of Medicine of Canada for the 2018/19 academic year. For each faculty member identified, we determined gender (man or woman), professorial rank and leadership positions. We compared regional gender differences among 3 groups: schools in eastern Canada and Quebec (6), Ontario (6) and western Canada (5). Gender comparisons were made for all variables of interest.Results:We identified 809 orthopedic surgeons at the 17 Canadian academic institutions, of whom 96 (11.9%) were women. In eastern Canada and Quebec, 16.2% of the faculty were women, significantly above the national average (p = 0.03). The corresponding values for Ontario and western Canada were 8.9% (p = 0.1) and 11.4% (p = 0.7). There were no significant differences in the proportions of women and men at lower levels of promotion, but significantly more men than women had attained full professorship (65 [9%] v. 1 [1%], p = 0.002). Women surgeons were not represented in leadership roles or within faculty roles of distinction.Conclusion:In 2018/19, women orthopedic surgeons were underrepresented in faculty positions across academic orthopedic training programs in Canada, and were disproportionately underrepresented in promoted academic faculty roles and leadership positions. These data can be used to review and educate on equity in hiring and promotion, as well as to foster mentorship and transition planning.

A new way forward via innovative integration: A 3-year family medicine and enhanced skills residency program.

The role of enhanced skills (ES) training programs in Canada has been the subject of extensive debate. These programs were designed to provide both residents and physicians in practice with opportunities to extend their competence in a focused area to support the delivery of comprehensive care that

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A94 BARRIERS TO ADVANCEMENT ALONG THE GASTROENTEROLOGY CAREER PATHWAY: A RESIDENT PERSPECTIVE

Abstract Background GI residency training programs in Canada are comprised of approximately 30% females. Survey data from procedural specialities reveal gender related differences relating to work-life balance, parental obligations, access to role models, and workplace gender discrimination. Aims To determine gender specific differences affecting the choice of GI as a sub-specialty and the experience of GI as a career during residency and fellowship. Methods A 91-question mixed methods survey was electronically disseminated in two recruitment waves to PGY4-6 gastroenterology residents and fellows across Canada between May 7th-July 1st, 2020. The survey consisted of nine groups of questions aimed at understanding personal, professional, financial, and training characteristics. Comparisons were made between self-identified male and female genders. Wilcoxon (Mann Whitney U test) was used for continuous variables while chi-squared test and fisher’s exact test was applied for categorical variables using SAS software. Qualitative thematic analysis was applied for short answer responses with two independent reviewers. Results A total of 122 residents were surveyed with a response rate of 36% (44/122).There were 17 PGY4s, 15 PGY5s, and 12 PGY6s. Females comprised 41% (18/44) of respondents. Women were statistically more likely to take on a predominant caregiver role for children (p=0.012) and state that having children would slow their career advancement (p=0.046). Men were more likely to state that it is preferable to have children during residency (p=0.036) and that their partner’s preference factored into their subspecialty training choice (p=0.009) than women. Male PGY4/5 trainees were more likely to select therapeutic endoscopy for advanced training (p=0.033). No statistical difference was found regarding aspirations for administrative/leadership positions, desired future income, practice setting, academic pursuits, and perspectives on compromising marriage for career. Qualitative analysis suggests non-gender specific challenges related to achieving work-life balance, securing a desired location of practice, and obtaining financial stability are common resident and fellow concerns. Conclusions Our study is the first of its kind within the field of gastroenterology to focus on GI residents and fellows’ experiences within Canadian training programs. Our results show that there exist gender related differences in relation to work-life balance and career advancement. Women may benefit from supports to cope with increased caregiver demands in order to allow them to meet career goals which are similar to their male peers. Funding Agencies None

Educating Residents About Cannabis: Results of a Needs Assessment.

Cannabis use by people receiving mental health services is increasingly common, yet many psychiatrists have limited knowledge about the pharmacology of cannabis or its clinical effects. Though clearly relevant to residency training, there is little information on unmet needs and current teaching practices to guide educators who wish to develop a cannabis curriculum. To address this, the authors interviewed key informants and surveyed Canadian psychiatry program directors and residents about cannabis education seeking to determine appropriate content and approaches to inform curriculum development. The authors conducted semi-structured interviews with 7 experts in addictions and psychiatry education. Findings were then used to develop a needs assessment survey about cannabinoid teaching in residency education. Residents and program directors from psychiatry training programs in Canada were invited to complete the online survey. Key informants believed residents are not adequately prepared to manage substance use disorders and recommended additional training be dedicated to cannabinoid education, including cannabis use disorder. Seven program directors and 27 residents completing the survey made recommendations for curriculum content and design. Pharmacology, neurobiology, and managing cannabis use disorders were identified as the most important topics for inclusion. A majority of respondents rated 5 of 8 proposed learning objectives as not supported by existing curriculum and supported an integration of key topics across training years. Respondents identified an urgent need for programs to offer an integrated cannabis curriculum. As cannabis use increases internationally, these findings may be useful to inform curriculum development in other countries.

Diagnostic Neuroradiology Subspecialty Training: 1 Versus 2 Years; the Canadian Perspective

Canada began a national reform of its post-graduate medical education training programs to a Competence By Design (CBD) model. Trends from accredited neuroradiology programs from the past 10 years were investigated to inform educators and stakeholders for this process. A 13-question electronic survey was sent to program directors of all 8 accredited neuroradiology training programs in Canada. Data was requested for each year on the 2008-2019 graduating classes. Questions pertained to program enrolment; program completion; post-training employment; and the sufficiency of 1-year training programs. Response rate was 100%. Over the timeframe studied, the 2-year programs increased in size (P = 0.007), while the 1-year programs remained steady (P = 0.27). 12.2% of trainees enrolled in the 2-year program dropped out after 1 year, and were considered 1-year trainees thereafter. A higher proportion of 2-year trainees obtain positions within academic institutions (89.5 vs 67.2%, P = 0.0007), whereas a higher proportion of 1-year trainees obtain positions within non-academic institutions (29.3 vs 8.1%, P = 0.0007). A higher proportion of those with Canadian board certification in diagnostic radiology who completed a 2-year program obtained a position within a Canadian academic institution compared to non-certified 2-year trainees (P < 0.001). 71.4% of program directors agreed that a 1-year program was sufficient for non-academic staff positions. The length of the training program has significant impact on employment in academic vs non-academic institutions. This information can be used to guide the upcoming CBD initiative for neuroradiology programs.

Does spaced education improve clinical knowledge among Family Medicine residents? A cluster randomized controlled trial

Spaced education is a learning strategy to improve knowledge acquisition and retention. To date, no robust evidence exists to support the utility of spaced education in the Family Medicine residency. We aimed to test whether alerts to encourage spaced education can improve clinical knowledge as measured by scores on the Canadian Family Medicine certification examination. Method: We conducted a cluster randomized controlled trial to empirically and pragmatically test spaced education using two versions of the Family Medicine Study Guide mobile app. 12 residency training programs in Canada agreed to participate. At six intervention sites, we consented 335 of the 654 (51%) eligible residents. Residents in the intervention group were sent alerts through the app to encourage the answering of questions linked to clinical cases. At six control sites, 299 of 586 (51%) residents consented. Residents in the control group received the same app but with no alerts. Incidence rates of case completion between trial arms were compared using repeated measures analysis. We linked residents in both trial arms to their knowledge scores on the certification examination of the College of Family Physicians of Canada. Results: Over 67 weeks, there was no statistically significant difference in the completion of clinical cases by participants. The difference in mean exam scores and the associated confidence interval did not exceed the pre-defined limit of 4 percentage points. Conclusion: Further research is recommended before deploying spaced educational interventions in the Family Medicine residency to improve knowledge.

Research Productivity of Canadian Radiation Oncology Residents: A Time-Trend Analysis.

(1) Background: Research productivity is a mandatory component of Canadian radiation oncology (RO) resident training. To our knowledge, Canadian RO resident research publication productivity has not previously been analysed. (2) Methods: We compiled a 12-year database of RO residents in Canadian training programs who completed residency between June 2005 and June 2016. Resident names and dates of training were abstracted from provincial databases and department websites and were used to abstract data from PubMed, including training program, publication year, journal, type of research, topic and authorship position. Residents were divided into four time periods and the linear trend test evaluated publication rates over time. Univariable and multivariable logistic regression analyses were performed to identify authorship predictors. (3) Results: 227 RO residents representing 363 publications were identified. The majority were first-author publications (56%) and original research (77%). Overall, 82% of first-author, and 80% of any-author articles were published in resident year 4 or higher. Mean number of publications for first-author and any-author positions increased significantly over time (p = 0.016 and p = 0.039, respectively). After adjusting for gender and time period, large institutions (> 3 residents per year) trended toward associations with more first-author publications (odds ratio (OR): 2.44; p = 0.066) and more any-author publications (OR: 2.49; p = 0.052). No significant differences were observed by gender. (4) Conclusions: Canadian RO resident publication productivity nearly doubled over a 12-year period. The majority of publications are released in the last 2 years of residency, and larger residency programs may be associated with more publications. These findings serve as a baseline as programs transition to Competency Based Medical Education (CBME).