Canadian Conference on Medical Education 2021 Abstracts

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Canadian Medical Education Journal

Revue canadienne de l'éducation médicale

Canadian Conference on Medical Education 2021 Abstracts

Les résumés de la Conférence canadienne sur l’éducation

médicale 2021

Volume 12, Number 2, 2021

URI: https://id.erudit.org/iderudit/1077216ar

DOI: https://doi.org/10.36834/cmej.72402

See table of contents

Publisher(s)

Canadian Medical Education Journal

ISSN

1923-1202 (digital)

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Cite this document

(2021). Canadian Conference on Medical Education 2021 Abstracts. Canadian

Medical Education Journal / Revue canadienne de l'éducation médicale, 12(2),

e138–e344. https://doi.org/10.36834/cmej.72402

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No responsibility is assumed for any claims, instructions, or methods contained in the abstracts: it is recommended that these are verified independently.

Canadian Medical Education Journal

Canadian Conference on Medical Education 2021 Abstracts

Les résumés de la Conférence canadienne sur l'éducation médicale 2021

https://doi.org/10.36834/cmej.72402. This is an Open Journal Systems article distributed under the terms of the Creative Commons Attribution License.

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Pre-Conference Workshops ............................................................................................................................................. 138

Oral Abstracts ................................................................................................................................................................. 142

Workshops ...................................................................................................................................................................... 249

Learner Posters ............................................................................................................................................................... 266

Posters ............................................................................................................................................................................ 323

April 15

, 2021

10:00 EST; PCW – 60550

Become a Rockstar Virtual Synchronous Facilitator in

Zoom

Heather MacNeill University of Toronto, Kataryna Nemethy University

of Toronto, Jason Liang University of Toronto

Rationale/Background: Social distancing has forced

educators into teaching virtually with little to no

preparation. This workshop is your opportunity to practice

"presenting like a Rockstar" using Zoom! Using Garrison's

community of inquiry framework, you will discuss social,

cognitive, and teaching presences to consider when

teaching synchronously. You will review "what buttons to

push" in this environment while incorporating effective

techniques such as interactivity, feedback, reflection, and

social learning, all within a healthcare context.

Methods: There are 3 parts to this fully online workshop

1. Asynchronous Prework: view 7 videos, group

introductions, needs assessment, and reflections (2-4 hrs

depending on learner comfort level) Optional

synchronous online meeting (for Zoom setup before the

conference) 2. Synchronous Online workshop during

CCME Preconference (3 hours on Zoom)- including review

of pedagogical principles and best practice in online

environments, online facilitation techniques, learner

considerations, and hands on group work to create

synchronous learning lesson plan 3. Post course

presentations (1 month after the course). Learners will

prepare in a 10 min group presentation using the

principles and tools learned in the course which they will

present to the rest of the group (3-6 hrs group prep, 2 hrs

presentation) Requirements: computer with webcam,

headset or earbuds with mic and a sense of adventure!

Target audience: Healthcare educators, including UGME,

PGME, CPD and CME.

Learning objectives: 1. Demonstrate interactive features

of synchronous technologies (e.g. Zoom) in teaching 2.

Recite practical tips and learning considerations for online

Table of Contents

Pre-Conference Workshops

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e139

synchronous learning 3. Contrast the advantages and

disadvantages of synchronous online learning

14:30 EST; PCW – 60219

Themes emerging from the 2020 National Resident

Survey

Ramona Neferu McMaster University, Tehmina Ahmad University of

Toronto, Michael Arget University of Ottawa, Kat Butler University of

Toronto, Colin Boyd Dalhousie University, Ishrat Gill University of

Alberta, Arno Kumagai University of Toronto, Elizabeth Sneyd Resident

Doctors of Canada; National Resident Survey Staff Lead, Robert Conn

Resident Doctors of Canada

Rationale/Background: There is a lack of empirical data

on a number of evolving issues faced by today's resident

doctors. The last National Survey conducted by Resident

Doctors of Canada (RDoC) was in 2018. To keep current

with our understanding of resident concerns, RDoC is

conducting a new National Survey in November 2020. The

bilingual online survey will be sent to resident doctors

training at 13 faculties of medicine across Canada and

contains 60 questions collecting demographic information

on diversity, bullying in the training environment,

workload and burnout, resident transfers processes,

transition to practice, and physician mobility. Many

questions are iterative from the 2018 survey, allowing for

longitudinal analysis. The survey has been approved by

the University of Toronto Research Ethics Board.

Methods: The session will begin with a presentation

summarizing some of the most informative data emerging

from the survey results. The second segment will include

a panel comprising a resident, medical student, and

medical educator who will respond to the findings

presented. The remainder will be dedicated to small group

discussions with the panelists and workshop participants

focusing on the survey's themes.

Target audience: This session is designed for medical

trainees, postgraduate program directors, administrators,

deans, educators and any others interested in the lives of

resident doctors.

Learning objectives: Workshop participants will: a) Gain

an appreciation of the many issues, perspectives, and

challenges of resident doctors in Canada relating to

residency training, diversity and wellness, and career

development. b) Identify the implications of the data and

generate recommendations

14:30 EST PCW-59997

Virtual Learning: A New Modality Of Medical Education

Teaching In The Era Of Pandemics

Manasik Hassan Hamad Medical Corporation, Magda Youssef SIDRA

medicine, Eman Almaslamani SIDRA medicine, Ahmed Alhammadi

SIDRA medicine

Rationale/Background: Teaching in the clinical

environment is a challenging. Many methods have been

described with wide variety of rang in delivering the

information. Recently, teaching and learning using

technologies such as virtual worlds have expanded rapidly

specially with new global situation of COVID19 pandemic

which may limit or change the way we teach the medical

learners. Virtual learning is distance learning conducted in

a virtual learning environment with electronic study

content designed for self-paced (asynchronous) or live

web-conferencing (synchronous) online teaching and

tutoring. It has several advantages over traditional

didactic models of instruction.

Methods: Participants will be engaged in several

activities: (1) Interactive didactic introduction highlights

the history; definition of virtual learning and it is

importance as alternative methods of education when it

is needed (2) In small groups table discussion; participants

will identify barriers to implement virtual learning in a

daily busy clinical environment (3) Engagement in

discussions and reflections on video-clips of different

approaches in how to implement the different types of

virtual learning (4) At the end we will share some

measures to assess the effectiveness of virtual learning on

patient outcomes and learners' behaviors, skills and

knowledge.

Target audience: The workshop welcomes all

stakeholders in medical education, physicians, training

program leaders, faculty development and other

educators interested in the medical education and

teaching.

Learning objectives: 1) Define the virtual learning and

highlight it is importance in medical education 2) Identify

benefits and challenges to apply it in a busy clinical setting

3) Describe different strategies to implement virtual

learning and how to assess its effectiveness

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e140

April 16

, 2021

10:00 EST; WE2-2-60540

FACILITATE: Acting-Based Communication &

Interpersonal Skills Training for Healthcare Professionals

Alexis del Vecchio Mayo Clinic, Phillip Moschella Prisma Health –

Upstate

Rationale/Background: Communication underlies

physicians' scope of practice. CanMeds lists

communicator as a core competency for medical practice

and education. Various models of communication training

have been proposed in medical school and residency

training. Acting provides a unique approach to developing

such skills. Our acting-based communication skills course,

taught by a Canadian-American professional actor and

physician, has been taught to hundreds of medical

students, nursing students, and medical residents at

multiple institutions in the United States and

internationally.

Methods: We will conduct sixteen acting exercises,

targeted to the unique needs of healthcare professionals,

especially physicians. This workshop is hands-on,

participatory, interactive. We start with a brief

introduction about educational theory and evidence

underlying this initiative. Our hand-picked exercises

develop skills such as nonverbal communication, active

listening, presence in the moment, situational awareness,

and self-awareness. Clinical correlates and debrief with

participants are included. The workshop includes two

peer-reviewed standardized patient vignettes in which

participants play a patient and provider, and apply skills

developed. We also provide a communication toolbox

with tools they can implement on their next shift.

Target audience: Healthcare professionals at every level

of training. This is an inter-professional initiative. We

welcome a mixed audience of medical students, resident

physicians, consultants/attendings, and allied members of

the healthcare team.

Learning objectives: Upon completion, participants will

be able to apply acting skills to facilitate patient-centered

communication, utilize specific tools to improve their

clinical practice, and practice skills of non-verbal

communication, self-awareness, and active listening.

12:00 EST; PCW-66400

FACILITER: Cours de Théâtre pour Développer la

Communication et les Relations Interpersonnelles Chez

Les Professionnels de la Santé

Alexis del Vecchio Mayo Clinic, Phillip Moschella Prisma Health –

Upstate

Rationale/Background: Communication underlies

physicians' scope of practice. CanMeds lists

communicator as a core competency for medical practice

and education. Various models of communication training

have been proposed in medical school and residency

training. Acting provides a unique approach to developing

such skills. Our acting-based communication skills course,

taught by a Canadian-American professional actor and

physician, has been taught to hundreds of medical

students, nursing students, and medical residents at

multiple institutions in the United States and

internationally.

Methods: We will conduct sixteen acting exercises,

targeted to the unique needs of healthcare professionals,

especially physicians. This workshop is hands-on,

participatory, interactive. We start with a brief

introduction about educational theory and evidence

underlying this initiative. Our hand-picked exercises

develop skills such as nonverbal communication, active

listening, presence in the moment, situational awareness,

and self-awareness. Clinical correlates and debrief with

participants are included. The workshop includes two

peer-reviewed standardized patient vignettes in which

participants play a patient and provider, and apply skills

developed. We also provide a communication toolbox

with tools they can implement on their next shift.

Target audience: Healthcare professionals at every level

of training. This is an inter-professional initiative. We

welcome a mixed audience of medical students, resident

physicians, consultants/attendings, and allied members of

the healthcare team.

Learning objectives: Upon completion, participants will

be able to apply acting skills to facilitate patient-centered

communication, utilize specific tools to improve their

clinical practice, and practice skills of non-verbal

communication, self-awareness, and active listening.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e141

14:30 EST; PCW-60328

Considering Knowledge Syntheses: Where to begin

Tanya Horsley The Royal College of Physicians and Surgeons, Rachel

Ellaway University of Calgary

Rationale/Background: Knowledge syntheses are

increasingly being conducted by health professions

education researchers in part due to the increase in

primary studies. A challenge faced by researchers is

determining what question maps to what knowledge

synthesis approach given the multiple types of knowledge

syntheses approaches available.

Methods: Didactic / dynamic participation in small groups

Target audience: Beginners interested in conducting

evidence syntheses / Consumers of evidence syntheses

Learning objectives: In this workshop, we will briefly

explore the nature, purpose, and value of common

knowledge synthesis techniques. Drawing from the

literature of synthesis methodology as well as experience,

faculty will 1) Provide a brief overview of the history of

evidence syntheses; 2) provide conceptual

recommendations and introduce participants to tools for

selecting the most appropriate knowledge synthesis

method to answer their questions; 3) address alignment

between question and synthesis methodology; and 4)

support participants in selecting the most appropriate

synthesis methodology for a question of their choice and

enhancing their ability to read, understand and apply

findings from common syntheses in medical education

(systematic, scoping, realist, narrative and critical)

14:30 EST; PCW-60784

Improving Presentations: Say - It - Better, Show - It - Better

Douglas Wooster University of Toronto, Elizabeth Wooster University of

Toronto

Rationale/Background: Electronic presentations are an

important component of scientific communication in the

health professions. Reviews and audits of short and long

presentations at a variety of levels by professional

presenters, educators and trainees show poor skills in

preparation of 'slides'. In more than 55%, the character of

text, background, animations and placements of logos

detract from the quality of otherwise well - presented

presentations. In up to 60% image optimization and

control is poor. There is a role for faculty development,

defined instruction of trainees and peer-to-peer

promotion to improve the quality of presentations.

Methods: The workshop leaders will present findings from

an audit of presentations and lead a large group discussion

of the relevance of these findings. Techniques to improve

text and optimize images will be examined using the

"think, pair, share" technique. Participants will have the

opportunity to participate in the modification of a

standardized set of slides to learn the techniques

discussed. Small and large group discussions will be used

to identify strategies to train others. Considerations of

different types of presentations will be discussed during

the workshop. Participants will leave the workshop with a

set of techniques to create better slides and ideas to

disseminate this information to others.

Target audience: Anyone interested in learning how to

improve their ability to create electronic presentations. A

basic understanding of powerpoint is essential for this

workshop.

Learning objectives: At the end of this workshop

participants will be able to: 1) describe the current status

of text and image use in electronic presentations 2)

demonstrate ten technical skills in optimizing text and

images for presentation 3) present a strategy to train

others.

April 17

, 2021 - 10:00 EST

OA1 -1 Curriculum - COVID

OA1-1-1-60538

Results From a Theater-Based Communication Course for

Medical Residents in the COVID Era

Alexis del Vecchio Mayo Clinic, Phillip Moschella Prisma Health -

Upstate, James Homme Mayo Clinic

Background/Purpose: Communication underlies

physicians' scope of practice. The necessary use of

Personal Protective Equipment (PPE), especially masks, as

a result of COVID, may make communication with patients

more challenging and could risk eroding the patient-

physician alliance. We previously created and taught a

theater-based communication skills course for physicians,

medical students, and nursing students. For this study, we

taught our course with all participants wearing masks and

practicing social distancing. We sought to assess if our

curriculum could still be successful in developing

communication skills deemed central to clinical practice.

Methods: Ten first-year emergency medicine residents at

a tertiary care, University-associated, urban center

participated in a one-hour workshop. A questionnaire was

distributed to participants to rate their agreement with

statements about communication and interpersonal skills

developed. Survey participation was voluntary and

confidential.

Results: For this IRB-approved study, 100% of participants

answered the survey. All agreed or strongly agreed the

workshop developed their skills of self-awareness,

observation, non-verbal communication, sensitivity to

emotions expressed by others, breaking bad news,

communication with "difficult" patients, situational

awareness, status awareness, teamwork, trust, presence

in the moment, mindfulness, felt the exercises provided

them tools to improve patient-physician and

interprofessional communication, and enjoyed the

experience.

Conclusions: An acting-based workshop is effective in

improving communication and interpersonal skills as

determined by self-evaluation, despite the use of masks.

This holds relevance as residency programs adapt their

curriculum to restricted learning modalities brought about

by COVID.

OA1-1-2-60789

Action research for course transformation: from face-to-

face to virtual CPD

Chloe Burnett University of Calgary, Alanna Wall University of Calgary,

Caitlin Ryan University of Calgary, Niamh Lyons University of Calgary,

Rosario Villalobos-Gonzalez University of Calgary, Shannon Stucky

University of Calgary, Melanie Planinsic University of Calgary, Dana

Young University of Calgary, Sheila Sun Sun University of Calgary, Diane

Simpson University of Calgary, Monica Rast University of Calgary,

Rosanna Saavedra University of Calgary, Susan Limongiello University of

Calgary, Elaine Chow Baker University of Calgary

Background/Purpose: The COVID-19 pandemic prevented

in-person gatherings, challenging traditional group

learning methods of continuing professional development

(CPD). In response, the University of Calgary's Office of

CME&PD transformed its scheduled Fall 2020 courses to

the online environment. This shift was a participatory and

democratic process which allowed us to explore an action

inquiry: "How do we best transform a CPD course into a

virtual one?"

Methods: We used the action-reflection cycle of action

research: planning, acting, observing and reflecting. The

initial cycle included learning from education and tech

guidelines, considering a participant view of course

experience, creating a template of planning and delivering

a virtual course, and then discussing and refining it. The

second cycle included using the template to transform and

run the first course in September 2020, then observing,

debriefing and revising the template for use in the next

course. This action-reflection cycle was repeated until the

virtual course process became stable.

Results: The team engaged in the practical and

collaborative process of course transformation. We held

frequent meetings during each step of the action-

reflection cycles. One distinct element of the practice was

sharing personal reflections of the working progress,

reflecting on individual and team values. Only through

team efforts was the course transformation

accomplished.

Conclusions: The pandemic dictated the need for

transition to virtual courses in CPD. This shift, however,

was not limited to solely exploring technical solutions.

Oral Abstracts

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e143

Through systematic inquiries in meaningful educational

practice the action research approach empowered us to

create dialogical forms, which promoted team ownership

of CPD excellence.

OA1-1-3-60058

Rapid Development of a COVID-19 Focused Curriculum

to Prepare Psychiatry Residents for Acute Changes to

Care

Natasha Snelgrove McMaster University, Sheila Harms McMaster

University, Jillian Lopes McMaster University, Anita Acai McMaster

University, JoAnn Corey McMaster University

Background/Purpose: The COVID-19 pandemic struck

Canada in mid-March 2020, resulting in fears that a

massive first wave might overwhelm the health care

system. In teaching hospitals, plans to redeploy residents

to needed services were quickly developed should they be

needed. Many resident physicians had not recently

worked in acute medical care units and expressed high

anxiety about redeployment. There was also uncertainty

about pandemic impacts on patient care.

Summary of innovation: The need to quickly develop a

COVID-related curricular intervention and rapidly

transition all learning online was clear. Three faculty

educators developed a curriculum outline that was

circulated to chief residents for feedback. Subsequently,

three phases of curriculum were implemented: 1) primers

on acute medical care and COVID, 2) sessions on providing

psychiatric care during the pandemic, including effects on

patient and provider wellbeing, and 3) sessions with a

focus on healthcare needs of disadvantaged populations.

Resident feedback was sought through evaluation forms

and a focus group. Residents appreciated the rapid

development of the curriculum to meet learning needs.

Many noted a benefit of having these sessions early to

better prepare them both practically and psychologically

for changes to practice.

Conclusions: Our curriculum serves as an example of rapid

curricular development to respond to a quickly developing

learning need. Despite its quick development and

implementation, a clear plan was developed, iterative

feedback was sought during development, and evaluation

of the curriculum occurred following delivery. This can

serve as a model for other programs to use to rapidly

develop local curricula in response to any rapidly

developing need, including future pandemics.

OA1-1-4-60681

Entering Medical Students' Transition to PBL - an

Enhanced (then Adapted) Curriculum

Jennifer MacKenzie McMaster University, Lori-Ann Linkins McMaster

University, Karen McAssey McMaster University, Robert Whyte

McMaster University

Background/Purpose: Problem Based Learning (PBL)

pedagogy utilizes patient scenarios to stimulate students

to link new knowledge to existing cognitive networks,

reflect on/design learning objectives, research, and co-

construct knowledge. PBL supports learning, retention,

contextual transfer, self-directed learning, and

cultural/ethical competencies. Primarily from traditional

curricula, entering medical students' transition to PBL with

its focus on collaboration, co-creation, and constructive

cognitive conflict, compounded by lack of familiarity with

PBL process and expectations, has resulted in anxiety and

uncertainty. Therefore, a scaffolded introduction to PBL

was introduced in 2019, and adapted to a remote platform

in 2020.

Summary of innovation: Introduction to Medicine, added

to McMaster's Undergraduate Medical curriculum,

includes themes of: learning process, communication,

professionalism, and wellness, based on stakeholder

feedback, published/grey literature, and expert input.

After an introduction and video modelling about PBL, 6-7

tutorial groups were placed in one classroom with 3-4

experienced tutors. One facilitator directed

structure/debriefs for major steps in PBL process,

scaffolded over 4 sessions. Objectives added included:

self-reflection, participation, goal-setting, learning

strategies, and feedback. The remote platform

maintained the introduction, 2 facilitated sessions with

break-out groups, addition of tutors and senior medical

students aware of session objectives to each group, and

redistribution of selected content to supporting curricula.

Conclusions: Feedback revealed accelerated growth in

PBL skills. Students' affirming experiences included

comparing objectives with other groups, clarifying

challenges, improved cohesion, and reduced tension.

Tutors reported shared understanding, improved

consistency, validation, and real- time peer support. The

addition of PBL tutors at the outset in 2020 was positive.

Future directions include ongoing refinement of learning

structure, integration of non-medical expert

competencies, supporting curricula, and tutor roles.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e144

OA1 – 2 Admissions Diversity

OA1-2-1-59906

Performance of Black and Indigenous applicants in the

admissions process of a Canadian medical school

Katie Girgulis Dalhousie University, Mohsin Rashid Dalhousie University,

Andrea Rideout Dalhousie University, Katie Girgulis Dalhousie University

Background/Purpose: Diversity in medical schools has

lagged behind Canada's growing multicultural population.

Dalhousie medical school in Halifax, Nova Scotia, Canada

allows Black and Indigenous applicants to self-identify,

and they are considered for admission based on meeting

academic and non-academic requirements. Our aim was

to examine how Black and Indigenous applicants

performed and progressed through the admissions

process compared to the Other group (applicants who did

not self-identify).

Methods: Retrospective analysis of four application cycles

(2015-2019) was performed. The Admissions Office

provided de-identified demographic data and scores for

Computer-Based Assessment for Sampling Personal

Characteristics (CASPer), Medical College Admission Test

(MCAT), Grade Point Averages (GPA), supplemental,

discretionary, and Multiple Mini Interview (MMI), and

total application.

Results: Of the 1322 applicants, 104 had identified as

Black, 64 as Indigenous, and 1154 were Other. GPA was

higher in the Other compared to the Indigenous group (p<

.001). CASPer score was higher in the Other compared to

the Black group (p= .047). There was no difference

between groups for all other application components. A

significant proportion of Black (51%) and Indigenous (42%)

applications were incomplete. Acceptance rates were

similar between all groups. Black applicants declined an

offer of admission (31%) more than expected (p< .001).

Conclusions: Black and Indigenous applicants who

completed their application progressed well through the

admissions process. The pool of diverse applicants needs

to be increased and support provided for completion of

their applications. Further study is warranted to

understand why a significant number of qualified

applicants choose to decline an acceptance.

OA1-2-2-60320

Towards greater equity, diversity and inclusion in medical

and health sciences studies in Quebec, Canada :

Evaluation of the "Accès médecine et santé" pipeline

program of Université de Montréal

Karina Cristea Université de Montréal, Stéphanie Leboeuf Université de

Montréal, Jean-Michel Leduc Université de Montréal

Background/Purpose: "Accès médecine et santé" is a

pipeline program that aims to demystify medical and

health sciences studies for youth from multicultural and

disadvantaged backgrounds. Our objective was to assess

the program's impact on participants' perception of

medical and health sciences studies.

Methods: An online survey was sent to former

participants between 2014 and 2017 who had already

completed their high school and college education.

Sociodemographic information and data about perception

of medical/health sciences studies were collected.

Descriptive statistics were computed and frequency

comparisons were made between pre/post answers for

perceived barriers and enablers to university-level

medical and health sciences studies using McNemar's test.

Results: Participation rate was 31.6% (n=154).

Participants' ages ranged from 18 to 23 years (mean= 20.3

and median= 20) with 72.7% identifying as females. 51.9%

of the participants were born outside of Canada, mostly in

countries of the Maghreb (20.0%) and Sub-Saharan Africa

(13.8%). More than half of the participants chose to

pursue university medical or health sciences studies

(58.9%). Participants reported that the program helped

remove some of the barriers they perceived in

undertaking medical and health sciences studies. Their

fear of not being "good enough" to complete these studies

decreased after their participation (p < 0.001). They also

reported changes in their perception of these studies.

After the program, they perceived them as being less

competitive (p= 0.013), unbalanced (p = 0.013) and

demanding (p = 0.021) than they did initially.

Conclusions: Our pipeline program reaches a very diverse

group of students. The various activities seem to have a

positive impact on participants' perception of some

barriers related to health sciences and medical studies.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e145

OA1-2-3-60645

Enhancing Equity, Diversity, and Inclusion in medical

school admissions - the Schulich Medicine journey

Tisha Joy Western University

Background/Purpose: Medical schools aim to select and

train future physicians representative of and able to serve

the diverse Canadian population. Enhancing equity,

diversity, and inclusion (EDI) in Admissions includes

identifying and mitigating barriers for those

underrepresented in medicine (URM).

Summary of innovation: In 2017, Schulich School of

Medicine & Dentistry critically reviewed the general

Admissions stream as interview invitations were primarily

based on academic metrics rather than holistic review as

in the Indigenous stream. Five key changes were

introduced for the general stream: 1. A voluntary

applicant diversity survey (ethnicity, socioeconomic

status, and community size); 2. An Equity Representative;

3. A biosketch for applicants' life experiences; 4. Implicit

bias training; and 5. A specific pathway for applicants with

financial, sociocultural, and medical barriers (termed

ACCESS pathway). Diversity data before (Class of 2022) vs.

after (Class of 2024) these initiatives and of the applicant

pool vs. admitted class were examined.

Conclusions: For the Class of 2024, the percentage of

admitted racialized students (55.2%), those with

socioeconomic challenges (32.3%), and those from

remote/rural/small town communities (18.6%) reflected

applicant pool demographics (52.8%, 29.9%, 17.2%,

respectively). Additionally, 5.3% (vs. 5.6% applicant pool)

of admitted students had applied through ACCESS. These

data suggest that barriers for these URM populations

were potentially mitigated by these initiatives. The

initiatives also improved representation of racialized

students (55.2% Class of 2024 vs. 45.3% Class of 2022),

those with socioeconomic challenges (32.3% vs. 19.3%),

LGBTQ2S+ (11.0% vs. 9.7%), and those with disability

(4.5% vs. 2.4%), while informing future EDI

enhancements.

OA1-2-4-60841

Structured File Review: Inter-rater reliability and impact

on socioeconomic diversity

Saad Chahine Queen’s University, Tisha Joy Western University, Saad

Chahine Queen’s University

Background/Purpose: In medical school admissions,

autobiographical sketches and statements have been

fraught with low reliability and concerns about an adverse

impact on applicants with socioeconomic challenges. This

study evaluated a recently implemented structured

abbreviated autobiographical sketch (AABS) in Schulich

Medicine Admissions in terms of reliability and effect on

socioeconomic diversity of the incoming medical school

class.

Summary of innovation: In 2018, the AABS was created to

assess applicants' values and life experiences in relation to

Schulich Medicine's four core values: 1. Teamwork and

leadership; 2. Social accountability and social

responsibility; 3. Respect for diversity, equity, and

inclusion; and 4. Higher learning skills. Applicant AABS files

(n=730) randomly distributed to physician and community

member raters were scored using a structured tool. No

other information (e.g. GPA, MCAT scores, full name,

demographics) was provided to raters. In addition to

implicit bias training, all raters received an unidentified

test file to establish standardized statistical criteria for the

need for an additional tie-breaker rater. Socioeconomic

status using the AAMC parental education-occupation

tool was captured through a voluntary diversity survey

and available for 571 (78%) of the applicant files reviewed.

Conclusions: The reliability was high with a

Generalizability coefficient of 0.93 and the variance of

scores was primarily attributed to applicants (74%).

Socioeconomic diversity of the applicant pool vs. admitted

students was not statistically different (27.2% vs. 23.1%,

p=0.31). Using a structured AABS tool in appropriately

trained raters allows for high reliability and no significant

impact on applicants with socioeconomic challenges.

OA1 – 3 Simulation

OA1-3-1-60723

Flipping the classroom never looked (or felt) so good.

Stephen Miller Dalhousie University, Karen Bassett Dalhousie

University, Lauren Duke Dalhousie University, Stephanie Rutherford

Dalhousie University, Osama Loubani Dalhousie University, Ross Morton

Dalhousie University, Jacquie Thillaye Dalhousie University

Background/Purpose: March of 2020 brought Covid-19

and our Medical School curriculum to a halt. In many areas

of teaching this had a significant impact on students'

hands-on simulated learning. Our final musculoskeletal

unit had a heavy hands-on experiential learning

component that had to be re-envisioned in a novel way

online.

Summary of innovation: Students do 12 simulated patient

(SP) case practice sessions in Med 2 where they practice

the history and physical examination assessment skills

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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they have learned in a particular component in a safe

environment with immediate feedback from a highly

trained SP. We developed an interactive series of cases to

replace these hands-on sessions. We actually added value

to the learning by adding sections on differential

diagnosis, management plans, evidence-based practice

guidelines, and disposition. Students worked through

each part of an online interactive case supplemented with

knowledge-based quizzes, multiple choice questions, and

self-refection. One very unique aspect was mobilizing

talents from our non-clinical staff at a very stressful time

and coming together as a team to create unique, thought-

provoking and challenging cases that reflected material

learned online. Theater and performing arts background

figured prominently in this case development.

Conclusions: Evaluation data from students was

overwhelmingly positive. Students engaged with and

enjoyed the interactive components which they felt

challenged them and extended their learning. They

requested more similar cases. Excellent and innovative

teamwork of clinicians and non-clinicians in developing

these cases was a great morale boost in a stressful time.

OA1-3-2-60852

Unpacking novice learners' experiences with cognitive

load during simulation-based training

Faizal Haji Queen’s University, Heather Braund Queen’s University

Background/Purpose: Cognitive Load Theory (CLT) is a

well-recognized instructional design framework. More

research is required to clarify the extent to which

instructional design features impact cognitive load and

learning in simulated environments. This qualitative study

describes medical students' experiences with cognitive

load in a simulated learning environment. We identified

sources of cognitive load, strategies for managing

cognitive load, and the realism of the environment.

Methods: This study involved a secondary analysis of

previously collected interview data. Medical students (n =

109) from two Canadian institutions participated in either

'simple' or 'complex' Lumbar Puncture tasks. Students

engaged in repetitive trials interspersed with expert

feedback. Semi-structured interviews were used to

understand participants' experiences and strategies used

to manage their cognitive resources. Data were analyzed

thematically in NVivo.

Results: Five themes emerged, three of which are detailed

below (due to space limitations). The first theme

identified the sources of cognitive load, including

purposefully embedded distractions (e.g. beeping), time

constraints, and application of new knowledge without

previous experience. The second theme described

features that facilitated learning including ability to

communicate with the patient, receiving feedback, and

repetition. The third theme highlighted learners' load

management strategies, including incorporating

feedback, rehearsing next steps, self-talk, prioritizing, and

ignoring distractions.

Conclusions: Participants were affected to varying

degrees by purposefully integrated design features.

Students described strategies used to manage their

cognitive resources that have implications for learning

outcomes. This study facilitated a better understanding of

facilitators and challenges to learning experienced by

novices training in a simulation environment informed by

Cognitive Load Theory.

OA1-3-3-60817

The invisible work of Cadaver Based Simulation: An

ethnography

Victoria Luong Dalhousie University, Paula Cameron Dalhousie

University, Anna MacLeod Dalhousie University, Molly Fredeen

Dalhousie University, Olga Kits Dalhousie University, Lucy Patrick

Dalhousie University, George Kovacs Dalhousie University, Jonathan

Tummons

Background/Purpose: Cadaver Based Simulation (CBS) is

on the rise in Canada, due to recent advances in cadaveric

preservation. However, the CBS literature tends to focus

on perceptions of CBS and procedural performance. The

complex work involved in CBS, particularly the invisible

work of clinical cadaver staff, is little understood. This

presentation therefore examines how cadavers, learners,

workers, tools and spaces come together in a clinical

cadaver program and offers implications for wider

processes and discourses of simulation learning.

Methods: Our ethnographic methods (observation [n=30

hours], interview [n=30], document analysis [n=22])

allowed us to follow the cadaver before educational use

(cadaver preparation), during (learning sessions with

physicians, residents), and after (memorial service) over a

two-year period (2018-2020) at Dalhousie University.

Results: Our analysis identified a complex work and

educational "life cycle" of the cadaver, from its entrance

into the body donation program through to burial and

interment. This cycle is characterized by a series of

transitions as cadavers pass through the hands of multiple

actors. Some of these shifts were obvious (e.g., passing

the threshold between home/hospital and morgue) and

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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others were subtle, rapid, and constantly changing (e.g.,

moving between person and tool).

Conclusions: Cadavers require a complex system of

invisible work processes within and beyond the classroom.

CBS requires workers and learners to navigate the tension

between treating the body as an anonymous educational

tool and as a specific, whole person. Better understanding

this nuanced process may inform how we use cadavers in

medical education.

April 17

, 2021 - 11:00 EST

OA2 – 1 Assessment & Entrustment

OA2-1-1-60879

Examining Myths in Assessment: An Opportunity to

Advance Trustworthiness in Assessment

Carlos Gomez-Garibello McGill, Maryam Wagner McGill, Valerie Dory

Background/Purpose: The shift to CBME places a

renewed emphasis on assessment. One challenge in this

context is that there are myths that affect the

trustworthiness of assessment use and interpretations. By

identifying myths, we aim to: 1) improve understanding of

diverse components of assessment; 2) raise awareness of

how to address multiple interpretations emerging from

assessment use; and 3) contribute to better assessment

practices.

Methods: This presentation draws from a narrative review

of the literature in Education and Health Professions

Education to identify myths associated with assessment

and uses analogies from Greek mythology to illustrate the

underlying misconceptions.

Results: Four myths capture assessment misconceptions:

i) Assessment development: Similar to the ancient Greeks

who consulted the Oracle of Delphi to find THE truth,

educators falsely hold the belief that there is a single best

assessment framework. ii) Generation of information:

Workplace-based assessment mistakenly assumes that

raters - like Zeus - know everything about assessment

including rating, and generating feedback, because of

their clinical exertise. iii) Feedback: Clinical teachers

assume that feedback always provides enlightenment to

learners, just as Prometheus lighted man's world through

fire. Unfortunately, learners will not always use feedback

as intended. iv) Decision-making: Assessment using EPAs

assumes that entrustment suggests competence. Like

Janus, the Greek god that sees simultaneously into the

future and the past, entrustability and competence may

be two aspects of learners' performance; they are not

synonymous.

Conclusions: Examining these myths provides an

opportunity for assessment users to adopt critical

perspectives on assessment and provides avenues for

advancing validation efforts to ensure that uses are

supported.

OA2-1-2-60608

Variable meanings of entrustment - variable decision-

making? How supervisors make procedural entrustment

decisions in simulation- and workplace-based settings

Thurarshen Jeyalingam University of Calgary, Catharine Walsh

University of Toronto, Walter Tavares University of Toronto, Maria

Mylopoulos University of Toronto, Kathryn Hodwitz University of

Toronto, Louis Liu University of Toronto, Ryan Brydges University of

Toronto

Background/Purpose: Entrustment, a central construct in

competency-based medical education (CBME), is

operationalized in the assessment of entrustable

professional activities (EPAs). While EPA assessment is

foundational in many CBME systems, research has yet to

clarify how supervisors form judgments when assessing

EPAs in both workplace- and simulation-based settings.

We aimed to explore the features supervisors report as

influencing their entrustment decisions across these

assessment settings.

Methods: We designed an interview-based, constructivist

grounded theory-informed study involving

gastroenterology supervisors and trainees. Supervisors

completed separate EPA assessments of each trainee's

endoscopic polypectomy (a relevant EPA) performance in

both workplace- and simulation-based settings.

Supervisors were interviewed after each to explore how

they made their entrustment decision within and across

settings. Transcribed interview data were coded

iteratively using constant comparison to generate themes.

Results: Based on 14 interviews with 7 supervisors, we

found that participants: 1) held multiple meanings of

entrustment, both within and across participants, (2)

expressed variability in how they justified their decisions,

the related narrative, and numerical scoring, (3) held

unique personal criteria for making decisions

'comfortably', and (4) perceived a relative freedom when

using simulation to make entrustment decisions.

Conclusions: We found that participants spoke about and

defined entrustment in a variety of ways, leading to

variability in how they judged entrustment within and

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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across participants and assessment settings. The observed

rater idiosyncrasies suggest residency programs cannot

assume equivalence of EPA data from different

assessment settings.

OA2-1-3-60055

Entrustment within an objective structured clinical

examination (OSCE) progress test: Bridging the gap

towards competency-based medical education

Samantha Halman University of Ottawa, Angel Fu University of Ottawa,

Debra Pugh Medical Council of Canada

Background/Purpose: Progress testing aligns well with

competency-based medical education (CBME)

frameworks, which stress the importance of continuous

improvement. Entrustment is a useful assessment

concept in CBME models. However, very little is known

about the role of entrustment in performance-based

assessment. The purpose of this study was to explore the

use of an entrustability rating scale within the context of

an objective structured clinical examination (OSCE)

Progress Test.

Methods: A 9-case OSCE Progress Test was administered

to Internal Medicine residents (PGYs 1-4). Residents were

assessed using a checklist (CL), global rating scale (GRS),

training level rating scale (TLRS), and entrustability scale

(ENT). Reliability was calculated using Cronbach's alpha.

Correlations between scores using the different rating

instruments were calculated. Differences in performance

by training year were explored using ANOVA and effect

sizes were calculated using partial eta-squared. Examiners

completed a post-examination survey.

Results: 91 residents and 42 examiners participated in the

OSCE. Inter-station reliability was high for all instruments

(0.74 to 0.83). There was an overall effect of training level

for all instruments (p < 0.001). Effect sizes were large. 88%

of examiners completed the survey. Most preferred the

ENT over other scales. Most (64%) indicated feeling

comfortable in making entrustment decisions during the

OSCE.

Conclusions: Entrustment scores were found to have high

reliability and demonstrated significant differences in

OSCE performance by level of training. This supports the

incorporation of entrustment scales in OSCE progress

tests.

OA2-1-4-60757

How clinical supervisors conceptualize entrustment in

procedural training: A qualitative study of entrustment

decision-making in endoscopic training

Thurarshen Jeyalingam University of Calgary, Ryan Brydges University of

Toronto, Shiphra Ginsburg University of Toronto, Graham McCreath

University of Toronto, Catharine Walsh University of Toronto

Background/Purpose: While entrustment is a central

assessment construct in competency-based medical

education (CBME), the factors clinical supervisors consider

in entrusting procedural skills and how they report

synthesizing these factors into their final decision has not

been clearly elucidated. We aimed to characterize this

process using gastrointestinal endoscopy as a model

procedure.

Methods: Using methods from constructivist grounded

theory, we interviewed 29 endoscopic supervisors from

across North America in pediatric and adult

gastroenterology, general surgery, and family medicine.

Interviews focused on how supervisors make endoscopic

entrustment decisions and which factors they consider in

this process. Transcripts were analyzed using constant

comparison to generate themes and an explanatory

framework.

Results: Twenty-nine supervisors were interviewed.

Participants conceptualized entrustment as a continuum

(vs. a binary decision) and perceived their decision could

fluctuate over time. That is, they reported their

judgements were influenced by both dynamic factors,

which change day-to-day, and by static factors, which

persist over time. In their final entrustment decision,

participants perceived synthesizing various dynamic

factors (patient acuity, procedural risk, time constraints,

etc.) against their personal baseline informed by static

factors (institutional culture, legal considerations, etc.).

Conclusions: Procedural entrustment appears to be a

complex cognitive process involving multiple dynamic

factors synthesized against a baseline of static factors.

CBME programs will benefit from understanding how this

synthesis of factors influences faculty judgments, trainee

learning, and program decision-making.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OA2 – 2 CPD

OA2-2-1-60485

An online CPD program on keeping medical records using

a serious gaming approach. You can't be serious, right?

Martin Tremblay Fédération des médecins spécialistes du Québec, Sam

Daniel Fédération des médecins spécialistes du Québec, Beatriz Merlos

Fédération des médecins spécialistes du Québec, Bruno Vaillancourt

Fédération des médecins spécialistes du Québec

Background/Purpose: About 25% of physicians in Quebec

do not create and maintain medical records properly

according to our physician professional order (CMQ). Our

organization had to develop an educational intervention

to address this important unperceived gap, which was

judged uninteresting as per participants.

Summary of innovation: We created a 1.5-hour online

knowledge self-assessment program. Coached by

Hippocrates himself; participants must solve various

vignettes developed from CMQ's medical record keeping

regulations. A validated questionnaire based on the

Theory of Planned Behavior was used to measure

participants' behavioral intention post intervention.

Launched in March 2016, 180 specialist physicians have

registered to this course (completion rate: 74%).

Participants agreed or totally agreed that a serious gaming

approach was appropriated for this topic (95%) and all

reported that this course met their learning objectives.

Self-reported confidence to respect good practices in

record keeping increased by 21%. 97% of the participants

would participate again in a serious gaming CPD activity. A

mean CPD REACTION score of 6.2/7 indicated that the

program was efficient to promote participants' intention

to respect good practices in record keeping. From the

early development phase, we knew that meaningful

vignettes were required to maintain participants'

engagement. A CMQ representative was involved in the

development of real-life scenarios. We also created a

short humoristic and appealing video to facilitate

recruitment.

Conclusions: Using a serious gaming approach for this

program convinced our organization that taking an

unconventional educational path with our learners is

feasible. We are now exploring broader instructional

design avenues for upcoming programs.

OA2-2-3-60483

Interdisciplinary Continuing Professional Development in

Time of Sanitary Crisis; is it Working?

Martin Tremblay Fédération des médecins spécialistes du Québec, Sam

Daniel Fédération des médecins spécialistes du Québec, Diane

Francoeur Fédération des médecins spécialistes du Québec

Background/Purpose: Among the highest incidence per

100,000 cases in the world, the province of Quebec was

severely affected by the COVID-19 pandemic. Our

organization had to provide continuing professional

development (CPD) to meet the needs of medical

specialists from 35 affiliated medical associations

representing 59 distinct medical specialties.

Summary of innovation: We conceived and implemented

a structured process to identify and address perceived,

unperceived, societal, and normative CPD needs. 26

webinars were organized in 16 weeks (March to June

2020). Each 1-hour event included a weekly update from

our president, presentation from a panel of 2 to 5 experts

from our affiliated medical associations, followed by a

period of Q&As. All 7 CanMEDS competencies were

covered during this series of webinars. This series has

attracted over 35,100 participants, including medical

specialists (89%), family physicians (10%) and other

healthcare professionals (1%). More than 4,200 questions

were asked to the experts. Unanswered questions were

analyzed, grouped, and answered. Participants agreed or

strongly agreed that these interdisciplinary webinars met

their learning objectives (96%) and were pertinent for

their practice (95%). These interdisciplinary webinars

were implemented weeks prior to COVID-19

hospitalization peak. They have attracted medical

specialists from all our 35 affiliated medical associations

(including 85% of all medical specialists in Quebec). CPD

needs changed very rapidly during the sanitary crisis, and

the responsiveness of our needs assessment strategy was

key to keeping our events relevant, as evidenced by

sustained participation.

Conclusions: The success of this series of webinars

showcased that large scale interdisciplinary CPD is feasible

with medical specialists. Our needs assessment strategy

can easily be adapted to other situations where a rapid

response is required to address ever changing CPD needs.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OA2-2-4-60272

Representations of Administrative Staff and Faculty over

50 Years of Reports from the Dean

Morag Paton University of Toronto, Stephanie Waterman University of

Toronto, Cynthia Whitehead University of Toronto, Ayelet Kuper

University of Toronto

Background/Purpose: Language and representation

matter. For a century, the Faculty of Medicine at the

University of Toronto has produced an annual report from

the Dean, discussing issues, showcasing successes and

acknowledging community members. Reports traced the

faculty through war, depression and the introduction of

socialized medicine. Included in those narratives are the

people who work within as staff members and teachers,

researchers, and leaders.

Methods: This study forms the beginning of my doctoral

research employing Foucauldian discourse analysis to

explore how administrative staff have been and continue

to be represented across three departments in the

Faculty. Fifty years of digitalized Reports from the Dean

(1920s-70s) form the archive and were reviewed, coded in

NVivo12, and analyzed.

Results: Staff and Faculty have been written about

differently and this changes over time. Staff

representations are minimal with specifically-named staff

mentioned rarely. This is juxtaposed by the heavy focus on

named Faculty members. Staff are constructed in various

ways, often using aspects of their personalities (e.g.

"cheerful"). In contrast, faculty are more often

constructed by accomplishments. Female faculty

members are described using language much closer to

descriptions of the largely feminized staff cohort (e.g.

"delightful") indicating that this is gendered.

Conclusions: Discourses employed in the Reports create a

number of 'truth statements' - Staff can be recognized but

rarely named, cheerful but not accomplished. Female

faculty can be delightful. These statements hint at possible

discourses that govern what can be said or not said of staff

and faculty and provide a glimpse of the differential power

ascribed to these groups. Further phases of this research

will further explore the discourses that govern this

differential power and explore discourses that continue to

regulate the work of and power relations between

administrative staff and faculty in health professions

education.

OA2 –3 Inter-professional Education

OA2-3-1-60858

Conference on Health Advocacy Toronto: Building a

national academic forum and community of practice for

health advocacy in Canada

David Wiercigroch University of Toronto, Hilary Pang University of

Toronto, David Wiercigroch University of Toronto, Jennifer Hulme

University of Toronto

Background/Purpose: Advocacy is an important

educational competency in medical training as physicians

are well-positioned to champion innovative solutions to

health and health care challenges. Academic forums are

important facilitators of knowledge exchange, skill

development and networking, however such

opportunities focusing on health advocacy are limited.

The Conference on Health Advocacy Toronto (CHAT) was

founded with the mission to recognize and share health

advocacy work at the local, provincial, and national level

and the vision of creating conversations among health

care stakeholders.

Summary of innovations: CHAT was a full-day conference

developed by a team of eight medical students which

featured a keynote address, two oral presentation

sessions, and two advocacy skill-building workshops. Due

to COVID-19, CHAT 2020 was reconfigured and delivered

virtually using Zoom within three weeks of the event

prompting a 4.5-fold registration increase. A total of 180

individuals attended; participants included health

professions students, graduate students, and physicians

from eight provinces. Thirty-eight initiative and research

abstracts were accepted for presentation. All survey

respondents (n=23) rated each session they attended as

'excellent' or 'good' on a 5-point Likert scale. Participants

expressed a desire for additional events related to health

advocacy in the future.

Conclusions: CHAT is a novel pan-Canadian academic

forum in health advocacy which fosters knowledge

sharing and mentorship. The event has provided a

launching point for a national network and community of

practice for trainees and health care professionals. Future

directions should include a needs assessment of the

community to inform future programming.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OA2-3-2-59949

Battling the Burnout Epidemic: An Interprofessional

Approach to Improving Student and Healthcare Provider

Wellness

Claire Bullock Dalhousie University, Kathleen MacMillan Dalhousie

University, Claire Bullock Dalhousie University, Lauren Miller Dalhousie

University, James MacMillan Dalhousie University, David Neeb

Dalhousie University, Angela Tsai Dalhousie University, Wolim Lee

Dalhousie University, Stephen Miller Dalhousie University, Kelly Lackie

Dalhousie University

Background/Purpose: Healthcare provider (HCP) wellness

is an area of increasing concern often only discussed in a

uniprofessional context. This approach fails to take into

consideration how the function of interprofessional (IP)

teams contributes to and is impacted by team members'

mental health.

Summary of innovation: An IP group of students from

Dalhousie University developed an Interprofessional

Education (IPE) Mini-Course. This course educated

students about wellness-related challenges faced by HCPs

and students. The course had three in-person sessions.

Session One introduced phenomena such as burnout and

compassion fatigue and available supports. Session Two

addressed the role of IP collaboration in HCP wellness,

focusing on mental health and professionalism. Finally,

students applied course content in simulated scenarios.

This session also focused on resilience strategies. This

mini-course received funding to be offered in 2019 &

2020.

Conclusions: Data surrounding participants'

understanding of IP collaborative competencies was

collected using questions from the validated

Interprofessional Collaborative Competencies Attainment

Survey (ICCAS) tool and a program evaluation survey that

required students to reflect on their resilience and

interprofessional abilities. ICCAS and the program

evaluation questions were combined into a single survey.

This survey was completed by 40/50 of students in 2019

who participated in the course and has been analyzed

using a two-tailed t-test. Many survey results were

statistically significant, including students being better

able to identify resources to provide mental health

support (p=0.001). These findings helped confirm our

hypothesis that after completing Battling the Burnout,

students were better recognized that HCP wellness is a

challenge for all professions.

OA2-3-3-60870

Collaboration, Communication, and Counselling:

Incorporating Allied Health Professionals into Curriculum

Development in a Medical Genetics Residency Training

Program

Joanna Lazier University of Ottawa, Claire Goldsmith CHEO, Alison

Castle University of Ottawa, Alison Castle University of Ottawa

Background/Purpose: Team-based care is known to be

integral to improving patient outcomes and safety. Many

studies outline the importance of interprofessional

education in training collaborative care providers, but

there are few formalized curricula that incorporate allied

health professionals in longitudinal residency training.

There are no such curricula in Medical Genetics programs

in Canada, despite there being extensive overlap between

objectives of training for Genetics residents and the scope

of practise of Genetic Counsellors (GCs). In Ottawa,

residents work closely with GCs but not all trainees have

equal experiences. As such, our program sought to

augment resident education and develop new evaluation

methods.

Summary of innovations: Pre-existing GC-led educational

opportunities were identified. Information was solicited

about similar opportunities across Canada. Residents,

Geneticists, and GCs helped create level-of-training-based

expectations. We designed a novel GC-led longitudinal

curriculum to improve resident counselling skills, foster

positive professional relationships between Geneticists

and GCs via a mentorship program, and introduced novel

evaluation methods transferable to a CBD model of

training. The curriculum aligns with the six

interprofessional competencies developed by the

Canadian Interprofessional Health Collaborative. In July

2019, it was implemented with the current resident

cohort. Feedback to date from educators and trainees is

overwhelmingly positive and we have already seen the

benefits of a more collaborative environment.

Conclusions: As CBD is implemented, use of allied health

professionals as resident educators will be essential. This

project has shown that it is appropriate and feasible to use

our colleagues' skills to maximize resident education and

train collaborative care providers.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OA2-3-4-60857

Getting them to the table: Engaging inter-professional

team members to talk about their workplace practices

Ryan Brydges St. Michael's Hospital, Unity Health Toronto, Lori Nemoy

St. Michael's Hospital, Unity Health Toronto, Kristen Sampson St.

Michael's Hospital, Unity Health Toronto, Christine Léger St. Michael's

Hospital, Unity Health Toronto, Nazanin Khodadoust St. Michael's

Hospital, Unity Health Toronto, Douglas Campbell St. Michael's Hospital,

Unity Health Toronto

Background/Purpose: We developed a novel tabletop

simulation approach to identify workplace practices and

intrapartum care providers' underlying rationales for how

they work through challenging interprofessional clinical

scenarios. These simulations also contributed data to an

institutional ethnography exploring the ruling relations

influencing workplace practices on the labour and delivery

(L&D) unit.

Summary of innovation: We combined 'think-aloud' and

simulation principles to design an approach for eliciting

healthcare professionals' descriptions of how they

collaborate in their work on a L&D unit, and their

rationalizations for why they work that way. We engaged

an interprofessional team of intrapartum clinicians,

researchers, and simulation experts to design three

tabletop simulation scenarios reflecting key challenges

identified from analyzing incident analysis reports (n=81),

field observations (75 hours), and semi-structured

interviews (n=15). We ran each scenario three times with

three separate teams of interprofessional clinicians from

the unit.

Conclusions: The tabletop simulations revealed

'disjunctures' in how different professionals interpreted

and adhered to key policies and procedures. These

scenarios allowed us to examine longitudinal work

processes in a condensed timeline, with opportunities to

pause and probe, and with reduced focus on individual

practitioner's competence. Moreover, participants

described how the scenarios opened a productive

dialogue between professional groups and suggested this

simulation-based approach might contribute to enhanced

interprofessional understanding and cultural change. Our

innovative tabletop simulations produced rich data about

what drives professionals' actions in veritable clinical

cases, improved their engagement in change processes,

and laid the foundation for informed change of policies

and practices on the unit.

OA2-3-5-60786

Intraoperative Communication Between Residents and

Staff Physicians During Awake Patient Surgery

Lorelei Lingard Western University, Yiannis Iordanous Western

University

Background/Purpose: In a teaching environment,

effective communication is important for patient safety

and resident learning; however, little is known about how

that communication is affected by the listening patient.

The purpose of this study was to examine the patterns of

communication between consultant physicians and

residents during procedures where patients are awake.

Methods: This was a qualitative constructivist grounded

theory study. Various pairings of ophthalmology residents

and staff physicians were observed in the cataract surgical

suite. Following several observed cases, semi-structured

interviews were conducted.

Results: The theme of "concealment" was prevalent in

most interviews. Much of the language and

communication used in the operating room had the

purpose of concealing the residents' level of participation

in the surgery. The rationale reported for concealing the

residents' participation was to not induce patient anxiety

and to allow for more resident participation in surgery.

Several communication techniques and linguistic

strategies were observed in support of concealment.

These techniques and strategies facilitated guiding and

teaching residents while making the residents' presence

and involvement in surgery less apparent to the patient

undergoing surgery.

Conclusions The presence of an awake patient presents

challenges for teaching residents. Various verbal and non-

verbal techniques are utilized to help ease patient anxiety

while concealing the residents' involvement in the

surgery. The value of identifying and labelling these

techniques is that staff surgeons can be more purposeful

and explicit with residents about how they will handle the

staff-resident communication in the presence of an awake

patient, which could help to minimize the potential for

ambiguity and misunderstanding.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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April 17th, 2021 - 12:00 EST

OA3 – 1 Postgraduate

OA3-1-1-60497

A Signal: Resident Perspectives on Decision-Making

Processes and Impacts of Back-up Call Activations in an

Internal Medicine Residency Program

Natasha Sheikh University of Toronto, Rupal Shah University of Toronto,

Stella Ng University of Toronto, Heather Flett University of Toronto

Background/Purpose: Residency programs rely on

jeopardy or back-up call systems to address gaps in

coverage when a resident cannot complete their call shift.

Residents' perceptions on underlying motivations for

activating back-up, and how these decisions vary by

context, remain unknown. The authors explored

residents' reasons for call activations and impacts of the

back-up call system on education and burnout.

Methods: Eighteen semi-structured one-on-one

interviews were conducted from September 2019 to

February 2020 with internal medicine and chief medical

residents from the University of Toronto. Interviews

explored participants' experiences and perceptions with

call activations. A constructivist grounded theory

approach was used to develop a conceptual

understanding of the back-up system as it relates to

residents' decisions underlying activations, downstream

impacts and relationships to burnout.

Results: Residents described a complex thought process

when deciding whether to activate. Decisions were

coloured by inner conflicts including sense of collegiality,

need to maintain an image, and time of year balanced

against self-reported burnout. Residents described how

back-up models can inherently perpetuate burnout,

lowering thresholds to trigger activations. Impacts

included anxiety of not knowing whether an activation

would occur, decreased educational productivity from

exhaustion and the "domino effect" of increased workload

for colleagues.

Conclusions: Residents weigh inner tensions when

deciding to activate back-up. Their collective experience

suggests that burnout is both a trigger and consequence

of back-up call activations, creating a cyclical relationship.

Escalating rates of call activations may signal that burnout

amongst residents is high, warranting further exploration

from educational leads.

OA3-1-2-60644

Coaching for Performance Change: The development

and evaluation of a longitudinal Academic Coaching

Program for Competency-Based Medical Education

residents in anesthesiology

Brittany Prevost University of Toronto, Alayne Kealey University of

Toronto

Background/Purpose: The shift to competency-based

medical education (CBME) provides trainees with

increased frequency of workplace-based assessments and

feedback conversations. In this new context, coaching has

gained significant attention as one method to promote

self-reflection and personalized goal setting with

postgraduate learners. The R2C2 model, is a 4-step

evidence-based guided reflection model for longitudinal

coaching: RELATIONSHIP building, exploring REACTIONS

to feedback data, discussing feedback CONTENT, and

COACHING for performance change.

Summary of innovation: In 2018, a longitudinal Academic

Coaching Program (ACP) was developed for CBME

anesthesiology residents at the University of Toronto.

Each resident was paired with a volunteer faculty

anesthesiologist, and all pairs were provided with

coaching tips and the R2C2 framework. Resident and

faculty participants were surveyed about their use and

perceptions of the program at one and two years after

implementation. Using a quality improvement (QI) lens,

survey data then directed iterative adjustments to the

program.

Conclusions: Surveying ACP participants has highlighted

improvement opportunities. Resultant adaptations have

included developing a resident-facing dashboard for

enhanced access to assessment data, creating a

worksheet to guide meeting structure, and ensuring

protected resident academic time. Additionally, the

survey responses on use data suggest residents steadily

progress through the R2C2 stages. Responses sorted by

postgraduate year demonstrated a progression from

relationship building in early residency towards exploring

and using assessment data to coach for change in later

training. Our program can serve as one example of

integrating the R2C2 model for longitudinal coaching, and

how to iteratively improve a coaching program with a QI

strategy.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OA3-1-3-60728

Practicing confidence: An autoethnographic exploration

of the first year as a physician

Andrew Perrella McMaster University, Glenn Regehr University of

British Columbia , Laura Farrell University of British Columbia , Alon

Coret University of Ottawa

Background/Purpose: Across Canada, July 1st is heralded

with the arrival of a cohort of newly-minted medical

graduates. Through intense residency training and

supervision, these learners gradually develop self-

assurance in their newfound skills and ways of practice.

What remains unknown, however, is how this confidence

develops. The following project seeks to provide an insider

view of this evolution from the frontline experiences of

resident doctors.

Methods: Using an analytic auto-ethnographic approach,

two resident physicians (internal medicine, pediatrics)

documented 43 real-time stories on their emerging sense

of confidence over their first year of residency. A narrative

analysis was conducted iteratively in partnership with a

staff physician and a medical education researcher,

allowing for robust multi-perspective input. Reflections

were analyzed and coded thematically; the various

perspectives on data interpretation were negotiated by

consensus discussion.

Results: Our analysis focused on the evolution of

confidence, which starts with initial experiences of

apprehension and the notion of 'faking it.' With time, the

act of confidence materializes through two processes: (1)

routinization and normalization; and (2) coming to

understand our place within a layered healthcare system.

Importantly, the development of confidence does not

follow a linear trajectory; rather, the trainee finds

themselves oscillating between states of imposterism,

frustration, self-defeat, and self-assurance.

Conclusions: Exploring the nature of confidence - a

seldom discussed but critically valued piece of one's

emerging physician identity - offers unique insights on

residency training, and provides key perspectives on the

ways in which residents' growth and learning can be best

supported.

OA3-1-4-60877

Practice Intentions and Practice Choices of Early Career

Physicians in Canada

Monica Aggarwal University of Toronto, Ivy Oandasan The College of

Family Physicians of Canada, Alix Holtby The College of Family Physicians

of Canada, Mahsa Haghighi The College of Family Physicians of Canada,

Dragan Kljujic The College of Family Physicians of Canada, Lorelei Nardi

The College of Family Physicians of Canada

Background/Purpose: One of the key foci for medical

education other than ensuring competence is influencing

the choices of learners in relation to their specialty, scope

of practice and location of practice. These choices have

implications for workforce planning. The purpose of this

study was to compare practice intentions of exiting family

medicine (FM) graduates with practice choices made by

early career family physicians (FPs) related to scope of

practice and factors that influenced their choices.

Methods: Using Family Medicine Longitudinal Surveys

(FMLSs), aggregate-level secondary data and thematic

analysis on responses to two partially open-ended

questions was conducted for FM residents that exited

residency in 2015 (n=632, RR=54.3%), 2016 (n=785,

RR=60.1%) and early career FPs (first 3 years in practice)

in 2018 (n=206, RR=17.2%) and 2019 (n=357, RR=23.7%).

Results: In both cohorts, there were statistically

significant declines in the proportion of FPs reporting

involvement in various activities in relation to their scope

of practice compared to their practice intentions. The

greatest declines were seen in long-term care facilities,

rural communities, emergency departments, intrapartum

and indigenous care. System, organizational and personal

factors were identified as reasons for not undertaking

these activities.

Conclusions: Practice choices do not match practice

intentions of early career FPs. Medical education may

influence the intentions and choices of graduates

however factors outside of medical education influence

what they actually do. Knowledge of the factors that

influence practice choices will assist workforce planners,

medical educators and stakeholders to support

opportunities for FPs as well as address social

accountability and access to care.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OA3 – 2 Navigating & Accessing Care

OA3-2-1-60578

Accessibility and equity in health and human service

educational programs: What are the best instructional

practices in fieldwork education?

Tal Jarus University of British Columbia, Elisabeth Gross University of

British Columbia , Fernanda Mira University of British Columbia ,

Shahbano Zaman University of British Columbia , Yael Mayer University

of British Columbia , Laura Bulk University of British Columbia , Earllene

Roberts University of British Columbia , Margot Young University of

British Columbia , Rosemary Lysaght Queen’s University, Donna Drynan

University of British Columbia

Background/Purpose: Students with disabilities (SWD)

experience systemic ableism, especially in health and

human service (HHS) programs, where they must

demonstrate competencies in both academic and clinical

contexts. Specifically, SWD in HHS programs face barriers

including lack of support, discriminatory program design,

and stigmatization (Bulk et al., 2017; Easterbrook et al.,

2015; Easterbrook et al., 2018). Further, educators and

clinicians often lack understanding regarding such barriers

and the consequent supports SWD need, particularly in

fieldwork education (Bulk et al., 2017; Easterbrook et al.,

2015). This study explored the current HHS programs'

practices for supporting SWD in fieldwork education.

Methods: Eighty-two SWD, 23 academic coordinators,

and 184 fieldwork educators completed tailored surveys.

Nine students and 5 academic coordinators participated in

follow-up interviews. Participants represented 15 UBC

HHS programs, and 14 Occupational Therapy programs

across Canada.

Results: Results revealed barriers and gaps in accessibility

practices in fieldwork education. Reasons for students not

receiving FW accommodations included cumbersome

accommodation processes, attitudinal barriers,

restrictions placed on programs by certification bodies,

and complexities of constant change in fieldwork. Results

also showed significant administrative gaps, such as lack

of student and coordinator education on accommodation

policies, inadequate time for preparation and

collaborative planning, and student concerns regarding

the use of ineffective accommodations. Notably,

evaluation processes for assessing the effectiveness of

accommodations appeared non-existent among the

programs surveyed.

Conclusions: Results have implications for developing

clear and effective resources and practices for supporting

SWD in fieldwork, ultimately ensuring implementation of

policies and strategies effective in promoting equity and

diversity in HHS programs.

OA3-2-2-60751

Elements Leading to Discharge Decisions in Ambulatory

Internal Medicine Clinics

Sheliza Halani University of Toronto, Lindsay Melvin University of

Toronto, Rodrigo Cavalcanti University of Toronto

Background/Purpose: Building competence in the

ambulatory setting is a key element to Canadian Internal

Medicine (IM) residency training. An existing gap in the

medical education literature is how to teach learners on

appropriately discharging patients from clinic to their

primary care providers. To define this competency of

discharge from IM clinics, we sought to understand how

practicing physicians engage in discharge decision-making

in the outpatient setting so as to inform development of

teaching frameworks.

Methods: We purposively sampled staff general internists

who practice in the ambulatory clinic from six academic

hospitals in Toronto. Twenty-three semi-structured

interviews were conducted from October 2019 to January

2020. Data collection and analysis were iterative with

constant comparison according to constructivist grounded

theory.

Results: The themes identified include: 1) Stability of the

medical condition, 2) Accessibility of appropriate care, 3)

Individual physician factors including risk tolerance and

experience, 4) Models of care including clinic structures,

and 5) Individual patient factors including frailty,

comorbidity burden, and vulnerability. Discharge from

clinic involved a discussion between the internist and the

patient with an "open-door" policy at the time of

discharge. Trainee education around these decisions is

informal and often relies on role modelling and supporting

trainee independent decision-making under guidance.

Conclusions: The critical elements that influence general

internists' discharge practices from ambulatory clinic are

centred around the value added to a patients' care. We

propose that these elements can be synthesized into a

framework for educating trainees regarding transitions of

care decisions in ambulatory Internal medicine.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OA3-2-3-60532

Rethinking "The [Past] Medical History": An Exploration of

Patient Networks of Care Providers

Laurent Perrault-Sequeira Western University, Jacqueline Torti Western

University, Andrew Appleton Western University, Maria Mathews

Western University, Mark Goldszmidt Western University

Background Purpose: Patients' networks of care providers

have largely been ignored in current models of history

taking. That each patient relies on a family physician who

helps them navigate the healthcare system is largely

assumed. For many hospitalized patients -especially those

with multi-morbidity -this may not accurately reflect their

reality. Moreover, failing to consider alternative care

networks could lead to inadequate care planning.

Methods: Prospective cohort study with data collection

and analysis informed by constructivist grounded theory

methodology. Data included interview transcripts from 30

patients admitted to an inpatient internal medicine

service of an urban academic health centre. Analysis and

data collection proceeded in an iterative fashion with

sampling progressing from purposive to theoretical.

Results: We found a complex interplay among the types

of family physician relationship (highly involved, less

involved, non-existent), specialist relationship(s) (highly

involved, consultative, fragmented), and patients'

personal abilities/social supports. These configurations

appeared to impact how each cared for self and navigated

the healthcare system. Those with less optimal

combinations described many challenges during

transitions in medical care arising from hospital

admission, new diagnoses, increasing medical complexity,

and changes in functional ability.

Conclusions: Our elaboration of the multiple

configurations of care networks has implications for

teaching history taking. Adapting history taking to more

effectively identify care networks can help guide discharge

and ongoing care planning for high risk patients. Doing so

requires moving from "past medical history" to "chronic

active issues," and exploring the associated network of

care providers and social context.

OA3-2-4-60657

Community Perspectives: Results from Community

Partners' Formal Review of the Service Learning Program

for Undergraduate Medical Students

Karen Cook University of Manitoba, Chelsea Jalloh University of

Manitoba, Nina Condo Elmwood Community Resource Centre - Service

Learning Site, Felicien Rubayita Manitoba Interfaith Immigration Council

- Service Learning Site, Ian Whetter University of Manitoba, Roger

Berrington CanU Canada - Service Learning Site

Background/Purpose: In 2016, Service Learning became a

curricular requirement for undergraduate medical

students at the University of Manitoba. Since that time,

significant feedback has been collected from students re:

their Service Learning experience. While many community

contacts who work with these students regularly provide

informal feedback to the university, this survey collected

systematic feedback from community partners involved

with Service Learning.

Methods: In June 2019, a survey was distributed to 36

organizations to seek feedback about their experiences

working with Service Learning students. Participation in

the survey was voluntary. In total, 27 organizations

participated.

Results: Respondent feedback could be grouped into two

main themes: Logistics, and the Service Learning

Experience. About half (52%) indicated it was "easy" to

schedule students for Service Learning; however,

students' busy schedules and differences between hours

of organization programming and students' availability

were identified as considerations. Most respondents

described students as "engaged" (70%) or "somewhat

engaged" (26%) in their Service Learning experiences.

Sixty-eight percent of respondents indicated Service

Learning raised students' understanding of power and

privilege, and systemic oppression.

Conclusions: Seeking feedback from community partners

involved with Service Learning provided valuable insights

to inform and improve the Service Learning program.

Results identified specific areas of the program and

logistic improvements to be addressed moving forward.

Ensuring processes are in place to obtain feedback from

community organizations is an important step to

strengthen reciprocal, working relationships between

community organizations and university. Doing so

enhances the Service Learning experience for both

students and community partners.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OA3–3 Teaching & Learning -Post

graduate

OA3-3-1-60935

Adapting the Motivated Strategies for Learning

Questionnaire for use with postgraduate medical

education learners

Cassandra Pirraglia University of Alberta, Alexandra Aquilina University

of Alberta, Shelley Ross University of Alberta

Background/Purpose: The Motivated Strategies for

Learning Questionnaire (MSLQ) has been widely used in

educational psychology literature to examine the

motivation and learning of high school and undergraduate

students, and is beginning to appear in health professions

education (HPE) research. However, HPE programs are

contextually different from the education environments

where the MSLQ was validated. Further, the few studies

reporting validation of adapted MSLQ items for HPE

learners have focused on undergraduate contexts. The

purpose of the current study was to describe the

adaptation of MSLQ items for use with postgraduate

medical education (PGME) learners.

Methods: MSLQ items for intrinsic motivation,

metacognitive self-regulation, and critical thinking were

initially reworded using a consensus panel approach with

experts in PGME. The adapted items were then

administered through either paper or online surveys to

family medicine residents in two programs. Learners

identified problematic items by commenting on the

survey and/or highlighting or underlining words or

phrases (paper only). Three focus groups were conducted

with PGME learners to discuss the problematic items. The

sessions were audio-recorded and transcribed. Deductive

thematic analysis was undertaken separately by two

researchers.

Results: Results indicated that the terminology on the

MSLQ did not readily transfer to the PGME context, as

specific words took on different meanings in PGME clinical

training contexts. Recommendations for the rewording of

items were provided by focus group participants.

Conclusions: Our results provide insights into how the

MSLQ may be adapted for use with PGME learners to

further understand this population's motivational

orientations and learning strategies.

OA3-3-2-59989

Implementation of a pilot financial/practice management

curriculum in a family medicine training program

Matthew Lee Western University, Lawrence Yau Western University,

Ada Gu Western University, Karan Chawla Western University, Adrienne

Wakabayashi Western University, Daniel Grushka Western University

Background/Purpose: Throughout residency, trainees

must make many financially important decisions. Despite

this, very few training programs provide formal education

for residents around financial literacy, an important

component of practice management. The purpose of the

project was to implement a practice management and

financial literacy curriculum.

Summary of innovation: A survey with a five-point Likert

scale and multiple focus group interviews were conducted

to evaluate the needs of the family medicine cohort during

the 2019-2020 academic year at Western University. A

pilot curriculum was then implemented during the spring

term, and was followed by a post-intervention survey. The

core concepts for the practice management curriculum

included transition to practice, financial planning, billing,

and family practice models. The curriculum framework

was delivered by family physicians, with a combination of

didactic lectures and panel discussions.

Conclusions: 46 participants surveyed prior to the

intervention indicated a value of 2.89/5 for their comfort

level with how the program had prepared them for

practice management. Key themes generated from the

qualitative survey included a lack of comfort with their

own knowledge, a lack of financial education provided by

the residency program, and a strong belief that the

program should provide training in financial education

and practice management. Following the implementation

of the curriculum, the comfort level for participants

improved to 3.15/5 indicating a self-perceived need for

practice management and financial literacy education

among family medicine residents. These findings will aid

in the continual evolution of a practice

management/financial literacy curriculum for other

residency programs.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OA3-3-3-60721

Typologies & Challenging Conversation Foci: A Novel

Model for Facilitating the Successful Resuscitation

Preference Conversation

Kristen Bishop Western University, Ravi Taneja Western University,

Mark Goldszmidt Western University, Hasan Hawilo Western University

Background/Purpose: Effective communication lies at the

heart of successful resuscitation preference conversations

(RPC); however, existing RPC resources are largely based

on expert opinion and take a one-size fits all approach.

This lack of insight into the complexity of RPCs represents

a significant gap leading to inadequate preparation of our

clinical trainees. This qualitative study sought to develop

a typological understanding of the diversity of RPCs

clinicians may find themselves in.

Methods: Constructivist grounded theory was used to

develop an understanding of the complex social processes

involved in RPCs. Theoretical and purposive sampling was

used to identify and select 106 rich patient narratives

capturing the full spectrum of RPCs in our dataset. The

team ensured our approach's trustworthiness and rigour

through constant comparison, consultation of the

empirical literature, and regular team examination of

cases.

Results: In total, we identified: (a) 11 typologies, which

reflect the RPC's overarching narrative (i.e., what defined

or was at the heart of the conversation), and (b) 8

categories of challenging conversation foci, which

represent other important RPC themes that went beyond

the standard descriptions found in most resources.

Typologies could be further categorized as barriers,

facilitators, and modifiers of the RPC based on how they

shaped the conversation.

Conclusions: Holding an effective RPC requires a rich

understanding of the multiple conversation typologies

and challenging foci that can be explored. The developed

model can be used to help clinicians and trainees to learn

and improve how they handle RPC.

OA3-3-4-60914

Shared Screens: Resident Perspectives of Virtual

Academic Half Day

Basil Kadoura University of British Columbia, Michaela Remington

University of British Columbia , Brett Schrewe University of British

Columbia, Matthew Carwana University of British Columbia

Background/Purpose: The COVID-19 pandemic has

significantly disrupted the postgraduate learning

environment. Balancing the need to comply with public

health recommendations and offer safe learning

environments, many programs have drawn upon virtual

technologies to continue delivery of formal academic

curricula. Despite widespread use, however, little is

currently known as to how trainees have viewed these

changes. We sought to explore resident perceptions on

the COVID-19 influenced shift from in-person to virtual

academic half day (AHD) delivery.

Methods: We created and distributed a cross-sectional

survey to 51 pediatric residents who participated in virtual

AHD delivery in a university-affiliated program,

distributed across three training sites. Survey responses

were obtained confidentially through a secure, online

platform (REDCap). Descriptive statistics and inductive

thematic analysis were used to analyze responses to close-

ended and free response questions, respectively.

Results: Response rate was 60.8%. Residents reported

statistically significant improvement in their attitudes

towards virtual AHD across all metrics collected. Areas

most strongly rated included increased trainee

engagement and overall satisfaction with virtual delivery,

in part due to increased relevance of content. Factors

enabling participation included more educationally safe

interactions and a more comfortable and flexible learning

environment.

Conclusions: Our results suggest that the transition to

virtual AHD has generally been well received. At an

uncertain time when trainee vulnerability is heightened,

the need to explicitly attend to issues of relevance,

engagement, safety, and comfort are crucial. Further,

given the rapid and reactive pivots to new curricular

strategies in the wake of COVID-19, it is incumbent upon

programs to incorporate resident feedback to ensure that

a learner-centred environment that addresses their

educational needs is maintained.

April 17

, 2021 - 15:30 EST

OB1 – 1 Curriculum

OB1-1-1 - 60670

Development and Implementation of a 2SLGBTQ+

Competent Trauma-Informed Care Intervention across

Ontario

Michelle Tam University of Toronto, Merrick Pilling University of

Windsor, Lori Ross University of Toronto

Background/Purpose: 2SLGBTQ+ people are more likely

to experience violence and/or trauma than heterosexual

or cisgender (i.e., non-trans) people. As many 2SLGBTQ+

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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people may be in need of support related to experiences

of violence and/or trauma, it is important that health and

social service providers have the ability to skillfully meet

the needs of 2SLGBTQ+ people from a trauma-informed

lens. However, research has shown that 2SLGBTQ+ people

face barriers in accessing health and social services as a

result of lack of 2SLGBTQ+ capacity from service providers

or the organizations they work within.

Summary of innovation: The Building Competence,

Building Capacity project developed a 2SLGBTQ+

competent trauma-informed care workshop to increase

capacity among healthcare and social service providers

delivering services to address violence and/or trauma

across the province of Ontario. The curriculum was

developed with a team of advisory committee members

consisting of service providers across Ontario and an

Indigenous Elder. Pilot workshops were delivered across

Ontario in-person (one full-day) and online (two half-

days), and evaluated for feasibility, acceptability, and

scalability. Pre-and post-workshop surveys (n=225) were

gathered for reaction, confidence, and knowledge. Lastly,

interviews were conducted with participants (n=22),

facilitators (n=4), and advisory committee members (n=6).

Conclusions: The workshop trained 294 multi-disciplinary

service providers working in healthcare, mental health,

social service, and anti-violence sectors. We reached 116

institutions, organizations, and services across Ontario.

Participants indicated that they would like to see this

workshop provided to their organizations, services, and

institutions, as well as national expansion to healthcare

and social service providers across Canada.

OB1-1-2 - 60849

Community As Teacher: Examining Educational

Strategies for Medical Education that Advance Social

Accountability

Erin Cameron Northern Ontario School of Medicine, Hafsa Siddiqui

Northern Ontario School of Medicine, Ghislaine Pilot-Attema Northern

Ontario School of Medicine

Background/Purpose: Community Engagement (CE), is a

critical component to socially accountable medical

education. As medical schools strive to be more socially

accountably, demonstrated partnerships and

collaborations withto communities need to be developed

and sustained. Integrating community into medical

education ensures that: a) students learn from the

community, b) medical schools engage with communities

to better understand their health needs, and c)

communities become empowered to teach and are part of

preparing future change agents. The aim of this study was

to identify best practices around educational strategies

that meaningfully engage community.

Methods: A scoping review of published studies on CE in

undergraduate and postgraduate medical education in

the last twenty years was completed. Mixed methods

analysis was preformed on selected articles based on

selection criteria.

Results: Findings from the review indicate that most

relationships are not described as bi-directional and are

primarily focused on school and student outcomes.

Definitions of community were found to be

heterogeneous and included specific community groups,

singular patients, community physicians, and health

institutions. Promising practices identify effective

strategies for engaging community in curriculum

development and where community members are seen as

important teachers. Lastly, paternalistic language within

CE research suggests unequal power dynamics are still

deeply embedded within the field.

Conclusions: Medical schools are increasingly expected to

graduate physicians equipped with the knowledge and

skills to respond to local health needs. This study identifies

the need to continue to advance knowledge around

medical education that identifies strategies to

meaningfully engage community in order to advance

social accountability.

OB1-1-3- 60646

Development and Evaluation of the Online Bridging

Program for New International Palliative Medicine

Fellows

Ahmed Al-Awamer University of Toronto, Breffni Hannon University of

Toronto, Camilla Zimmermann University of Toronto, Ebru Kaya

University of Toronto, Madelaine Amante University of Toronto, Hanan

Al-Mohawes University of Toronto

Background/Purpose: International Medical Graduates

(IMGs) who train in countries with well-developed

palliative care delivery systems are key to advancing

palliative care globally. However, these IMGs may

encounter unique challenges that compromise their

learning experiences. Here we describe the development

of the Online Bridging Program in the Division of Palliative

Care at the University Health Network Toronto, and

discuss its effectiveness in improving IMGs' readiness for

Canadian fellowship training.

Methods: The annual Online Bridging Program consists of

eight online modules with weekly live sessions.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Summative program evaluation was conducted first

through an online survey immediately after completing

the Program, and then 6 months into the fellowship,

through qualitative one-on-one semi-structured

interviews. The interviews were analyzed using Braun and

Clarke's model for thematic analysis.

Results: Nine IMGs have participated in the Online

Bridging Program from 2018 to 2020. Nine (100%)

participated in the survey, and eight (89%) in the

interviews. Responses to the online survey were almost

unanimously positive, suggesting its effectiveness in

assisting the IMGs' transitions into fellowship. Themes

that were revealed in the interviews included: the

importance of combining online modules and live

sessions; easing the fellows' anxiety and facilitating the

transition into their new role; improved overall learning

and satisfaction because of the Program; and recognizing

online format limitations.

Conclusions: The Online Bridging Program effectively

eased IMG Palliative Medicine fellows' transition into

training and enhanced their learning experience. The

Online Bridging Program can be adapted for use by other

fellowship specialties.

OB1-1-4 - 60726

Wellness Curriculum Framework for Canadian Medical

Education

Rena Far University of Calgary, Dax Bourcier Université de Sherbrooke,

Lucas King University of Saskatchewan, George Cai University of

Manitoba, Joanna Mader Dalhousie University, Sarah Strong Memorial

– University of Newfoundland, Madeleine Bond University of Ottawa,

Emily Yung McGill, Inderdeep Mander University of Alberta, Raphaelle

Koerber McMaster University, Maggie Xiao University of Alberta

Background/Purpose: Rigorous academic expectations

and systemic factors within the training environment are

linked to significantly higher prevalence of mental

illnesses in Canadian medical students relative to the

general population. Medical faculties have responded by

incorporating wellness content in their programs.

Currently, there is no framework available that guides

wellness curriculum implementation for medical

education in Canada.

Methods: The Wellness Curriculum Task Force, part of the

Canadian Federation of Medical Students, adapted the

Thomas et al. six-step approach to medical curriculum

development to develop an evidence-based Wellness

Curriculum Framework (WCF). The needs analysis

consisted of a literature review, an environmental scan,

and two different targeted surveys to medical students'

associations. Goals and objectives were elaborated

followed by recommendations for educational strategies,

implementation, and evaluation.

Results: Six of the 15 faculties did not have a formal

wellness curriculum, and there was heterogeneity in

program content and delivery. The topics of career

planning & CaRMS, suicide prevention, and experiential

learning had the greatest importance to students. The

WCF consists of 16 goals each with 2-5 associated

objectives, and is anchored in the five domains of wellness

(World Health Organization definition) as well as with the

CanMEDS physician health competencies.

Conclusions: The goal of creating the WCF was to support

Canadian medical faculties in evaluating their existing

wellness programming, or to help guide the development

of a new wellness curriculum. The WCF will be a valuable

reference to optimize wellness programming to ensure

that upcoming physicians are healthy and able to provide

the highest quality of care to patients.

OB1 – 2 Health & Wellness

OB1-2-1-60668

A Mindfulness Medical Program in Continuing Education

for «Making Humanists Waves» into Physicians' Life by

Cultivating Mindful Awareness, Stress Management,

Compassion and Health Advocacy

Hugues Cormier Université de Montréal, Lixin Zhang Université de

Montréal, Robert Gagnon Université de Montréal, Vincent Jobin

Université de Montréal, Hélène Boisjoly Université de Montréal

Background/Purpose: Recent studies reported wide-

ranging benefits of clinician mindfulness training, namely

reduction of burnout, increased empathy, and

improvements in patient-centered care. We examined if a

brief Mindfulness continual medical education Program -

inspired by Oxford Mindfulness professor Mark Williams -

enhances capacities such as stress management,

Canadian medical competencies (CanMEDS), mindful

attention and awareness aptitudes.

Summary of innovation: The program consists of nine

hours of mindfulness exercises over three weeks

(3h/week.) +home practice. Among the brief exercices:

befriending the present moment through body sensations

and daily routine exercices at work or at home. Methods:

Online questionnaires were used. First, participants were

invited to auto-evaluate their pre/post-training

(respondents N=68 and 61 respectively) abilities at: i)

practicing mindfulness and compassion exercises, ii)

cultivating awareness in daily life and medical practice,

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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and iii) taming challenges like stress management in their

everyday or professional life. Second, the 34 most recent

participants completed the Mindful Attention Awareness

Scale (MAAS) pre/post-training. Third, 53 participants

answered 3 pre/post "CanMEDS": health advocacy,

compassionate communication, and professionalism.

Results: Before participation, 77 %, 63%, and 79% (N=68)

answered they were NOT comfortable with the above-

mentioned abilities i), ii), and iii) respectively, while they

became 93%, 98%, and 93% (N=61) comfortable after.

"CanMEDS" assessment (N=53): 74% noted improvements

in health advocacy, 40% in compassionate

communication, and 25% in professionalism. Compared to

pre-training MAAS scores (47.9±11.6), post-training

scores (54.8±11.2) significantly improved (N=34, z=3.82,

p<0.01.)

Conclusions: Notable benefits were observed for

participants-respondents to a Mindfulness Medical

Training Program.

OB1-2-2-60541

Changing the Culture: An Introduction to Medical Student

Peer Support at the University of Alberta

Inderdeep Mander University of Alberta, Victor Do University of

Toronto, Cheryl Goldstein University of Alberta, Kendra Raffael

University of Alberta

Background/Purpose: Medical student levels of distress,

depression and anxiety exceed that of their non-medical

student peers (Moir et al, 2016). Despite this, many avoid

seeking professional help, preferring instead to access

support from their medical student peers (Chew-Graham

et al, 2003). Peer Support has been shown to increase help

seeking behaviors, decrease stigma around suicidality and

promote social inclusion (Moir et al, 2016).

Summay of innovation: Until recently, the University of

Alberta MD Program did not have a Medical Student Peer

Support Service. In efforts to promote help seeking

behaviour, we designed a student-lead and operated

program in which medical students could schedule a one-

on-one appointment with a trained peer supporter. We

developed a training program adapted from the Canadian

Mental Health Association's Edmonton Distress Line and

tailored it to medical students providing peer support.

Over the inaugural year we have recruited and trained 45

peer supporters from five classes and booked 27

appointments. Common topics discussed include

academics (100%), Clerkship concerns (68%), CARMS

(56%) and Personal Relationships (50%). All students

receive a feedback survey post-appointment to which 41%

(n=11) of students replied. All survey respondents strongly

agreed that peer support helped them address their

concern(s) and all respondents agreed or strongly agreed

they would reach out to peer support again in the future.

Conclusions: The peer support program is well received by

medical students providing support and those accessing it.

To enhance visibility and address the isolation related to

virtual teaching we have launched peer facilitated group

support for the incoming class of 2024 and plan to follow

data trends related to uptake and repeat appointments.

OB1-2-3-60820

Resilience in the New Millennium - Where Are We and

How Are We?

Airiss Chan University of Toronto, Zi Ying Zhao University of Toronto,

Alon Coret University of Ottawa, Andrew Perrella McMaster University

Background/Purpose: Resilience is regarded as a holistic

approach to preventing burnout, and in recent years,

medical education has emphasized the importance of

developing strategies for resilience early in training.

Whether this cultural shift has achieved its intended

impact is yet to be elucidated. The purpose of our

narrative review is to examine the range and nature of

research activity regarding resilience in undergraduate

medical education, and to identify areas for improvement

in the current literature.

Methods: MEDLINE and PsycINFO were searched for

articles published between January 1, 2000 and July 25,

2019 on the themes of resilience, wellness, or burnout

interventions in undergraduate medical education in

North America. Two authors independently screened each

article, with conflicts resolved via consensus discussion.

All included articles then underwent data extraction.

Results: 3323 unique manuscripts were screened,

identifying 421 full-text studies for eligibility assessment

and 237 articles for data extraction. The majority of

articles were published after 2010, especially in the latter

half of the decade. 19% of articles were focused on

interventions. Several concepts emerged: definitions of

resilience and wellness, predisposing and personal

protective factors to burnout, institutional changes, as

well as curricular interventions designed to augment

student resilience or intervene on burnout.

Conclusions: Over the past two decades, medical faculties

have come to recognize the importance of fostering and

teaching resilience, with increased research interest and

sustained student- and faculty-led interventions in this

area. Future research should continue to promote

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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resilience and build wellness through outcome-proven

interventions early in medical training.

OB1-2-4-60875

Improving Workplace Mental health: An Evaluation of

Managers' Perceived Ability to deal with Workplace

Mental Health Issues

Eleftherios Soleas Queen’s University, Nicholas Cofie Queen’s

University, Nancy Dalgarno Queen’s University

Background/Purpose: Unresolved workplace mental

health disability issues have the potential to produce

deleterious outcomes including employee absenteeism,

presenteeism, reduced productivity, increased turnover,

and other organizational behaviors, especially in stressful

environments such as healthcare. This evaluation study

determined the impact of a Morneau Shepell Workplace

Mental Health Leadership Certificate (MHLC) training

program at Queen's University. We evaluated managers'

perceived ability to understand, explain, describe, and

express confidence in managing employees with various

mental health issues in the workplace.

Methods: Using descriptive and inferential statistical

techniques, we analyzed training evaluation scores of five

cohorts of participants at pre-training (n =109) and three-

months post training sessions (n =73) with a response rate

of 67%.

Results: We found statistically significant differences

between pre- and post-training evaluation scores. Post-

training scores reflected higher increases in participants'

perceived ability to manage all the aspects of mental

health issues examined (t = -15.39, p < 0.001), particularly

with respect to managers' ability to explain why the

Declining Behaviour/Performance Model is the best

practice approach to addressing an employee's declining

mental behaviour in the workplace (t = -16.15, p < 0.05).

Also, participation in the training program significantly

increased perceived overall ability to manage workplace

mental health issues (b = 1.023, p < 0.001) after

accounting for effects of demographic factors.

Conclusions: These findings demonstrate the importance

of developing and implementing mental health leadership

programs for the workplace. The MHLC program can be

adapted and implemented in other workplaces to

enhance leaders' ability to manage mental health issues.

OB1 – 3 Teaching & Learning - Patient

Involvement

OB1-3-1-60492

Community-based Patient Panels as Teaching Tools in

Medical Education to build Anti-Oppressive Medical

Practice and Advocacy Skills

Helena Kita University of Toronto, Nikisha Kharé University of Toronto,

Chantal Phillips University of Toronto, Alexandra Florescu University of

Toronto, Helena Kita University of Toronto

Background/Purpose: Patient panels-in which patients

share their lived experience with illness, injury, and

disability-are important tools in pre-clinical medical

education that build empathy and understanding of the

holistic illness experience. Currently at the University of

Toronto, panelists are recruited as volunteers from

curriculum leads' own patient pools-a method that has led

to panels composed of patients who are primarily White,

of high socioeconomic status, and with strong social

supports. Thus, students learn to empathize with

privileged patients, often undermining empathy for

patients without social supports, who cannot adhere to

"healthy lifestyles", and who experience discrimination

and oppression in healthcare. This perpetuates

inequitable healthcare outcomes.

Summary of innovation: A pilot patient panel was

conducted using a recruitment approach focused on

intentional diversification of patient panels through

community-based engagement. A partnership was

formed with an organization that houses a speaker's

bureau of panelists with lived experience of various forms

of marginalization. A grant was obtained to compensate

panelists. In a post-panel survey (n = 59), students

highlighted that the more diverse panel helped them build

empathy towards marginalized patients (93%) and explore

approaches to addressing inequity (81%). Students

requested this approach play a more consistent role in the

curriculum.

Conclusions: Community-based patient panels that are

diverse across social differences and illness experiences

are important teaching tools to educate medical students

about health and structural inequities, build

understanding towards marginalized populations, and

promote reciprocal approaches to advocacy. This pilot

project was used to advocate for permanent

implementation of such approaches to all patient panels.

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OB1-3-2-59912

Humanism in Surgery - Developing a Patient as Teacher

Initiative in Surgical Clerkship

Jory Simpson University of Toronto, Emilia Kangasjarvi University of

Toronto, Allia Karim, Stella Ng University of Toronto

Background/Purpose: Patient as Teacher (PAT) programs

offer an approach to education that recognizes patient

expertise and engages patients in the medical education

process. Sharing patient experiences through narratives

can create learning and understanding that encourages

meaningful dialogue and partnerships between patients

and providers. Despite increased adoption in medical

education, PAT programs have not been studied

sufficiently in the context of surgery.

Summary of innovation: We report findings from the

development and evaluation of a newly established PAT

program at University of Toronto. Integrated into third

year surgery clerkship, the program consists of 3

interactive workshops with 4 different breast cancer

survivors and creation of an arts-based reflection. To

explore students' experiences, 5 focus groups with 46

students were conducted at rotation's end. Students

reflected on overall program experience, including its

impact on their educational practices and identity.

Transcripts were analyzed using thematic analysis

involving an iterative process of inductively coding data

and organizing codes into relevant thematic categories.

Students valued protected time to learn directly from the

patients, slowing down and focusing on the human side of

surgical care and from hearing the experiences the "less

victorious" narratives. They learnt the significance of the

"the little things" in patient-provider interactions, further

developed an appreciation for the individuality of

experiences despite the same disease and finally the

impact of breast cancer on a person's identity and life.

Conclusions: The PAT program successfully promoted and

fostered the humanistic side of surgery and is a model that

could be incorporated into surgical clerkships throughout

Canada.

OB1-3-3-60609

From Skillful to Empathetic: Shifting Medical Students'

Perceptions of Surgeons through a Patient as Teacher

program

Jory Simpson University of Toronto, Gurjot Gill, Stella Ng University of

Toronto, Emilia Kangasjarvi University of Toronto

Background/Purpose: Patient as the teacher (PAT)

programs utilise a humanistic approach to medical

education. Students attend sessions in which patients

share their personal stories and perspectives on how their

illness has impacted their lives. Students listen, engage in

dialogue, and then use art as a means to reflect on how

this has influenced their medical outlook. Evaluating the

influence of such initiatives on desired outcomes of

interest has proven challenging in the past. Our study uses

a novel method to evaluate the effects of the PAT program

on humanistic perspectives.

Methods: Students were asked to "list the top 5 attributes

of a surgeon, in order of perceived importance" before

and after the PAT program. The resulting attributes were

coded as either "humanistic" or "non-humanistic" and

analysed through an innovative model of qualitative data

generation and Bayesian statistical approaches.

Results: After participation in the PAT program students

were nearly twice as likely to rank a humanistic

characteristic as the most important attribute of a

surgeon (OR 1.98, 85% CI 0.80-4.98). After participation in

the PAT program, students were also 3.58 times more

likely to rank a humanistic characteristic amongst their

reported top three attributes for a surgeon (OR 3.58, 89%

CI 1.60 - 8.85).

Conclusions: Our innovative statistical model supports the

success of this educational PAT program in encouraging a

humanistic perspective in surgery and can be used to

evaluate the efficacy of new humanistic education

initiatives amongst medical education.

OB1-3-4-60520

Clinical teaching at distance: an educational approach of

Kazan State Medical University

Elena Koshpaeva Kazan State Medical University, Laysan

Mukharyamova Kazan State Medical University, Arina Ziganshina Kazan

State Medical University

Background/Purpose: In the face of the Covid-19

pandemic medical schools worldwide have faced a

challenge of delivering clinical training remotely. Fast

generation of online teaching and learning recourses is a

positive aspect of the current situation. However, the lack

of data on the effectiveness of such methods in medical

students' training creates the agony of choosing for the

educators.

Summary of innovation: On March, 2020 due to the

pandemic Kazan State Medical University (KSMU) has

transferred to the distance learning. Along with the

common methods of remote training, such as video

conferences with faculty members, assignments and

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MCQs at KSMU educational portal, readings, self-studies

and watching recorded lectures, as a part of their

curriculum certain groups of students undergoing internal

medicine and general surgery rotations were introduced

to a platform called CyberPatientTM (CP), which is a

University of British Columbia innovative online

simulation solution designed for acquisition of applied

medical knowledge and experience via virtual

environment. Other clinical discipline learners were able

to voluntarily access the platform. By the end of the term

both groups were surveyed on a subject of satisfaction

with the provided online learning opportunities.

Conclusions: According to the results of the survey, CP

was rated as intuitive and easy to operate platform. The

learners were satisfied with the variety of provided clinical

cases. CP was identified as valuable, effective and highly

impactful both in terms of the knowledge and experience.

So that, the CyberPatientTM platform can be

recommended as an effective resource for clinical

training.

April 17

, 2021 - 16:30 EST

OB2 – 1 Assessment - Approaches

OB2-1-1-60545

Validation of a Novel Resident Assessment Tool to

Support an Anesthesiology Competency-Based Medical

Education Curriculum

Alayne Kealey University of Toronto, Fahad Alam University of Toronto,

Lisa A Bahrey University of Toronto, Clyde T Matava University of

Toronto, Graham McCreath University of Toronto, Catharine M Walsh

University of Toronto

Background/Purpose: Workplace-based assessment

(WBA) is key to a competency-based assessment strategy.

Concomitantly with our program's launch of Competence

by Design, we developed a new formative WBA, the

Anesthesia Clinical Encounter Assessment (ACEA), to

assess readiness for independence (i.e. entrustability) for

competencies essential for perioperative patient care.

This study aimed to examine validity evidence of the ACEA

during postgraduate anesthesiology training.

Methods: The ACEA comprises an 8-item global rating

scale (GRS), an 8-item checklist, an overall independence

rating, and case details. ACEA data were extracted for the

University of Toronto anesthesia residents from July 2017

to January 2020. Validity evidence was generated from

sources based on the unified theory of validity, including

internal structure, relations with other variables, and

consequences.

Results: We analyzed 8536 assessments for 137 residents

completed by 341 assessors. From generalizability

analysis, ten observations (2 assessments each from 5

assessors) were sufficient to achieve the reliability

threshold of 0.70 for in-training evaluations. A mean GRS

score of 3.65/5 provided optimal sensitivity (94%) and

specificity (91%) for determining competency on ROC

analysis. Test-retest reliability was high (ICC=0.81) for

matched assessments within 14 days of each other. Mean

GRS scores differed significantly between residents based

on their training level (p<0.0001) and correlated highly

with overall independence (0.91, p<0.001). The internal

consistency of the GRS (α=0.96) was excellent.

Conclusions: This study provides evidence supporting

validity of the ACEA for assessing the competence of

residents performing perioperative care and supports its

use in competency-based anesthesiology training.

OB2-1-3-60651

Assessment beyond the individual: A scoping review on

measuring interdependent performance in collaborative

environments

Lorelei Lingard Western University, Stefanie Sebok-Syer Stanford,

Michael Panza Western University, Jennifer Shaw Western University,

Farah Asghar University of Toronto, Mark Syer Facebook

Background/Purpose: Individual assessment disregards

the team context of clinical work. Team assessment

dissolves the individual into the group. Neither

assessment is sufficient for medical education, where we

require measures that attend to the individual trainee

while accounting for their interdependence. This study

aimed to identify existing approaches to measuring

interdependence.

Methods: Following Arksey & O'Malley's methodology,

we conducted a scoping review in 2020. A search strategy

involving six databases located >11,000 citations. Two

reviewers independently screened titles and abstracts,

screened full-texts (n=131), and performed data

extraction on 26 included articles.

Results: Seventeen of the 26 articles were empirical; 9

conceptual with empirical illustration. Seventeen were

quantitative; 9 used mixed methods. The articles spanned

5 disciplines (Education, Psychology, Computer Science,

Mathematics, Biology) and various application contexts,

from online learning to sports performance. Only two

articles were from medical education. Articles

conceptualized interdependence of a group, using

theoretical constructs such as collaboration synergy and

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temporal dependence; of a network, using constructs

such as degree centrality; and of a dyad, using constructs

such as synchrony and cumulative experience. Both

descriptive (e.g., social network analysis) and inferential

(e.g., multi-level modelling MLM) measurement

techniques were employed.

Conclusions: Efforts to measure interdependence are

preliminary and scattered across disciplines. Multiple

theoretical concepts and inconsistent terminology may be

limiting programmatic work. However, the literature

reveals the potential of measurement techniques such as

MLM and efforts that combine multiple measures. With

only two studies in medical education, application and

adaptation of existing approaches to the clinical training

context requires further study.

OB2-1-4-60904

Assessing Professionalism: what works and what does

not

Keith Wilson Dalhousie University, Wendy Stewart Dalhousie University

Background/Purpose: Numerous instruments exist to

assess professionalism in undergraduate medical schools.

These include self-administered rating scales, direct

observation, multi-source feedback (including peer

assessment), patient opinion, and simulation. Challenges

in using these tools include feasibility and alignment with

overarching objectives of the respective institutions. We

underwent an exploration of different methods and set

out to improve our assessment of professionalism at the

undergraduate level.

Summary of innovation: A Professionalism Working

Group was created, tasked with exploring options to

improve our ability to define and assess professionalism

qualities that we expect of our graduates. Pilots were

conducted using peer and self assessment as potential

models in pre-clerkship. Peer feedback was anonymized

and given to learners by their tutors. Additionally, guided

self-reflection was used to help learners assimilate their

own observations with those of their peers and tutors. In

clerkship, changes to the assessment of professionalism

and its position and priority on our In-Training Evaluation

Reports (ITERs) were made. It was found that peer

assessment during our longitudinal Professional

Competencies course aligned with observations of

professionalism by our tutorial faculty. At the clerkship

level, making the assessment of professionalism a priority

by placing it at the forefront of all clerkship ITERs,

addressed some previously unmasked hidden curriculum

issues of professionalism being a secondary or tertiary

goal. Following the changes, there was a significant

increase in the amount of actionable assessment targets.

Conclusions: Prioritizing professionalism assessment at

the undergraduate level leads to improved quality of

assessment narratives. Corrective action, if necessary, can

thus be implemented at a much earlier stage in a very

transparent way. Approaches to assessment of

professionalism need to be multifaceted and in keeping

with programmatic assessment principles. Garnering the

input of numerous stakeholders and willingness to pilot

assessment initiatives can enhance existing assessment

modalities.

OB2 – 2 Curriculum

OB2-2-1-60688

Curriculum Renewal as Organizational Learning

Christen Rachul University of Manitoba, Benjamin Collins University of

Manitoba, Helen Mawdsley University of Manitoba, Keevin Bernstein

University of Manitoba, Ira Ripstein University of Manitoba, Joanne

Hamilton University of Manitoba

Background/Purpose: In 2015, the UGME program at the

University of Manitoba began implementing a renewed

curriculum after a process that began in 2010. To identify

factors that facilitate and impede the goals of curriculum

renewal, we relied on Crossan's 4Is model of

organizational learning that links individuals, groups, and

the organization through the four processes of intuiting,

interpreting, integrating, and institutionalizing.

Methods: As part of a mixed-methods evaluation of the

new curriculum, we conducted 16 semi-structured

interviews with leadership, faculty members, and

administrators who played key roles in the curriculum

renewal process. We conducted a thematic analysis of

interviews informed by Crossan's 4Is model of

organizational learning.

Results: Analysis of interviews revealed that while many

of the goals for the renewed curriculum have been

achieved, some outstanding issues remain. Also,

curriculum renewal is not a bounded event, but an

ongoing process of organizational learning. The themes of

Collaboration, Engagement, Leadership, Decision-making

Practices, and Processes and Structures provide insight

into the factors that facilitated and impeded the renewal

process.

Conclusions: Some of the goals of curriculum renewal

have been achieved through strong leadership, frequent

collaboration, and engagement from multiple

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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stakeholders that facilitated the development of shared

understandings through which new routines and

processes formed. Curriculum renewal was impeded by

inconsistent decision-making processes and evolving

processes and structures in terms of sufficient labour

force, recognition, and protected time. Findings provide

insight into ways that outstanding issues can be addressed

and that the on-going process of curriculum renewal can

be supported through individual and collective actions.

OB2-2-2-60619

Problem-Based Learning: Future of Genetic Education

Bipandeep Abbat McMaster University, Jennifer Mackenzie McMaster

University

Background/Purpose: The incorporation of genetics into

medical practice has the potential to improve patient

health outcomes but is often overlooked. Problem-based

learning (PBL) is a well-established pedagogy in medical

education but there is little literature exploring PBL to

improve genetics literacy. The medical school at

McMaster University, which uses PBL as the primary pre-

clerkship pedagogy, launched a renewed spiral curriculum

in 2019 involving revision of the PBL scenarios. Feedback

is provided throughout with no formal examinations. Our

goal was to explicitly integrate genetics into PBL cases and

determine if objectives were met.

Summary of innovation: PBL scenarios were reviewed for

opportunities to integrate the Canadian genetics (2019

consensus), and McMaster specific objectives. Initially,

objectives were mapped to each case. Subsequently, a

medical student (BA), through lived experience and

informal peer feedback assessed the extent to which, if at

all, genetics concepts were explored and scaffolded during

PBL. Genetics was also blueprinted into formative

assessments to successfully include concepts from the

curriculum. Recommendations were made to address

gaps in content and organization of the spiral curriculum.

Conclusions: Although the objectives were covered,

repetition of basic concepts and less attention to more

complex objectives was observed as the cases progressed.

Challenges included finding opportunities to include

genetics in common patient scenarios and variation

between PBL groups. The PBL process inherently includes

self-directed learning and application of genetics in

common clinical contexts, thus improving gaps in

translation of genetics into daily practice. Therefore, these

students are well-positioned to adapt to the rapidly

changing role of genetics in healthcare.

OB2-2-3-60821

The impact of undergraduate conferences on medical

student engagement in Ophthalmology and surgery.

Loay Rahman The Hillingdon Hospital NHS Foundation Trust, Daniel CS

Wheeler St. George's Hospital NHS Foundation Trust, Roxanne Lee

Southend University Hospital NHS Foundation Trust, Filippos

Papadopoulos King's College London

Background/Purpose: Given the highly competitive

nature of Ophthalmology and the decreasing emphasis on

surgical teaching at undergraduate level, early exposure is

an important factor in developing interest and awareness

for Ophthalmology and its application process. Thus, we

organised an Ophthalmology conference for UK

undergraduate medical students as a curriculum adjunct,

whilst aiming to ascertain pre- and post-conference

perceptions towards a career in Ophthalmology.

Methods: Collaborating with Moorfields Eye Hospital, we

delivered a national conference incorporating keynote

lectures into the Ophthalmology subspecialties, panel

discussions, and practical workshops including

microsurgical skills and portfolio and interview

techniques. Pre- and post-conference questionnaires

were distributed to the 56 attendees, assessing key

metrics encompassing awareness of Ophthalmology and

surgery as a career and confidence in performing relevant

practical skills.

Results: Pre- and post-conference 5-point Likert

responses demonstrated statistically significant increases

across metrics including understanding of Ophthalmology

Speciality Training application (2.80±1.13 to 4.37±0.63

(p<0.001)), understanding of Ophthalmology as a career

(3.27±0.93 to 4.41±0.62 (p<0.001)) and confidence

performing basic microsurgical techniques from 1.71±1.14

to 3.51±0.62 (p<0.001). Thematic analysis of qualitative

responses revealed lifestyle or work-life balance as the

biggest attracting factor to the speciality (pre-conference

22.2% of respondents, post-conference 29.3%), whereas

competition rate as the major deterring factor (31.8% pre-

conference vs 35.6% post-conference). Lectures were

rated at 4.26±0.53, workshops 4.35±0.17, and an overall

conference rating of 4.55±1.13, with 98% of attendees

indicating they would recommend this to colleagues.

Conclusions: We demonstrate the profound value of this

conference on improving awareness of Ophthalmology

from an early career stage. We propose that extrapolating

this undergraduate curriculum adjunct will stimulate

similar impactful engagement across other surgical

specialities.

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OB2-2-4-60807

Using a Rapid-Cycle Approach to Evaluate

Implementation of Competency-Based Medical

Education

Tessa Hanmore Queen’s University, Nancy Dalgarno Queen’s University,

Stephanie Baxter Queen’s University, Heather Braund Queen’s

University

Background/Purpose: Queen's University implemented

competency-based medical education (CBME) across all

29 programs on July 1, 2017. The purpose of this study is

to describe key stakeholders lived experiences in CBME

Foundation of Discipline stage in the Ophthalmology

department.

Methods: Using a case study approach, a mixed method

rapid-cycle evaluation was conducted during the 2018-

2019 academic year. The evaluation consisted of two

evaluation cycles with the first round of interviews and

focus groups occurring in October 2018 and in March

2019. Residents, faculty, academic advisors, competence

committee members, program director, program

administrator, and the educational consultant were

interviewed. Recommendations were implemented in

January 2019 and June 2019.

Results: Stakeholders identified the need to build a shared

understanding about how to both trigger assessments and

encourage all faculty members to engage in the process.

Stakeholders also described how their roles continued to

evolve following CBME implementation. Participants

discussed how the department functioned and would

continue to build understanding about the assessment

process. The rapid-cycle evaluation identified the need for

streamlining and clarifying specific Entrustable

Professional Activities. Stakeholders did suggest a

preference for narrative feedback and identified the

benefits of the feedback provided.

Conclusions: Rapid-cycle evaluation has been a valuable

process for identifying key strengths and

recommendations following implementation of a new

CBME curriculum. Exploring lived experiences resulted in

positive and immediate improvements to the residency

program. Both the recommendations and evaluative

approach will benefit other departments and institutions

as they implement CBME.

OB2 – 3 Teaching & Learning

OB2-3-2-59952

Image Interpretation: Evidence Informed Learning

Opportunities

Manuela Perez University of Toronto, Martin Pusic Boston Children's

Hospital, David Rizutti Western University, Elana Thau University of

Toronto, Martin Pecaric Contrail Consulting Services Inc, Kathy Boutis

University of Toronto

Background/Purpose: Learning analytics is the

measurement, collection, analysis and reporting of data

for the purposes of understanding and optimizing

learning. We derived learning analytics on a challenging

radiograph to determine variables that predict for an

incorrect diagnostic interpretation. Furthermore, we

determined image review processes inherent to novice

versus experienced participants that were associated with

a higher diagnostic performance.

Methods: Physician participants attempted to detect

pneumonia on 200 pediatric chest radiograph (pCXR) on a

digital platform. We examined associations with

diagnostic success with respect to physician demographics

and pCXR variables.

Results: We enrolled 83 participants (20 medical students,

40 postgraduate trainees and 23 faculty), obtaining

12,178 case interpretations. Variables that predicted for

pCXR interpretation difficulty were pneumonia present vs.

absent (β = 8.7; 95% CI 7.4, 10.0); low vs. high visibility of

pneumonia (β = -2.2; -2.7, -1.7); non-specific lung

pathology present vs. absent (β = 0.9; 0.4, 1.5); and,

localized vs. multifocal pneumonia (β = -0.5; -0.8, -0.1).

Novices reviewed both available radiograph views less

often than faculty and were more accurate when they

reviewed both views (p<0.0001). Novices also spent less

time reviewing images, despite lower accuracy scores

(p<0.0001). Physician certainty was associated with an

increased probability of case correctness, and this effect

was more prominent in faculty (p<0.0001).

Conclusions: Learning analytic information can be used to

allow for a customized weighting of which cases to

practice and predict participant review processes that

may lead to diagnostic error.

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OB2-3-3-60530

The impact of teaching for critical reflection: A Bayesian

analysis

Stella Ng University of Toronto, Nicole Woods University of Toronto, Jeff

Crukley independent, Victoria Boyd University of Toronto, Ryan Brydges

University of Toronto, Emilia Kangasjarvi University of Toronto, Mahan

Kulasegaram University of Toronto, Adam Gavarkovs University of

Toronto

Background/Purpose: While critical reflection supports

effective practice within socially challenging situations

(e.g. effectively advocating for equitable access), most

professionals develop these capabilities by happenstance.

Teaching for critical reflection has shown some promise in

helping health professionals navigate these challenges.

We aimed to examine this potential and asked: does

teaching critical reflection influence what learners talk

about (i.e., the content of their talk) and how they talk

(i.e., whether they talk in critically reflective ways) during

a subsequent learning session and debrief?

Methods: We randomized pre-clinical students (n = 75)

into control and intervention conditions (8 groups each of

up to 5 students). Participants completed a Social

Determinants of Health (SDoH) module, followed by a

SDoH discussion (control) or critically reflective dialogue

(intervention). Afterwards all experienced a common

learning session (homecare curriculum and debrief) as

outcome assessment. Blinded coders coded transcripts for

what was said (using a codebook) and how (critically

reflective or not). We constructed Bayesian regression

models to determine the probability of what codes and

how codes in each meaningful segment of "talk."

Results: Groups exposed to the intervention condition

were more likely, in a subsequent learning experience, to

talk in a critically reflective manner (0.096 [0.04, 0.15]) but

we found no meaningful differences in what was said.

Conclusions: This study empirically demonstrated

theoretical assertions that teaching critical reflection can

impact learners' subsequent ways of approaching

practice, toward more critically reflective views. By

definition, critical reflection attends to equity and

compassion. Both the results and methods of this study

raise important research and education considerations.

OB2-3-4-60718

Exploring the intraoperative teaching approaches of

influental surgeons

Aaron Grant Western University, Jecqueline Torti Western University,

Mark Goldszmidt Western University

Background/Purpose: There is wide variability in how

academic surgeons manage their role as intraoperative

educators. This study sought to explore the practices of

surgeons deemed influential by their residents, allowing

insight into a variety of potentially effective practices.

Methods: Constructivist grounded theory was used to

guide data collection and analysis. Data sources included

(1) electronic surveys from senior surgical

residents/recent graduates from an academic hospital in

Canada, (2) intraoperative observations of teaching

interactions followed by (3) semi-structured interviews

with observed surgeons.

Results: We developed a framework which groups

effective teaching into three overlapping approaches:

exacting, empowering, and fostering. The approaches

differed based on the level of independence granted and

the degree of expectation placed on individual residents.

Each demonstrates a different way of balancing the

multiple supervisory roles. We also identified strategies

that could be used across approaches to enhance learning.

Conclusions: For surgical educators seeking to improve on

the quality of intraoperative supervision they provide,

frameworks such as this may be demonstrative of what

effective supervision may look like. Knowledge of proven

strategies combined with reflection on how surgeons

teach, and on how they balance responsibilities to

patients and trainees may allow them to broaden their

educational practice.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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April 18

, 2021 - 10:00 EST

OC1–1 Teaching & Learning -

Accountability

OC1-1-1-60850

Power to the people? A critical review of co-produced

mental health professions education

Csilla Kalocsai University of Toronto, Terri Rodak CAMH, Nancy

McNaughton University of Toronto, Andrew Johnson CAMH, Alise de

Bie McMaster University, Suze Berkhout University of Toronto, Michaela

Beder University of Toronto, Gail Belissimo , Kim McCullough Wilfrid

Laurier, Sacha Agrawal University of Toronto, Sophie Soklaridis

University of Toronto

Background/Purpse: By involving service users in health

professions education - often referred to as coproduction,

educators aspire to produce transformational change by

centring the human, social and ethical dimensions of care

through shifts in power between service providers and

users. However, the literature on whether and how co-

production achieves these ambitious goals remains under-

developed. This gap is particularly pressing in mental

health education, where power differences between

service providers and service users are heightened. This

critical literature review aimed to understand how power

is addressed in co-produced mental health professional

education.

Methods: Our team of service user educators, health

professionals and education researchers conducted

systematic searches in multiple databases not limited by

study design, publication type or year. We screened 6162

titles and abstracts. Articles focusing on co-production in

mental health professions education were included for

full-text review. Of the 303 articles, 171 were selected and

iteratively analyzed.

Results: Power figures prominently in this literature, but

it is rarely made visible. Few articles explicitly use a theory

of power to understand changing relations of service

providers and users; the democratic and emancipatory

values that underpin co-produced education are rarely

reflected in the epistemology or methodology of studies

about it; authors infrequently engage in reflexivity; and

the larger social structures that shape and constrain co-

produced education are rarely considered.

Conclusions: Our review highlights a crucial contradiction

in this literature: while the potential benefits for shifting

power are recognized, authors often fail to seriously

contend with the complexities of power relations. This

lack of critical analysis threatens the goals of co-

production, paradoxically serving to reinforce existing

power relations and structures in health professions

education and beyond.

OC1-1-2-60700

Actions speak louder than words: A critical discourse

analysis of anti-racism statements released by medical

schools and organizations

Allison Brown University of Calgary, Favour Omobhude University of

British Columbia, Emmanuelle Auguste University of Ottawa, Naomie

Bakana University of Lethbridge, Javeed Sukhera Western University,

Allison Brown University of Calgary

Background/Purpose: In the context of increasing

attention to anti-racism in medical education, several

organizations responded to the murder of George Floyd

with public statements. Although this response is

encouraging, a deeper exploration of anti-racist discourse

may improve our understanding on how to address anti-

racism in a meaningful and sustainable way. This aim of

this study was to critically examine this discourse.

Methods: A three-dimensional model for critical discourse

analysis (Fairclough, 2013) was used to examine 45

statements released by medical schools and organizations

in Canada in the United States.

Results: Discourse varied across geographic and

organizational contexts. While some statements included

an explicit focus on anti-Black racism and racial injustices

in society, healthcare, and medical education, conflicting

messages were prevalent across the statements.

Statements often centred previous efforts within the

institution rather than outlining future action to promote

racial justice at an institutional level. While racism was

described as systemic, statements commonly articulated

recommendations at an individual level (e.g., self-

education). Only three statements stated the phrase

"Black Lives Matter". Statements acknowledged the

trauma and grief experienced by racialized members at

their institution without offering resources or supports to

them. A common message was "we're listening and

learning" - yet no mechanisms provided for individuals to

be heard.

Conclusions: Despite any well intentions, the vast majority

public statements released by medical schools and

organizations lacked critical introspection and actionable

steps towards anti-racism. Findings suggest the need for

concern about the potentially performative nature of

academic medicine's efforts to promote racial justice.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OC1-1-3-60559

Exploring how providing care for stigmatized patients

influences the moral development of medical learners

Mark Goldszmidt Western University, Sara Calvert Northern Ontario

School of Medicine, Sarah Burm Dalhousie University, Sayra Cristancho

Western University, Jacqueline Torti Western University, Javeed

Sukhera Western University, Lisa Liu Western University

Background/Purpose: In acute hospital settings, medical

trainees provide care for many stigmatized patient

populations such as patients who inject drugs (PWID) and

are often confronted with ethical dilemmas inherent to

their care. Although providing care to these populations

likely contributes to trainee's moral development, little

research has explored its impact. As part of a larger study

exploring the inpatient care of PWID patients, we

identified how social and material forces may be playing a

role in shaping trainee moral development.

Methods: We conducted a qualitative study informed by

sociomaterial theories. Data consisted of observational

field notes from 48 medical learners, 8 interviews and

medical documentations from inpatient units of two

urban hospitals in Ontario, Canada. Constant comparative

coding and analysis were conducted consistent with

constructivist grounded theory methodology.

Results: In contrast to other patient populations, caring

for PWID patients appeared to frequently trigger a sense

of frustration in learners. In certain learners, this

frustration is observed to further perpetuated a sense of

indifference and avoidance behaviour. Numerous social

and material entities appeared to play a role in shaping

this outcome, including: the cyclic nature of treatment,

perceptions of stigma, difficulty establishing patient

rapport, variability in supervisory practices of senior

residents and attending physicians, and material

influences such as hospital policy and physical

environment.

Conclusions: Existing practices may hinder the moral

development of medical trainees involved in the care of

stigmatized populations such as PWID. Recognizing and

addressing the moral experiences within clinical training

provides an opportunity to improve equity and address

health disparities.

OC1-1-4-60924

Integrating anti-racism and structural violence education

into pre-clerkship psychiatry curricula

Kavya Anchuri University of Calgary, Taelina Andreychuk University of

Calgary, Natalie Jacox University of Calgary, Allison Brown University of

Calgary

Background/Purpose: The recent global resurgence of the

Black Lives Matter movement has manifested within

Canadian medical schools as anti-racist commitments,

manifestos, curriculum changes, and calls to action. BIPOC

(Black, Indigenous and, People of Colour) students are

asking medical schools to confront racism within Canada's

healthcare institutions and improve the quality of care

that marginalized patients receive. Racism in Canada can

take the form of structural violence, which can include

police brutality, medical violence, systematic neglect, and

intergenerational trauma. Among other pathologies,

these phenomena can yield the mental health effects of

chronic stress, anxiety, and collective/ community PTSD.

Summary of innovation: We designed and evaluated a

mandatory teaching session delivered to 153 second-year

medical students about the disproportionate impacts of

structural violence on the mental health of marginalized

communities-specifically Black, Indigenous, 2SLGBTQIA+,

and PWUD (People Who Use Drugs) communities. This

session was taught during the 3-week pre-clerkship

psychiatry course in August 2020. We leveraged Zoom and

the transition to online learning necessitated by COVID-19

to assemble an interdisciplinary panel of experts from

around Canada with collective expertise in psychiatry,

clinical psychology, anti-racism, police violence, and

Indigenous health. The panel format was supplemented

by 'breakout rooms' of approximately 10 students to

facilitate more intimate discussions.

Conclusions: Findings from our repeated measures study

and program evaluation highlight numerous pedagogical

and professional benefits of this session for medical

students, suggesting the urgency for longitudinal

integration of training on anti-racism and structural

violence throughout pre-clerkship curricula around the

country, beyond the psychiatry block alone.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OC1 – 2 Admissions General

OC1-2-1-60808

Rural and Remote Sustainability Score. Eight years of

experience as a screening tool for admission to a

distributed medical education program (DME) with an

emphasis on rural practice.

Tammy Klassen-Ross University of Northern British Columbia, Paul

Winwood University of British Columbia, Geoff Payne University of

Northern British Columbia

Background/Purpose: The University of British Columbia

(UBC) is addressing the shortage of physicians in remote

and rural communities in BC through a distributed model

of undergraduate medical education (DME). For its

Northern Medical Program (NMP), whose goal is to train

physicians for northern and rural communities, a novel

admissions tool, the Rural and Remote Suitability Score

(RRSS) was developed. The RRSS was designed to provide

an objective measure of undergraduate medical

applicants' affinity for training in rural, remote, and/or

northern settings and those most likely to practice family

medicine in such communities.

Methods: The RRSS is a self-report screening tool that is

used as part of the admissions process to the NMP. The

RRSS assesses students in four categories 1) Rural lived

experiences, 2) Self-Reliance and Independence, 3) Rural

related activities, and 4) other information including ties

to rural areas and rural mentors. An adjusted total score

RRSS is generated combining all categories. Practice

locations were scored on a 6-point scale based on the BC

Rural Subsidiary Agreement designation and population

size. Practice locations were obtained from the College of

Physicians of BC, the Canadian Medical Directory and

alumni data.

Results: Preliminary analyses of RRSS scores of graduating

classes from 2008-2016 (n=245) indicated a significant

positive correlation between RRSS adjusted total score

and recruitment location r = 0.16, p < .05. Furthermore, it

was found that 59% of the students who chose NMP as

their first-choice ranking of the 4 DME sites of UBC

pursued a career in Family Medicine.

Conclusions: There is a positive relationship between the

RRSS score and rural practice location. This supports the

use of the RRSS as an admissions tool for rural DME. The

results also demonstrate that students are more likely to

pursue family medicine if they attend the Northern

Medical Program, which was one of the purviews of the

distributed site.

OC1-2-2-60845

The impact of a medical school admissions pathway on

social accountability and rural physician recruitment

Kristi Thompson Western University, Tisha Joy Western University, Saad

Chahine Queen’s University, Don Cartwright Western University

Background/Purpose: To improve local and rural

physician recruitment, the Schulich School of Medicine

and Dentistry introduced, in 2005, a Southwestern

Ontario Medical Education Network (SWOMEN) pathway

for medical school admissions to attract high school

graduates within the ten predominantly rural counties in

the catchment region. This study assesses the impact of

the SWOMEN admissions pathway on the percentage of

medical school graduates practising in a rural setting in the

SWOMEN region and across Canada.

Methods: Either high school or home postal code of

student applicants admitted to Schulich Medicine from

2002 to 2010 were tracked to practice location postal

code as of 2020, extracted from Scott's Medical Directory.

SWOMEN and rural classifications at time of application

and at practice were substantiated by Canada Post postal

code data. Chi-Squared analyses were performed.

Results: Of the 1,000 (77%) Schulich Medicine graduates

tracked to a Canadian practice location, 44.9% vs. 14.0%

(p<0.001) of those from SWOMEN vs. non-SWOMEN

regions, respectively, were practising within the SWOMEN

region as of 2020. The implementation of the SWOMEN

pathway resulted in a near-doubling of graduates

practising within the SWOMEN region by 2020 (28.1% vs.

15.4%, p<0.001). Most notably, the introduction of the

SWOMEN pathway significantly increased graduates

practicing in rural locations within the SWOMEN region

(7.2% post-pathway vs. 3.3% pre-pathway, p=0.008) as

well as across Canada (15.7% vs.11. 2%, p=0.04).

Conclusions: The introduction of the SWOMEN pathway

helped achieve social accountability by increasing local

physician recruitment within SWOMEN and rural

physician recruitment within SWOMEN and across

Canada.

OC1-2-3-60910

Gender and age effect in integrated French Multiple Mini

Interviews. A maturity issue?

Jean-Michel Leduc Université de Montréal

Background/Purpose: Since the implementation of MMI

in three French-speaking medical schools in Québec in

2009, higher scores are obtained by female candidates.

Analysis of scores by gender and by age shows interesting

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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patterns. The objective of this study was to study the

effect of gender, age and their interaction in MMI scores.

Methods: Scores on MMI from 2009 to 2019 were

assembled and standardized on a common scale with a

mean of 500 and a standard deviation of 50. Anova on

mean scores and graphical presentations were used for

analysis.

Results: Results were obtained for 14,615 candidates and

mean age was 21.5 (sd =3.7). Mean score for women (n=

8,837) was 505.2 (sd = 47.4) and 492.7 (sd = 51.4) for men

(n= 5,778). ANOVA showed a significant effect of gender

(F=7.536; p=0.006) and age (F=12.969, p<0.001) and no

interaction between gender and age. While male have

lower scores at all age groups, a clear parallel progression

of scores by age for both gender groups is seen until the

age of 25-26y, with a significant drop of scores for both

groups after 27y.

Conclusions: MMI scores are significantly associated with

gender and age. A non-linear U-shape progression of MMI

scores is associated with age. While the delayed

progression of MMI scores in male applicants could be

explained by a possible lag in maturity, drop of

performance for both groups after 27y is more challenging

to interpret. Some implications of those effects on

students cohorts will be discussed.

OC1-2-4-60702

Adapting the Admissions Interview During COVID-19: A

comparison of in-person and video-based interviews'

validity evidence

Kulamakan Kulasegaram University of Toronto, Victorina Baxan

University of Toronto, Elicia Giannone University of Toronto, David

Latter University of Toronto, Mark Hanson University of Toronto

Background/Purpose: COVID-19 physical distancing

limited many schools' ability to conduct in-person

interviews for the 2020 admissions cycle. The University

of Toronto was already in the midst of its interview

process with two-thirds of the applicants having

completed the in-person modified personal interview

(MPI). As the university and surrounding region was

shutdown, we shifted in the middle of the application

cycle to a semi-synchronous video-based interview

approach (vMPI). We describe the development,

deployment, and evaluation of the two approaches in the

midst of the admissions cycle.

Summary of innovation: Existing resources and tools

were used to create a bespoke interview process with the

assistance of applicants. The vMPI was similar in content

and process to the MPI: a four station interview with each

station mapped to attributes relevant to medical school

success. Instead of live interviews, applicants recorded 5-

minute responses to questions for each station using their

own webcams or other hardware. These responses were

later assessed by raters asynchronously. A total of 232

applicants completed the vMPI out of a total of 627. We

compare the validity evidence for the vMPI to the MPI on

the internal structure, relationship to other variables, and

consequential validity including applicant and interviewer

acceptability. Evaluation Outcomes: The vMPI

demonstrated similar reliability and factor structure to the

MPI. Like the MPI, it was predicted by non-academic

screening tools but not academic measures. Applicants'

acceptability of the vMPI was positive. The vast majority

of interviewers also found the vMPI to be acceptable and

demonstrated confidence in their ratings.

Conclusions: Continuing physical distancing concerns will

require multiple options for the admissions committee to

select medical students. The vMPI is an example of a

bespoke approach that schools can implement and may

have advantages for selection beyond the COVID-19

pandemic. Future evaluation will examine additional

validity evidence for the tool.

OC1 – 3 Research Methods

OC1-3-1-60856

What influence do systematic reviews in medical

education really have? A bibliometric perspective

Tanya Horsley The Royal College of Physicians and Surgeons, Yvonne

Steinert McGill, Karen Leslie Queen’s University, Anna Oswald

University of Alberta, Farah Friesen Women's College Hospital, Rachel

Ellaway University of Calgary

Introduction: Knowledge syntheses in medical education

are intended to promote the translation to, and

mobilization of, research knowledge into practice. Despite

the effort invested in conducting them, how these

knowledge syntheses are used is unclear. This study aimed

to explore how knowledge syntheses published by the

Best Evidence Medical Education Collaboration (BEME)

have been used in a cross-section of published literature.

Methods: Using bibliometric techniques, citation patterns

for BEME reviews were explored using data drawn from

Web of Science and Scopus, and a sub-sample of citing

papers.

Results: Bibliometric data on 3419 papers citing 29 BEME

reviews were analysed. More detailed data were

extracted from a random sample of 629 full-text papers.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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BEME reviews were most often positioned to consolidate

and summarize the current state of knowledge on a

particular topic and to identify gaps in the literature; they

were also used to justify current research, and less

frequently to contextualize and explain results, or direct

future areas of research. Their use to identify instruments

or methodological approaches was relatively absent.

Conclusions: While BEME reviews are primarily used to

justify and support other studies, the current literature

does not demonstrate their translation to educational

practice.

OC1-3-2-60235

Global Perceptions on Social Accountability and

Outcomes: A Survey of Medical Schools

Cassandra Barber Maastricht University, Saad Chahine Queen’s

University, Jimmie Leppink University of York

Background/Purpose: Social accountability is central to

medical education, yet despite repeated international

calls for stronger evidence of institutional effectiveness,

programs continue to struggle to demonstrate social

accountability. This study explores institutional practices

and administrative perceptions of social accountability in

medical schools, globally.

Methods: An online survey was emailed to a purposeful

sample of academic deans and program directors/leads of

English-speaking medical schools that offer an

undergraduate medical program from 245 institutions in

14 countries. Survey items were developed using previous

literature and categorized using context-input-process-

products (CIPP) evaluation model as an organizational

framework. Exploratory Factor Analysis (EFA) was used to

assess the inter-relationships among items. Reliability and

internal consistency of items were evaluated using

McDonald's omega. Analysis of variance (ANOVA) and

post hoc analyses were used to examine institutional

differences.

Results: Findings from 103 deans and program

directors/leads collected between February-June 2020

are presented. Common perceptions and institutional

practices of social accountability were identified. Five-

factors were extracted, accounting for 68% of the

variance: community partnerships; institutional

mandates; selection/recruitment; institutional activities;

and community responsibility. Institutional nuances and

differences among factor subscales were observed.

Conclusions: This study identified institutional practices

and administrative perceptions of social accountability.

While, most medical schools expressed an institutional

commitment to social accountability, the effects of their

outcomes on the community remain unknown and not

evaluated. Institutional practices of social accountability

focus on inputs and processes and lack product outcomes.

Overall, this paper offers programs and educators a

psychometrically supported tool to aid in the

operationalization and reliability of evaluating social

accountability.

OC1-3-3-60491

How medical students make meaning of early significant

clinical experiences: The role of social networks

Samantha Stasiuk University of British Columbia, Laura Nimmon

University of British Columbia, Maria Hubinette University of British

Columbia

Background/Purpose: Medical curricula are increasingly

providing opportunities to promote, support and guide

reflection for medical students. However, we do not fully

understand the broader social influences that shape

reflection. This understanding is critical to frame our

teaching language and enhance authentic meaning

making in early years medical students. This study asks the

question: How do students use social networks to reflect

on early significant clinical experiences, and what meaning

do students find in these interactions?

Methods: This study employed a qualitative social

network analysis approach. Our study was conducted with

seven first year undergraduate medical students. Data

consisted of participant generated sociograms and in-

depth individual semi-structured interviews.

Results: Learners described the importance of verbal

processing within their social networks and engaging in

dialogue around early significant clinical encounters.

Learners also struggled to find meaningful ways to involve

their networks outside of medicine in their new

experiences. Learners found some curricular

opportunities such as reflective portfolio sessions to be

useful.

Conclusions: Our study is one of the first to characterize

the social networks inside and outside of medicine that

medical students utilize in order to make meaning of early

significant clinical experiences. We were able to capture

the role students' social networks play in the support of

their developing professional identity. This study is a first

step in helping students to identify their own social

networks, and an explicit acknowledgment of important

identity intersections both inside and outside of medical

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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school, through a vivid representation of the composition

of network ties. The insights add to a growing body of

literature demonstrating the importance of relationship-

centered education for reflection.

OC1-3-4-60583

Peer Mentorship to RE-ignite the SEARCH in Students for

Research

Huma Ali Aga Khan University Medical College, Pakistan, Russell Martins

Aga Khan University Medical College, Pakistan, Sadia Fatima Aga Khan

University Medical College, Pakistan

Background/Purpose: Research is an integral part of

medical education across the globe. However, the

research output from medical students often leaves a lot

to be desired. This can be attributed to inadequate

research training, and lack of mentors and opportunities.

Thus, our innovative approach of introducing peer

mentorship in research aims to increase not only the self-

proficiency of students but also the quality and quantity

of research.

Summary of innovation: A predefined criterion was used

to select 16 penultimate and final year medical students

to serve as Student Mentors (SMs). They designed

innovative pedagogies, conducted a series of research

workshops (RWs) for 187 participants in January 2020 at

the Aga Khan University, Pakistan, and mentored them for

6 months. Data was collected through three

questionnaires; pre- and post-RWs self-proficiency ratings

(lowest: 1- highest: 10), a feedback form, and a 6-month

follow-up survey.

Conclusions: With a response rate of 92%, a significant

improvement was seen in overall self-proficiency post-

RWs (p < 0.001), with the highest increase in 'Avoiding

Plagiarism and Using Referencing' (4.78 ± 2.31). A 6-month

follow-up survey evidenced an increase in student

involvement in research by 29.2% (p < 0.001). 18 (20.5%)

students published their work in peer-reviewed journals

(mean impact factor =1.393) versus only 3 (3.4%) pre-RWs

(p < 0.001). These results establish the effectiveness of

peer-learning and student mentorship in improving the

research output. Additionally, the teaching pedagogies

implemented in the RWs can be used as a solid framework

for adaptation within conventional undergraduate

medical education.

April 18

, 2021 - 11:00 EST

OC2 – 1 CPD

OC2-1-1-60630

A Qualitative Study to Understand the Cultural Factors

that Influence Clinical Data Use For Continuing

Professional Development

Sanjeev Sockalingam Vice President of Education, Centre for Addiction

and Mental Health; Associate Professor, Department of Psychiatry,

Spencer Williams Research Analyst, University Health Network, Rebecca

Charow University of Toronto, Tharshini Jeyakumar Education

Specialist, Digital Education, University Health Network, Craig Campbell

Principal Senior Advisor, Competency-based Continuing Professional

Development, Office of Specialty Education, Royal College of Physicians

and Surgeons of Canada; Associate Professor, Faculty of Medicine,

University of Ottawa, Dave Davis University of Toronto, Maria

Mylopoulos Scientist & Associate Director of Training Programs, Wilson

Centre, University Health Network; Program Director, Health Professions

Education Research, Institute of Health Policy, Management and

Evaluation & Dalla Lana School of Public Health, University, Allan

Okrainec Head, Division of General Survey, Peter A. Crossgrove Chair in

General Surgery & Director, Temerty/Chang Telesimulation Centre,

University Health Network, Ivan Silver Staff Psychiatrist, Centre for

Addiction and Mental Health; Professor, Department of Psychiatry,

University of Toronto, Walter Tavares Scientist, Wilson Centre,

University Health Network; Assistant Professor, Post MD Education,

Faculty of Medicine, Institute of Health Policy, Management and

Evaluation & Dalla Lana School of Public Health, University of Toronto,

David Wiljer Executive Director, Education Technology and Innovation,

University Health Network; Associate Professor, Institute of Health

Policy, Management and Evaluation & Department of Psychiatry,

University of Toronto

Background/Purpose: The use of data to inform lifelong

learning (LLL) has become an increasingly important

dimension of clinical practice. Physicians could leverage

data to develop adaptive expertise in identifying practice

needs, developing learning plans, and evaluating practice

adjustments. Despite these benefits, there is variable

evidence in physicians engaging in data-informed learning

activities, particularly for continuing professional

development (CPD). The purpose of this study is to explore

cultural factors (individual, organizational, and systemic)

that influence the use of clinical data to inform LLL and

self-initiated CPD activities.

Methods: This qualitative study is part of an explanatory

sequential mixed-methods study examining data-

informed learning. Participants were psychiatrists and

general surgeons from Canada and the United States.

Recruitment occurred between April-November 2019 and

the authors conducted telephone semi-structured

interviews between May- November 2019. Content

analysis was performed using an iterative, inductive

method of constant comparative analysis.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Results: Three major themes emerged: (1) data quality

and the trustworthiness of the data, (2) the importance of

a team-based approach to data, including collaboration

with data specialists within clinical departments and

leadership support, and (3) the need for a systematic

approach to the use of the data, including organizational

support for data literacy skill development, infrastructure

and investments.

Conclusions: Building trust, taking a team-based

approach, and engaging multiple stakeholders throughout

the data lifecycle, particularly data specialists and

organizational leadership, may significantly improve

physicians' use of data for learning.

OC2-1-2-60341

Exploring learning needs and preferences among early

career physicians

Anne Mahalik Dalhousie University, Tanya MacLeod Dalhousie

University, Connie LeBlanc Dalhousie University, Lisa Bonang Dalhousie

University

Background/Purpose: It is reasonable to expect that early

career physicians have unique continuing professional

development (CPD) learning needs and preferences,

however, there is little research available on this topic.

The purpose of this study was to explore the learning

needs and preferences of early career physicians (≤10

years in practice) to inform CPD program planning.

Methods: An online survey and individual interviews were

conducted with early career physicians in Nova Scotia.

Survey data were collected from 51 participants; of these,

11 participated in personal interviews. Descriptive

statistics and thematic analysis were used to analyse the

data.

Results: Participants identified the need for education in

practice management (e.g., billing, medicolegal concerns,

time management); navigating the local healthcare

system (e.g., referral practices and requirements); skills-

based knowledge (e.g., changes in practice, maintaining

clinical competency); and career development (e.g.,

opportunities for mentorship, research, teaching,

academic career progression and leadership). Participants

also described various factors that influence their

participation in CPD. Examples included their preferred

learning method, relevance of the topic to their practice,

location, reputation of the speaker, and the cost of the

event, both in money and time.

Conclusions: In this presentation, we will review highlights

from the study findings and recommendations to inform

future CPD programs. We will also provide a handout of

the research materials for CPD offices with an interest in

replicating this study.

OC2-1-3-60263

A Qualitative Study on the Educational Needs of Family

Physicians Regarding Quality Improvement in

Newfoundland and Labrador

Heidi Coombs Memorial – University of Newfoundland, Cheryl

Etchegary Quality of Care NL/Choosing Wisely NL, Tobias Gelber Health

Innovation Group, Xiaolin Xu Memorial – University of Newfoundland,

Karla Simmons Memorial – University of Newfoundland

Background/Purpose: Primary healthcare providers in

Newfoundland and Labrador maintain large, busy

practices and face significant challenges to effectively

managing their practices and providing timely, quality

care. This study explored the perspectives of family

physicians and the experiences of patients in accessing

primary healthcare. The results have informed the

development of a longitudinal education and support plan

for family physicians in Newfoundland and Labrador.

Methods: Three data gathering methodologies were used,

including an environmental scan, focus groups with family

physicians (n=35) and patient representatives (n=8), and

key informant interviews with stakeholders in primary

care (n=10) and representatives from other jurisdictions in

Canada (n=8). Thematic analysis was adopted in the study.

Results: The most significant challenges and barriers for

family physicians include maintaining large practices of

patients with complex health needs, financial

management and the Fee for Service Model, information

management and technology, and human resource

management. Barriers identified by patients include the

lack of timely access, patient-centred care, and team-

based care. The key informants recommended simplifying

and specifying improvements, maintaining positive

professional relationships, building on readiness for

change, and enabling family physicians to engage in

educational activities and support.

Conclusions: This study identified four main educational

needs of family physicians, including enhancing patient

safety and care, practice effectiveness and efficiency,

quality improvement, and team-based care. The findings

have important implications for developing an education

and support plan to enhance the efficiency, cost-

effectiveness, and sustainability of primary healthcare.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OC2-1-4-60528

Interactive Learning in Continuing Education Conferences

Tanya MacLeod Dalhousie University, Diana Sanchez-Ramirez University

of Manitoba, Christine Polimeni University of Manitoba, Constance

LeBlanc Dalhousie University, Dori Rainey University of Manitoba

Background/Purpose: Education standards for accredited

continuing professional development (CPD) require that

programs dedicate a minimum of 25% of time to

interactive learning. Anecdotal evidence suggests that

CPD conferences rely heavily on end-of-lecture question

and answer (Q&A) periods to fulfill this standard. Little is

known or described in the literature about interactive

approaches in real-world conferences. The purpose of this

study was to explore interaction during CPD conferences

with a focus on the Q&A period.

Methods: Data were collected from 49 CPD conference

lectures in Nova Scotia and Manitoba. Attendance ranged

from 139-320 healthcare providers. In each lecture, an

observer used an evidence-informed field guide to record

information.

Results: On average, lectures were 46 minutes, with 7

minutes for the Q&A period. In NS, 66% (12/18) of

speakers ran out of time or did not have any Q&A; MB

used an online Q&A format (Slido) and 100% (31/31) of

speakers included Q&A, however, back-and-forth

dialogue in the conference setting was not observed.

Assuming that the Q&A period was the only interaction

that occurred, interactivity accounted for a mean of 15%

of the allotted time for the session (18% in Manitoba and

11% in Nova Scotia).

Conclusions: Results suggest that most conference

lectures do not meet the minimum for interactivity using

the Q&A period only. In this presentation, we will share

findings of the nature of Q&A in conference lectures, and

other forms of interaction that were observed. This study

has important implications for faculty development and

the delivery of CPD in conference settings.

OC2 – 2 Postgraduate

OC2-2-1-59976

The Attitudes of Canadian Ophthalmology Residents and

Pre-Clerkship Medical Students at an Ontario Medical

School Towards Homeless Individuals: A Cross-Sectional

Study

Aman Sayal University of Toronto, Marko Popovic University of Toronto,

Majd Mustafa McGill, Stephen Hwang University of Toronto, Myrna

Lichter University of Toronto

Background/Purpose: Homeless individuals experience

visual impairment at rates much higher than the general

population. This cross-sectional study assessed the

attitudes of Canadian ophthalmology residents(PGY1-5)

and pre-clerkship medical students(year 1 and 2) at the

University of Toronto, towards homeless individuals.

Methods: Residents and students were invited to

complete the Health Professionals' Attitudes Towards the

Homeless Inventory(HPATHI) tool to assess attitudes,

interests and confidence in working with the homeless

population on a 5-point Likert scale. Comparisons were

made between residents and pre-clerkship learners and

between junior and senior residents using the Fisher's

exact test and Mann-Whitney U test.

Results: Responses were received from 114 of 220

ophthalmology residents(52%) and 315 of 534(59%) pre-

clerkship medical students. Residents had significantly

more negative overall attitudes(pre-clerk median=4.4,

resident median=4.1, both still indicating positive

attitudes) and interests(pre-clerk median=4.0, resident

median=3.3, residents with more neutral interests)

towards working with the homeless population compared

to pre-clerkship students. Using both statistical methods,

beliefs were significantly more negative in 7 of 9 'Attitude'

items, 5 of 5 'Interest' items and 1 of 4 'Confidence' items.

Ophthalmology residents were more positive in 1 of 4 of

the 'Confidence' items. Attitudes were similar across

PGY1-5 training years, except PGY4 and PGY5 residents

were more negative than PGY1-3 residents on 1 of 5

'Interest' items.

Conclusions: Ophthalmology residents have an at least

neutral perception of individuals experiencing

homelessness, while medical students have a more

positive opinion. Studies exploring optimal ways to

advocate for this population are needed for Canada's eye-

care trainees.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OC2-2-3-60523

"One step away from 'you don't know what you're

doing'": A qualitative study exploring perspectives of

uncertainty among residents and early career clinicians

Taryn Taylor Western University, Brittany Dellar Western University,

Simranjot Sehgal Western University, Chris Watling Western University,

Sayra Cristancho Western University

Background/Purpose: Current competency frameworks

reflect the inevitability of uncertainty in clinical practice.

Such frameworks emphasize that all trainees must learn

to recognize and respond to uncertainty. Yet it remains

unclear how trainees can learn this skill when the

dominant ethos of medical training equates competence

with absolute certainty. Thus, we sought to explore how

early career clinicians (ECC) and residents understand the

significance of clinical uncertainty and its relationship with

competence.

Methods: Using Constructivist Grounded Theory, we

conducted semi-structured interviews with 13 residents

and 11 ECC (n=24), from ten different specialties. Iterative

data collection and analysis directed constant comparison

and theoretical sampling to sufficiency.

Results: Our analysis developed three main dimensions of

uncertainty: (1) Trajectories of uncertainty, (2)

Performances of (un)certainty and 3) Pedagogies of

uncertainty. Trajectories captured the dynamic, non-

linear relationship between uncertainty and experience.

Performances highlighted how declarations of uncertainty

are often constrained by gendered social norms and other

implicit biases. Pedagogies identified the predominantly

informal curriculum that shapes how our participants

made inward and outward judgements of competence in

light of uncertainty.

Conclusions: Our analysis reveals a complexity that is not

captured by existing competency frameworks, which

position "managing uncertainty" as a skill that is

straightforwardly mastered during training. Rather, our

participants described a non-linear evolution in how they

both managed and understood the significance of

uncertainty in their clinical practice. A lack of intentional,

structured curriculum enables implicit biases about

uncertainty and its relationship with competence to

persist.

OC2 – 3 Undergraduate

OC2-3-1-60273

Evaluation of a Pilot Addiction Medicine Week Created

for and by Pre-Clerkship Medical Students

Robin Glicksman University of Toronto, Melissa Tigert University of

Toronto, Hilary Stone University of Toronto, Ruby Alvi University of

Toronto, Peter Selby University of Toronto, Azadeh Moaveni University

of Toronto, Joyce Nyhof-Young University of Toronto

Background/Purpose: Medical students receive limited

exposure to substance use disorders (SUDs) throughout

their undergraduate medical training, despite its

prevalence in society. At the University of Toronto, a pilot

week-long extra-curricular program in addiction medicine

was developed by medical students for pre-clerkship

students to enhance their SUD knowledge, skills and

attitudes to better prepare them for clinical practice.

Summary of innovation: Curriculum objectives were

created to reflect the CANMEDs roles. The novel

curriculum included half didactic and half clinical

shadowing experiences. Didactic lectures and workshop

topics included: the biopsychosocial model of addiction,

motivational interviewing, harm reduction care models,

naloxone training and stigmatization of addiction

disorders. The clinical course component involved

placements at residential treatment facilities, in-patient

hospital services, rapid access clinics and specialty

addiction medicine placements (e.g. substance use in

pregnancy clinics, etc.). The curriculum was evaluated

using a mixed-method design, and all learning objectives

were addressed, as determined by qualitative analysis.

During the COVID-19 pandemic, the program was shifted

to a virtual format.

Conclusions: Participants reported being highly satisfied

with the program, and felt the clinical exposure was

invaluable for skills building, career exploration, and

understanding stigma and the patient experience. In

addition, participants felt that program stimulated

personal and professional growth, and introduced them to

forms of advocacy for this vulnerable population. Key

learning points included prioritizing patient and family

member perspectives. Overall, participants felt the week

initiated a change for their future practice and felt that all

medical students should have similar exposure to

addictions medicine.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OC2-3-2-60569

Autopsy of a Longitudinal Integrated Clerkship: An

Organizational Process Analysis of a Clerkship Program's

Demise

Clare Hutchinson University of Toronto, Abdollah Behzadi University of

Toronto, Natalie Clavel University of Toronto, Ra Han University of

Toronto, Adam Kaufman University of Toronto, Piero Tartaro University

of Toronto, Kulamakan Kulasegaram University of Toronto, Maria

Martimianakis University of Toronto, Maria Mylopoulos University of

Toronto, Stacey Bernstein University of Toronto

Background/Purpose: In 2014 the University of Toronto

launched a multi-site, urban longitudinal integrated

clerkship (LInC), encompassing all medical and surgical

disciplines. After expanding to 10% of the class in seven

sites, this pilot program was terminated in 2018. This

descriptive study outlines the reasons for the program's

discontinuation using an organizational processes

framework.

Methods: As co-creators of the program, we identified

several factors that led to the program's collapse. Based

on our observations and qualitative analysis of focus

group transcripts, we have described our findings related

to the structural, human resource, symbolic and political

challenges.

Results: Structurally, the co-existence of LInC and block

clerkship within the same hospitals created confusion and

competition for scarce clinical resources. From a human

resource perspective, the program carried a significant

administrative burden to allow for the creation of

personalized daily schedules for each LInC student.

Symbolically LInC represented the promotion of

heightened humanism in medicine. Paradoxically this

holistic emphasis was perceived as both less rigorous

compared to traditional block clerkship, and as an

invalidation of block student interpersonal skills.

Politically, LInC created issues of equity among the

medical school class, due to the significant resources

allocated to a small minority of the class perceived as

being treated preferentially.

Conclusions: LInC challenged the culture of our large,

traditional medical school. Despite the program being

highly successful clinically, asking students to choose

between two parallel clerkship curricula co-existing in the

same institution proved unsustainable. We are planning

on bringing the most impactful elements of the program

to the entire medical school class.

OC2-3-3-60008

Factors Impacting Medical Student Comfort with

Procedural Skils

Bright Huo Dalhousie University, Wyatt MacNevin Dalhousie University,

Dr. Stephen Miller Dalhousie University, Michael Smyth Dalhousie

University

Background/Purpose: Medical students entering

clerkship may have low confidence and high levels of

anxiety in performing common procedural skills.

Increasing opportunities for skills exposure may improve

medical student confidence in procedural skills

performance prior to clerkship. The impact of career

interest and elective choice on pre-clerkship student

comfort with procedural skills is unclear. This study

examines the relationship between student procedural

skills comfort, career interest and elective choices.

Methods: Surveys were completed by 53 second year

Dalhousie medical students. A 5-point Likert scale was

used to evaluate students' exposure, comfort, and

motivation to learn common procedural skills. Descriptive

and quantitative analysis methods were performed.

Results: Medical students (>60%) reported poor comfort

levels for most skills, despite >80% of students rating high

motivation to learn them. Elective choice impacted

student comfort levels as students who completed

electives in anesthesiology were more comfortable with

performing intubation (23% vs 10%, p = 0.026) and IV

insertion (38% vs 13%, p = 0.002). Most participants

(60%) reported low exposure to basic skills including

phlebotomy (62.2%), breast exam (62.3%), bag mask

ventilation (64.2%), Digital Rectal Exam (DRE, 64.2%) and

throat swabbing (79.2%).

Conclusions: This study supports that medical students

feel low levels of comfort with performing procedural

skills despite high motivation for learning. Comfort was

influenced by both career interest and elective

experience. Programs aiming to increase students'

comfort levels in performing procedural skills should

adapt curricula toward increasing early exposure to these

skills.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OC2-3-4-60829

Steps towards building psychological safety within the

Faculty of Medicine & Dentistry at the University of

Alberta

Penelope Smyth University of Alberta, Blaine Aucoin University of

Alberta, Hanne Ostergaard University of Alberta, Pamela Brett-MacLean

University of Alberta

Background/Purpose: In Canada, psychological safety is

mandated within the workplace. Despite regulations,

anonymized graduating learner surveys continue to

identify the presence of mistreatment, while learners

report fear of reporting mistreatment. In 2019, the

professionalism committees within the Faculty of

Medicine & Dentistry (FoMD) initiated early steps directed

to creating a culture of psychological safety for all

workplace members, to support more open dialogue

around professionalism and treatment of others in our

workplace, from learners through faculty.

Summary of innovation: Members of FoMD

professionalism committees, along with internal and

external FoMD stakeholders, met at a psychological safety

retreat to answer three questions: (1) What is a

psychologically safe workplace, and how does it impact

you?; (2) What do you perceive to be the barriers in

shifting FoMD culture?; and (3) What are some

opportunities we could build upon to start moving

towards psychological safety within the FoMD workplace?

Small group-generated barriers and opportunities were

themed into the 13 psychosocial factors, then prioritized

through anonymous stakeholder individual survey

ranking. The top nine identified barriers & actionable

opportunities were then organized into four key

implementation priorities: 1) Faculty Structure; 2) Faculty

Development; 3) Faculty Communication Strategy; and 4)

Individual Stressors. Progress of working groups, through

the COVID-19 pandemic and an unprecedented period of

academic restructuring at the University of Alberta, is

described.

Conclusions: To build a culture of psychological safety for

all members of an academic medical workplace, initiatives

must translate stakeholder views into structured actions

in a safe, transparent, and accountable manner.

April 18

, 2021 - 12:00 EST

OC3–1 Teaching & Learning-

Feedback

OC3-1-1-60661

In Support of Meaningful Assessment and Feedback: A

Study of 'Reasoning Tasks' Used During Case Review in

the Ambulatory Setting

Radha Joseph McMaster University, Jacqueline Torti Western

University, Kristen Bishop Western University, Mark Goldszmidt

Western University

Background/Purpose: Faculty and trainees are familiar

with clinical tasks, but less familiar with metacognitive

'reasoning tasks' that influence clinical task performance.

As part of a multi-phase study exploring reasoning tasks

across internal medicine settings, the purpose of this

study is to explore patterns of reasoning tasks used in

ambulatory geriatric clinics.

Methods: Data consists of 18 audio-recorded case review

discussions between 4 geriatricians and 11 trainees

(medical students, residents and fellows). Transcript

analysis included constant comparison and template

analysis using a previously validated list of 3 overarching

and 23 supportive reasoning tasks.

Results: The most addressed reasoning tasks reflect the

nature of this specialty: trainees emphasize precipitants to

the current problem, explore physical and psychosocial

consequences of the current conditions or treatment, and

may formulate tentative management plans

contextualized to the psychosocial. Faculty refine

management plans by weighing alternative treatment

options, considering the impact of comorbid illness on

management and vice versa. They also demonstrate

expertise with the healthcare system via collaborative

practices and navigation of resource constraints.

Theoretically, 2 new reasoning tasks were identified: 1)

consider the quality of the data source, including

credibility, reliability and other barriers to effective data

collection; 2) determine the need for further data

gathering.

Conclusions: Developing a shared language around

reasoning tasks will support trainee preparation and

development, through more explicit feedback around

patterns of omission and inter-specialty differences.

Understanding which tasks are commonly addressed by

trainees vs. faculty can also help delineate the

competency continuum and support assessment design.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OC3-1-2-60690

Findings from the Implementation of a Modified R2C2

Model of Feedback for Psychiatry Residents within a

Competency-based Medical Education Framework

Shaheen Darani University of Toronto, Anupam Thakkur University of

Toronto, Yasmin Lalani University of Toronto, Sophie Soklaridis

University of Toronto, Ivan Silver University of Toronto, Csilla Kalocsai

University of Toronto, Sanjeev Sockalingam University of Toronto

Background/Purpose: Coaching and feedback are crucial

to facilitate progress for residents. R2C2 is a validated

model of feedback comprising of four iterative phases

(building relationship, exploring reactions, exploring

content, coaching). This study reports on the

implementation of a modified iteration of the model in a

competency-based medical education (CBME) context.

The Consolidated Framework for Implementation

Research (CFIR) was used to identify factors that

influenced intervention, implementation and

effectiveness. The modified R2C2 model encourages

supervisors to reflect on power dynamics within the

supervisor-resident relationship, whilst using all other

elements of the original model.

Methods: Supervisors received training in the modified

R2C2 model. During implementation, support from

educational leaders was available to help supervisors

solidify their learning. Semi-structured interviews were

conducted with supervisors (n=9) to understand their

experience of using the model and the implementation

process.

Results: Using a grounded theory approach, results from

supervisor interviews revealed factors associated with the

process of implementing an educational initiative.

Participants also highlighted a need to consider power-

dynamics in the supervisor-resident relationship.

Conclusions: The supervisors' experiences of the modified

R2C2 model offer promising insights for considering the

implementation supports needed to sustain

programmatic feedback. This study will be of interest to

supervisors or other clinical leaders who aim to implement

structured feedback practices within a CBME framework.

OC3-1-3-60136

Feedback Delivery in an Academic Cancer Centre:

Reflections From an R2C2-based Microlearning Course

Amir H. Safavi University of Toronto, Janet Papadakos Cancer Education,

Princess Margaret Cancer Centre, Tina Papadakos Cancer Education,

Princess Margaret Cancer Centre, Naa Kwarley Quartey Cancer

Education, Princess Margaret Cancer Centre, Karen Lawrie Cancer

Education, Princess Margaret Cancer Centre, Eden Klein Cancer

Education, Princess Margaret Cancer Centre, Sarah Storer Cancer

Education, Princess Margaret Cancer Centre, Jennifer Croke University

of Toronto, Barbara-Ann Millar University of Toronto, Raymond Jang

University of Toronto, Andrea Bezjak University of Toronto, Meredith E.

Giuliani University of Toronto

Background/Purpose: There is longstanding evidence of

feedback competency deficiencies in supervisors in

medical education. Enhancing feedback delivery skills is a

critical aspect of competency-based medical education.

R2C2 (relationship, reaction, content, coaching) is an

increasingly adopted evidence-based model for feedback

delivery. The purpose of this study was to assess the

feasibility and utility of an R2C2-based microlearning

course and to solicit multidisciplinary staff perspectives on

current feedback delivery practice in an academic cancer

centre.

Methods: A prospective longitudinal qualitative design

was utilized. Five staff (three oncologists and two allied

health professionals) with supervisory roles were selected

by purposive sampling. Each staff participated in four

semi-structured interviews conducted pre- and

immediately post-course, and at one- and three-months

post-course. Interviews were audiotaped and transcribed

verbatim. Transcripts were coded using an abductive

approach informed by the R2C2 model.

Results: All participants found the course to be time

feasible and completed it in 10-20 minutes. The course

was deemed to be useful and fulfill a perceived need for

feedback training in the cancer centre. Relationship

building and exploring reactions were the R2C2 domains

most discussed during post-course interviews. Several

relationship-oriented themes were generated: 1)

hierarchical and interdisciplinary relationships modulate

feedback delivery 2) interest in feedback delivery varies by

duration of the supervisory relationship 3) the perceived

transactionality of supervisor-trainee relationships

influences feedback delivery.

Conclusions: An R2C2-based microlearning course is

feasible and deemed useful by multidisciplinary cancer

centre staff. Optimization of the course and further

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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characterization of current feedback practices in the

cancer centre are ongoing.

OC3-1-4-60576

Perceptions of Resident feedback Among Medical

Students

Shannon Wong University of British Columbia, John (Cong) Luo

University of British Columbia, Rose Hatala University of British Columbia

Background/Purpose: Feedback is a valuable component

of medical education. The majority of studies investigating

effective feedback have focused on faculty-learner dyads.

In clinical education, residents play a pivotal role in

providing feedback to medical students, but no studies

have explored resident-student feedback encounters. Our

objective was to gain a deeper understanding of medical

students' perceptions of resident-led feedback.

Methods: In this pilot study, we used a qualitative

research design informed by phenomenology. We

conducted 5 semi-structured one-on-one interviews with

fourth year UBC medical students. Interviews were

transcribed and anonymized, and then read

independently by each co-author. We collaboratively

developed and applied initial codes to all transcripts. We

then iteratively analyzed the data using thematic analysis

to organize the codes into themes and subthemes.

Results: We identified several themes, including

relationships and outcomes, which provide novel insight

into student-resident feedback interactions. Students

value supportive resident relationships, as they were

associated with positive emotional responses. Direct

observation was a useful tool employed by residents to

help students feel well-supported. As well, a strong

interpersonal relationship positively impacted students'

learning goals. Students perceived resident feedback as

focused on their growth, in contrast to faculty feedback,

which was often perceived as having an assessment focus.

Conclusions: Our pilot study provides some insights into

how and why students value feedback from residents.

Explicit strategies on how to build supportive student-

resident relationships and incorporate direct observation

into routine clinical practice may be needed for residents-

as-teachers in order to engage in meaningful feedback

conversations with students.

OC3 – 2 Teaching & Learning - Novel

Approaches

OC3-2-1-60478

F-SOAP: A simple model to teach oral case presentations

to medical students

Anthony Seto University of Calgary, Katie Lin University of Calgary

Background/Purpose: Presenting clinical cases orally is a

critical skill in medical teaching, yet learners may find it to

be one of the most challenging and intimidating

interactions to have with preceptors. Introducing learners

to an organized, structured oral case presentation model

may enhance their preparedness and confidence in this

skill.

Summary of innovation: To fulfill this goal, the F-SOAP

model (Frame, Story, Objective, Assessment, Plan) was

created by adapting the SOAP notes method of clinical

documentation. The F-SOAP presentation approach was

taught to second-year medical students through a pre-

recorded podcast, which discussed the model and

included two case-based simulation exercises. Students

then used an evaluation checklist to facilitate self-

reflection. 153 second-year medical students were

surveyed post-workshop to reflect on the impact of the F-

SOAP model. Students' (n=66) confidence in oral case

presentation skills increased significantly (p<0.001) pre- vs

post-session (mean 2.59 to 3.55/5.00; mode 2.00 to

4.00/5.00) with a large effect size (Cohen's d=1.10).

Additionally, 94% of students (n=66) found the F-SOAP

model to be "useful" or "very useful"; the "usefulness"

was rated a mean of 4.41/5.00 and was bimodal at

4.00/5.00 and 5.00/5.00. 100% of students (n=64) planned

on using the F-SOAP model for future case presentations

to preceptors.

Conclusions: F-SOAP (Frame, Story, Objective,

Assessment, Plan) is a simple, structured tool that appears

effective in improving medical student confidence with

oral presentation skills. Prior to introducing F-SOAP,

medical students expressed low to neutral confidence in

presenting cases, identifying the need for a presentation

approach (i.e. F-SOAP) to practice and build confidence for

presentations.

OC3-2-2-60474

Evaluation of a Student-Led Global Health Certificate

Program: A Mixed Methods Study

Khalidha Nasiri Western University, Jenny Lee Western University,

Jelena Poleksic Western University, Divya Santhanam Western

University, Anita Cheng Western University

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Background/Purpose: Globalization and demand from

medical students call for global health training

opportunities that build proficiency to care for diverse

patient populations. There is currently a lack of research

on the impact of Canadian global health training programs

for medical students.

Summary of innovation: A student-led Global Health

Certificate Program (GHCP) was developed using

evidence-based recommendations and AFMC-mapped

competencies in the principles of global health and social

medicine. It is delivered through advocacy training,

lectures/workshops, and experiential projects. We

evaluated the impact of the GHCP on student perspectives

and global health competencies using an online mixed

methods survey of 115 medical student participants

conducted before and after the program.

Conclusions: Participants reported knowledge

improvements in 5 of 6 AFMC competencies. A majority

reported a moderate/major impact on all CanMEDS

competencies (range: 53.3% to 84.4%) and most reported

a positive impact on personal development outcomes

(range: 44.4% to 84.4%). Qualitative themes identified

were that the GHCP expanded the meaning and role of

physicians; filled a knowledge gap in current medical

education curricula; assisted with future career

development; increased community involvement; and

provided insight into the local nature of global health.

Areas for improvement were providing more

opportunities to apply skills and to have the program

formally recognized on their MSPR or transcript. These

results demonstrate that participants perceived value in

their experience. This study establishes an evaluation for

a GHCP that can serve as a model for Canadian medical

schools to use for students seeking in-depth experience

and training in global health.

OC3-2-3-60479

IP&C 2.0: An online, interactive curriculum to engage and

teach medical students in Infection Prevention & Control

practices

Anthony Seto University of Calgary, Nicole Ertl Alberta Health Services,

William Kennedy University of Saskatchewan, Paul Bryan University of

Calgary, Dione Kolodka Alberta Health Services

Background/Purpose: Occupied with learning biomedical

content, medical students may not be as motivated to

learn about Infection Prevention & Control (IP&C). To

better motivate and engage learners, we developed IP&C

2.0. This online curriculum is grounded in the self-

determination theory, which posits that motivation

requires the needs of competence, autonomy, and

relatedness met. In IP&C 2.0, competence is achieved

through educational puzzles, autonomy through choice in

task completion order, and relatedness through peer

collaboration.

Summary of innovation: A multidisciplinary healthcare

panel (student, resident, physician, nurse, IP&C

practitioner) identified a list of IP&C knowledge (e.g.

isolation precautions) and skills (e.g. hand hygiene)

thought to be essential for medical students. This list was

further refined to align with the Medical College of

Canada's learning objectives. Teams of maximum 5

students worked through 4 learning stations of puzzles

and activities on Google Forms, via Zoom breakout rooms.

They tackled stations in any order. Afterwards, teams

regrouped in the Zoom lobby, competing in a Kahoot quiz

to immediately apply and retrieve learned knowledge.

Students' evaluation (n=65-66) of self-efficacy for session

objectives significantly increased (p<0.001, one-tail

repeated-measures t-test) pre- vs. post-session from

3.28/5.00 to 4.21/5.00, with large effect size (Cohen's

d=1.10). Average satisfaction scores (n=67) were

3.72/5.00 and 5.00/5.00 for mean and mode, respectively.

Conclusions: The IP&C 2.0 online curriculum incorporates

active learning and collaboration through interactive

puzzles and activities. Educators can consider

incorporating online puzzles to engage and teach content

relevant to clinical practice, as this gamified approach

improved self-efficacy and was rated overall satisfactory

by medical students.

OC3–3 Teaching & Learning-

Undergraduate

OC3-3-1-60589

Health Empathy Map: Creation of an Instrument for

Empathy Development

Aline Barbosa Peixoto José do Rosário Vellano University, José Maria

Peixoto José do Rosário Vellano University, Eliane Perlatto Moura José

do Rosário Vellano University

Background/Purpose: Empathy is a multidimensional

construct that requires the ability to perceive and

understand the others' perspectives, as well as feel their

emotional state. It is an intellectual skill to be learned and

represents one of the domains of emotional intelligence.

There are few studies on structured methods for teaching

and practicing empathy in care settings. Some students

report difficulties in coordinating the cognitive knowledge

necessary for care and still consider the patient's

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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perspective. The XPLANE, a business design thinking-

company, developed the Empathy Map to be used when

one need to immerse oneself in a user's environment. The

aim of this study was to create an instrument for teaching

and practice of empathy skills in medical education, called

the Health Empathy Map (HEM).

Summary of innovation: The aim of this study was to

create an instrument for practice of empathy in medical

education. This study had 3 phases: Adaptation of

XPLANE's Empathy Map for medical education; Adequacy

of the instrument content and feasibility performed by

teachers from José do Rosário Vellano University and then

by focal group and 3ª-year medical students during

outpatient clinic practice and in the tutorial group.

Conclusions: The adequacy of the instrument for medical

education was based on empathy framework:

perspective-taking, emotional sharing, and empathetic

concern. The final version was considered by participants

as an educational instrument with great instructional

potential in medical education. This is an innovative

instrument, simple and easy to apply, that can get a

student to focus on the patient feelings and needs.

OC3-3-2-60719

When Patients Teach Empathy - A Systematic Review of

Training for Medical Students

Alex Lee University of Ottawa, Mina Boshra University of Ottawa, Man

Ting Kristina Yau University of Ottawa, Elise Malek-Adamian University

of Ottawa, Isaac Kim University of Ottawa, Kori Ladonna University of

Ottawa

Background/Purpose: Despite growing emphasis on

patient-centered care, numerous studies have

demonstrated diminishing empathy in medical students

as they progress through their medical education.

Involving patients as educators in medical curricula has

been proposed as a solution. Therefore, this systematic

review was conducted to evaluate patient-involved

interventions aimed at promoting empathy among

undergraduate medical students.

Methods: A literature search of MEDLINE, Embase,

PsycINFO, and ERIC databases was performed using the

keywords "empathy", "medical student", and their

synonyms. Results were independently screened in

duplicate and conflicts were resolved by group consensus.

Any studies in English describing interventions aimed at

promoting empathy in medical students by utilizing

patients as educators were included. Relevant data were

extracted and summarized.

Results: Of the 1467 studies screened, 14 studies were

included, 11 of which were pilot studies. Studies included

patient educators in storytelling (5/14), shadowing for

students (3/14), recorded videos (3/14), or a combination

of methods (3/14). Empathy was most frequently

measured using qualitative techniques (e.g., written

feedback, interviews) or the Jefferson Scale of Empathy,

and all studies demonstrated improvements in empathy

among medical students. Participants reported

satisfaction with training and acknowledged its relevance

to medical humanities and patient-centered care.

Conclusions: Interventions utilizing patient-educators can

improve empathy among medical students. Shared

culture around patient-centered care must be supported

by patient-driven medical education beyond simple pilot

projects and feasibility studies.

OC3-3-4-60513

Teaching learning by concordance (LbC) methodology via

a virtual workshop

Marie-France Deschesne Université de Montréal, Veronique Phan

Université de Montréal, Margaret Henri Université de Montréal,

Genevieve Gregoire Université de Montréal, Bernard Charlin Université

de Montréal, Tania Riendeau Université de Montréal

Background/Purpose: The COVID pandemic has forced

medical schools to create educational material to palliate

the anticipated and observed decrease in clinical exposure

during clerkship. Learning by concordance (LbC) is a novel

educational approach that places learners in authentic

situations and enable them to compare their answers to

those of expert panelists. We wanted to teach this

approach to educators, to enable them to create clinical

vignettes and questions for 3rd and 4th year students. The

goal was the creation a web-based bank of LbC-based

vignettes and questions to elicit clinical reasoning.

Summary of innovation: A three-hour virtual workshop

with two experts in LbC was held last July with participants

from mandatory clerkship rotations (faculty and

residents), who were trained to the LbC methodology.

After the workshop, participants had 1 month to create

clinical vignettes, related questions and educational

rationales using LbC. The vignettes centered around

learning objectives expected to be less frequently

encountered during clinical rotations. The questions were

revised by the LbC experts and sent to a panel of experts.

Results Twenty participants to the workshop created a

total of 72 vignettes, 275 questions and rationales which

were answered by 25 expert panelists. At the end of the

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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process, this new educational material will be accessible

to clerkship students on a web-based platform.

Conclusions: After a 3-hour workshop, faculty at our

medical school was able to create a significant quantity of

LbC based clinical reasoning educational material for

clerkship.

April 18

, 2021 - 15:30 EST

OD1 – 1 Leadership

OD1-1-1-60605

Beyond "mini-me" and #MeToo?: An environmental

scan of physician leadership programs that include

concepts of diversity, gender and race.

Elizabeth Lin The Centre for Addiction and Mental Health, Georgia Black

The Centre for Addiction and Mental Health, Yasmin Lalani The Centre

for Addiction and Mental Health, Reena Besa The Centre for Addiction

and Mental Health, Ayelet Kuper University of Toronto, Morag Paton

University of Toronto, Anna McLeod Dalhousie University, Constance

LeBlanc Dalhousie University, Ivan Silver The Centre for Addiction and

Mental Health, Cynthia Whitehead University of Toronto, Sophie

Soklaridis The Centre for Addiction and Mental Health

Background/Purpose: Current literature indicates that

there is a lack of training for physicians in relation to

equity, diversity and inclusion (EDI).This can impede

physicians' ability to lead a diverse workforce,

representing a barrier for certain groups to obtain

positions of power within medicine. To explore this gap,

we conducted an environmental scan to understand

current trends in physician leadership training with regard

to EDI.

Methods: We used a three-pronged approach to provide

a nuanced portrayal of current training initiatives;

scanning medical education conferences, physician

leadership programs and peer reviewed literature.

Working with a librarian, we searched grey literature from

2015 to 2020 and peer reviewed literature from 2013 to

August 2020. Reviewers extracted relevant data

independently using standardized abstraction sheets,

before interpreting findings as a group.

Results: Although integrating EDI concepts into leadership

programs could hold great promise for redressing health

inequalities, our findings indicate that EDI content was

generally absent from programming A relatively low

number of sources featured EDI programming, with only

20 of 3877 studies screened meeting this criteria. A closer

narrative examination of specific physician leadership

programming is provided.

Conclusions: The apparent lack of EDI content in physician

leadership training is troubling, given the trend towards

rapid racial/ethnic diversification in North America. The

findings provide CME/CPD educators an opportunity to

make more strategic decisions regarding the content of

physician leadership training given the identified gaps. We

present these considerations along with implications for

the wider literature, practical applications for CME/CPD

initiatives, and the methodological limitations/challenges

encountered during this work.

OD1-1-2-60792

Perceived Effectiveness of a Graduate Education Degree

for Health Professionals: A Program Evaluation

Toni Ungaretti Johns Hopkins University, Jennifer Amadio University of

Toronto, Ronish Gupta McMaster University

Background/Purpose: The evolving needs of health

education has led to a substantial increase in healthcare

professionals in Canada and around the world pursuing

formal graduate training. Healthcare specific graduate

programs, while increasing in number and popularity,

remain in their infancy relative to traditional graduate

education programs. It is prudent to understand whether

Master of Education degrees for the health professions

result in improved educational leadership/innovation for

graduates.

Summary of innovation: The Master of Education in the

Health Professions (MEHP) program at Johns Hopkins

University conducted a program evaluation involving

alumni from 2011 (inception) until 2017. Survey responses

were analyzed descriptively and interview content

analyzed thematically by the School of Medicine Office of

Assessment and Evaluation. Of 63 successful graduates,

31 (49%) and 9 (14%) provided survey and interview data

respectively. The majority reported that the MEHP

effectively prepared them for the roles of "educator"

(26/31, 84%), and "education leader" (19/31, 61%).

Effective program aspects highlighted by alumni were

learning curriculum development, instructional strategies,

as well as networking with students and instructors. Views

on research experience/exposure were mixed with 7

alumni desiring more (22.6%) and 12.9% finding research

coursework as the least valuable component.

Conclusions: This single centre evaluation suggests that

focused graduate programs in health professions

education lead to the development of meaningful skills in

their graduates. Topics such as curriculum development

should be considered essential and warrant substantial

time and attention. Others, such as research have the

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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potential to be useful but should be carefully designed to

assure applicability to health professions education.

OD1-1-3-60623

Innovation Procurement: CPD Program and Knowledge

Translation

Eleftherios Soleas Queen’s University, Jenny Debruyn Queen’s

University, Klodiana Kolomitro Queen’s University, Laurilain Gamalinda

Queen’s University, Iris Ko Georgian College, Richard van Wylick

Queen’s University, Angela Coderre-Ball Queen’s University, Nancy

Dalgarno Queen’s University

Background/Purpose: The Innovation Procurement

program was an accredited blended learning opportunity

organized by the Queen's Professional Development

Office in partnership with the Kingston Health Sciences

Centre. The goal of the collaboration was to develop the

innovation procurement strategies of practitioner-

decision makers in units of KHSC to procure high-efficacy

solutions addressing healthcare challenges such as COPD,

diabetes, opioid dependence, and cancer care.

Summary of innovation: A needs assessment was

conducted to establish the educational needs of

physicians, allied healthcare professionals and healthcare

administrators involved in innovation procurement

strategies (IPS). The needs assessment featured two

stages: (i) a systematic review of grey literature, and (ii)

semi-structured interviews with healthcare professionals,

Ontario health agencies, and procurement centres with

varying IPS experience. The accredited educational

program included an online foundational module and a

one-day, face-to-face workshop for healthcare

professionals and administrators. A mixed-method

evaluation of the educational program revealed that the

vast majority of participants believed that the online

module and face-to-face workshop were effective

educational initiatives that both improved IPS knowledge

and was immediately useful to them in their current work

environments.

Conclusions: Recommendations for improvement

centered on increasing the time spent on interactive

activities, simplifying the case studies, better connecting

each section of the workshop, and providing cases prior to

the workshop. This program was found to increase

physician and leader capacity to effectively define

problems as well as ask the right questions leading to

more efficacious solutions enhancing patient-centred

care.

OD1-1-4-60928

Key drivers of social accountability in medical schools:

Perspectives across leadership, faculty and students

Erin Walling University of Saskatchewan, Kira Koepke University of

British Columbia, Eric Lachance Université de Sherbrooke, Robert

Woollard University of British Columbia, Lisa Yeo University of Calgary

Background/Purpose: Across Canada, social

accountability is expected to be interwoven into medical

education, guided by values of equity, social justice, and

community engagement. All Canadian medical schools

have taken on this challenge, but in different ways. A

collaborative study using an appreciative inquiry approach

was conducted to examine how schools are putting social

accountability into action.

Methods: An appreciative inquiry-based research design

was employed in a two-part study. Semi-structured

interviews with key informant leaders (phase 1) and focus

groups sessions with "front-line" students, faculty and

staff (phase2) from 10 of the 17 Canadian medical schools

(n=41 individuals) were conducted over a two-year period.

Qualitative thematic analysis led to the identification of 10

key themes.

Results: Key drivers of social accountability in Canada

were found to include accreditation standards, visionary

leadership, contextually-relevant vision and mandate,

champions, authentic community engagement, cultural

humility, admissions policies, community-based learning,

supportive organizational structure and measurement.

Thematic analysis revealed that leadership is a necessary

but not sufficient factor in successful progress towards

social accountability; student and community-driven work

is also necessary. The relationship triad of community-

leadership-student was found to be particularly crucial for

driving positive change in social accountability in Canada.

Conclusions: Leadership, students, staff and faculty in

Canadian medical schools share similar perspectives

regarding the key drivers of social accountability.

Appreciative inquiry was a useful methodology in building

a greater understanding around how schools are actioning

social accountability values.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OD1–2 Distributed Medical Education

OD1-2-2-60887

Essential Features and Priorities for Distributed Medical

Education: The Final Delphi Results (Part 1)

Charles Penner University of Manitoba, Peggy Alexiadis-Brown

Dalhousie University, John Murray University of Manitoba

Background/Purpose: The AFMC Distributed Medical

Education (DME) Resource Working Group sponsored

Delphi consensus study on DME was undertaken to seek a

consensus definition of DME, define key features of DME,

and evaluate priorities for DME to expand.

Methods: The study used a consensus methodology in the

form of a modified Delphi involving all 17 Canadian

medical schools. Key themes were established through

round 1. Rounds 2 and 3 pursued a definition of DME as

well as ranking priority areas for further development of

DME, essential features, internal/external pressures, and

opportunities/barriers to DME. Semi-structured

interviews were used in round two to establish context

and provide clarity around themes.

Results: Rounds one, two and three had 88, 42, and 24

participants, respectively. Twenty-one semi-structured

interviews were conducted. Although no consensus

definition was reached, five essential features of DME

were identified. They include: increased contribution of

distributed sites to local governance (91.7%), engagement

of local community physicians (88.1%), expansion of

specialty training to distributed sites (87.5%), increased

access to professional learning in community (82.9%), and

the flow of faculty development funding directly to

distributed sites (70.9%). The top three priority areas

required to help develop DME nationally include

developing social accountability metrics (58.3%),

expanding distributed site authority over fiscal and

teaching resources (54.2%), and establishing metrics to

demonstrate comparable and equitable programs (50%).

Conclusions: The DME community is a heterogenous

enterprise. The Delphi study shows that local ownership,

autonomy, as well as community engagement are

considered key features in DME programming. Developing

social accountability metrics and accreditation are

perceived as keys to DME's future.

OD1-2-3-60892

Pressures and Opportunities for Distributed Medical

Education: The Final Delphi Results (Part 2)-

John Murray University of Manitoba, Charles Penner University of

Manitoba, Peggy Alexiadis-Brown Dalhousie University

Background/Purpose: The AFMC Distributed Medical

Education (DME) Resource Working Group sponsored

Delphi consensus study on DME was undertaken in part to

evaluate the internal/external pressures on DME and the

major opportunities and barriers.

Methods: The study used a consensus methodology in the

form of a modified Delphi involving all 17 Canadian

medical schools. Key themes were established through

round one. Rounds two and three pursued a definition of

DME as well as ranking priority areas for further

development or DME, essential features,

internal/external pressures, and opportunities for DME.

Semi-structured interviews were used in round two to

establish context and provide clarity around themes.

Results: Rounds one, two and three had 72, 42, and 24

participants, respectively. Twenty-one semi-structured

interviews were conducted. The top five pressures on

further development of DME included heavy faculty

teaching and clinical loads (83.3%), inadequate

assignment of faculty (59.1%), lack of specific rural

competencies (47.8%), lack of social accountability

metrics (41.7%) and inadequately trained physicians for

environments of greatest need (41.7%). Opportunities

included promotion of rural generalism and a wider scope

of practice (91.7%), faculty-level departments specializing

in rural/remote medicine (75%), accreditation standards

unique to rural/remote medicine (75%) and increased

development of longitudinal integrated clerkships

(70.9%).

Conclusions: The major threat to DME's future is the

supply of enough faculty with enough time to teach. Major

opportunities are the possibility of further promotion of

generalism and changing the organization of faculties of

medicine to include departments of rural/remote

medicine with accreditation standards unique to this

specialty.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OD1-2-4-60902

What is the Meaning of Distributed Medical Education?

Peggy Alexiadis Brown Dalhousie University, Charles Penner University

of Manitoba, John Murray University of Manitoba

Background/Purpose: The meaning of the phrase

Distributed Medical Education (DME) is unclear. Medical

educators and administrators from a variety of medical

schools have drawn upon existing terminology and

personal experiences to develop definitions of what they

believe DME is. This has made it difficult to develop a

common definition so that DME can be studied and

evaluated nationally. In response, a national study was

conducted in order to develop a unifying definition of

DME in Canada.

Methods: A 2-year national study used a Delphi consensus

building iterative process to ascertain what DME is in

Canada. The study included three rounds of surveys and

interviews with over 94 respondents representing all 17

Faculties of Medicine in Canada. Findings were used to

develop a DME definition model that consisted of 5 key

areas. While the model provided a starting point for

defining DME, it did not capture the contextual meaning

associated with each area identified within the model.

Using narrative data from the Delphi study, a qualitative

study was conducted to explore the meaning and context

associated with DME.

Results: Terminology used to define DME ranged from

being prescriptive to theoretical. In some cases, DME was

described in terms of how it was operationalized and/or

evaluated, while in other cases it was described as a

philosophical innovation.

Conclusions: Defining DME is challenging. While only a

few of the study participants were able to find words to

capture the essence of DME, most of the study

participants were able to describe DME in terms of how,

where and why it exists.

OD1 – 3 COVID - Pot pourri

OD1-3-1-60588

Using a Virtual Educational Model to Support Healthcare

Professionals' Mental Wellbeing during the COVID-19

Pandemic

Sanjeev Sockalingam Centre for Addiction and Mental Health, University

of Toronto, Cheryl Pereira Centre for Addiction and Mental Health,

Chantalle Clarkin Centre for Addiction and Mental Health, Javed Alloo

Nymark Medical Centre, Victoria Bond Centre for Addiction and Mental

Health, Mark Bonta University of Toronto, University Health Network,

Heather Flett Centre for Addiction and Mental Health, University of

Toronto, Andrea Furlan University Health Network, Jenny Hardy Centre

for Addiction and Mental Health, Mona Loutfy Women's College

Research Institute, Women's College Hospital, University of Toronto,

Maple Leaf Medical Clinic, Sarah MacGrath Centre for Addiction and

Mental Health, Maurey Nadarajah Centre for Addiction and Mental

Health, Terri Rodak Centre for Addiction and Mental Health, Allison

Crawford Centre for Addiction and Mental Health, University of Toronto

Background/Purpose: Frontline healthcare professionals

(HCPs) are at increased risk of experiencing psychological

distress and negative mental health outcomes during and

following public health crises. Tele-mentoring

interventions have the potential to address HCPs needs

for emerging evidence, while providing a sense of

community and supporting self-care at a distance.

Summary of innovation: In March 2020, the Centre for

Addiction and Mental Health launched Project Extension

for Community Healthcare Outcomes-Coping with COVID

(ECHO-CWC), a virtual educational program supporting

Canadian HCPs during the COVID-19 pandemic. ECHO-

CWC creates a virtual community of practice by

connecting HCPs to an inter-disciplinary specialist team.

Weekly sessions include a mindfulness exercise, "COVID-

19 Q&A", resource update, didactic on social and clinical

impact, and discussions of HCPs experiences and coping

strategies. The aim of this initiative is to promote

resilience, and reduce feelings of isolation and distress.

ECHO-CWC featured a rapid design and implementation

cycle using previously established ECHO implementation

tools and processes based on the Consolidated

Framework for Implementation Research. Curriculum was

developed and finalized using a modified Delphi approach,

with ongoing adaptations to topics in response to

pandemic phases and emerging participant needs. 426

HCPs registered for ECHO-CWC within the first few weeks,

with 32 participants attending the first session. Participant

satisfaction ratings were high across the initial five

sessions (mean=4.26/5).

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Conclusions: Our experience using existing ECHO

implementation frameworks and a rapid needs

assessment approach has demonstrated that the ECHO

tele-mentoring model can be quickly mobilized to address

HCPs mental health needs during COVID-19.

OD1-3-2-60251

Increasing Equity, Diversity and Inclusivity during the

COVID-19 Pandemic: Improving Interview Skills and

Confidence for Underrepresented Minorities in Medicine

through an Interview Preparation and Support Program

Farhan Mahmood University of Ottawa, Johanne Mathieu University of

Ottawa, Lolade Shipeolu University of Ottawa, Charnelle Djeukam

University of Ottawa, Saada Hussen University of Ottawa, Patricia

Burhunduli University of Ottawa, Ike Okafor University of Toronto

Background/Purpose: Canadian medical schools host

interviews as part of the application process, assessing

candidacy for matriculation, and communication, ethical

reasoning, and critical thinking skills. Underrepresented

minority applicants often lack access to a network of

individuals who can offer guidance and expertise in

medical school interviews and ethical decision making.

Minority applicants also tend to underperform on non-

academic parameters of medical school applications.

Summary of innovation: University of Ottawa medical

students designed a free multimodal (virtual and in-

person) Interview Preparation and Support Program

(IPSP) for underrepresented medical school applicants

across Canada with support from the Community of

Support. The virtual component was implemented to

remain adherent to public health guidelines for the

COVID-19 pandemic. The program included 23 applicants

and 17 medical student volunteers. Medical students

were paired with applicants and shared information about

interview structures, conducted mock interviews,

provided long-term peer-to-peer mentorship and

networking, and shared approaches to answer ethical and

traditional style questions. We aimed to increase diversity

by helping minority applicants matriculate, improve

confidence and self-perceived competency in ethical-

decision making, reduce the anxiety and financial burden

of purchasing interview preparation courses.

Conclusions: Pre and post-program surveys demonstrated

significant improvements in the applicants' self-

perceived: confidence in their competency to perform

well and knowledge about interview structures,

preparedness, and competency to answer ethical and

traditional style questions, as well as reduced anxiety (all

p<0.05). All applicants were relieved of the financial

burden of purchasing interview preparation courses and

89% matriculated. IPSP addresses barriers faced by

minority applicants and aims to increase equity, diversity,

and inclusivity.

OD1-3-3-60034

Structural Distress: Experiences of Moral Distress related

to Structural Stigma during the COVID-19 Pandemic

Javeed Sukhera Western University, Chetana Kulkarni University of

Toronto, Taryn Taylor Western University

Background/Purpose: The COVID-19 pandemic has taken

a significant toll on the health of structurally vulnerable

patient populations as well as healthcare workers. The

concepts of structural stigma and moral distress are

important and interrelated, yet rarely explored or

researched in medical education. Structural stigma refers

to how discrimination towards certain groups is enacted

through policy and practice. Moral distress describes the

tension and conflict that health workers experience when

they are unable to fulfil their duties due to circumstances

outside of their control. In this study, the authors explored

how resident physicians perceive moral distress in relation

to structural stigma. An improved understanding of such

experiences may provide insights into how to prepare

future physicians to improve health equity.

Methods: Utilizing constructivist grounded theory

methodology, 22 participants from across Canada

including 17 resident physicians from diverse specialties

and 5 faculty were recruited for semi-structured

interviews from April to June 2020. Data were analyzed

using constant comparative analysis.

Results: Results describe a distinctive form of moral

distress called structural distress, which centers upon the

experience of powerlessness leading resident physicians

to go above and beyond the call of duty, potentially

worsening their psychological well-being. Faculty play a

buffering role in mitigating the impact of structural

distress by role modeling vulnerability and involving

residents in policy decisions.

Conclusions: These findings provide unique insights into

teaching and learning about the care of structurally

vulnerable populations and faculty's role related to

resident advocacy and decision-making. The concept of

structural distress may provide the foundation for future

research into the intersection between resident well-

being and training related to health equity.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OD1-3-4-60865

Strategies to support the well-being of learners in the

health professions during the COVID-19 pandemic

Deborah Friedman McGill, Camila Velez McGill, Emily Wasylenko McGill

Background/Purpose: The COVID-19 pandemic presents

significant challenges to universities and their learners

and faculty. Many universities have suspended in-person

activities and adopted remote teaching and services.

Pandemic-related fear and uncertainty, as well as

disruptions to learners' personal, academic, and clinical

routines, can impact well-being. Universities are

encouraged to prioritize and proactively foster learner'

well-being through diverse means.

Summary of innovation: The WELL Office in the Faculty of

Medicine and Health Sciences at McGill University has

been responding to the needs of learners in the School of

Physical and Occupational Therapy, Ingram School of

Nursing, and School of Communication Sciences and

Disorders. Since March 16, the WELL Office has been

functioning remotely, ensuring learners remain connected

to counselling services, and academic/clinical guidance

and support. In April, a needs-assessment survey on the

well-being of learners was conducted. Learners identified

struggling with: fear, uncertainty, remote learning,

completing academic and clinical requirements, isolation,

relationships, and changes to future plans. In response,

these interventions were implemented: (a) a webinar on

strategies to cope with common stressors; (b) adapting

the academic wellness curriculum to reflect the current

reality; (c) the Assistant Dean, Student Affairs met with

faculty, learners, and campus services to share learner

concerns and foster improvements; (d) regular

communications with learners trough website,

newsletters, resource sharing; and (e) working with

student representatives to assess and respond to

concerns of different learner cohorts. A follow-up survey

will be disseminated in mid-October.

Conclusions: The strategies implemented by the WELL

Office have garnered positive feedback from learners and

faculty. Reflections on strategies used, lessons learned,

challenges and recommendations will be shared.

April 18

, 2021 - 16:30 EST

OD2 – 1 Professionalism

OD2-1-1-60698

Bringing the Patient Voice to Professionalism in Medical

Education

Simon Haney University of Toronto, Shiphra Ginsburg University of

Toronto, Ayelet Kuper University of Toronto, Ryan Brydges University of

Toronto, Paula Rowland University of Toronto

Background/Purpose: 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. 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.

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.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OD2-1-2-59994

Dual but dueling purposes: The use of reflective writing to

remediate professionalism

Tracy Moniz Mount Saint Vincent University, Dalhousie University,

Carolyn Gaspar Dalhousie University, Andrew Warren Dalhousie

University, Chris Watling Western University

Background/Purpose: Underperformance in the

professional role has high stakes for learners and

educators. Problems with professionalism, unless

appropriately and effectively remediated, may portend

problems in practice. Yet, remediation is challenging.

Increasingly, educators turn to reflective writing (RW) as a

remediation strategy in residency, yet little is known

about what educators expect RW to accomplish, how they

choose tasks, why they use RW, or how they assess it. In

this study, we aimed to understand how and why

postgraduate medical educators use RW as an educational

intervention to remediate professionalism.

Methods: We interviewed 13 medical education

professionals with experience using RW to remediate

professionalism across five Canadian medical schools.

Data was analyzed iteratively for themes using

constructivist grounded theory.

Results: Educators are using RW for dual purposes--as a

learning tool to develop insight and as an assessment tool

to unearth evidence of insight. The goal of learning may

compete with the goal of assessment, creating tension

that leads to uncertainty about the sincerity, quality and

effectiveness of RW and concerns about learner safety.

Educators are uncertain about whether learners write to

perform or to reflect and about how to judge RW's

effectiveness as a learning tool. Educators are concerned

about creating a safe environment for learners--one that

enables the genuine reflection required for insight

development--while meeting requirements of the

remediation process.

Conclusions: Educators often express ambivalence about

using RW in remediation around professionalism in

residency. Understanding the potential and pitfalls of RW

may inform more tailored and effective approaches to

professionalism remediation.

OD2-1-3-60894

Whose "Societal Needs": Exploring the Implicit Social

Contract Between Medicine and Society

Brett Schrewe University of British Columbia, Tina Martimianakis

University of Toronto, Claudia Ruitenberg University of British Columbia

Background/Purpose: The CanMEDS framework speaks

frequently to the relationships between physicians and

society. For example, within the text of the Professional

Role, the former is positioned in service to the latter, and

governed by an "implicit contract between society and the

medical profession". Yet ambiguity around what this

implicit social contract entails raises questions about

which party decides what that service should look like and

how medical faculties educate learners to provide it.

Methods: This work presents a critical discourse analysis

of texts related to the CanMEDS framework, focusing on

discourse around "society" and "societal needs." Its

purpose is to shed light on how these documents frame

the social contract "between society and the medical

profession."

Results: Findings suggest that medical education leaders

have interpreted the social contract in ways that speak for

and about societal needs. While the Royal College's

policies and frameworks do address the common good, its

authoring of "society" is a key discursive technique by

which self-regulation, autonomy, and privilege can be

implicitly and strategically maintained.

Conclusions: These discursive practices may

unintentionally constrict professional medicine's

understandings of the myriad health care needs of the

diverse Canadian society and its constitutive publics.

Further, they may potentially undermine trust and

accountability to that society and shape educational

practices in ways that reproduce this asymmetric power

relationship. If we are to educate physicians to work for

the equitable realization of the social right to health care,

we need consider alternative models that are

democratically produced and created in a more egalitarian

partnership with the society that medicine is to serve.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OD2-1-4-60788

Help! My patient is a jerk: Delivering exceptional patient

care in the face of discrimination

Amr Hamour University of Toronto, Anita Balakrishna University of

Toronto, Yvonne Chan University of Toronto

Background/Purpose: Learner mistreatment in medical

education is a problem that transcends geography.

Patients or patient's families remain the number one

source of medical student and resident mistreatment.

While there is increasing focus on addressing

mistreatment within the medical circle, such as from

attending physicians and allied health professionals,

initiatives targeting learner mistreatment from patients

are rare. Moreover, delivering exceptional care in the face

of discrimination from patients presents an challenging

problem for learners.

Summary of innovation: A mixed-methods approach was

used to develop educational programming targeted to

early clerkship third year medical students. First, a

literature review was undertaken. Drawing from this,

several stakeholder meetings were held in order to design

educational content. Learners, faculty members, and

administrative staff were involved in the creation of a

small group one-hour session focused on equipping

students with strategies to deal with situations of

mistreatment from patients. Specifically, emphasis was

placed on the goal of delivering excellent patient care

towards potentially abusive and/or discriminatory

patients. Roughly 90% of attendees found the workshop

to be valuable. 100% of attendees indicated that they

would recommend the workshop to a colleague. These

figures were reproducible three months following the

workshop in a follow-up survey.

Conclusions: Learner mistreatment from patients is often

overlooked in medical education curricula. This initiative

involving several stakeholders led to the development of

a practical workshop aimed at equipping learners with

strategies to navigate interactions with discriminatory

patients.

OD2 – 2 Health & Wellness

OD2-2-2-60853

Moral Distress Among Practicing Canadian Critical Care

Physicians: The Role of Moral Orientation

Dominique Piquette University of Toronto, Peter Dodek University of

British Columbia, Karen Burns University of Toronto, Franco Carnevale

McGill, Aime Sarti University of Ottawa, Mika Hamilton University of

Toronto

Background/Purpose: Moral distress is defined as a

cognitive-emotional dissonance experienced when being

compelled to witness or deliver patient care that does not

meet personal moral standards. Moral distress is an

important and under-recognized problem among medical

trainees and practicing physicians. Moral distress has

direct negative consequences for patient care (e.g.,

decreased compassion), individuals (e.g., burnout), and

the healthcare system (workforce attrition).

Methods: We conducted a qualitative, interview-based

study of practicing critical care physicians. We

purposefully selected a sub-group of physicians who had

agreed to be contacted after completing a national survey

on moral distress. Our objective was to enrich our

understanding of moral distress experiences and

relationships between professional interactions, context,

and moral distress. Phone interview audio-recordings

were transcribed verbatim and analyzed using an

inductive thematic analysis. We used thematic saturation,

researcher triangulation, and reflexivity to ensure rigor.

Results: We interviewed 20 critical care physicians. Moral

orientation (how individuals usually perceive and resolve

moral dilemmas), combined with legal, societal, clinical,

and team contexts, contributed to moral distress.

Participants commonly described three moral

orientations: a justice orientation, a relationship

orientation, and a non-committal orientation. We

described how individual susceptibility to moral distress

depended on moral orientation, how individuals learn to

manage moral dilemmas over time, how different moral

stances led to conflicts within team, and how

communication within teams was as important as

communication with families to reduce moral distress.

Conclusions: Moral orientation is a key aspect of moral

distress. Certain moral orientations, as well as divergent

moral orientations among colleagues, create internal and

external conflicts, and may represent promising targets of

educational interventions to reduce moral distress.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OD2-2-3-59668

Psychological Need Fulfilment Mediates Well-being in

Medical Students: A Case for Shifting the Focus of

Wellness Curricula

Adam Neufeld MD MSc University of Calgary, Greg Malin MD PhD

University of Saskatchewan

Background/Purpose: During medical school, students'

motivation and well-being stand to take a hit. While

researchers continue to explore the utility of various

wellness interventions to reduce student distress, studies

have neglected to account for learners' basic

psychological needs-autonomy, competence, and

relatedness. From a Self-Determination Theory (SDT)

perspective, these oversights are critical, because barriers

and affordances to need satisfaction are ultimate sources

of stress and obstacles to growth, resilience, and well-

being. Our research explores how students' perceptions of

autonomy, competence, and relatedness in medical

school impact their intrinsic motivation and well-being,

mindfulness, perceived stress, and ability to cope with

stressors in the learning environment.

Methods: Medical students from our institution

completed questionnaires related to the learning

environment and aspects of their well-being. Mediation

was used to assess the relationship between students'

perceptions of the need-supportiveness of their

instructors and learning environment in medical school

and the aforementioned well-being indicators. Post-hoc

tests were conducted to explore the contribution of each

basic need and whether subgroup differences existed

among our variables, by age, gender, and year of study in

the MD program.

Results: Need fulfilment, more than resilience and

mindfulness, related to students' perceived stress and

mediated the relationship between students' mindfulness

and coping. The more autonomy-supportive students

perceived their learning climate, the greater their need

satisfaction and psychological well-being. A range of

subgroup differences existed in need fulfilment, stress,

mindfulness, and coping.

Conclusions: Overall, results highlight psychological need

fulfilment as a key mediator of students' ability to cope

adaptively with stress, to be mindful and resilient, and to

maintain their wellness during medical school. Findings

have potentially important implications for teaching,

curriculum, and wellness initiatives aimed at reducing

medical student distress and improving their

development and well-being.

OD2-2-4-60624

Resident and health profession student well-being: A

novel promotive and hindering perspective on their

thriving

Denise Stockley Queen’s University, Eleftherios Soleas Queen’s

University, Heather Coe-Nesbitt Queen’s University, Nadia Arghash

Queen’s University, Anoushka Moucessian Queen’s University

Background/Purpose: A majority of initiatives for trainee

wellness have focussed on promoting positive well-being

strategies as opposed to addressing systematic

hindrances to thriving. This study uses Expectancy-Value-

Cost motivation theory (Flake et al., 2015) to

systematically identify the specific promotive factors and

to investigate the hindrances to trainee well-being as a

means of enabling a thoughtful response to them.

Methods: We surveyed health professions trainees about

the promotive and the hindering factors for their thriving

through a questionnaire on motives, supports, barriers,

and experiences. Respondents included 128 residents,

130 medical, 78 nursing, 215 rehabilitation therapy, 124

public health sciences, and 183 biomedical sciences

students from one Ontario Faculty of Health Sciences

constituting response rates between 11-51%. We

performed thematic and statistical analyses using Atlas.Ti

v 8.0 and SPSS v25.0.

Results: Statistical and thematic results suggest, in the

aggregate, residents and medical students have

comparable levels of thriving-promotive factors that

include engagement, positive experiences, and self-worth

as their other health profession peers, but significantly

lower comprehensive thriving as well as control over their

lives while also having significantly higher perceived

loneliness and negative feelings than their peers in other

health science fields (MANOVA; p-values=<0.001, 99%

confidence, medium/large effect sizes).

Conclusions: These results illustrate that are real and

unaddressed hindrances to thriving that are not

addressed by adding a wellness program to Health

Professions Education. Addressing systematic hindrances

like isolation, burnout, overworking, lacks of resources,

negligent or unproductive supervision, and curricular

overload should be the first changes before adding

wellness curriculum.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OD2 – 3 Assessment & Feedback

OD2-3-1-60806

Assessment For Learning: A better understanding for a

better implementation

Elise Vachon Lachiver Université de Sherbrooke, Aliki Thomas McGill,

Meghan McConnell University of Ottawa, Christina St-Onge Université

de Sherbrooke

Background/Purpose: Researchers and educators often

import concepts or approaches from educational and

social sciences into health professions education (HPE).

One example is "Assessment for Learning (AFL)" which is

gaining popularity with the widespread implementation of

Competency-based Medical Education. However, when

importing a concept in a new discipline, there is always a

risk of altering its conceptualization. Our aim was to

document how AFL has been conceptualized and

operationalized in HPE research and practice.

Methods: We conducted a scoping study informed by

Arksey and O'Malley's methodology. Two team members

screened all the abstracts and extracted numerical (e.g.

year of publication, country) and qualitative data (e.g. AFL

definition, conceptualization) based on a pre-defined set

of extraction categories. Descriptive analyses were

conducted for numerical data, and thematic analysis was

conducted on qualitative data.

Results: The search strategy, applied to six databases,

yielded 5239 articles. Only 123 articles met our inclusion

criteria for full-text review, with 71 articles confounding

AFL and formative assessment. Of the 52 remaining

articles, most provided a definition of AFL (n=43),

however, these definitions varied greatly across articles.

Theoretical frameworks underpinning the use of AFL were

present in only 15 articles.

Conclusions: Our results highlight a variety in

conceptualizations of AFL. When we compare the broader

literature on assessment in higher education, we realize

that some elements of AFL may have been transformed

during its operationalization. Consequently,

operationalisations of AFL in HPE are greatly disparate and

may not be sufficiently aligned with the original intended

underpinnings to achieve its full potential.

OD2-3-2-60572

Perceptions of Assessment and Feedback: Relationships

and Reconciliation

Kaif Pardhan University of Toronto, Christopher Watling Western

University, Linda Jones University of Dundee

Background/Purpose: Supervisors in postgraduate

medical education may deliver different assessments for

the same quality of performance. Residents may struggle

to make sense of inconsistent and sometimes

contradictory information. We sought to explore how

residents experience feedback from supervisors, how they

process inconsistent information, and what factors

influence their experiences.

Methods: Eighteen residents participated in semi-

structured interviews to explore their perspectives on

feedback. Data collection and analysis occurred

iteratively, informed by constructivist grounded theory,

and sample size was determined by theoretical sampling

to sufficiency. Constant comparative analysis was used to

identify and define themes.

Results: We identified a central theme of reconciliation,

which we defined as the act of processing inconsistent

feedback and determining how to engage with it. This

reconciliation is informed by the credibility of, and

residents' relationship with, supervisors and is achieved

through conversation with others, observation of others'

behaviour toward their performance, and reflection on

their own performance. Residents' emotional responses

and insight on the value of feedback for their own growth

as professionals were important factors in feedback

incorporation.

Conclusions: The findings of this study show that while

residents are regular consumers of feedback, not all

feedback is used equally. Residents actively reconcile

incongruous feedback and its incorporation falls on a

spectrum of outright dismissal to significant reflection and

impacts on learning. This work reinforces the importance

of pedagogical relationships where there are shared goals

of educational outcomes, and development of supervisors

as credible feedback providers.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OD2-3-3-60738

Multi-source feedback following simulated resuscitation

scenarios: A qualitative study

Timothy Chaplin Queen’s University, Heather Braund Queen’s

University, Adam Szulewski Queen’s University, Nancy Dalgarno

Queen’s University, Rylan Egan Queen’s University, Brent Thoma

University of Saskatchewan

Background/Purpose: The direct observation and

assessment of resuscitations in the clinical environment is

difficult for attending physicians due to their

unpredictable and time-sensitive nature. It is unclear how

the assessments of allied health professionals and

resident peers, who often attend resuscitations, compare

to those of attendings. Soliciting multisource feedback

(MSF) may improve the quality of feedback. We explored

MSF during a longitudinal simulation-based curriculum

with the goal of characterizing its role in the competency-

based assessment of resuscitation.

Methods: This qualitative study included medical

residents in their first postgraduate year who participated

in a simulation-based resuscitation course during the

2017-2018 academic year at two Canadian institutions.

Assessments included an entrustment score and narrative

comments from attendings, registered nurses, and peers

in addition to a self-assessment. Narrative comments

were thematically analyzed overall and within assessor

groups.

Results: Sixty residents from 14 medical specialties

participated. 223 assessments were completed and

analyzed. Four themes emerged: 1) Communication, 2)

Leadership, 3) Demeanor, and 4) Medical Expert. Relative

to other assessor groups, feedback from nurses focused

on patient-centered care and team communication while

attendings focused on the medical expert theme. Peer

feedback was the most positive. Self-assessment

comments addressed all emergent themes.

Conclusions: In the context of a simulation-based

resuscitation curriculum, feedback from different sources

had varied areas of focus. Therefore, while feedback from

peers and allied health professionals cannot replace the

feedback of attending physicians, MSF may provide a

more holistic reflection of resident performance.

OD2-3-4-60664

Defining the skills needed to perform advanced

laparoscopic suturing in simulation: a qualitative

descriptive study

Elif Bilgic McGill, Allan Okrainec University of Toronto, Gerald M. Fried

McGill, Caterina Masino University of Toronto, Pepa Kaneva McGill,

Katherine M. McKendy McGill, Yusuke Watanabe Hokkaido University

Faculty of Medicine, Melina C. Vassiliou McGill

Background/Purpose: Advanced laparoscopic suturing

(ALS) remains a challenge to trainees. Formative feedback

should be meaningful and measurable to direct training

and monitor progress. In this study, we identified themes

that would be important to focus on for formative

feedback when assessing 2 advanced laparoscopic

suturing tasks.

Methods: Experienced MIS surgeons at McGill and

University of Toronto(UofT) performed 2 ALS tasks using

Endo StitchTM device: suturing under tension(UT) and

continuous suturing(CS). After, they were shown an edited

video of a novice performing the tasks and were asked to

comment on the performance and key technical skills

needed to perform each task. Interviews were

transcribed, and inductive thematic content analysis was

conducted.

Results: 11 MIS surgeons(5 UofT, 6 McGill) participated.

Previously, seven key principles were identified and used

to structure the feedback: depth perception, laparoscopic

safety, bimanual dexterity, exposure, tissue handling,

instrument manipulation, and planning. For both tasks,

emerging themes were: leaving appropriate length of the

suture tail, knowing how to use the suturing device, using

non-dominant hand as a post, coordinating both hands,

taking bites in the right orientation, tying the knot

securely, maintaining appropriate tension, and keeping

target tissue steady.

Conclusions: This study identified formative feedback

themes for 2 device-assisted laparoscopic suturing tasks.

These themes will be useful for formative feedback and

assessment as part of an advanced laparoscopic suturing

curriculum. These themes could be used to develop a

formative feedback tool.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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April 19

, 2021 - 10:00 EST

OE1 – 1 Faculty Development

OE1-1-1-60709

Employing a coach-approach in faculty development

through in-person and virtual group coaching

Ingrid Price University of British Columbia, Heather Buckley University

of British Columbia Linlea Armstrong University of British Columbia,

Maria Hubinette University of British Columbia

Background/Purpose: Within the UBC MD curriculum,

faculty provide group coaching as part of a longitudinal

portfolio that supports self-assessment, self-regulated

learning and professional identity formation through

exploring patient-care interactions in a safe, social space.

However, not all faculty have training or experience with

coaching nor skills needed to support identity formation

and maximize peer-peer learning. Further, faculty were

requesting more opportunities to connect with and learn

from each other. Thus, we identified two faculty

development needs: to support development of novel

group coaching skills while building community among a

professionally heterogeneous and geographically

dispersed faculty.

Summary of innovation: A coach approach was used to

flexibly deliver the program and model a set of skills that

embodied core principles of portfolio: personally relevant,

goal-directed and identity (coach) focussed. This allowed

participants to experience the application of group

coaching and support the development of their coaching

skills. Further, by employing a group coaching model,

sessions were designed to take advantage of participant

experience and expertise in order to build connection and

community.

Conclusions: Participants found connection to each other,

credibility of the facilitator as a coach and portfolio coach,

and modelling group coaching to be of most value. Faculty

developers observed that small coaching group sessions

appeared to foster a deep, ongoing and guided

conversation regarding the portfolio coach role, allowing

participants to link this to their own coaching skills and

challenges. Further, while the flexibility of virtual group

coaching sessions created a supportive space for

geographically dispersed coaches, potential technological

barriers need attention and mitigation.

OE1-1-2-60289

Learner driven faculty development

James Goertzen Northern Ontario School of Medicine, Clare Cook

Northern Ontario School of Medicine

Background/Purpose: Medical education experts suggest

learner evaluations often do not significantly change

faculty's teaching. Providing faculty development to

distributed preceptors can be challenging. This project

links concepts from quality improvement, communities of

practice, and reflection on education practice to assess

the impact of a workshop using learner evaluations to

stimulate teaching improvements.

Methods: A faculty development workshop based on

grouped, anonymized evaluations was offered to

Northern Ontario Local Education Groups (LEGs). LEGs are

key to delivering undergraduate and postgraduate

educational activities at NOSM and function as

communities of practice. Participants reviewed strengths

and areas for improvement; discussed individual and

group-based improvement strategies; and completed

intention to change declarations. Follow-up surveys and

interviews assessed impact.

Results: Eleven workshops with LEG membership of 291

representing 25% of NOSM's clinical faculty participated,

including rural and urban LEGs; small and large LEGs;

family medicine and specialty LEGs. Common themes such

as improving learning orientation and providing regular

feedback emerged across multiple LEGs. Weaknesses

unique to specific LEGs were also identified including

appropriate response to learners' negative experiences

and how to manage patients with learners. Outcomes

include individual faculty changes (e.g. eliciting feedback;

clarifying learning objectives) and LEG-based changes (e.g.

new tools, processes, assessments). Faculty responded

positively and report increased awareness of their LEG as

a Community of Practice.

Conclusions: Learner evaluations provide opportunities to

engage faculty individually and within a community of

practice to implement meaningful improvements to their

teaching practices.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OE1-1-3-60050

Exploring the Role of Social Networks in Supporting

Faculty Development

Heather Ncole Buckley University of British Columbia, Laura Nimmon

Universityof British Columbia

Background/Purpose: Faculty development is

increasingly important in health professions education.

Faculty developments' conceptualization has evolved

from an individual skills training activity to more

contemporary notions of an organizational model. This

organizational model recognizes relationships and

networks as increasingly important mediators of

knowledge mobilization. Although these conceptual

advancements are critical, we lack empirical evidence and

therefore robust insights into how networks shape

processes of learning in faculty development. To fill this

gap the following research question was explored: How do

the professional social networks of faculty shape their

learning about teaching?

Methods: This study used a qualitative social network

approach to explore how teaching faculty's relationships

influenced their learning about teaching. The study was

conducted in an undergraduate course at a Canadian

medical school. Eleven faculty participants were recruited

and 3 methods of data collection were employed; semi-

structured interviews, participant drawn sociograms, and

demographic questionnaires.

Results: Results showed that the networks of faculty

participants influenced their learning about teaching in

the following four areas: knowledge acquisition and

mobilization, identity formation, vulnerable expression

(intellectual candour), and scaffolding.

Conclusions: Our insights illuminate how social factors

may influence faculty's learning about teaching. The

findings support the recent calls to re-orient faculty

development in the health professions as a dynamic social

enterprise. We propose that faculty developers should

consider faculty's social embeddedness in their

professional social networks to strategically enhance and

optimize faculty learning.

OE1-1-4-60637

Building a Faculty Development Resource across the

Medical Education Continuum to Rapidly Adapt Teaching

and Learning for the Virtual Environment

Latika Nirula University of Toronto, Jana Lazor University of Toronto,

Lindsay Baker University of Toronto, Susan Glover Takahashi University

of Toronto, Susanna Talarico University of Toronto, Suzan Schneeweiss

University of Toronto, Heather MacNeill University of Toronto

Background/Purpose: The COVID-19 pandemic has

shifted our learning environments online, leaving many

faculty, learners and organizations unprepared for the

new realities of education. We describe an innovative

approach to creating a faculty development (FD) resource

to support equitable, inclusive, and engaging virtual

learning environments. Identifying nuanced

considerations around how structures, processes and

people align within contexts along the medical education

continuum is key.

Summary of innovation: A collaborative of individuals

across the medical education continuum (undergraduate,

post-graduate, continuing professional development,

faculty development) came together to engage in an

innovative and integrative approach to developing a FD

resource with broad applicability across a variety of

environments. Drawing from evidence-informed learning-

centered pedagogical principles and also purposely

attending to the principles of equity and universal learning

design, an e-resource was developed which provides

guidance for faculty and learners embarking on teaching

and learning within online synchronous environments. Six

key areas of consideration were identified (accessibility,

equity/inclusivity, collaboration, learner engagement,

educational context, privacy/security/copyright) with

links to practical resources to assist with application and

implementation. We describe the iterative and

collaborative process of developing this FD resource, and

evaluating its efficacy and impact across the medical

learner continuum.

Conclusions: This integrated approach reduces duplicative

efforts, minimizes confusion for those needing "just in

time" support, and promotes consistency across learning

contexts within a Faculty of Medicine. While the impetus

for the e-resource was in response to the pivot to virtual

learning, we hope this integrated model for FD resource

creation can be applied to other priority faculty

development areas in the future.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OE1 – 2 Assessment OSCE

OE1-2-1-60500

Formative Learner Assessment in the Time of COVID-19:

Implementing a Pediatric Postgraduate VOSCE

Jason Silverman University of Alberta, Jessica Foulds University of

Alberta

Background/Purpose: Traditional objective standardized

clinical examinations (OSCEs) are not possible in the

context of COVID-19 physical distancing guidelines and

group gathering limitations. Program directors have been

forced to delay, cancel, or find alternatives to these

assessments. In response we developed and assessed the

implementation of virtual OSCEs (VOSCEs).

Summary of innovation: We modified OSCEs from two

pediatric training programs to run virtually using video

communication software (Zoom) . We surveyed all

participants on their experience and baseline comfort

with technology based on the Technology Acceptance

Model. Administrators documented the frequency and

reason for deviations from planned procedures. Survey

response rates were high across all participant groups

(34/39, 87%). Most trainees (10/18, 56%), examiners

(9/11, 82%) and program staff (5/5, 100%) were positive

or very positive toward VOSCEs. Participation in, or

administering, the VOSCE was rated as easy or very easy

by 44% of learners, 64% of examiners and 100% of

administrators. Most procedure deviations (5/6, 83%)

were technology-related issues that were easily

addressed. Years of experience did not significantly

influence responses for either administrators or

examiners.

Conclusions: The development and implementation of a

pediatric VOSCE required creative methods for replicating

a traditional OSCE experience, increased time for

participant instructions, and scheduling flexibility during

administration to manage technology-related deviations

from procedure. Despite these potential barriers, our

work clearly showed that VOSCEs are a feasible and

acceptable method allowing for continued formative

learner assessment in the context of restrictions

preventing traditional OSCE administration.

OE1-2-2-60302

The OSCE date: A movie and dancing.

Jinelle Ramlackhansingh Memorial – University of Newfoundland, Fern

Brunger Memorial – University of Newfoundland

Background/Purpose: Students do Objective Structured

Clinical Examinations (OSCEs) to assess clinical skills in

preparation for ward work. The students are taught

examination and are observed in formative and

summative assessments. Critics of OSCEs argue that

students "perform" rather than practicing patient-

centered care.

Methods: This work was part of a larger study examining

professional identity development in pre-clinical medical

students. Focus groups were carried out over two years

with groups of pre-clinical students. Transcripts were

critically analyzed and themes developed.

Results: The students described the social choreography

of the OSCE as they performed clinical skills. The students

likened the performance to the Disney movie "Monsters

Inc.". Like the scary monsters, who apprehensively wait

outside the children's doors, the students nervously

waited outside the standardized patient's door. The

monsters are rated on their ability to scare children, while

the students are assessed on their clinical skills. The

monsters wait for a bell to go inside the room, as the

students wait for the buzzer to enter the patient's room.

The students spoke about a "backstage area" where they

wait, read the scenario, and decide their actions. This area

was a liminal space where the students prepared

themselves for what they describe as their

"performance".

Conclusions: These findings add support to concerns that

OSCEs may not truly assess the ability to apply clinical skills

in the complex environment of patient care. The

"performance" of clinical skills through OSCE may result in

hidden incompetence. The presentation concludes by

proposing an alternate model of "in-situ" clinical skills

assessment.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OE1-2-3-60695

Exploring communication skills when introducing an EMR

in an OSCE

K. Jean Chen University of Ottawa, Ilona Bartman Medical Council of

Canada, David Topps University of Calgary, K. Jean Chen University of

Ottawa, Doug Archibald University of Ottawa, Isabelle Desjardins

University of Ottawa, Melissa Forgie University of Ottawa, Debra Pugh

Medical Council of Canada

Background/Purpose: Despite efforts to introduce

electronic medical records (EMRs) into learning, there is

little literature related to the assessment of EMR-related

competencies. To address this gap, this study explored

EMRs' impact on medical student-patient communication.

Methods: Communication skills with the introduction of

EMR use were explored during an objective structured

clinical examination (OSCE) administered to 99 third-year

students. An EMR pilot station was developed, built in

OpenLabyrinth and designed to emulate MedAccess©, to

gather information needed to counsel a Standardised

Patient (SP). Students' communication skills were

assessed by SPs and physician examiners (PEs) using

checklists and ratings scales. EMR station characteristics,

including item total correlation (ITC) and difficulty were

analyzed and compared to overall OSCE performance.

Results: Compared to the other 9 OSCE stations, the EMR

station had the second lowest mean, lowest pass rate, and

largest standard deviation based on PE scoring. It had an

acceptable ITC (.217). Pearson correlations between PE

and SP rating scales ranged from non-significant (0.081)

(Listening) to moderately significant (0.433) (Information

Giving). The skills around EMR use discriminated among

students, with higher overall scores awarded by SPs and

higher Listening and Adherence Optimization scores

awarded by PEs.

Conclusions: While the students performed poorer in the

EMR station, it had acceptable psychometric

characteristics. Students' ability to use EMR, measured

from the SP's and PE's perspectives, correlated with

communication skills. There is a difference between how

physicians and patients interpret communication skills

when the student uses and EMR and is an area of potential

future research.

OE1 – 3 Simulation

OE1-3-1-60518

Needs Assessment Study to Build Interprofessional In situ

Simulation Training in Non-technical Skills: Improving

Quality of Care and Patient Safety During Acute Clinical

Adverse Events.

Ahmed Moussa Université de Montréal, Claude-Julie Bourque

Université de Montréal, Nathalie Loye Université de Montréal, Audrey

Larone Juneau Université de Montréal, Michael-Andrew Assaad

Université de Montréal, Evelyne Wassef Université de Montréal, Marta

Martisella Université de Montréal

Background/Purpose: Healthcare providers (HCP) must

master technical and non-technical skills (NTS) necessary

to ensure patient safety and favourable outcomes. In situ

simulation (ISS) possibly improves teamwork and team

satisfaction, however evidence describing the effect of ISS

on HCP NTS is not well described. We aimed to conduct a

needs assessment to identify knowledge and competency

gaps regarding NTS of HCP during acute events.

Methods: HCP in a level 3 NICU completed a

questionnaire: 1) Open-ended comments on key

concepts; 2) Needs assessment based on their past

experiences in acute events; 3) Perceptions of past team

performance and latent safety threats (LST) during critical

events; 4) Perception of quality of interactions with other

professionals during emergency interventions, open-

ended questions about expectations in terms of training

and barriers to participating in simulation training; 5)

Demographics.

Results: 125 HCP responded (40% response). Crisis

resource management and specific NTS (communication

with families during events, teamwork and controlling

stress) were identified as training needs. At least 50% of

respondents state that during critical events 1) they feel

anxious, 2) have the impression that a leader is never

identified, 3) leaders do not coordinate communication

between team members, 4) team members do not repeat

or feedback information to ensure comprehension in the

team. Two thirds of respondents identify lack of transfer

of information as the main LST during acute events.

Conclusions: Competency gaps of HCP are related to NTS

and specifically leadership, communication and stress

management, which are essential to ensure patient safety

and favorable outcomes. Upcoming ISS curriculum will

include these concepts and will measure its effect on HCP

behaviors and institution culture change.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e199

OE1-3-2-59923

Online Simulation Curriculum to Prepare Interdisciplinary

Medical Teams for Electronic Dance Music Festivals

Anthony Seto University of Calgary, Allen Vorobeichik University of

Calgary, Logan Haynes University of Calgary, Abraham Hussein

University of Calgary, William Kennedy University of Saskatchewan,

Logan Haynes University of Calgary

Background/Purpose: Patient care in Electronic Dance

Music (EDM) festivals presents unique challenges,

including resource limitations, loud music, crowdedness,

and working in ad hoc teams. We developed an online

program to prepare medical teams to assess and manage

life-threatening cases uncommon to most practices.

Summary of innovation: Teams of 4-5 healthcare

providers/trainees participated in 3 online simulations

(cardiac arrest, serotonin toxicity, and toxin-induced

seizure). A facilitator managed case progression through a

Zoom screen-share of Google Forms. Participants

completed self-efficacy and knowledge assessments 1

week pre- and post-session, as well as surveys

immediately post-session, reflecting on teamwork, take-

home learning points, and program quality.

Conclusions: Average self-efficacy ratings (n=18)

increased pre- vs. post-session (one-tail 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). Average

knowledge (n=18) increased pre- vs. post-session (one-tail

repeated-measures t-test) for all cases (p<0.001): cardiac

arrest (67% to 80%), serotonin toxicity (65% to 83%), and

seizure (54% to 76%). Participants reported collaborative

decision-making and communication as teamwork

strengths. Commonly reported learning points were

related to pharmacology/toxicology, clinical approaches,

and differential diagnoses. Average program satisfaction

rating (n=22) was 4.36/5.00. Online simulation has several

benefits: i) serves as an icebreaker for teams prior to

arriving at events, ii) eliminates physical distractions (e.g.

loud music) to focus on clinical knowledge and

approaches, and iii) offers convenience and cost-savings.

OE1-3-3-60818

"She's a manikin; she won't mind": A sociomaterial look at

patient centredness in manikin-based simulation

Paula Cameron Dalhousie University, Molly Fredeen Dalhousie

University, Anna MacLeod Dalhousie University, Rola Ajjawi Dalhousie

University, Jonathan Tummons , Olga Kits Dalhousie University, Victoria

Luong Dalhousie University, Marti Cleveland-Innes

Background/Purpose: Medical educators increasingly

prioritize Patient Centred Care (PCC), and have identified

simulation as a promising area for preclinical PCC practice.

However, due to the traditional separation of "hard" and

"soft" skills in medical curricula, patient centredness is

often associated with simulated patients and overlooked

in clinical skill sessions with manikins. Manikins are often

assumed to be "human enough" for skill practice but their

influence on teaching and learning PCC can be overlooked.

We therefore sought to understand (1) how manikins

shape teaching and learning in undergraduate medical

simulation, and (2) implications for PCC.

Methods: Informed by a broader body of data, this

presentation offers a sociomaterial analysis of a third-year

pre-clerkship simulation that combined six clinical skills

within one overarching case. Two sets of student and

instructor pairs were each assigned to a male-presenting

medium fidelity manikin overlaid with an IV arm,

phlebotomy trainer, and injection pad. Our ethnographic

methods included video observations (n=240 minutes),

curriculum analysis (n=8), and interviews (n=11).

Results: Human-manikin interactions both affirmed and

undermined PCC. Affirming actions included teachers

voicing patient concerns and directing students to seek

consent; and students offering the patient procedural

choices. Undermining elements included lack of student-

patient communication; leaning on the manikin; centering

teacher approval and expertise; and caricaturing the

patient as stereotypically feminine.

Conclusions: Patient centredness is both affirmed and

undermined in manikin-based simulation. The material

form of the manikin complicates PC teaching and learning.

Intentionally planning for this complexity may ensure

more consistent adherence to patient centred principles.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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April 19

, 2021 - 11:00 EST

OE2 – 1 Curriculum

OE2-1-1, 60733

Resident satisfaction and practice exposure in horizontal

vs block family medicine curricula - a Canadian

perspective

Miriam Lacasse Université Laval, Jean-Sébastien Renaud Université

Laval, Batya Grundland University of Toronto, Maria Hubinette

University of British Columbia Fok-Han Leung University of Toronto,

Theresa van Der Goes University of British Columbia

Background/Purpose: The family medicine (FM)

horizontal (longitudinal) residency curriculum is a model

of training thought to better align with actual practice. The

FM clinic is the core setting with integrated specialty

rotations throughout the majority of training. Few studies

have rigorously documented outcomes of the horizontal

curriculum model. This study aimed to compare resident

satisfaction and practice exposure in horizontal and

traditional block curricula.

Methods: This curriculum structure evaluation used a

retrospective semi-experimental study design based on

CFPC FM Longitudinal Survey data from 3 Canadian FM

programs. Data from 2014 to 2019 resident cohorts were

categorized by horizontal or block curricula. We used

Kirkpatrick's taxonomy to assess satisfaction (level 1, 13

items, α=.87) and domains of clinical care exposure (level

3) during residency. Associations between curriculum

structure and scores on satisfaction and exposure (5-point

Likert scales) were tested using one-way ANOVAs.

Results: We analyzed data from 1853 residents (block:

nT1;T2=670;740, horizontal: nT1;T2=186;256) from 46

teaching sites. The horizontal curriculum was associated

with slightly higher satisfaction (4.34 vs 4.25, p=0.02) and

more exposure to home care (2.80 vs 2.52, p<.0001) and

chronic diseases (3.00 vs 2.97, p=.02). Block curricula were

associated with higher exposure to vulnerable

populations (2.66 vs 2.47, p<.0001) and First

Nations/Inuit/Metis (2.31 vs 2.10, p=.0002). Exposure to

intrapartum care, emergency medicine, in-hospital

practice, mental health, long-term care and palliative care

was not significantly different.

Conclusions: Resident satisfaction appears to be slightly

higher in horizontal curricula, which offers similar

exposure to block curricula for most domains of clinical

care.

OE2-1-2, 60546

Exercise Prescription Curriculum Re-design in the UBC

Faculty of Medicine

Arielle Roberts University of British Columbia, Catherine Gaul School of

Exercise Science, Physical & Health Education, University of Victoria, Ron

Wilson University of British Columbia

Background/Purpose: Canadians are insufficiently active,

leading to an increased risk of premature mortality and

over 35 chronic health conditions. Exercise prescription

increases physical activity and creates significant health

benefits, but few Canadian physicians use this tool. A lack

of knowledge or training was the second most common

barrier to its use cited by physicians, and UBC Medicine

students have described themselves as not prepared to

prescribe exercise, which perpetuates this lack of use.

Summary of innovation: We reviewed relevant literature

to determine best practice content and teaching methods,

which were used to develop an exercise prescription spiral

within the UBC Medicine curriculum. By revising and

expanding existing case-based sessions across all

disciplines in 11/56 (19.6%) of pre-clinical weeks, we were

able to deliver a comprehensive exercise prescription

curriculum with no additional curricular time or resources

required. The principles of exercise prescription were

introduced, reviewed and integrated with the prevention

and management of chronic conditions across the

lifespan. The principles of behaviour change were

included as a foundation for the use of exercise

prescription in clinical practice.

Conclusions: Initial informal student and facilitator

feedback was positive and indicated a desire for wider

integration of exercise prescription content and further

condition-specific recommendations, which will be goals

of future projects. Our approach to integration proved a

good solution to adding content to a full curriculum and

was supported by faculty leadership. This worked well for

UBC Medicine's spiral curriculum, as small amounts of

content could be reviewed and built upon in later sessions

but may require alternative solutions in different

curricular models.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OE2-1-3, 60529

Comment former le médecin de famille de 2035 ? Étude

prospective

Yves Delair Université de Montréal, Diane Robert Université de

Montréal, Nicolas Fernandez Université de Montréal, Nathalie Caire Fon

Université de Montréal, Alain Papineau Université de Montréal, Lyne

Ménard Université de Montréal, Riendeau Tania Université de

Montréal, Marie-Claude Lussier Université de Montréal, Codsi Marie-

Pierre Université de Montréal, Barbara Fillion Université de Montréal

Contexte : L'évolution des besoins de santé des

populations exerce une pression pour transformer la

pratique de la médecine de famille et la pédagogie

médicale. L'université doit préparer les résidents actuels à

répondre aux besoins de leurs patients du futur. Le Conseil

pédagogique (CP) des programmes de médecine familiale

de l'Université de Montréal a entrepris une réflexion

collective pour déterminer les adaptations nécessaires

visant à former à la relève. Objectifs : identifier les enjeux

centraux de la pratique de la médecine de famille de 2035

qui doivent être intégrés dès aujourd'hui à la formation

des résidents.

Méthode : Les travaux ont débuté en juin 2019 par une

recension des écrits portant sur l'avenir de la médecine de

famille. Ensuite, avec l'appui de spécialistes en

planification stratégique nous avons conçu une démarche

innovatrice de prospective. Nous avons invité les

responsables de l'enseignement clinique dans les 18

unités de médecine de famille affiliées à une retraite afin

de valider et enrichir notre portrait de l'avenir. Les

participants ont complété - en équipe - l'agenda d'une

semaine de travail en 2035 d'un clinicien-enseignant.

Parallèlement, un groupe de patients partenaires s'est

constitué pour contribuer à la réflexion.

Résultats : Les enjeux qui ont émergé portent sur les

pratiques pédagogiques qui sont en changement. En ce

sens, les contenus à enseigner et à évaluer sont appelés à

évoluer, faisant appel davantage à la technologie. Par

ailleurs, la collaboration avec les patients, les collègues et

les professionnels des autres disciplines devra aussi

occuper une place importante. Finalement, la

responsabilité sociale devra être tissée de manière plus

serrée à l'intérieur des activités d'enseignement et

d'évaluation pour ne jamais perdre de vue la santé des

patients, de leurs familles et leurs communautés.

Conclusion : Les priorités identifiées par les responsables

de l'enseignement nous permettront, lors d'une retraite

en 2021 d'initier les travaux d'adaptation du programme

de formation.

OE2-1-4, 60307

Evaluating a pen-pal curriculum innovation: A novel

medical education tool to teach medical students

compassion for homelessness

Jackie Tsang University of Toronto, Abirami Kirubarajan University of

Toronto, Seiwon Park University of Toronto, Roxanne Wright University

of Toronto, Heather Dirckze University of Toronto, Ivona Berger

University of Toronto, Fok-Han Leung University of Toronto

Background/Purpose: Despite homelessness being one of

the most powerful social determinants of health, it

remains difficult to teach empathy for this population to

pre-clerkship medical students. Current homelessness

health curriculum is limited and can portray negative

stigmas of homelessness. This study evaluates a pilot pen-

pal curriculum innovation that aimed to facilitate

compassion through letter exchanges, where medical

students were paired with community members with lived

experiences of homelessness and mental illness.

Methods: By using a grounded theory approach, the

researchers explored pre-clerkship medical students'

experience in this four-week pilot project. In-depth, semi-

structured interviews with medical student participants

were conducted by telephone. These were recorded,

transcribed, and coded using deductive and inductive

coding by two independent coders. Codes were analyzed

within code groups for themes, supported by group

discussion and analytic memos.

Results: Out of 11 students in the pilot project, 10

consented to partake in this study. Four key themes

emerged in the thematic analysis: 1) Evaluation of

Experience, 2) Personal Connection with a Community

Member, 3) Skill Development, and 4) Implementation

into Medical Education Curriculum.

Conclusions: Medical students' sentiments about their

experience were overwhelmingly positive and were

frequently attributed to developing a genuine and

mutually beneficial friendship with a community member

through the letter exchange. In addition, students

highlighted the utility of the pen-pal project in facilitating

improved communication, advocacy, and empathy skills.

Lastly, despite the perceived importance of homelessness

education, all students that were interviewed felt the

University of Toronto's pre-clerkship curriculum is lacking

in this area.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OE2 – 2 Equity

OE2-2-1, 60224

Communication skills: Going beyond eye contact

Samantha Stasiuk University of British Columbia, Sara Shahram

University of British Columbia, Heather Buckley University of British

Columbia, Maria Hubinette University of British Columbia

Background/Purpose: Traditional medical education

communication curricula typically focus on the

fundamental tasks of communication (lean in, have an

open posture, make eye contact, etc.). There are several

established frameworks, such as the Kalamazoo

consensus statement, that describe "essential" elements

in physician-patient communication. However, many of

these frameworks only briefly and superficially elude to

broader concepts such as patient centered care or cultural

humility. While the mechanics of communication are

necessary, we argue that focusing on these process tasks

is not sufficient for a holistic communication skills

curriculum.

Summary of innovation: The first year Communication

Skills program at UBC was redesigned recognizing that

equity concepts can play more of a role in achieving

effective communication than conversational mechanics

could ever accomplish. The goal was to move beyond the

"how" methodology of communication frameworks into a

more reflective space that acknowledges and empowers

patients. Theoretical concepts highlighting

intersectionality and trauma informed care were woven

through the existing 8-week suite; time was designated

within each weekly small group session to discuss pre-

assigned articles in a "journal club" format. The aim in

highlighting these concepts foundationally allows learners

to link the ideas covered to their experiences in patient

care going forwards and enact social change.

Conclusions: Tutors and students alike received the new

curriculum with positivity and interest. Operationalizing

social accountability within a curricula proves difficult to

move from theory to practice. This integration into

communication skills is one proposed method. We want

to cultivate young physicians to become those who

practice with thoughtful perspectives that address social

determinants of health.

OE2-2-2, 60579

Diversifying the Health and Human Service Professions:

Indigenous Perspectives

Emilie Nevill University of British Columbia, Kirsten Joy Correll University

of British Columbia, Hali McLennan University of British Columbia, Hailey

Matheson University of British Columbia Ashley Quinn University of

Toronto, Yael Mayer University of British Columbia, Tal Jarus University

of British Columbia

Introduction: Indigenous peoples make up 5% of

Canadian population, however, only 3% of health care

professionals identify as Indigenous. As various studies

have reported the benefits of diversifying the health

professions, the barriers and facilitators of increasing the

number of Indigenous peoples in these professions must

be identified. Objectives: In response to the Truth and

Reconciliation Commission of Canada's Calls to Action, the

purpose of this project is to identify and understand the

barriers and facilitators Indigenous peoples face in

occupations related to achieving and maintaining a

position in health and human service professions.

Methods: A narrative approach was used to collect

perspectives based on individual experiences through

facilitation of sharing circles with Indigenous students,

staff, and clinical and academic faculty. Thematic analysis

was used to reveal themes regarding participant

experiences and the impact of those experiences on

participation in study and career-related occupations.

Results: Results from this study identified current

academic structures and ideologies rooted in colonialism,

that act as barriers for engagement and inclusion of

Indigenous students, staff, and clinical and academic

faculty. Our main themes identified include negotiation of

identity in different spaces, negotiating colonial structures

in health and human service professions, and negotiating

changes and transitions in health and human service

professions.

Conclusions: We anticipate these results will act as a

catalyst for uncovering further changes to be made

regarding attitudes, procedures, and practices present in

an academic environment that limit the inclusion of

Indigenous peoples in health and human service

professions.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e203

OE2-2-3, 60730

The Diversity Mentorship Program: a model for effective

equity-based mentorship

Imaan Javeed University of Toronto, Anita Balakrishna University of

Toronto

Background/Purpose: Effective mentorship is a

contributing factor to academic and workplace success in

medicine, yet medical trainees from underrepresented /

minoritized groups in medicine (UMGMs) often struggle to

find mentors who are from similar social backgrounds.

There is a lack of research on equity-based mentorship

programs for UMGMs, especially in the Canadian context.

To help address these gaps, the University of Toronto

Diversity Mentorship Program (DMP) pairs 1st and 2nd

year UMGM mentees with staff mentors who ideally share

a similar social identity to foster equity-based mentoring

relationships.

Summary of innovation: In 2018-2019, the DMP

facilitated 52 mentor-mentee matches, forming pairs that

were to meet throughout the academic year. We also

offered structured events centered around the theme of

equity-based mentorship, creating additional

opportunities for learning and networking. The DMP

centers around three main objectives: fostering identity

development, strengthening community, and

empowering excellence. We distributed an online survey

to DMP mentors (response rate: 56%) and mentees

(response rate: 44%) to learn more about their

experiences, assess goal achievement, and highlight the

DMP's strengths and weaknesses.

Conclusions: High proportions (>85%) of mentors and

mentees felt they had productive mentoring relationships.

Four in five mentors (79%) also found the DMP to be

personally rewarding. The DMP provides a framework for

an effective mentorship program for medical students

belonging to UMGMs. Our data highlights activities,

discussion topics, and techniques used by mentor-mentee

pairs, showing that many goals of the program were

achieved. We are continually enhancing the program

based on feedback to better achieve objectives.

OE2-2-4, 60811

"Head of the Class": Equity policies, practices and

discourses related to Department Head appointments at

a Canadian medical school

Paula Cameron Dalhousie University, Christy Simpson Dalhousie

University, Shawna O'Hearn Dalhousie University, Roger McLeod

Dalhousie University, Anne Mahalik Dalhousie University, Constance

LeBlanc Dalhousie University, Anna MacLeod Dalhousie University

Background/Purpose: Academic medicine leaders play a

crucial role in medical education, research and practice. A

Department Head (DH), for example, is "head of the

class"-both figurehead and decision-maker. People in this

role regularly influence the medical education continuum,

thereby impacting future researchers, medical educators,

and clinicians. DHs are crucial change-makers and have a

visible (and expected) role in supporting new policies and

initiatives within their Departments and Faculty. Who

these leaders are therefore matters. However, diversity

amongst DHs remains a key challenge for medical schools.

We require a better understanding of barriers and

enablers to equitable leadership appointments,

particularly here in Canada.

Methods: We conducted a critical discourse analysis

(CDA) to examine underlying assumptions shaping EDI

policies and DH appointments in one Atlantic Canadian

medical school from 2005-2020. We conducted 1.

document analysis of equity policies and HR documents,

and 2. interviews with successful DHs and hiring

committee chairs, looking for implicit values and

assumptions relating to equity and academic medicine

leadership.

Results: We identified several discourses relating to

equity and DH appointments, framing equity as: 1.

documentation; 2. redressing injustice; 3. relinquishing

privilege; 4. legal obligation; 5. moral commitment; and 6.

aspiration. Normative assumptions related to "good

leadership" appeared to remain abstract and

unchallenged, while the accomplishment of equity was

often equated with the existence of equity policies

themselves. Legal obligations were often presented as

hopes and intentions, with formal accountability and

evaluation of equity remaining largely invisible.

Conclusions: Underlying ideas about "good leadership" in

academic medicine were largely unquestioned, with

equity often perceived as starting and ending with formal

recruitment policies. Deeper engagement with normative

characteristics of leadership, and barriers beyond

recruitment policies, offers rich potential for more

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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effectively achieving equity in academic medicine

leadership.

OE2 – 3 CBME

OE2-3-1, 60782

Spotting Potential Opportunities for Teachable moments

(SPOT)

Spencer Sample McMaster University, Hussein Al-Rimawi McMaster

University, Teresa Chan McMaster University

Background/Purpose: With competency based medical

education (CBME), entrustable professional activities

(EPAs) are used to evaluate residents on performed

clinical duties. This study aimed to determine if

implementing a case-based discussion, designed to

increase recognition of available EPAs, into CBME

orientation would help residents increase the number of

EPAs completed.

Methods: We designed an intervention consisting of

clinical cases that were reviewed by national EPA experts

who identified which EPAs could be assessed from each

case. A case-based session was incorporated into the 2019

CBME orientation where Postgraduate Year (PGY)1

residents read the cases and discussed which EPAs could

be obtained with PGY2/faculty facilitators. The number of

EPAs completed in the first two blocks of PGY1 was

determined from local program data. Student's t-test was

used to compare averages between cohorts.

Results: We analyzed data from 22 trainees (7 in 2017, 8

in 2018, and 7 in 2019). In the first two blocks of PGY1, the

intervention cohort (2019) had a significantly higher

average number of EPAs completed per trainee (47.4 [SD

11.8]) than the pre-intervention cohort (25.3 [SD 6.7])

(p<0.001) (Cohen's d=2.3). No significant difference

existed in the number EPAs obtained between the

2017/2018 cohorts, with averages of 24.3 [SD 6.8] and

26.1 [SD 7.0] per trainee respectively (p=0.6).

Conclusions: A case-based orientation led by CBME-

experienced facilitators nearly doubled the EPA

acquisition rate of our PGY1s. The constant EPA

acquisition rate between the 2017 and 2018 cohorts

suggests this post-intervention increase was not solely

based on user familiarity with EPAs.

OE2-3-2, 60779

Lost in Translation: Adaptations to implementation of

Competence By Design

Rachael Pack Western University, Mary Ott Western University, Sayra

Cristancho Western University, Melissa Chin Western University,

JulieAnn Van Koughnett Western University, Michael Ott Western

University

Background/Purpose: Given the complexity of the

transition to competency-based medical education

(CBME) and the diversity of systems, programs and

learning contexts, the literature has acknowledged that a

one-size-fits-all approach to implementation is

unattainable. Customization and adaptation of curricula

are crucial to ensure that the aims of CBME can be

realized. Examining these adaptations and their effects is

a priority for implementation research.

Methods: This constructivist grounded theory study

explores the implementation of a CBME curriculum

organized around entrustable professional activities

(EPAs). To examine how implementation was unfolding in

daily practice, we conducted individual semi-structured

interviews with 17 faculty members and 11 residents from

surgical and perioperative programs. Data collection and

analysis were iterative.

Results: While participants embraced the objectives of the

new CBME curriculum, they overwhelmingly reported that

EPAs, as designed, did not fit within the context of their

programs. In our data, we identified a series of adaptive

strategies (e.g., delayed completion, minimal feedback

etc.,) employed by faculty and residents. These

adaptations effectively allowed faculty and residents to

'workaround' EPAs. In effect, the practices of

implementation we were inquiring about were not

recognizable as CBME. However, our data contained rich

evidence of pre-existing teaching practices that are not

explicitly part of the CBME implementation plan, but that

deliver CBME-informed expectations.

Conclusions: Our results illustrate that both adaptations

of CBME curriculum and pre-existing pedagogical

practices may dilute or foster the principles of CBME.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e205

OE2-3-3, 60863

Evaluation of an Academic Coaching Program for

Undergraduate Medical Students

Jeremy Chitpin Western University, Stephanie Giberson-Kirby Western

University, Jane Stokes-Rees Western University, Priya Subramanian

Western University, Kyle Massey Western University

Background/Purpose: Academic coaching is increasingly

recognized as an effective learner performance

intervention in competency-based medical education

programs. Although sharing several key elements, North

American Undergraduate Medical Education (UGME)

academic coaching programs vary in structure, scope, and

exclusions. Factors that contribute to sustainable

coaching program within the Canadian context are not

fully understood.

Summary of innovation: Western's UGME Academic

Coaching Program was designed by melding available best

practices with practical and contextual considerations.

Student and coach feedback was collected at the end of

the program's first year. In addition to the quantitative

rating data, a qualitative content analysis was conducted

using the coaches' and learners' narrative feedback.

Deductive coding revealed several themes that describe

our coaches' and learners' positive and negative coaching

experiences.

Conclusions: Five primary thematic categories were

identified; program structure, coach/learner skills,

coach/learner tasks, relationship qualities, and implicit

coaching assumptions. We discovered that implicit

assumptions such as "coaching is only useful for struggling

students," and role confusion between coaching and

mentorship paradigms may affect the quality and

outcomes of the coaching relationship. The data was used

to refine communications provided to students, the

program structure, and faculty coaching workshops and

online resources. We caution that while program

structure may facilitate increased collaboration between

coach and learner, care should be taken to establish

supports for students' needs that fall outside of the

program scope. These findings reveal specific adaptions

for the development of UGME coaching programs and

may enrich medical education coaching paradigms.

OE2-3-4, 59953

An evaluation of the Surgical Foundations curriculum: a

nationalstudy

Ekaterina Kouzmina Queen’s University, Stephen Mann Queen’s

University, Timothy Chaplin Queen’s University, Boris Zevin Queen’s

University

Background/Purpose: Canadian Surgical Foundations (SF)

residency programs transitioned to Competency Based

Medical Education in 2018. It is unknown how well the SF

curriculum prepares surgery residents for peri-operative

patient management.

Methods: We administered online surveys to 300 first-

year English-speaking surgery residents across Canada to

assess self-reported confidence in recognizing and

managing seven common peri-operative patient

presentations at 3 time points: pre-SF (Jul 2019), mid-SF

(Dec 2019), and post-SF (May 2020). We conducted multi-

station simulation-based OSCEs for surgery residents at

our institution pre-SF (Aug 2019) and mid-SF (Dec 2019),

and collected Workplace-Based Assessment (WBA) data

for six pre-selected Entrustable Professional Activities

(EPAs) (Jul 2019 - May 2020).

Results: 55 residents (18%) completed pre-SF, 31 (10%)

completed mid-SF, and 52 (17%) completed post-SF

surveys. Confidence in recognizing 6 out of 7 patient

presentations was high pre-SF and did not improve

significantly except for recognizing poor glycemic control

(p <0.01). Confidence in managing 7 out of 7 patient

presentations improved significantly (p<0.05). OSCEs

performance did not change significantly between pre-SF

and mid-SF (4(3.5-4.5) vs 4(3-4); p=0.28). Residents

received high entrustment scores from the start of the SF

curriculum and they improved significantly for 2 out of 6

EPAs. Only 56% of WBA assessments had narrative

feedback, 16% of which had somewhat constructive

feedback.

Conclusions: Participation in the SF curriculum lead to

improved confidence of surgery residents in managing

common peri-operative patient presentations, and

greater level of entrustment for some EPAs. Consideration

should be given to further faculty development to

increase the quantity and quality of narrative feedback.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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April 19

, 2021 - 12:00 EST

OE3 – 2 Simulation - Skills

OE3-2-1-60803

Using a simulation-based emergency airway mastery

curriculum for CCFP-EM residents to teach airway

management skills

Fil Gilic Queen’s University, Heather Braund Queen’s University

Background/Purpose: Emergency airway management

requires complex skills typically taught through short

courses and clinical exposure however, it is unlikely that

robust learning occurs with this model. Using cognitive

load theory (CTL), mastery approach, and the 4

Component Instructional Design (4CID) we designed a

course including 12 monthly modules, high volume

deliberate practice, and intermittent reinforcement using

mental rehearsal. This research question guided our

study: does such an approach to airway learning reliably

produce mastery of the full spectrum of airway

management skills?

Methods: 10 CCFP-EM residents in the 2019/2020

academic year completed the modules, 5 locally-

developed Objective Structured Assessments of Technical

Skills (OSATS), and 2 validated Objective Structured

Clinical Evaluations (OSCE)s. A secondary task distraction

(a buzzer that needed silencing) was present throughout

the tests in order to increase the difficulty. OSATS were

scored using validated Global Rating Index of Technical

Skill (GRIT) and OSCEs using Queen's Simulation

Assessment Tool (QSAT).

Results: The average grade on OSCE 1 was 4.1 (+/-0.54)

and on OSCE 2 4.1 (+/-0.54). 9/10 of learners achieved the

Superior GPR (Global Performance Rating) or higher on

both. The average GRA on OSATS 1-5 were 4.4 (+/- 0.80),

4.1 (+/-0.70), 4.3 (+/-0.64), 4.0 (+/-0.89) and 4.0 (+/- 0.77)

with 9/10 learners achieving Superior or higher on 4/5

tests and 1 learner achieving Competent on all 5 tests.

Conclusions: Our course reliably produced mastery on

both OSCEs and OSATs, with 90% of the learners achieving

the Superior or higher performance, despite the vide

variety of skills sampled and the distracting secondary

task.

OE3-2-2-60901

Enhancing Suicide Risk Assessment Skills Through

Simulations in a Virtual Environment

Lauren Riggin Western University, Priya Subramanian Western

University, Sreelatha Varapravan Western University, Iouri Rybak

Western University, Jin Liu Western University

Background/Purpose: Suicide risk assessment is a core

skill-set in psychiatry, but dealing with suicidal patients is

emotionally and ethically challenging for medical

students. Competence is dependent on clinical variables

including patient volumes and supervision. Simulations

can supplement this by providing repeated practice with

feedback that is standardized, safe and cost-effective.

Summary of innovation: Five interactive, e-learning

simulation cases were developed that included suicidal

ideation comorbid with depression, schizophrenia,

substance use disorders including alcoholism, personality

disorders with non-lethal self-harm behaviors, and

chronic medical illness. Students watched videos of

simulated patient encounters that proceeded sequentially

and were asked to choose response options. For each

option at each stage, real-time feedback was provided.

Students were encouraged to select the correct response

before moving on to the next stage.

Conclusions: After establishing usability, reliability and

validity, this medical education innovation was tested

with a randomized control study design. 61 students were

randomized to the e-learning intervention or in person

psychiatry education as usual. We measured SIRI-2 scores

to measure competence in responding to suicidal

statements. The intervention group had a statistically

significant improvement in SIRI-2 scores following the e-

learning, compared to the control group (p=0.04). There

was a significant improvement in confidence (p<0.01) and

competence (p<0.01) following the intervention. There

were no differences between this e-learning intervention

and in person education as usual for confidence and

competence. With limits to available clinical exposures for

medical students, this tool offers a unique approach to

enhancing medical education in suicide assessment.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OE3-2-3-60893

MacSim: novel, immersive, and technology-enhanced

case siulations for undergraduate medical students

Kay Wu McMaster University, Puru Panchal McMaster University, Alex

Chan McMaster University, Avinash Pandey McMaster University,

Maroof Khalid McMaster University, Samveg Shah McMaster University,

Sudarshan Bala McMaster University

Background/Purpose: Preclinical curriculum is often

taught and evaluated discontinuously in foundation

blocks. While simulations that enhance competency via

deliberate practice are used in postgraduate medical

training, this approach is often limited at the

undergraduate level. Additionally, there tends to be few

opportunities for students to directly contribute to

curriculum development.

Summary of innovation: MacSim is a student-led,

simulation-based educational workshop for medical

students to develop both clinical and professional

competencies. Comprehensive cases with decision

pathways, representative of real clinical scenarios, were

created by senior medical students and were reviewed by

faculty. These were delivered to 66 first-year medical

students in the McMaster Centre for Simulation-Based

Learning. In teams, participants obtained a history,

performed a physical exam, and developed and

implemented an assessment and plan for a simulated

patient. A custom EMR was created for participants to

order and view labs and imaging. Patient vitals and

telemetry were updated in real-time to reflect changes in

status with treatment decisions. Feedback was delivered

to participants by physicians who observed their

performance through a one-way glass.

Conclusions: MacSim was well-received by medical

students and faculty, demonstrating the value it adds to

the existing curriculum. In the post-event survey, 86% of

respondents (n=22) agreed MacSim helped develop

clinical expertise and teamwork skills and 95% found the

feedback they received valuable. They stated MacSim

"translated theory into practice" and was "more

interactive and educational than usual SP interactions". In

the future, MacSim can be expanded to incorporate larger

groups and more diverse clinical scenarios.

OE3-2-4-60481

Developing the Virtual Resus Room: Usability,

Accessibility, and Applicability of a virtual simulation

alternative for teaching and learning

Alim Nagji McMaster University, Sarah Foohey University of Toronto,

Teresa Chan McMaster University, Yusuf Yilmaz McMaster University,

Matthew Sibbald McMaster University, Sandra Monteiro McMaster

University

Background/Purpose: Physical distancing restrictions

resulting from the COVID-19 pandemic lead to the

transition from in-person simulation teaching to online

alternatives. The Virtual Resus Room (VRR), developed by

the lead author, is an online setting in which learners can

rehearse their crisis resource management skills and apply

their knowledge using simulated patient cases.

Summary of innovation: The VRR uses Google Slides and

Zoom to create an interactive virtual environment.

Learners collaboratively complete tasks by making

synchronous edits to their virtual "room", a shared Google

Slide document consisting of a patient silhouette

surrounded by moveable images of resuscitation

equipment. Facilitators type in the vital signs in response

to the learners' actions. Learners and facilitators

communicate with each other using Zoom or an

equivalent program. A program evaluation survey was

completed by a group of 11 facilitators and 46 McMaster

medical students after they used the VRR interface.

Facilitators and learners reported high scores for usability,

acceptability, and applicability. Students showed a

significant improvement in their post-test scores

(M=89.06±9.56) compared to the pre-test scores

(M=71.17±15.77), t(34)=7.28, p<.001 with a large effect

size Cohen's d=1.23.

Conclusions: This study established the utility of the VRR

at the clerkship level. It has also been used to provide

education to residents, with plans currently underway to

expand its use to include remote, interprofessional faculty

development. The VRR is an open-access resource that

can easily be adapted to a multitude of cases, learners,

and environments to provide an effective simulation

experience.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e208

OE3 – 1 Teaching & Learning - COVID

OE3-1-1, 60840

Response to COVID-19: Implementing a Combination of

In-person and Remote Delivery of Laboratory-based

Human Anatomy Education to Medical Students

Jobanpreet Dhillon McGill, Sean McWatt McGill, Nicole Ventura McGill,

Geoffroy Noel McGill, Mayssa Moukarzel McGill

Background/Purpose: As remote teaching has become

the forefront of education during the COVID-19 pandemic,

medical curricula have been forced to adapt to provide

quality education for core competencies. In particular,

hands-on laboratory components have been largely

reduced or removed from anatomy education to comply

with social distancing guidelines. While this initially

compromised typical learning environments, it also

offered a unique opportunity to implement innovative

teaching practices and assess their impacts on student

learning.

Summary of innovation: In the 2020-2021 academic year,

the Faculty of Medicine and Health Sciences at McGill

University initiated a modified teaching strategy for the

anatomy laboratory curriculum that combined limited

hands-on cadaveric dissection with laboratory-adjacent

remote activities using a 3-D software application

(Complete Anatomy 2021). All first-year medical students

had the opportunity to experience both teaching formats

during the respiratory and cardiovascular anatomy units

in the Fall 2020 semester. Our study evaluated the efficacy

of this new curriculum delivery format by comparing the

hands-on and remote teaching approaches on the

following outcomes: (i) student and instructor

experiences, (ii) students' approach to learning and

performance, and (iii) time, resource, and cost

considerations.

Conclusions: The implementation and assessment of this

modified teaching strategy will help guide educational

policy revisions targeted at maintaining student-centered

learning activities during the current and future

disruptions to in-person teaching. Furthermore, given the

visuospatial nature of anatomy, our findings can be

broadly applied to courses in other hands-on disciplines

that have been forced to move online.

OE3-1-2, 60477

Implementation of case-based learning strategies in the

development of an online clerkship curriculum during the

COVID-19 pandemic.

Chad Kimmitt University of Calgary, Allison Brown University of Calgary,

Rahim Kachra University of Calgary

Background/Purpose: Clerkship is an integral time in

medical education to build clinical reasoning and

communication skills on the foundation of content

knowledge learned in pre-clinical years. Due to the COVID

pandemic, clerks were removed from clinical rotations,

necessitating a shift to virtual teaching.

Summary of innovation: Final year clerkship students

were divided into 2 groups and completed 4 weeks of

Internal Medicine teaching via Zoom. Teaching for the first

cohort included physical examination teaching, didactic

lectures, skills drills, Cardboard and Cards, two Calgary-

developed virtual patient platforms. A needs assessment

was performed and identified that case-based learning

(CBL) methods were the preferred strategy. A CBL

curriculum was implemented for the second cohort

entailing small-group exercises, didactic lectures, Cards

and Cardboard.

Conclusions: Data from our program evaluation (N=48)

suggest the evolution to CBL was associated with multiple

advantages during the virtual clerkship. Although students

felt it could not replace traditional clinical teaching, 83%

of students believed online teaching with a clinical focus

organized around 1-2 organ systems per week cultivated

clerkship-specific skills. This was especially true when

delivered in a small group, CBL format which increased

student engagement and allowed real-time questions

with individualized feedback. Virtual patient platforms

(Cards, Cardboard) were more effective than didactic

lectures, and 95% of students believed that CBL should be

incorporated into traditional clerkship teaching in the

future. This study can inform future virtual clerkship

teaching and can also be considered to supplement the

traditional clerkship curricula beyond the pandemic.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e209

OE3-1-3, 60252

Transformative Approaches to Global Health Education

for Medical Students During COVID-19

Nikisha Khare University of Toronto, Jacob Alhassan University of

Saskatchewan, Carlyn Seguin University of Saskatchewan, Dr. Lori

Hanson University of Saskatchewan

Background/Purpose: At the University of Saskatchewan,

a Global Health Certificate program was created to teach

health advocacy and community engagement to medical

students. Catalyzed by both the recommendations of a

recent program review and the novel COVID-19

environment, a 6-week online practicum course was

successfully developed and delivered to 17 medical

students.

Summary of innovation: Practicum sites included

Indigenous communities and advocacy organizations. A

syllabus was developed that was informed pedagogically

by anti-oppressive and transformative education

principles to engender praxis through cycles of critical self-

reflection, experiential learning, and in-depth exploration

of processes of power and oppression. Online course

components included (1) a 20 hours per week community

placement, (2) weekly instructor-led guided reflection

sessions and (3) assignments designed to promote a

reciprocal advocacy process.

Conclusions: The participatory reflection sessions enabled

students to critically contextualize their practicum

experiences into theoretical frameworks of advocacy and

health equity. Students commented on gaining new

perspectives, being challenged by stimulating discussions,

and developing their positionality within and sense of

responsibility to the world. Instructors and students

reflected on the central importance, rewards, and

challenges of applying principles of humility and solidarity

in building relationships with communities to engender

mutuality, accountability, trust, and agency, a process that

is further challenged by the online setting. Finally, COVID-

19 was approached as a global health learning opportunity

rather than an impediment. Students appreciated the

topical nature of readings, videos and discussions

exploring the profound impact of COVID-19 on pre-

existing global health issues.

OE3-1-4, 60756

"COVID-19 as the equalizer": Evolving discourses of

COVID-19 and implications for medical education

Vincent Tang University of Toronto, Asia van Buuren University of

Toronto, Tina Martimianakis University of Toronto

Background/Purpose: The othering of individuals has

been identified as a concern during the COVID-19

pandemic. The purpose of this study was to examine the

popular press during early stages of the pandemic for: 1)

emerging discourses that highlighted population-level

inequities, and 2) the implications these discourses may

have for medical education.

Methods: Using a critical discourse analysis (CDA)

approach, an archive of public domain texts discussing

COVID-19 was iteratively created, reviewed, and coded. It

was analyzed for patterns of how COVID-19 highlighted

structural and institutional inequity at the population level

using an intersectional framework.

Results: We archived 86 texts published from March to

June 2020. We focused our analysis on implications within

Ontario. The two major discourses that emerged were

"COVID-19 as equalizer" and "COVID-19 as discriminator".

The former emerged in the early stages of the pandemic

to mobilize public health recommendations and describe

near-universal impacts on the public. The latter followed

to highlight new and pre-existing forms of marginalization

exacerbated by the pandemic in an attempt to motivate

an equity-informed pandemic response.

Conclusions: There will never be another generation of

medical learners that is not aware of COVID-19 and the

ways in which it challenged our medical system. This study

provides a unique perspective on how COVID-19 is

understood through analysis of the public domain, and

therefore, has implications for how the pandemic is

framed for future medical learners. We hope that making

visible how othering and stigmatization has been

exacerbated by COVID-19 motivates equity-informed

pandemic education.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e210

OE3 – 3 Postgraduate

OE3-3-1, 60687

'Building Your Neurology Acumen': a flipped classroom

approach to strengthen Internal Medicine residents'

neurological skills

Zoya Zaeem University of Alberta, Penelope Smyth University of Alberta,

Vijay Daniels University of Alberta

Background/Purpose: Rotating internal medicine (IM)

residents do not feel adequately prepared to approach

patients with neurologic issues. This may be due to a

variety of factors. The purpose of this project was to

conduct a needs assessment to determine the optimal

components and delivery of a neurology curriculum for

internal medicine residents.

Methods: We utilized a mixed-methods design and

recruited participants through a combination of purposive

and convenience sampling. We conducted interviews with

IM residents (n=12) and focus groups with neurology

residents (n=7) and neurology staff (n=8). Also, IM

residents completed entry- and post-call surveys while on

a neurology rotation.

Results: We performed a deductive analysis organizing

qualitative themes (by consensus) according to Kern's

framework for curriculum development: 1. Problem:

Discomfort and perception of under-preparedness

amongst IM trainees 2. Needs Assessment: What the

learners (stakeholders) think they need to know vs. what

their teachers want them to know vs external

requirements (Royal College) 3. Goals/objectives: What

content is relevant for clinical requirements vs

assessments? Are they mutually exclusive? 4. Methods

and setting: Didactic vs bedside vs virtual 5.

Implementation of the curriculum: Educational days vs

bedside vs scheduled rotation teaching 6. Evaluation and

feedback: Curriculum could be evaluated with surveys,

performance on rotation, and board examination results

Conclusions: Our findings illustrate a possible mismatch

between internal medicine residents' needs and

neurologist teachers' expectations in teaching neurology.

Addressing learners' needs could enhance neurology

knowledge and sense of preparedness when encountering

patients with neurologic issues.

OE3-3-2, 60939

Identifying Learning Needs in Medical Assistance in Dying:

from the Perspective of Internal Medicine Residents

Krista Reich University of Calgary, Jaqueline Hui University of Calgary,

Amy Tan University of Calgary

Background/Purpose: Medical Assistance in Dying (MAiD)

was legalized in Canada in 2016. There have been a total

of 13,946 medically assisted deaths between 2016-2019.

Integration of MAiD into the medical curriculum is

important to provide trainees with the skills to care for

patients requesting MAiD. We determined the learning

needs in MAiD for Internal Medicine (IM) residents.

Methods: At an academic session, residents were

recruited and completed three patient cases created to

test situational judgement and knowledge in MAiD. Cases

were discussed and recorded in a group setting guided by

a MAiD expert. Written responses and transcripts were

analyzed manually to identify themes and key quotes of

learners' perspective on MAiD.

Results: Twenty-eight residents participated (44%

response rate). Three high level categories were identified

that outline the approach residents have to a MAiD

request: Action, Reaction, and Decision Making. Residents

are comfortable taking action in managing acute and

chronic medical problems near end of life and create an

environment for shared decision-making. However, they

lack knowledge in basic MAiD eligibility criteria and

struggle with the concept of "do no harm" in this context.

When making decisions, residents prioritize a pragmatic

approach to requests for MAiD and are limited in their

discussion around managing personal reactions.

Conclusions: IM residents require content based teaching

on MAiD, but there is an additional need for an approach

to end of life care discussions, specifically around

addressing uncertainty and personal reactions. This is

important because these emotions and personal reactions

impact decision making, patient care, and resident

wellbeing.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e211

OE3-3-3, 59642

Informing a medical assistance in dying curriculum in

specialty residency training programs

Susan MacDonald Queen’s University, Sarah LeBlanc Queen’s

University, Mary Martin Queen’s University, Adam Fundytus Queen’s

University, Marie-Josee Lafleche Queen’s University, Ross Walker

Queen’s University, David Taylor Queen’s University, Karen Smith

Queen’s University, Richard van Wylick Queen’s University, Rylan Egan

Queen’s University, Karen Schultz Queen’s University, Nancy Dalgarno

Queen’s University

Background/Purpose: Medical assistance in dying (MAID)

became legal across Canada when Bill C-14 was passed in

2016. Currently, little is known about practitioner interest

in MAID education, the most effective strategies for

providing MAID education, and the importance of

integrating MAID into existing curricula. This study

examines and compares residents' and faculty preceptors'

perspectives about MAID.

Methods: Two anonymous surveys were distributed to

residents (n=549) and preceptors (n=797) in 29 different

specialty programs. Survey data was analyzed using

descriptive and inferential statistics.

Results: Response rates were 23.1% for residents and

13.0% for preceptors. Preceptors were more comfortable

and competent discussing MAID with a patient compared

to residents (p<0.00 and p=0.007, α=0.05), though

residents were more likely to want to participate in a

MAID assessment (p<0.000). The majority of both

residents (73.5% ± 8.0%) and preceptors (79.0% ± 8.0%)

believe it is important to include MAID education in their

specialty's curriculum. The most important topics included

the discussion of MAID with patients (90.4%[ ±5.4%] and

79.6%[ ±8.0%] of residents and preceptors, respectively)

and regulations and legal aspects of MAID (87.0%[ ±6.2%]

and 84.7%[ ±7.0%] of residents and preceptors,

respectively).

Conclusions: Significantly more residents want to be part

of the assessment and clinical teams providing MAiD

compared to preceptors, however both groups agree that

it is important to include MAID education in the

curriculum of their specialty program. Next steps will

focus on creating MAID learning outcomes and developing

MAiD curriculum appropriate to the educational needs of

each specialty residency program.

OE3-3-4, 59663

An innovative approach to Program Evaluation in PGME:

Design, Development, and Implementation

Theresa Beesley McGill, Carlos Gomez-Garibello McGill, Maryam

Wagner McGill, Regina Husa McGill, Evelyn Constanin McGill, Armand

Aalamian McGill

Background/Purpose: Residency program directors are

required to gather evidence to make decisions about their

program, to improve its effectiveness, and to inform

decisions. Recent changes to the CanRAC accreditation

standards include program evaluation. However,

residency programs have diverse needs, and program

directors (PDs) have limited time and varied knowledge of

program evaluation. In response, we developed an

innovative approach to support program evaluation in the

over 70 different residency programs, using a scholarly

and iterative process. This innovative approach included

standardized templates delivered alongside capacity-

building workshops.

Summary of innovation: The innovative approach was

implemented in two phases. Phase 1 included a capacity-

building initiative for PDs as a one-day retreat. The retreat

included three workshop activities using a stepwise

approach to teaching principles of program evaluation,

how to develop a logic model and evaluation matrix, and

distributed logic model and evaluation matrix templates.

Workshop activities integrated the CanRAC accreditation

standards to provide PDs with concrete examples of how

to use program evaluation to facilitate informed decisions

on how to improve their residency program. Phase 2

included follow-up meetings with the education team

members to review PD developed program evaluation

plans. One-on-one support was offered to PDs once a

month over the last year to assist PDs with the

implementation of their program evaluation plans.

Conclusions: This innovative approach provides

standardized program evaluation templates for PDs to use

in their program evaluation process, contributes to

capacity building in PGME for program evaluation, and is

a practical process, which can be implemented in PGME

across Canada.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e212

April 19

, 2021 - 15:30 EST

OF1 – 1 CPD

OF1-1-1, 60591

The Opioids Clinical Primer: Design, Development,

Delivery and Evaluation of an Open Access, Online

Continuing Medical Education Curriculum

Anthony Levinson McMaster University, Jennifer Wyman University of

Toronto, Lori Mosca McMaster University, Mel Kahan University of

Toronto, Lynn Wilson University of Toronto

Background/Purpose: As part of Ontario's Opioid Strategy

there was a need to expand education for healthcare

providers who prescribe opioids. Our objective was to

design, develop, and implement six accredited online

courses for health care providers on a range of topics

related to opioids.

Summary of innovation: Based on a needs assessment

and feedback from a steering committee and expert

advisory group, the six online courses related to both

opioid use disorder and managing chronic pain were

designed, developed, and implemented on the machealth

platform (opioids.machealth.ca). Our project

management method was based on the Successive

Approximation Model (SAM). Subject matter experts and

community practitioners provided feedback in an iterative

process with regard to the design, development and

evaluation of the courses and associated resources. Best-

evidence principles of multimedia instructional design

were utilized, such as interactive case-based scenarios.

Each course is self-contained, but thematically linked to

the others. In total the courses are certified for 10 credits.

Conclusions: As of Sept 2020, there have been over 1,765

program registrations, with over 1,220 course

completions. Over 96% of learners who completed a

course agreed that the learning experience was valuable,

with 94% agreeing they would recommend the course to

a colleague. 85% agreed that the courses helped them

identify changes they would like to make in their current

practice. The companion resource 'Buprenorphine

Reference Guide' has been downloaded over 1,660 times.

The courses are being used by a range of learners,

including CME/CPD, PG and UGMD; and easily integrated

into academic curricula and hospital training. Updates and

dissemination are ongoing.

OF1-1-2, 60029

Reading of the Week: A Novel, National Program Offering

"Just-in-Time" Education for Psychiatry Residents

David Gratzer University of Toronto, Faisal Islam CAMH, Sanjeev

Sockalingam University of Toronto

Background/Purpose: Osler started the first journal club

more than a century ago. Though technology has

advanced, in our day as in Osler's, CME is challenging to

deliver. This presentation discusses the Reading of the

Week (ROTW), an innovative education project, aimed at

Canadian residents of psychiatry, and the contribution of

this project to residents' learning. ROTW summarizes the

latest literature and is emailed out weekly through formal

partnerships with 12 Canadian post-graduate programs;

Readings are also available online. The selections cover

everything from public policy to practice, including studies

from the British Journal of Psychiatry and Lancet

Psychiatry. Readings include commentary, providing a

larger context. Like Osler's journal club, there is the

opportunity to exchange ideas, with "letters to the

editor." In the spring of 2019, we aimed to assess

outcomes for ROTW using continuing medical education

(CME) evaluation framework (Moore's framework).

Summary of innovation: A total of 332 responded to the

online survey (a third of subscribers). 90% reported they

"always or usually" read the summary. 97% were satisfied

with ROTW; 93% agreed that ROTW had improved their

understanding of the current psychiatry research; 60%

shared ROTW to someone else at least once. "I have used

the summaries to make better informed clinical

decisions."

Conclusions: This presentation outlines the practical

implementation and impact of a unique CME intervention

aimed at addressing challenges related to remaining "up-

to-date" amidst the vast amount of resources available in

print and online. ROTW provides a boundless option for

CME for trainees and providers.

OF1-1-3, 59513

Management of Patients with Morbid Obesity in Primary

Care: Informing a CPD Event

Nancy Dalgarno Queen’s University, Boris Zevin Queen’s University,

Mary Martin Queen’s University, Colleen Grady Queen’s University,

Linda Chan Queen’s University, Robyn Houlden Queen’s University,

Richard Birtwhistle Queen’s University, Karen Smith Queen’s University,

David Barber Queen’s University

Background/Purpose: Over one million Canadians have

Class II or III obesity and are eligible to be referred by

Primary Care Providers (PCP) for surgical and/or medical

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e213

weight loss; however, fewer than 7% are referred. The

purpose of this study is to explore the knowledge,

experience, perceptions and educational needs of PCPs in

managing weight loss in primary care to inform

development of a Continuing Professional Development

(CPD) event.

Methods: Mixed method study combining a survey and

focus groups with PCPs (n=591) in eastern Ontario. Survey

data analyzed using descriptive and inferential statistics in

SPSS. Thematic analysis utilizing an inductive approach

completed on qualitative data through open coding with

NVivo.

Results: The survey was completed by 103 PCPs (17.4%).

Overall, 39.1% had participated in education on the

management of patients with obesity in the past 5 years,

however 88.5% believe there is a need for education on

bariatric surgery. Seven focus groups with 17 PCPs were

conducted. PCPs described lack of knowledge as a barrier

to managing obesity in primary care. Topics suggested for

CPD included general information about bariatric surgery

(procedures, referral process, post-operative follow-up,

surgical complications), effective weight-loss strategies,

and availability of local resources.

Conclusions: Given the high prevalence of Class II and III

obesity, PCPs are now key stakeholders for ensuring

patients with obesity receive timely and high quality care.

Understanding past experiences and perceptions of PCPs

informed the development of a CPD intervention to

support PCPs in providing quality and evidence-based care

to their patients with obesity.

OF1-1-4, 60594

Paediatric Project ECHO® for Managing Pain in Children

and Youth: Development and Use of Simulation-Based

Scenarios to Enhance Healthcare Providers' Clinical Skills

Naiyi Sun The Hospital for Sick Children, Jo-Ann Osei-Twum The Hospital

for Sick Children, Chitra Lalloo The Hospital for Sick Children, Jennifer

Tyrrell The Hospital for Sick Children, Giulia Mesaroli The Hospital for

Sick Children, Shirin Ataollahi-Eshqoor The Hospital for Sick Children,

Emily Louca The Hospital for Sick Children, Alison Dodds The Hospital for

Sick Children, Annie Jiwan The Hospital for Sick Children, Linda Nguyen

The Hospital for Sick Children, Senthoori Sivarajah The Hospital for Sick

Children, Alyssa Gumapac The Hospital for Sick Children, Jennifer

Stinson The Hospital for Sick Children

Background/Purpose: Simulation-based learning mimics

clinical practice whilst providing a safe learning

environment. The Paediatric Project ECHO® Education

Event (E3) offered in-person instruction on evidence-

based care for pain management in a paediatric

population. This presentation describes the development

and evaluation of three paediatric simulation-based

scenarios delivered as part of E3.

Methods: Contextual paediatric simulation scenarios

were developed to support interdisciplinary learning.

Simulations were co-facilitated by simulation educators

and subject matter experts, with patients and caregivers

represented by actors and a high-fidelity infant

mannequin. Attendees participated in 15-minute

scenarios followed by a 45-minute structured debrief.

Acceptability and satisfaction as well as changes in

knowledge and self-efficacy were assessed by a

prospective, mixed-methods study with repeat measures.

Surveys were administered at baseline, immediately post-

simulation and at 6-months. Follow-up surveys will be

administered at 12-months. This study was approved by

the local Research Ethics Board.

Results: Participants reported moderate-to-high

acceptability and satisfaction with simulation-based

learning. HCPs endorsed the use of simulation-based

learning for clinical skills development. Respondents

agreed that "simulations were an effective way to develop

communication and teamwork skills", with an average

score of 6.2 ± 1.2. Perceived positive changes in

knowledge and self-efficacy of pain topics were observed

immediately post-simulation and at 6-months.

Conclusions: Simulation-based learning was successfully

integrated into the E3 program for paediatric pain.

Learner participation in the scenarios resulted in

perceived increases in knowledge and self-efficacy, which

will be re-assessed at 12-month follow-up.

OF1 – 2 Health & Wellness - COVID

OF1-2-1, 60755

Managing expectations, uncertainty, and growth: An

autoethnographic lens on resilience building in clerkship

and COVID-19

Zi Ying Zhao University of Toronto, Airiss Chan University of Toronto,

Andrew Perrella McMaster University, Alon Coret University of Ottawa

Background/Purpose: Autoethnography is a qualitative

research methodology with increasing popularity in

medical education, wherein the author uses dedicated

self-reflection to explore personal experiences and derive

broader sociocultural understanding. The purpose of this

project was to reflect on the nature of resilience - along

with factors that foster and hinder it - using an

autoethnographic lens.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e214

Methods: Two third-year medical students reflected on

transformative moments throughout their core clerkship

(11 months of clinical work, 3 months of hiatus secondary

to COVID-19). Reflections were guided by prompts - all

centred on events, emotions, factors, and outcomes, and

how each of these fit with their sense of personal

progress. In an iterative process, the students met

quarterly with two first-year resident physicians with

previous experience in autoethnography to explore

reflections and discuss broader implications.

Results: 40 reflections were written over 14 months.

Major themes for building resilience included: learning to

focus on internal validation and strength, self-worth

outside of preceptor feedback, and viewing harsh

criticisms and self-inflicted failure through a rational lens.

Other key themes, especially in the context of the COVID-

19 hiatus, were the inevitability of uncertainty in clinical

work and finding solace in efforts instead of results. Both

students found near-peer debriefing with residents to be

therapeutic for augmenting change and growth.

Conclusions: Autoethnography provides a safe space for

learners to grow and explore their 'insider' experience in

the culture of medical training. Undergraduate medical

programs should strongly consider implementing

autoethnography and near-peer groups to improve

student introspection and resilience.

OF1-2-2, 60568

Nurses and physicians' distress, burnout, and coping

strategies during COVID-19: Sources of stress and impact

on perceived performance and intentions to quit

Nigel Mantou Lou McGill, Tina Montreuil McGill, Liane Feldman McGill,

Gerald M. Fried McGill, Mélanie Lavoie-Tremblay McGill, Farhan Bhanji

McGill, Heather Kennedy McGill, Pepa Kaneva McGill, Susan Drouin

McGill, Jason M. Harley McGill

Background/Purpose: Healthcare providers (HCPs) have

experienced more stress and burnout during COVID-19

than before. Understanding HCPs' challenges, risks, and

proactive factors during COVID provide an educational

opportunity for training future physicians and nurses. We

compared sources and levels of stress, distress, and

approaches to coping between nurses and physicians, and

examined whether coping strategies helped mitigate the

negative impact of stress and intentions to quit.

Methods: Using a cross-sectional design, burnout was

measured with the Maslach Burnout Inventory.

Psychological distress was measured using the

Depression, Anxiety, Stress Scale. A self-reported survey

was used to evaluate stressors, impact on perceived

performance, and intentions to quit.

Results: Responses of 119 HCPs from a hospital in

Montreal were analyzed. Findings suggest that (1) Both

nurses and physicians experienced more distress and

burnout during COVID-19 than before. (2) Compared to

physicians, nurses experienced a higher level of distress

and burnout during COVID. (2) Adaptive coping strategies

moderated the negative impact of stress on work

performance. (3) Adaptive coping strategies moderated

the negative effect of stress on burnout, which in turn

reduced intentions to quit. That is, stress negatively

impacted performance and burnout only for those with

low, but not high, levels of adaptive coping strategies.

Conclusions: The current findings of HCPs' challenges,

risks, and protective factors provide valuable information

(a) on COVID-19's impact on HCPs, (b) to guide

distributions of institutional supportive efforts, and

recommend adaptive coping strategies, and (c) to inform

medical education, such as resilience training, focusing on

adaptive coping approaches.

OF1-2-3, 60659

"I am just waiting to step into the fire and there is nothing

I can do about it:" An international study of learner

perceptions regarding the impact of COVID-19 on their

medical training and wellbeing

Allison Brown University of Calgary, Aliya Kassam University of Calgary,

Mike Paget University of Calgary, Kenneth Blades University of Calgary,

Megan Mercia University of Calgary, Rahim Kachra University of Calgary

Background/Purpose: The COVID-19 pandemic required a

rapid reorganization of medical training globally in

response to the urgent needs of the health system. Our

understanding of how medical learners perceived the

pandemic to have affected their training was limited.

Methods: A cross-sectional survey was conducted

between March 25-June 14th, 2020, shortly after the

World Health Organization declared COVID-19 a

pandemic. The survey was available in 19 languages and

collected quantitative and qualitative data to broadly

explore learner perceptions on how their training and

well-being were influenced during the initial spread of the

pandemic.

Results: 6492 medical learners completed the survey from

140 countries. Most schools removed learners from the

clinical environment and adopted online learning

modalities, however, students expressed concerns about

the quality of their learning and training progression. Most

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e215

trainees felt under-utilized and wanted to contribute in

meaningful ways, particularly postgraduate learners,

although some felt that providing care during a pandemic

was beyond the scope of a trainee. Statistically significant

differences were detected between levels of training and

geographic regions for satisfaction with organizational

responses, the impact of COVID-19 on wellness, and state-

trait anxiety.

Conclusions: The disruption to the status quo of medical

education was initially perceived by learners across all

levels and geographic regions to have adversely affected

their training and well-being, particularly amongst

postgraduate trainees. This global study offers empirical

insights into research and policy areas that warrant

consideration, such as policies for clinical utilization of

learners during public health emergencies.

OF1-2-4, 60761

Medical trainees in a COVID-19 world: The relations

between level of training, personal health conditions and

mental health outcomes

Yael Mayer University of British Columbia, Ido Lurie Shalvata Mental

Health Center, Noga Shiffman Hilel Yafe Hospital, Shir Etgar Columbia

University, Tal Jarus University of British Columbia

Background/Purpose: There is growing evidence on how

the level of training and other risk factors, such as chronic

health conditions may impact the mental health of

medical trainees. During the COVID-19 pandemic, medical

trainees and especially those with personal health

conditions were more vulnerable to experience

psychological distress. This study aimed to explore how

the level of training as well as other health risk factors

impacted the mental health outcome of medical interns,

residents, and experts during the pandemic.

Methods: Participants in the study were 68 interns, 132

residents and 147 experts in various fields of medicine in

Israel. Participants filled up an online survey including the

Fear of COVID-19 scale, the depression and anxiety stress

scale (DASS-21), and the mental health continuum scale to

measure well-being.

Results: Participants with a disability or a health risk factor

for COVID-19 experienced higher levels of fear of COVID-

19, depression, anxiety, stress, and lower levels of well-

being than participants with no health conditions. In

general, residents experienced higher levels of stress and

lower levels of well-being.

Conclusions: Medical residents, and especially residents

with a disability or a health condition, are at risk of

experiencing high levels of stress during the COVID-19

pandemic more than medical interns and experts.

Therefore, educational programs must provide residents

the support they need to cope with the psychological

burden they may experience during the pandemic, while

promoting a culture of legitimation to express emotional

hardships and receive support.

OF1 – 3 Assessment SJT

OF1-3-1, 60714

Gaming the Medical School Application System:

Revealing the Coaching Effect Size of a Constructed

Response SJT

Heather Davidson Altus Assessments, Kelly Dore Altus Assessments,

Harold Reiter Altus Assessments

Background/Purpose: Situational judgment tests (SJTs)

are increasingly used for medical trainee selection, but the

effects of test preparation strategies on these tests,

especially open-ended SJTs, has not been explored. The

greatest concern is coaching effects, as they threaten

score enhancement driven by construct-irrelevant factors

like response distortion and test-wiseness, and advantage

high SES applicants with access to these resources. This

study sought to examine the role of coaching effects on

SJT performance.

Methods: We invited test-takers to indicate whether they

used any of the following preparation strategies: read the

tips for applicants on the test website, completed the free

practice test, participated in a commercial test

preparation course, studied potential questions based on

assessment competencies, rehearsed responses with

technology, and rehearsed responses without technology.

We conducted a multiple regression analysis to compare

the additive effect of each preparation method on SJT

scores.

Results: Of the six preparation strategies, only completing

the free practice test on the test website (b = 0.16, p <

.001), studying potential questions based on the

assessment competencies (b = 0.13, p = 0.02), and

rehearsing responses with technology (b = 0.18, p < .001)

provided significant additive benefit to test scores. Test

preparation method only accounted for 2% of the overall

variance in test scores (R2 = 0.02, F(6,2887) = 14.44, p <

.001).

Conclusions: Results suggest coaching effects are

extremely small. These results highlight the importance of

ensuring equitable access to practice tests, and relieves

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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concerns over potential socially regressive impact of

commercial test preparation.

OF1-3-2, 60601

Is the Casper test a good predictor of medical student

outcomes?

Xin Wei Yan Altus Assessments, Timothy Wood University of Ottawa,

Genevieve Lemay University of Ottawa

Background/Purpose: Increasingly, medical schools are

using non-academic characteristics in admissions towards

more holistic decision making. Casper, a widely used SJT,

has demonstrated reliability, however, little is known

regarding its relationship with in-program non-academic

measures or sociodemographic variables. This study aims

to understand the associations between non-academic

performance at admissions and in-program measures.

Methods: Graduating classes of 2020 and 2021 from

University of Ottawa MD student data were

retrospectively analyzed. Admissions data including

demographics, interview score, Casper, and wGPA were

compared to course grades, clerkship ratings and OSCE

scores collected during training. Analysis included

Independent samples t-tests, mon-parametric

regressions, Spearman's rho, and multiple regression.

Results: Over the three graduation classes, the total

number of students was (N=496). Of those, 55% were

female, 67% had a bachelors, and the average age at the

time of graduation was 22.4. There was no significant

gender (p = .53 and .19), age (p = .41 and .68), language

stream (p = .18 and .21) differences in Casper scores for

both Classes of 2020 (p = .19 to .68) and 2021. Casper was

significantly associated with professional and skill

development OSCE score (b = 0.53, p = .02) for Class of

2020. The multiple regressions with GPA and Casper

showed minimal total variance accounted for across

clerkship scores (adjusted R2 = 0.03, p = .11; adjusted R2

= 0.08, p = .001).

Conclusions: Preliminary results suggest that Casper is

significantly associated with OSCE, however, other

academic and non-academic metrics only accounted for

minimal total variance of in-program measures. Results

from further analyses related to range restriction of scores

and missing data will be reported.

OF1-3-3, 60752

Bridging the Gap: Improving CASPer Test Confidence and

Competency for Underrepresented Minorities in

Medicine through Interactive Peer-assisted Learning

Lolade Shipeolu University of Ottawa, Johanne Matthieu University of

Ottawa, Farhan Mahmood University of Ottawa, Ike Okafor University

of Toronto

Background/Purpose: The Computer-based Assessment

for Sampling Personal characteristics (CASPer) is a

situational judgement test (SJT) that is adopted by medical

schools to assess for interpersonal and professional

characteristics of applicants. Unlike conventional SJTs

whereby test takers select their preferred response to an

ethical dilemma from a series of choices, applicants

writing the CASPer compose their own responses, thereby

providing a window into the applicant's rationale for

ethical decision-making. Underrepresented minority

medical school applicants usually lack access to a network

of individuals and/or resources that offer guidance and

prepare them for the various application requirements of

medical school.

Summary of innovation: Under the support of University

of Toronto's Community of Support program, medical

students at the University of Ottawa designed and taught

a free online CASPer coaching program for

underrepresented medical school applicants across

Canada. The program consisted of 35 learners and three

medical student tutors. Important attributes of the 4-

week program included free access to a medical ethics

book, insight sharing from three distinct tutors, feedback

provision to in-class and homework responses, and

facilitation of a mock CASPer test. Through extensive peer-

to-peer mentorship, we aimed to reduce anxiety, improve

confidence, and increase competency among minority

students in our CASPer coaching program.

Conclusions: Results from our pre and post-program

survey showed significant student improvement in

familiarity with the test, increased competence,

confidence and preparedness, as well as reduced anxiety

(p<0.05). Through peer-to-peer teaching and access to

medical student mentors, our program recognizes and

addresses socioeconomic barriers that several minority

applicants face when applying to medical school.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e217

OF1-3-4, 60590

Are age, gender, language, ethnicity and socioeconomic

status associated with Casper scores? Findings from a

multicenter study in Quebec, Canada

Jean-Michel Leduc Université de Montréal, Sébastien Béland Université

de Montréal, Christian Bourdy Université de Montréal, Robert Gagnon

Université de Montréal, Karina Cristea Université de Montréal, Nathalie

Loye Université de Montréal, Martine Bourget Université Laval, Marie-

Pier Carrier Université Laval, Claude Labrie Université Laval, Jean-

Sébastien Renaud Université Laval, Isabelle Gauthier Université de

Sherbrooke, Annie Ouellet Université de Sherbrooke, Saleem Razack

McGill, Estelle Chétrit McGill, Xin Wei Yan Altus Assessment

Background/Purpose: Casper is a situational judgment

test widely used for selection in healthcare professions

programs. Associations between sociodemographic

characteristics and scores, which can impact diversity in

admissions, were described in the USA. This study

assesses subgroup performance differences for applicants

in Quebec, Canada.

Methods: Sociodemographic data were collected using an

exit-survey after Casper completion. Data from unique

applicants to any of the four medical schools in Quebec

were anonymized and linked with Casper z scores. A

multiple regression model was created using backward

stepwise regression.

Results: Of 5012 applicants who took Casper for the 2020

admission cycle, sociodemographic data was available for

3491 (69.7%). Overall, 17.3% were aged ≥26, 61.8% were

women, 55.9% self-identified as white and 4.1% as black,

36.4% declared a family income <75,000$ and 19.3%

spoke a different language than French or English. In a

regression model, age ≥26 (β=-0.069; 95%CI -0.110;-

0.028), male gender (β=-0.064; 95%CI -0.105;-0.022),

language other than French or English (β=-0.102; 95%CI -

0.136;-0.068), self-declared black race (β=-0.116; 95%CI -

0.177;-0.055) were associated with significantly lower

scores. Other non-white applicants had lower scores only

if aged ≥26 (β=-0.125; -0.166;-0.084) or if their parental

income was <75,000$ (β=-0.066; 95%CI -0.120;-0.012).

Parental education level was non-significant.

Conclusions: For the 2020 application cycle in Quebec,

Casper scores presented subgroup differences related to

gender, age, language, parental income, and

ethnicity/race. These findings are in accordance with

previously published studies and need to be monitored

and compared to subgroup differences observed with

other admission tools such as academic measures to

inform selection methods.

April 19

, 2021 - 16:30 EST

OF2 – 1 Health & Wellness

OF2-1-1, 60574

Pandemic and Postponed Exams: Impacts on Resident

Wellness

Laila Nasser McMaster University, Michelle Onlock University of

Toronto, Natasha Snelgrove McMaster University, Kaif Pardhan

University of Toronto, Tara Riddell McMaster University

Background/Purpose: The COVID-19 pandemic resulted

in worldwide lockdowns beginning in March 2020. Fears

of overwhelmed hospitals led to significant changes in

care provided by residents. Due to concerns regarding

disease transmission, certification examinations in Canada

were indefinitely postponed with minimal notice. This

resulted in uncertainty and stress among residents in their

certification exam year, many of whom were transitioning

to practice. We explored residents' (a) perception of the

pandemic's impact on their transition to practice, and (b)

experience of exam cancellation, including personal and

professional impacts.

Methods: We used qualitative description methodology.

Residents from McMaster University and the University of

Toronto were recruited through snowball sampling. In

depth, semi-structured one-on-one interviews were

conducted. Each was transcribed, reviewed and coded

using content analysis by two members of the research

team.

Four main themes were identified. Residents endorsed

significant feelings of uncertainty and loss after spending

months preparing for both their exam and transition to

practice. They were acutely aware of potential impacts of

the pandemic on learning and future career plans. There

was also significant stress regarding the timing and format

of rescheduled exams and impacts on licensure. However,

they identified their residency training programs and

colleagues as significant sources of support.

Conclusions: The COVID-19 pandemic has impacted all

medical trainees and faculty. Our research demonstrates

the impacts on certification year residents, including

stressors and sources of support. This research may

inform decision making during future waves of the COVID-

19 pandemic or future disasters that will improve

certainty and support during this critical year.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OF2-1-2, 60039

Medical Student Mistreatment and Reporting: A Journey

Amanda Bell McMaster University, Meredith Vanstone McMaster

University, Allyn Walsh McMaster University, Catherine Connelly

McMaster University

Background/Purpose: Over 50% of Canadian medical

students report experiencing mistreatment, yet only a

small proportion of students report these concerns to

school administration. It is unknown how medical

students make sense of their experiences of mistreatment

and come to decide whether to formally report these

experiences. A better understanding of this phenomenon

will facilitate changes by the medical school to better

support students.

Methods: This Constructivist Grounded Theory study

interviewed 19 current and former medical students from

one institution about their experiences with mistreatment

and reporting. Anonymized transcripts were reviewed,

coded and theory was developed.

Results: Students undergo a journey surrounding

experiences of mistreatment in five phases: Situating,

Experiencing and Appraising, Reacting, Deciding, and

Moving Forward. Students move through these phases as

they come to understand their position as medical

learners and their ability to trust and be safe within this

institution. Each experience of mistreatment causes

students to react to what has happened to them, and then

decide if they will share their experiences and reach out

for support. They choose if they are going to report the

mistreatment, at what cost and for what outcomes.

Students continue through their training while

incorporating their experiences into their understanding

of the culture in which they are learning and continually

resituating themselves within the institution.

Conclusions: This study revealed institutional mistrust

from students especially as it related to reporting

mistreatment. Interventions designed to support students

and decrease exposure to mistreatment may be best

focused on increasing organizational trust between

students and medical school leadership. Students

volunteered mechanisms to support them. Medical school

administration should consider how they can increase

trust with their learners while identifying areas of concern

and procedures for intervening and providing more

transparent resolutions.

OF2-1-3, 60737

5C's of understanding resident wellbeing on call: a quality

improvement perspective in emergency psychiatry

Sandra Westcott McMaster University, Tara Riddell McMaster

University, Christopher Clarkstone McMaster University, Nick Kates

McMaster University

Background/Purpose: Concerns from educational

stakeholders at McMaster University in 2019 regarding

local Psychiatric Emergency Services (PES) led to a

reappraisal of the service infrastructure and role of

psychiatry residents. Although a valuable learning and

required training experience, working in PES can be

inherently stressful. A group of residents applied quality

improvement (QI) methods to understand factors

impacting resident wellness related to PES during this

transformation, and to identify areas for ongoing

improvement.

Methods: A QI process was utilized with four phases. First,

the problem of resident wellness in PES was defined. A

process map provided a working model to understand

factors that may impact resident well-being. This was

translated into a resident survey, the results of which

were analyzed for themes and compared to data from

various educational meetings and prior surveys. A

subsequent resident survey was administered to explore

possible solutions. Project results have been disseminated

to key stakeholders to implement change through

sequential PDSA cycles.

Results: Five major themes impacting resident wellness

related to PES were identified - the "5Cs": communication,

care management, comfort and environment, competing

demands, and connectedness. It was subsequently

recognized that for meaningful change to occur, control

and courage were paramount. These concepts led to an

expanded "5C+" model of resident wellness.

Conclusions: Results of this QI initiative will help inform

hospital, department, and educational leadership as

changes in PES continue to unfold. Although McMaster

psychiatry residents' experience in PES was the primary

focus, this model may be generalizable to learners and

staff in other settings.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OF2-1-4, 60163

Promoting the Well-Being and Resilience of Health

Professional Learners: Developing and Implementing an

Interprofessional Academic Wellness Curriculum

Camila Velez McGill, Emily Wasylenko McGill, Deborah Friedman

McGill, Nicole-Ann Shery McGill, Emily Wasylenko McGill

Background/Purpose: Health professional learners often

experience significant distress that can impair their

mental health, decision-making, and ability to thrive in

their programs. Besides dealing with a demanding

academic curriculum, clinical rotations, and constant

evaluations, health professional learners also have to

respond to their patients in a professional and

compassionate manner. It is critical to equip learners with

skills to problem solve and develop resilience within a

challenging health care system.

Summary of innovation: Since 2016, the WELL Office in

the Faculty of Medicine and Health Sciences at McGill

University has been working to promote the well-being of

learners from the School of Physical and Occupational

Therapy, Ingram School of Nursing, and School of

Communication Sciences and Disorders. The WELL Office

is proactive in reaching learners through the Academic

Wellness Curriculum and providing them with tools to

becoming problem solving, critical thinking, and resilient

health professionals. Concurrently, we are reactive in

offering academic and mental health counselling.

Curriculum topics include stress and time management,

building resilience, finding positive solutions to negative

interactions, managing perfectionism, grit, and

leadership. The topics are based on feedback from

learners in different forums, curriculum evaluations and

exit surveys, and input from leadership, faculty, wellness

consultants, and Assistant Dean, Student Affairs.

Feedback has been positive and the desire for a

longitudinal curriculum continues to grow.

Conclusions: This presentation will share the

implementation process of the Wellness Curriculum, the

nature of the curriculum sessions and feedback from

learners, as well as recommendations for the successful

development of a curriculum to foster health professional

learners' well-being.

OF2 – 2 Works in Progress

OF2-2-1, 60309

A primer on persuasion: Teaching narrative-based

advocacy for undergraduate medical students

Hilary Pang University of Toronto, David Wiercigroch University of

Toronto, Sabrina Yeung University of Toronto

Background/Purpose: Advocacy is a health professions

competency that is critical to improving the health of

Canadians and requires accessible and persuasive

communication skills. Yet, there is limited skills-based

training dedicated towards advocacy communication.

Medical residents who have completed health advocacy

curricula have reported increased self-perceived

competency and knowledge scores.

Summary of innovation: We designed a two-day

workshop for undergraduate medical students enrolled in

the community-based service learning curriculum of the

University of Toronto MD Program. The seminar is

designed around the Rhetorical Triangle framework of

ethos, logos, and pathos. Students are to deliver a brief

pitch presentation to key stakeholders. Using the flipped

classroom model, participants are asked to watch a video

example of a health advocacy pitch and to complete a

guided "mind map", which involves applying the

Rhetorical Triangle to a proposed ask. The workshop

begins with a theory burst on the Rhetorical Triangle.

Subsequently, students complete their mind map and

practice their pitches in small breakout groups. The

workshop concludes with a large-group debrief session

identifying take-home lessons, and possible areas of

career application. Finally, participants present their pitch

to a community partner who asks questions for reflection

and feedback.

Conclusions: Advocacy is a critical health professions

competency yet there is a lack of opportunities to learn

practical communication skills to advocate effectively.

Upon completion of the workshop, medical students

acquire practical experience developing a pitch,

knowledge of best practices for persuasive

communication, and ideas of how to apply this skill set in

their career.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e220

OF2-2-2, 60647

Moving Beyond a "Guest Speaker" Role: An Exploration

of "nil appointments" for Community Partners Involved in

Community-University Collaborations

Chelsea Jalloh University of Manitoba, Karen Cook University of

Manitoba

Background/Purpose: Increasingly, medical education

related to learning experiences such as service learning,

population health and interprofessional education draws

upon collaborations with community partners in

capacities such as guest lecturers, placement supervisors

and subject matter experts. While modest honoraria is

provided for their involvement in some capacities, this

project sought to engage in dialogue with community

partners to explore ways universities could acknowledge

and support their important roles in community-

university collaborations (CUC). This dialogue included

exploration of a formalized "nil appointment" for

community partners.

Summary of innovation: In 2019/20, we conducted 12

interviews with community partners involved in CUC,

many of whom are actively involved in medical education.

Individuals were recruited to represent various roles in

CUC and diverse lived experiences and identities. All

individuals expressed interest in a form of university "nil

appointment" including ideas of what that role might

involve, and how people would come to hold the role and

for what duration. In addition, supports such as subsidized

transportation for travel to/from campus, access to

university libraries and active living centers, inclusion on

university email lists, and having access to space on

campus were identified as valuable to differing degrees.

Conclusions: These preliminary interviews expressed

support to continue to explore how to establish a

formalized "nil appointment" role for community partners

actively involved in CUC. As colleges of medicine commit

to providing students with socially accountable

educational experiences, institutions acknowledging

community partners for their essential contributions to

health professions education are essential elements of

this commitment.

OF2-2-3, 60697

Morbidity and Mortality Rounds as a Learning Practice: A

Critical Interpretive Synthesis

Paula Rowland University of Toronto, Nathan Cupido University of

Toronto, Simon Kitto University of Ottawa, Mathieu Albert University of

Toronto

Background/Purpose: Morbidity and mortality rounds

(MMRs) are a learning practice that have been a part of

medicine for more than 100 years. Recently, MMRs have

become a site of interest for educators, hospital

administrators, and governing bodies. As such, MMRs

occupy a hybrid organizational space with multiple

accountabilities. To date, there have been few

examinations of processes of learning emerging in new

iterations of MMRs, specifically how those logics of

learning are interacting, complicating, or confounding one

another.

Methods: To address this conceptual problem, we

reviewed MMR literature using a critical interpretive

approach. The aim of the review was to document how

MMRs are constructed in the published literature and to

interpret what those constructions imply about the nature

of professional knowledge and learning within hybrid

organizational spaces. Following a search and selection

process, we included 60 articles in the dataset.

Results: Current literature reflects a range of competing

imperatives in the design, delivery, and evaluation of

MMRs. Some scholars have reflected on the possible

implications of a single learning practice attempting to

serve individual learning needs and organizational

performance requirements. Despite this, there have been

few empirical studies of the potential impact of these

multiple imperatives acting on a single learning practice.

Conclusions: MMRs serve as an ideal site to explore the

interactions between individuals, organizations,

professions, and policy-makers. Understanding how

knowledge is produced, contested and maintained across

these boundaries is increasingly important for educators

seeking to support clinical learning environments and

lifelong learning in clinical workplaces.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e221

OF2-2-4, 60819

Residency training experiences of residents with children:

a phenomenology study

Erin Boschee University of Alberta, Zoya Zaeem University of Alberta,

Marghalara Rashid University of Alberta, Aditi Amin University of

Calgary, Karen Moniz University of Alberta

Background/Purpose: Residency training is a challenging

and demanding period for many physicians. For many

residents, the timing of residency training coincides with

childrearing years. The proportion of female medical

trainees and residents has also increased significantly in

recent decades. Residency training may therefore have an

impact on the timing and experience of pregnancy and

parenting for many physicians.

Methods: We are in the process of conducting 15

interviews using transcendental phenomenology as a

methodology. The phone interviews each lasted for

around an hour. Our study population includes post-

graduate medical education trainees at the University of

Alberta who were already parents upon entry to residency

or who became parents during their residency training.

Results: We performed a thematic analysis with our data

which resulted in the following themes: 1) work-life

balance; 2) support systems; 3) culture of residency; 4)

impact on social interactions; and 5) clinical expectations.

We divided our data into two portions to accurately reflect

both the issues and solutions that were being suggested.

The second part of our analysis resulted in themes which

can be categorized as actionable solutions. These include:

1) scheduling flexibility; 2) family-inclusive events; 3)

mentorship; 4) individualized residency plan; 5) supports

for fathers; and 6) childcare options.

Conclusions: It is evident that despite the current focus on

resident wellness, there are still immense challenges for

individuals trying to navigate parenthood and residency.

The hope is that the recommendations that come from

this study can be implemented within residency programs

across the country.

OF2 – 3 Faculty Development

OF2-3-1, 60069

The Impact of Local Health Professions Education Grants

- Is it Worth the Investment?

Susan Humphrey-Murto University of Ottawa, Simran Aggarwal

University of Ottawa, Kyle Walker University of Ottawa, Nina Dhillon,

Timothy Wood University of Ottawa

Background/Purpose: The rapidly evolving pace of

medical education calls for rigorous research to inform the

development of educational practices. Despite the well-

established fact that funding improves quality of research

in medical education, funding is limited. The development

of local grant programs aims to address this gap in

funding; given the amount of money awarded and the

resources taken to administer these programs, it is

important to evaluate relevant outcomes. The purpose of

this project is to analyze factors predicting the success of

these grants by studying the impact of two local medical

education grants programs at a single university in a

Canadian context. The following two questions will be

addressed: 1) What have been the outcomes of the

grants? 2) Can we identify factors that appear to

contribute to the success of those projects funded?

Methods: We distributed an electronic survey to previous

Department of Innovation in Medical Education (DIME)

and Department of Medicine (DOM) grant recipients

(n=108) to gather information pertaining to PI

demographics, grant-funded research outcomes and

dissemination, and factors leading to success in research.

A literature search (Medline, Scopus) was performed to

obtain records for non-responders. Multivariable logistic

regression and backward logistic regression was used to

determine the effects of collected variables on publication

success.

Results: In total, 67 cases were analyzed for 10 variables

and two were found to be statistically significant in

predicting likelihood of publication success. The odds of

publication were 3 times higher for researchers who had

presented their research either orally or as a poster. In

addition, the odds of publication were more than 6 times

higher for researchers receiving grants through DIME vs.

DoM, suggesting that differences between the structure

of the two programs plays a significant role in the success

of its recipients.

Conclusions: The results of this study inform both DIME

and the DOM about the ongoing success of their funding

programs and, on a larger scale, guide Canadian centers

looking to institute or improve their local grant programs

in medical education. Identification of factors associated

with publication can both help inform local grants

development and promote grant recipient success.

Rigorous research and thoughtful innovation in medical

education has the potential to benefit trainees, and

ultimately our patients.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e222

OF2-3-2, 60580

Developing and Delivering Incentives for Clinical Teaching:

Proceed with caution

Katherine Wisener University of British Columbia, Erik Driessen, Cary

Cuncic University of British Columbia, Cassandra Hesse University of

British Columbia Kevin Eva University of British Columbia

Background/Purpose: When medical education programs

have difficulties recruiting or retaining clinical teachers,

they often introduce incentives to help improve

motivation. Unfortunately, previous research has shown

incentives can have unintended consequences, but when

and why that is the case in the context of incentivizing

clinical teachers is unclear. The purpose of this study was

to understand how teaching incentives have been

perceived to provide recommendations to those seeking

to better support medical teachers.

Methods: Following an interpretive description

methodology, a purposeful sampling strategy identified a

heterogenous sample of clinical faculty teaching in

undergraduate and postgraduate contexts. Sixteen semi-

structured interviews were conducted and iterative

analysis led to a thematic structure that accounted for

general trends and individual variations.

Results: Clinicians articulated interrelated and dynamic

personal and environmental factors that had linear, dual-

edged and inverted U-shaped impacts on their

motivations towards teaching. Clinical teachers felt valued

when they felt recognized and connected to learners,

peers, leadership, and/or the medical education

community. While incentives aimed at producing these

connections could be perceived as supportive, they could

also negatively impact motivation if they were

impersonal, inequitable, inefficient, or poorly framed.

Conclusions: Implications of this work include proceeding

with caution when labeling any particular factor as a

motivator or barrier to teaching. Rather, clinical teachers'

perceptions are unique, dynamic and fluid. Incentives,

therefore, need to be designed with nuance based on

what makes clinicians feel valued. Further, any reward

scheme should be crafted and delivered with care to lower

the risk of reducing motivations to teach.

OF2-3-3, 60592

A Pan-Canadian Evaluation of the College of Family

Medicine Canada's Fundamental Teaching Activities

Framework

Rachelle Lee-Krueger University of Ottawa, Douglas Archibald

University of Ottawa, Katherine Moreau University of Ottawa, Dianne

Delva Queen’s University, Viola Antao University of Toronto, Cheri

Bethune Memorial – University of Newfoundland, Vina Broderick

Memorial – University of Newfoundland, Kaylee Eady University of

Ottawa, Catherine Giroux University of Ottawa

Background/Purpose: The primary purpose was to

conduct an evaluation of the CFPC's Fundamental

Teaching Activities (FTA) in Family Medicine Framework.

Methods: Using a practical participatory evaluation

approach a partnership between the project team and

members of the CFPC Faculty Development Education

Committee (FDEC) solidified the evaluation design,

development of data tools, implementation strategies,

validated key findings, and dissemination. Faculty

Development programs across Canada were targeted for

this evaluation, particularly Faculty Development

Directors, Postgraduate Directors, and Site Directors were

invited to participate. Mixed methods consisting of an

online survey sent by FDEC to all Family Medicine Faculty

Development Directors, Postgraduate Directors, and Site

Directors and follow-up interviews with self-selected

participants conducted by the research team.

Results: The surveys were distributed to the 15 Faculty

Development Directors, the 18 Family Medicine Program

Directors and 174 Family Medicine Site Directors in the

Fall of 2018, soliciting response rates of 80%, 66.7%, and

19.5% respectively. Interviews were conducted with a

representative sample of 12 survey participants in Winter

and Spring of 2019. Surveys and interviews were

conducted in either French or English. Survey and

interview responses suggest that awareness of the FTA

was highest among Faculty Development Directors. There

have been varied levels of implementation of the FTA

framework across the country.

Conclusions: Recommendations to reduce barriers to

implementation, such as readability and clarity of the FTA

framework and highlighting the collective and individual

values of the framework will be presented.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e223

OF2-3-4, 60339

Inter-Professional Faculty Development in small groups -

the importance of a safe environment.

Erica Amari University of British Columbia , Wilson Luong University of

British Columbia , Jenn Clark University of British Columbia , Katherine

Wisener University of British Columbia , Brenda Hardie University of

British Columbia , Sue Murphy University of British Columbia , Robin

Roots University of British Columbia , Donna Drynan University of British

Columbia , Julia Klick University of Northern British Columbia, Rose

Hatala University of British Columbia , Kiran Veerapen University of

British Columbia

Background/Purpose: Faculty Development (FD) utilizing

inter-professional small groups is uncommon. At the

University of British Columbia, we implemented a

longitudinal FD program where faculty from various

health professions taught and learned from each other.

We sought to understand how the inter-professional

setting impacts teaching and learning in FD.

Methods: Eight cohorts of five to eight participants each,

met for six, 90-minute sessions that were moderated by

FD leads over one year. Each participant developed and

delivered an interactive lesson on a key educational topic.

Participants gave structured feedback; dialogue and

reflection were encouraged. A safe space was actively

promoted through modeling of respectful, collaborative

communication by the facilitator, corresponding ground

rules and a focus on educational topics. Interviews were

conducted with seven participants and seven cohort

leaders. Preliminary content analysis was conducted by

two of the authors by coding the transcripts and

identifying themes.

Results: Participants reported feeling safe in sharing their

experiences and perspectives more freely in these groups

than in their own uni-professional groups. They began to

appreciate commonalities and variations in how health

professions applied educational principles. They took into

consideration the needs and perspectives of other

professions when planning lessons, resulting in a fresh

approach. Over time, the feedback and discussions

became robust, and participants incorporated the

observed learned strategies in their own practices.

Conclusions: Longitudinal FD in small groups with active

participation of inter-professional faculty in a safe

environment promotes a deeper understanding of how

other professions teach and work and enhances the

feedback process.

April 20

, 2021 - 10:00 EST

OG1 – 1 Learning Outcomes

OG1-1-1, 60626

Developing a New Measure of Cultural Sensitivity for

Health Professions Learners

Eleftherios Soleas Queen’s University, Jennifer Carpenter Queen’s

University, Nicholas Cofie Queen’s University, Jessica Baumhour

Queen’s University, Rylan Egan Queen’s University

Background/Purpose: Immersion in other cultures is a

transformative learning opportunity for learners to

become lifelong advocates for all their patients. To

measure the efficacy of these experiences, a validated

instrument to measure change on the relative cultural

sensitivity, is necessary. The last validated instrument was

revised in 2002 (Neuliep, 2002). We live in a more socially

aware era than when these items were written and

crafted. To sincerely understand people's latent

perceptions, we need a shrewder instrument that cannot

be as easily 'gamed' for a socially desirable outcome.

Methods: This instrument development combined 12

expert consultations and the narrative experiences of 95

health professions students and then rigorously applied

item-response theory and instrument development

science to develop a generalizable scale of cultural

perceptions.

Results: The developed scale was prototyped with an

interprofessional sample of health professions students

and analysed using correlation analyses and exploratory

factor analysis revealing a 4-factor structure. From these

findings, items were dropped and the scale trimmed to a

final form.

Conclusions: The constructs of this instrument are highly

interdisciplinary and transferable across health

professions and beyond. For example,

electives/placements for nurses, physiotherapists, and

medical trainees expose learners to many different health

provision and learning contexts that may have very

different cultural feels to them. This instrument would

offer a means for measuring the efficacy of these training

programs to increase learner advocacy and cultural

sensitivity. We look forward to freely sharing our learning

and instrument with any health professions educator to

promote the development of health advocates

everywhere.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e224

OG1-1-2, 60911

Teaching Medicine to a General Public: How to Assess If

Your Audience Is Learning

Malgorzata Kaminska University of Northern British Columbia, Trina

Fyfe University of Northern British Columbia, Cirisse Stephen University

of British Columbia , Lisa Munro University of Northern British Columbia,

Sonya Kruger University of Northern British Columbia, Lindsay Mathews

BC Cancer Agency, Peyton Fisher University of British Columbia

Background/Purpose: Public medical education programs

(e.g., Mini Med Schools (MMS)), frequently limit

evaluations to self-reported learner satisfaction. Based on

Kirkpatrick's evaluation model, other methods could be

used to assess educational impact. Instruments such as

retrospective pre/post surveys (RPPS) detect a shift in

learners' understanding, while script concordance tests

(SCTs) measure clinical reasoning. Unaware of any

publications about knowledge increase, application, or

retention in MMS participants, we wondered whether

RPPS and SCTs be used to evaluate such programs?

Methods: A 6-week MMS for the general public consisting

of weekly 2-hour lectures on basic sciences and

biomedical topics was delivered by medical faculty,

covering material similar to medical school lectures. RPPS

and SCTs were administered to all participants at the end

of each lecture with SCTs repeated 8 weeks post-MMS.

Results: 59 participants (<16 to 69 years old) with diverse

educational backgrounds took part in the MMS. RPPS

showed an increase of at least 2 points on a 6-point Likert

scale for each session. The SCTs' Cohen d effect size

between participants and experts was 2.81 (98% response

rate), remaining unchanged post-MMS (47% response

rate). The SCT instrument Cronbach's alpha was 0.69. 98%

of participants found assessments to be "fun and useful".

Conclusions: The RPPS consistently showed significant

self-assessed increases in understanding of the material

presented. The ability of our varied non-medical

participants to apply newfound medical knowledge in

SCTs was within the effect size typical for medical

students. The ability to apply this knowledge 2-3 months

later was maintained over time. RPPS and SCTs can be

used to help guide and improve MMS curricula, thus

ensuring that the intended knowledge is successfully

transmitted.

OG1-1-3, 60553

Examining Diagnostic Radiology Residency Case Volumes

from a Canadian Perspective: A Marker of Resident

Knowledge

Benjamin Kwan Queen’s University, Omar Islam Queen’s University,

Alexandre Menard Queen’s University, Benedetto Mussari Queen’s

University, Lynne Meilleur Queen’s University, Nancy Dalgarno Queen’s

University, Nicholas Cofie Queen’s University

Background/Purpose: New guidelines from the

Accreditation Council for Graduate Medical Education

(ACGME) have proposed minimum case volumes to be

obtained during residency but there are currently no

minimum case volumes standards for radiology residency

training in Canada. Using data from a pilot study, we

examine radiology resident case volumes among recently

graduated cohorts of residents and determines if there is

a link between case volumes and measures of resident

success.

Methods: Resident case volumes for three cohorts of

graduated residents (2016-2018) were extracted from the

institutional database. Achievement of minimum case

volumes based on the ACGME guidelines was performed

for each resident. Pearson correlation analysis (n = 9) was

performed to examine the relationships between resident

case volumes and markers of resident success including

residents' relative knowledge ranking and their American

College of Radiology (ACR) in-training exam scores.

Results: A statistically significant, positive and strong

correlation was observed between residents' case volume

and their relative knowledge ranking (r = 0.682, p < 0.05).

Residents' relative knowledge ranking was also strongly

and positively correlated with their ACR in-training

percentile score (r = 0.715, p < 0.05).

Conclusions: This study suggests that residents who

interpret more cases are more likely to demonstrate

higher knowledge. This highlights the utility of case

volumes as a prognostic marker of resident success. The

results also underscore the potential use of ACGME

minimum case volumes as a prognostic marker. These

findings can inform future curriculum planning and

development in radiology residency training programs.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e225

OG1-1-4, 60741

Utilizing a Community Health Incubator as a Novel Health

Advocacy Education Tool

Youshan Ding Western University, Lorelei Lingard Western University,

Nick Maizlin Western University, Tharsan Kanagalingam Western

University, Yashasavi Sachar Western University, Jess Rhee Western

University, Sumit Dave Western University, Zhan Tao Wang Western

University, Taryn Taylor Western University

Background/Purpose: Health advocacy is a vital pillar of

the CanMEDs competency framework, yet it is difficult to

teach and assess. Service learning may address this deficit,

but is implemented heterogeneously across medical

schools in Canada and produces inconsistent learning

outcomes. Although business incubators are commonly

used to teach intangible skills and drive innovation, the

use of an incubator to teach advocacy remains unexplored

in medical education.

Summary of innovation: Accel Labs is a social incubator

that supports student-led teams seeking to build

community health projects. Design thinking approach to

healthcare innovation underpins our application process,

which asks applicants to empathize with a target

population, describe specific needs and ideate a solution.

Selected teams receive funding and expert mentorship to

propel projects through the startup phase.

Multidisciplinary workshops in business, design and public

health, are provided to teach practical skills for launching

startup initiatives. Overall, 4 projects aimed at improving

health outcomes in marginalized populations were funded

and matched with mentors. Structured survey measuring

self-perceived ability to engage in health advocacy was

given upon acceptance and tracked over time.

Improvements in attitudes toward health advocacy and

perceived ability to generate impact was found amongst

trainees enrolled in the incubator.

Conclusions: By utilizing an incubator framework,

students receive a unique and engaging learning

opportunity while generating positive health impact for

underserved groups. This structured framework can be

replicated to develop multidisciplinary skills, build

partnerships across sectors and foster a spirit of social

entrepreneurialism that may be critical for effective

health advocacy.

OG1 – 2 Rural Medicine

OG1-2-1, 60473

Surrounded by slippery slopes: Navigating paradox while

living and practising in rural communities

Andrea Gingerich University of British Columbia, Kevala van Volkenburg

University of Northern British Columbia, Sean Maurice University of

British Columbia, Christy Simpson Dalhousie University, Robin Roots

University of British Columbia

Background/Purpose: Rural practitioners who develop a

sense of belonging in their community tend to stay;

however, belonging means having neighours as patients

and makes incidental encounters with patients outside of

the clinic unavoidable. Despite its impact on retention, the

navigation of overlapping personal and professional

relationships remains largely undescribed and educational

efforts would benefit from its explication.

Methods: Constructivist grounded theory guided the

iterative recruitment and analysis of interviews with 22

physiotherapists (PTs) living and practising in rural,

northern or remote communities.

Results: During incidental encounters, PTs wanted to

show compassion as a good neighbour while also

protecting patient confidentiality. Similarly, they recall

practice standards advise referral to avoid overlapping

relationships but neighbours sought care from someone

they knew and who knew them; plus, referrals could block

access to care. Further complicating decisions was the

view that outcomes were improved by tailoring care

based on knowledge of the patient as a community

member; but, mitigation strategies were also needed

when judgment was identified as being clouded by

overlapping relationships.

Conclusions: Overlapping relationships tend to be seen as

a step away from the ethical and towards a slippery slope

of poor decisions. For rural PTs it seemed more like being

between a rock and a hard place with slippery slopes in

sight. Their grappling with the inherent contradictions is

consistent with a paradox mindset. Conceptualizing

overlapping relationships as paradox offers new

possibilities for teaching and critiquing how to be

professional while rural.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e226

OG1-2-2, 60501

Stay on MD: Recruitment and Retention Factors for New

Brunswick Medical Graduates

Kathleen MacMillan Dalhousie University, Keith Brunt Dalhousie

University, Sarah Melville Dalhousie University, Daniel Dutton Dalhousie

University, Alexandra Fournier Dalhousie University, Peggy Alexiadis

Brown Dalhousie University

Background/Purpose: The Dalhousie Medicine New

Brunswick medical school distributed medical campus

opened in 2010, however, there is no data about where

the graduates choose to practice. The objectives of this

study are: to evaluate the factors that compelled the 2014

graduates to choose to practice in select locations; to

learn where the class of 2021 would like to practice, and

the factors that compelled them to choose select

locations; and to compare the factors that influenced the

chosen practice location.

Methods: The graduates of the 2014 class (N = 28) were

asked to complete a questionnaire about their choice of

practice location and preferred medical specialty. The

class of 2021 (N = 28) were also asked to complete a

similar questionnaire. Quantitative data regarding

migration patterns in NB were extracted from the

Canadian Institute of Health Information to compare

trends with the data collected from the questionnaires of

each class.

Results: The median number of physicians over 65 years

old who are practicing in NB has increased by 32.7% from

2008 to 2018. In this same time period, the total

physicians per capita has increased by 25.7%. We received

19 of 28 responses from the class of 2014 and 11 of 28

from the class of 2021. Most respondents indicated

personal and social reasons for practicing in specific

locations (2014: 14/19 vs. 2021: 10/11). From the class of

2021, 82% of respondents (9/11) wanted to practice in NB.

From the class of 2014, 53% (10/19) are practicing in NB.

Conclusions: The results from this study provide evidence-

based feedback about recruitment and retention rates of

physicians in NB in relation to the objective of the medical

school distributed medical campus.

OG1-2-3, 60822

The Impact of a Pre-Clerkship Self-Learning Module (SLM)

to Improve Student Knowledge and Interest in Rural

Medicine and Rural Health

Celina DeBiasio University of Ottawa, Timothy Wood University of

Ottawa, Charles Su University of Ottawa, Craig Campbell University of

Ottawa

Background/Purpose: 21.4% of Canada's population

resides in rural communities, while only 9.4% of physicians

practice in these areas. Numerous attempts to address

this discrepancy exist, including mandatory medical

undergraduate rural rotations. However, current

standardized training methods designed to prepare

students for different clinical and cultural interactions are

extremely limited. In response, we developed and

implemented a novel online pre-departure SLM for first-

year medical students. The goal of this study is to evaluate

the SLM's impact on students' interest and self-assessed

knowledge of rural medicine.

Methods: Survey questions were developed in

consultation with rural medicine education experts.

Measurement consisted of rating scales (1-5) and

comment boxes. Pre and Post-SLM surveys were

distributed to students. Surveys assessed students' rural

background, knowledge, and interest in rural medicine as

well as their opinions on the importance of the SLM.

Results: 31 of the 136 students identified as having lived

in a rural area (control group). Post-SLM items related to

rural medicine interest and self-assessed knowledge,

showed an increase in all categories, including interest in

pursuing a career in rural medicine for students who had

lived in rural areas (M=3.4; M= 3.5) and those who did not

(M= 2.8; M= 3.0). Comments were generally positive.

Conclusions: In showing the feasibility of developing a

rural education SLM, we have successfully implemented a

virtual standardized training program. This SLM can be

expanded to other Canadian medical schools to help

prepare medical students for rural medicine experiences

and ultimately increase interest in rural medicine and

related career opportunities.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e227

OG1-2-4, 60487

A student's background is important to rural and northern

practice recruitment, but what about rural placements?

Robin Roots University of British Columbia, Anne Worthington

University of British Columbia, Andrea Gingerich University of Northern

British Columbia, Sue Murphy University of British Columbia

Background/Purpose: Rural communities remain

medically underserved due to the maldistribution of

health professionals. Substantial modifications to

selection processes and curricula in health profession

education programs aim to increase recruitment and

retention in rural locations, but evidence of their impact

has been inconclusive.

Methods: Five years of student data (n = 281) from the

Master of Physical Therapy program at the University of

British Columbia was analyzed with multiple binary logistic

regression to identify which 'nature' (background) and

'nurture' (exposure to rural practice settings) indicators

were most predictive of rural and northern practice

outcomes.

Results: Students with a rural background were 2.7 times

more likely to go into rural practice and those with a non-

science degree were 5.2 times more likely. For every one

additional clinical placement completed in a rural

community, students were 1.6 times more likely to go into

rural practice. Students with a rural background were 6.2

times more likely to go into northern practice. At

admission, for every one-point increase in self-reported

intent to practice rural/remote, students were 3.8 times

more likely to go into northern practice and those with

interest in northern practice were 5.8 times more likely to

go into northern practice.

Conclusions: Nature (rural background, non-science

degree) and nurture (number of rural clinical placements)

predicted rural practice. However, only nature (rural

background, interest in northern or rural/remote practice)

predicted northern practice. Therefore, modifications to

both admissions criteria and curricula are needed to

address maldistribution of physiotherapists.

OG1 – 3 Distributed Medical Education

OG1-3-1,60218

Improving Resident Education and Patient Care through

National Physician Licensure

Brandon Tang University of Toronto, Bernard Ho University of Toronto

Background/Purpose: The lack of a unified national

physician licensure in Canada restricts physician mobility

and negatively impacts patient care. Currently, working in

a different province/territory requires a separate medical

license for each of the thirteen medical regulatory

authorities, despite similarities in licensure processes and

required documentation. These barriers limit the

exposure of early career physicians including residents,

while restricting access to physician care, especially in

rural communities.

Summary of innovation: Resident Doctors of Canada

(RDoC) has been advocating for a unified licensure process

through several avenues. Firstly, our 2018 national

resident survey demonstrated that while only 18.5% of

residents plan to locum outside the province/territory of

their primary practice, 52% would pursue locum

experiences if no additional license applications were

required. Secondly, RDoC published a Collaborative

Statement on Canadian Portable Locum Licensure in 2017,

endorsed by our national partners in medical education.

Thirdly, RDoC has advocated for improved physician

mobility, and are supportive of the Fast Track and License

Portability Agreements proposed by the Federation of

Medical Regulatory Authorities of Canada. However,

these preliminary agreements do not include residents

and do not include new-in-practice physicians who have

held an independent license for less than three years.

Conclusions: RDoC's national survey identified residents'

desires to practice in jurisdictions outside their primary

province/territory. RDoC supports the work of our

partners to facilitate a unified or fast-track licensure. This

would enrich resident education by facilitating exposure

to diverse practice settings and would help address

healthcare needs in underserved communities by

encouraging resident mobility.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e228

OG1-3-3,60783

Innovations to Extend Scholarly Activities to Medical

Students at a Regional Medical Campus

Larry W. Chambers McMaster University, Seddiq Weera McMaster

University, Chris Henderson McMaster University, Amanda Bell

McMaster University

Background/Purpose: According to CanMEDS, scholarly

activity includes "contributing to the creation and

dissemination of knowledge and practices applicable to

health". Regional medical campuses are an established

part of medical education and can promote scholarly

activity in their environments. At McMaster University's

Niagara Regional Campus (NRC), innovative approaches

allow our 84 medical students and 450 faculty to learn

about and engage in applied health research, quality

improvement of health services and education research.

Summary of innovation: A steering committee facilitates

participation of faculty and students in scholarly activities;

it collects and summarizes data to support faculty and

student scholarly activities; it nurtures research

communities of practice; and it connects NRC to resources

and individuals at other academic centres. Our research

coordinator maintains a list of projects for trainees and

faculty during the three-year MD Education Program.

These approaches to recruiting, cataloguing and

supporting projects began in 2019. In 2018, 2019 and

2020, 33, 60 and 53 projects were available to students,

respectively. Projects were supervised by 9, 18 and 24 NRC

faculty over each of the three years. In 2018, only 25% (7

of 28) of first year students were involved in projects.

Whereas, 100% (28 of 28) and 73% (21 of 28) of first year

students were involved in projects in 2019 and 2020,

respectively. During 2019 and 2020, 24 peer-reviewed

manuscripts and abstracts co-authored by students were

published or are in press.

Conclusions: The NRC's innovative approaches can be a

model for other regional medical campuses to advance

scholarship and reflect local context.

OG1-3-4, 60851

Mixed Messages: A Visual and Textual Analysis of a Rural

Medicine Website

Rebecca Malhi University of Calgary, Douglas Myhre University of

Calgary

Background/Purpose: The mission of Distributed Learning

and Rural Initiatives (DLRI), University of Calgary, is to

facilitate relationships between "medical educators,

healthcare professionals in training, and individuals and

families living in rural communities." The current study

evaluates the DLRI website to determine whether it

accurately reflects our mission and commitment to rural

medicine.

Methods: We examined all public-facing webpages that

comprise the DLRI website. Text were analyzed for both

purpose and content. We also conducted a visual analysis

of images on the webpages using techniques derived from

art criticism. Specific attention was paid to the subject and

context of the images as well as any notable presences or

absences.

Results: Thirty-two webpages were analyzed. DLRI's

mission was only described explicitly on one webpage.

Text on many webpages were procedural with substantial

use of jargon. Student pages, in particular, were very

directive and often used negative phrases. The visual

analysis found that of 23 individual images, 14 of them

were rural landscapes with no people. The majority of

images containing people showed students, often

depicted socializing. Little ethnic diversity was seen in

images

Conclusions: Textual analysis of the DLRI webpages

indicates a mixture of welcoming and bureaucratic

discourse. The visual analysis of the images documented a

focus on isolated, de-populated rural landscapes. In

addition, there was a notable absence of images of

patients, community members, or individuals from

diverse backgrounds. The analysis informed

recommendations to align the text and images with the

DLRI mission and the social accountability mandate of the

University of Calgary.

April 20

, 2021 - 11:00 EST

OG2 – 1 Patient Safety

OG2-1-1, 60325

Disclosure: Policy, Practice and Medical Education

Julia Trahey Memorial – University of Newfoundland, Nicholas

Fairbridge Memorial – University of Newfoundland, Heidi Coombs-

Thorne Memorial – University of Newfoundland, Elizabeth Ross

Memorial – University of Newfoundland

Background/Purpose: Transparent communication with

patients is expected after harm. In Newfoundland and

Labrador, a well-publicized error event prompted

education in disclosure communication for physicians and

a procedure for disclosure was formalized for each

Regional Health Authority in the province. This study was

designed to assess the penetrance of educational and

policy initiatives to frontline physicians and trainees, and

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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the openness to trainee involvement in the formal

disclosure process.

Methods: A cross-sectional survey was sent to physicians,

including trainee physicians, in Newfoundland and

Labrador. Focus groups were conducted with physician

administrative leaders responsible to lead formal

disclosure teams and Quality and Risk Management

personnel responsible for institutional disclosure

processes and training.

Results: Few clinicians had received education in

disclosure. Less than half of respondents were aware of

guidelines, legislation or institutional policies relating to

disclosure of medical error. Almost all respondents

supported trainee involvement in the disclosure process

yet procedural resistance and barriers to trainee

involvement were documented.

Conclusions: Uptake of disclosure education by physicians

and trainees remained low. Education beyond

undergraduate training was uncommon, and awareness

of institutional policies and procedures was also low.

Despite a lack of training, physicians participated in

disclosure discussions. Training programs should continue

to emphasize disclosure education beyond undergraduate

lectures. Institutions have an opportunity in their on-

boarding process to familiarize physicians to disclosure

policies and procedures. Mentoring residents in disclosure

is dependent on Faculty who have the knowledge and

skills to do so.

OG2-1-2, 60878

The impact of learner involvement in emergency

department patient assessments on short-term return

visits: A cross-sectional study

K. Jean Chen University of Ottawa, Christopher Elliott, Tania Fitzpatrick

University of Ottawa

Background/Purpose: Learners, either medical students

or residents, often perform the initial assessment of

patients visiting the Emergency Department (ED). Their

involvement in the ED has been shown to increase

patients' length of stay, physicians' time to disposition

decision, departments' utilization of imaging and

admission rates. It is unclear, however, if learners affect

the rate of short-term unscheduled return visits. The

objective of this study was to determine if the

involvement of learners in ED visits increases the rate of

short-term unscheduled return visits.

Methods: This study was a retrospective cross-sectional

analysis of ED visit data at a single tertiary care center over

a one-year period. Return visits were defined as ED visits

presenting within 72 hours of discharge from an initial

non-admit ED visit and resulting in an admission on the

second visit. The primary outcome was the odds of return

visits with and without learners involved during the initial

visit. The secondary outcome assessed the interaction of

level of training and program on return visits.

Results: Return visits meeting our criteria occurred after

658 (1.3%) of 51,149 encounters involving learners and

701 (0.8%) of 83,310 encounters with no learner

involvement (adjusted OR = 1.15, [95% CI 1.03 to 1 .29]).

This effect was heterogeneous over learner level of

training with no association between clerkship students or

senior residents and return visits. However, involvement

of post-graduate year (PGY) one (adjusted OR = 1.28, [95%

CI 1.09 to 1.50]), PGY2 (adjusted OR = 1.24, [95% CI 1.00

to 1.53 ]) and PGY3 (adjusted OR = 1.45, [95% CI 1.18 to

1.79]) residents significantly increased the odds of a

return visit. Program of study did not independently

predict return visits.

Conclusions: This study demonstrated that the

involvement of learners, specifically PGY1, PGY2 and PGY3

residents, in ED patient assessments increased the rate of

short-term unscheduled return visits. Further work is

needed to understand the factors that contribute to this

phenomenon.

OG2-1-4, 60313

Unique features of rural generalist to urban specialist

consultation: A qualitative study of rural family physicians

Margo Wilson Memorial – University of Newfoundland, Augustine

Joshua Devasahayam Memorial – University of Newfoundland,

Nathaniel Pollock Memorial – University of Newfoundland, Adam

Dubrowski University of Ontario Institute of Technology, Tia Renouf

Memorial – University of Newfoundland

Background/Purpose: Communication is a key

competency for medical education and comprehensive

patient care. Several models of teaching communication

exist in medical education, but none address rural to

urban consultation. The aim of this study was to explore

rural physicians' perspectives on consultations with urban

specialists to better inform existing communication

teaching tools.

Methods: This qualitative study involved semi-structured,

one-on-one interviews with rural family physicians (n=11)

with varied career stages, geographic regions, and rural

community sizes in Newfoundland and Labrador.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Thematic analysis was used to analyze the interview

transcripts.

Results: Participants identified features of consultation

and referral process that were unique to rural practice and

illustrated strategies to improve communication. Four

themes specific to communication in rural practice were

identified. The themes included: (1) understanding the

contexts of rural care; (2) geographic isolation and patient

transfer; and (3) respectful discourse; and (4) overcoming

communication challenges in referrals and consultations.

Conclusions: Rural physicians see value in conveying the

unique aspects of rural practice during communication

with urban specialists. Modification of traditional teaching

models to convey the rural context, challenges related to

patient transfers, and respect for rural expertise may

serve to improve the quality and effectiveness of

communication between rural and urban settings.

Trainees in undergraduate and post-graduate medical

education may benefit from opportunities for clinical

experience in rural settings, along with enhancements to

content about the distinct aspects of rural care.

OG2 – 2 Pot Pourri

OG2-2-1, 60322

International training considerations of Canadian

clinician-scientist trainees - a national survey

Adam Pietrobon University of Ottawa, Charles Yin Western University,

Derek Chan University of British Columbia, Elina Cook Queen’s

University, Tina Marvasti University of Toronto

Background/Purpose: Canadian clinician-scientist

trainees enrolled in dual degree programs often pursue an

extended training route following completion of MD and

PhD/MSc degrees. However, the proportion, plans, and

reasoning of trainees who intend to pursue training

internationally following dual degree completion has not

been investigated. In this study, we assessed the

international training considerations of current clinician-

scientist trainees.

Methods: We designed an 11-question survey which was

sent out by program directors to all current MD-PhD/MSc

program and Clinician Investigator Program trainees.

Responses were collected from July 8th, 2019 to August

8th, 2019.

Results: We received a total of 191 responses with

representation from every Canadian medical school and

both MD-PhD/MSc program and CIP trainees. The

majority of trainees are considering completing additional

training outside Canada, most commonly post-doctoral

fellowships and/or clinical fellowships. The most common

reasons for considering international training include

those related to quality and prestige of training programs.

In contrast, the most common reasons for considering

staying in Canada for additional training are related to

personal and ethical reasons. Irrespective of intentions to

pursue international training, the majority of trainees

ultimately intend to establish a career in Canada.

Conclusions: While most trainees are considering

additional training outside of Canada due to prestige and

quality of training, the majority of trainees ultimately

intend to pursue a career back in Canada. Trainees would

likely benefit from improved guidance and mentorship on

the value of international training, as well as enhanced

support in facilitating cross-border mobility.

OG2-2-2, 60915

Lessons Learned: Setting Up a Large Educational Event on

a Shoestring Budget

Malgorzata Kaminska University of Northern British Columbia, Trina

Fyfe University of Northern British Columbia, Cirisse Stephen University

of British Columbia, Lisa Munro University of Northern British Columbia,

Sonya Kruger University of Northern British Columbia, Lindsay Mathews

BC Cancer Agency

Background/Purpose: Want to set up a larger educational

event on a limited budget? We use a "Mini Med School"

(MMS) event as a case study to provide tricks and tips. The

MMS was conceived 30 years ago by a professor who

wanted to showcase to the general public the teaching

and learning happening at his medical school. Since then,

other medical schools and government agencies around

the world have created similar series of weekly lectures on

basic science and biomedical topics. The costs associated

with putting on such event is usually handled by large

organizing institutions using internal funds.

Summary of innovation: Despite a lack of internal funding

and the small size of our medical program, our team set

up a MMS in our rural community. An age and education

level diverse group of 59 community members

participated in 2 hours of activities during 6 consecutive

weeks. Our MMS spiral curriculum featured a variety of

teaching methods and environments, regular

assessments, and a graduation ceremony. 100% of

participants rated the program as engaging, fun, and

worth attending again. We attribute our success to the

engagement and in-kind donations from our small local

medical community. Additionally, we asked and received

different forms of support from both private and public

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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organizations. Lastly, we made judicious use of technology

to keep costs in check.

Conclusions: Our experience demonstrates that money is

not necessary to put on a large event extravaganza when

one uses a bit of creativity, engages the interest of the

local medical and public community, utilizes freely

available technological resources, and reaches out to

local, provincial, and national organizations for support. A

low-cost event which feels like, to quote one of our mini-

students, "one of the greatest experiences of my life!" is

within everyone's reach.

OG2-2-3, 60011

The Good Student or the Good Patient? The Barriers

Encountered by Undergraduate Medical Students with

Disabilities at the Northern Ontario School of Medicine

Rachel Belanger Northern Ontario School of Medicine, Elizabeth Levin

Northern Ontario School of Medicine, Jason Shack Northern Ontario

School of Medicine, Diana Urajnik Northern Ontario School of Medicine,

Kathleen Beatty Northern Ontario School of Medicine

Background/Purpose: The American Association of

Medical College's Lived Experience report was released in

March 2018 with hopes of broadening the diversity of

medical students to include more of those with disabilities

(Meeks & Jain, 2018). In response to this publication, we

replicated this study with the research question "What are

the barriers encountered by undergraduate medical

students with disabilities at the Northern Ontario School

of Medicine?". The Lived Experience Project provides a

unique opportunity to learn about, and compare the

experiences of, participants in this study to medical

students at the Northern Ontario School of Medicine

(Meeks & Jain, 2018). In doing so, the research explored

the climate and culture at NOSM and how this affects the

treatment and education of students with disabilities,

including the barriers they face throughout medical

school.

Methods: A qualitative descriptive study design was used.

Data was collected using an initial demographics-based

survey followed by a semi-structured interview.

Interviews were conducted in person or by telephone

Data was transcribed and analysed using Braun & Clarke

Thematic Analysis (2013).

Conclusions: It was found that the participants identified

barriers directly associated with their medical education

in addition to barriers indirectly associated with their

medical education and finally, barriers outside of medical

school.

Conclusions: The barriers encountered by medical

students with disabilities at NOSM supported the themes

and barriers identified in Meeks and Jain's (2018) Lived

Experience Report. Implications for this research include

reviews of accommodation policies, revision of technical

standards at a national and institutional level as well as

strengthened communication between the student, the

medical school, faculty, and administration.

OG2-2-4, 60855

There's got to be a better way: Institutional Ethnography

of intrapartum practices on a Labour & Delivery unit

Stella Ng St. Michael's Hospital, Unity Health Toronto, Douglas Campbell

St. Michael's Hospital, Unity Health Toronto, Filomena Meffe St.

Michael's Hospital, Unity Health Toronto, Linda Moscovitch St. Michael's

Hospital, Unity Health Toronto, Sabina Fella St. Michael's Hospital, Unity

Health Toronto, Nirmala Chandrasekaran St. Michael's Hospital, Unity

Health Toronto, Ryan Brydges St. Michael's Hospital, Unity Health

Toronto, Lori Nemoy St. Michael's Hospital, Unity Health Toronto

Background/Purpose: Labour and delivery (L&D) units can

be contested workplaces with tensions between

obstetrician, nursing, and midwifery practices. These

tensions can impede communication and raise patient

safety concerns. Remedying such tensions requires study

of the driving forces contributing to these recurrent

problems in interprofessional practices.

Methods: Our institutional ethnography study initially

used critical incident analysis reports to identify recurrent

issues related to transfers of care (TOC) and consultation

requests between midwives and obstetricians. We then

mapped the work of midwives, nurses, family physicians,

and obstetricians by observing (75 hours) and

interviewing them (n=15). We also traced work processes

to local (forms and hospital policies) and external texts

(national policies and evidence-based guidelines). Final

analysis made visible the otherwise hidden links between

everyday work of L&D practitioners and higher-level

coordinators.

Results: We identified three work processes involving

midwives consulting obstetricians: induction with TOC

back to midwife, consultation without TOC, and TOC.

Three points of disjuncture complicated these processes:

a local "3 consult rule", linked to higher-level medical-legal

governance and remuneration structures; subjective

interpretations of the "4cm dilation rule", a policy meant

to standardize practice; and regulations that delayed

timing of consultations.

Conclusions: Our study extends existing research

demonstrating that medicine-driven governance of

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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midwifery practices can perpetuate interprofessional

challenges. For example, the "3 consult rule" was

established for patient safety purposes, but in practice can

actually function to delay and disrupt work processes,

potentially compromising patient safety. While

practitioners spoke of the three points of disjuncture as

'laws', most also viewed them as ostensibly modifiable.

OG2 – 3 Assessment Validity

OG2-3-1, 59500

Learner Handover - Who is it really for?

Susan Humphrey-Murto University of Ottawa, Shiphra Ginsburg

University of Toronto, Lorelei Lingard Western University, Christopher

Watling Western University, Kori LaDonna University of Ottawa, Lara

Varpio Uniformed Services University of the Health Sciences

Background/Purpose: Learner handover, is the sharing of

information about learners between faculty supervisors.

Learner handover can support longitudinal assessment in

rotation-based systems, but concerns have been raised

regarding the potential for it to bias future assessments or

to stigmatize struggling learners. Because successful

implementation relies on a better understanding of

existing practices and beliefs, the purpose of this study

was to explore how faculty perceive and enact learner

handover in the workplace.

Methods: Using constructivist grounded theory, 23 semi-

structured interviews were conducted with faculty from

two universities. Participants were asked to describe their

learner handover practices, including learner handover

that was delivered or received about resident and student

trainees either within or between clinical rotations. We

probed to understand why it was used by faculty, and its

perceived benefits and risks.

Results: Learner handover occurs both formally and

informally and serves multiple purposes for learners and

faculty. While participants reported that learner handover

was motivated by both learner benefit and patient safety,

they primarily described motivations focused on their own

needs. Learner handover was used to improve faculty

efficiency by focusing teaching and feedback, and it was

perceived as a "self-defence mechanism" when faculty

were uncertain about a learner's competence and

trustworthiness. Informal learner handover also served

social or therapeutic purposes when faculty used it to

gossip, vent, or manage insecurities about their

assessment of learner performance. Because of its

multiple, sometimes unsanctioned purposes, participants

advised being reflective about the motivation behind

learner handover conversations.

Conclusions: Learners are not the only potential

beneficiaries of learner handover; faculty use learner

handover to lessen insecurities surrounding entrustment

and assessment of learners and to openly share their

frustrations. The latter created tensions for faculty

needing to share stresses, but wanting to act

professionally. Formal education policies regarding

learner handover should consider faculty perspectives.

OG2-3-2, 60785

Gathering Evidence of Validity for a Therapeutics

Decision-Making (TDM) Examination for Assessing

International Medical Graduates

Fang Tian Medical Council of Canada, Marguerite Roy Medical Council

of Canada, André De Champlain Medical Council of Canada, Claire

Touchie Medical Council of Canada, Brent Kvern The College of Family

Physicians of Canada, Jon Witt University of Saskatchewan

Background/Purpose: The TDM Exam is one of the tools

used by Pan-Canadian Practice-Ready Assessment (PRA)

programs for selecting international medical graduates

(IMGs) into over-time clinical assessment to determine

their readiness to enter independent practice in Canada.

It assesses the application of therapeutics knowledge and

decision-making skills in the pharmacological and non-

pharmacological management of medical conditions at

the level required of family physicians (FM) practicing

independently and safely in Canada. This study assesses

whether the TDM Exam measures therapeutics

knowledge and skills at its intended level by comparing

the performances of PRA applicants and a sample of

Postgraduate Year 2 (PGY2) FM residents.

Methods: The study included 90 PRA applicants as the

control group and 17 PGY2 FM residents as the

experimental group. Both took the TDM Exam in January

2020 and their responses were marked by the same

physician markers who were blind to examinee group

membership. The analyses included independent samples

t-test and chi-square to compare total score means and

pass/fail status between the two groups, and a multi-

variate analysis of variance to compare their

performances on sub-scores.

Results: There's no statistically significant difference in

mean scores or pass rate between the two groups. They

performed similarly on all sub-areas except for one

dimension (i.e., Acute Illness).

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Conclusions: This study provided preliminary evidence to

support the use of the TDM Exam for its intended purpose

as one of the tools for selecting IMGs who would likely

succeed into PRA programs. A follow-up study will include

more PGY2 residents.

OG2-3-4, 60796

Assessment in Continuing Professional Development:

What does it look like?

Mélanie Marceau Université de Sherbrooke, Élise Vachon-Lachiver

Université de Sherbrooke, Danika Lambert Bishop's University, Julianne

Daoust Université de Sherbrooke, Marie-France Langlois Université de

Sherbrooke, Meghan McConnell University of Ottawa, Aliki Thomas

McGill, Christina St-Onge Université de Sherbrooke

Background/Purpose: Continuing professional

development (CPD) is an essential component of health

professionals' practice. CPD contributes to professionals'

development and maintenance of competence within

evolving contexts of care. While assessment could be used

in CPD to ascertain participants' learning, its use is rare or

irregular. The aim of this study was to document the

breadth and depth of what is known about the

development and implementation of assessment

practices within CPD.

Methods: We conducted a scoping review based on

Arksey and O'Malley's methodology. Two team members

reviewed all abstracts with a 90% inter-rater agreement.

When needed, other members provided a third opinion. A

data extraction form was developed. We conducted a

descriptive analysis for numerical data (e.g. year of

publication) and thematic analysis of qualitative data (e.g.

assessment format, timing of assessment).

Results: The search strategy was conducted in six

databases and included terms such as lifelong learning

and professional development. Of the 1733 abstracts

identified, 136 were retained for the full review. We

included papers that assessed health professionals in a

CPD context. The majority of studies used a written exam

(75%) over a performance-based assessment. Multiple-

choice exams were most common (62%). Barriers

identified include resources required to develop

assessments and time pressure on learners to complete

assessment. Facilitators identified were related to a

positive perception of the assessment from the learner's

perspectives.

Conclusions: While assessment drives learning in the

context of health professions training programs, it may

not have the same purpose or influence on learning with

practicing professionals, particularly when the assessment

does not have a summative value.

April 20

, 2021 - 12:00 EST

OG3 – 1 Faculty Development

OG3-1-1, 60816

Gender-affirming care for trans and non-binary youth:

Lessons for Canadian medical education from Trans

Youth CAN!

Arati Mokashi IWK Health Centre, Julie Temple Newhook Memorial –

University of Newfoundland, Sandra Gotovac Western University,

Gagandeep Singh University of Toronto, Natasha Johnson McMaster

University, Robert Stein Western University, Margaret Lawson

Children's Hospital of Eastern Ontario (CHEO), Bob Couch University of

Alberta, Greta Bauer Western University

Background/Purpose: Referrals of trans youth for gender-

affirming care have increased internationally. Trans Youth

CAN! is a prospective 24-month cohort study of youth

referred for puberty suppression/gender-affirming

hormones, medical, social, and family outcomes.

Methods: Eligible participants were aged <16, new to

puberty blockers/hormones, and enrolled at first

appointment for gender-affirming medication, along with

their parent/caregiver (P/C), from 10 Canadian gender

clinics. Baseline sociodemographic, health, pathways to

care, and family data were collected from interviewer-

assisted youth surveys, self-completed P/C surveys, and

medical records from 09/2017 to 06/2019.

Results: 174 youth (75.8% trans males, 15.9% trans

females, 8.3% non-binary), and 160 P/Cs (85.1% female,

96.1% birth/adoptive parents) were enrolled. Most

common youth comorbid diagnoses were anxiety (40.2%)

and depression (32.0%). Family doctors or pediatricians

were first providers seen to discuss blockers or hormones

by 58.9% of youth, and accounted for 68.8% of clinic

referrals. Before coming to clinic, 41.0% of youth saw non-

clinical community stakeholders (school counsellors,

community groups) regarding their gender. On average,

youth spent 13.5 months seeking hormone care, waited

8.7 months from referral to first medical appointment,

and saw 2.7 different types of providers (maximum 8)

before coming to clinic.

Conclusions: There is a need to expand healthcare

capacity for trans youth in Canada, including hormone

care and community support. Comprehensive education

in gender-affirming care during training programs will

empower primary care providers and pediatricians to ease

distress of gender dysphoria, empower trans and non-

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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binary youth, and support positive mental and physical

health.

OG3-1-2, 60504

Experiences of diversity and inclusion in medical school

orientation: A Qualitative Study

Wid Yaseen University of Toronto, Asia van Buuren University of

Toronto, Paula Veinot Independent research consultant, Maria

Mylopoulos University of Toronto, Marcus Law University of Toronto

Background/Purpose: There is increasing effort among

medical schools to recruit a diverse student body.

However, there is a paucity of research into the unique

experiences of students with diverse backgrounds during

their transition to medicine. This study explored how

experiences during medical school orientation influence

students' transition into the medical profession.

Methods: Between April and August 2019, 16 first-year

Canadian medical students completed audio-recorded

semi-structured interviews. Interviews explored how

issues of diversity and inclusion during orientation

affected students' transition into medicine and their

professional identity development. Interviews were

transcribed and analyzed for common themes using

descriptive analysis.

Results: Participants described orientation as essential to

the curriculum. They highlighted the importance of the

social orientation during their transition into medical

school and noted experiencing complex social pressures

during this time. Participants were introduced to the

dominant medical professional identity during

orientation. While participants noted a number of

tensions, many of which revolved around the dominant

identity as related to? their past, present and future

selves, such tensions were salient for students from

diverse backgrounds.

Conclusions: Longstanding issues of diversity and

inclusion in medicine manifest from day one of medical

school. While orientation may be seen as a student-run

week to welcome students into the profession, it is a

crucial period for medical schools to properly set the stage

to intentionally demonstrate its commitment to an

inclusive culture and meaningful professional identity

development. To wait to address these issues later in the

school year is too late.

OG3-1-3, 60625

Using case-based learning to teach biopsychosocial

complexity and adaptive expertise to third-year

psychiatry residents

Sacha Agrawal University of Toronto, Maria Mylopoulos University of

Toronto

Background/Purpose: Supporting the recovery of

individuals with severe and persistent mental illness

(SPMI) requires clinicians to flexibly apply a diverse set of

knowledges ranging from neuroscience through

psychodynamic theory to issues of stigma and racism.

While some of this work is routine, much of it occurs in the

grey zones of practice, where empirical evidence offers

few directives and clinicians must therefore innovate

solutions to complex problems. Theories of adaptive

expertise emphasize the need for practitioners to learn to

both efficiently apply known solutions to known problems

as well as generate novel solutions to novel problems by

acquiring both factual (what?) and mechanistic (why?)

information in training (Mylopoulos et al. Med Teach

2018). Adaptive expertise thus offers a helpful framework

for teaching in the SPMI context.

Summary of innovation: We developed a series of case-

based learning (CBL) tutorials, designed to foster adaptive

expertise, to serve as the curriculum for the 3-month PGY3

SPMI block in our residency program. Nine fictional cases

were developed in collaboration with 17 content experts

and iteratively improved over the past and current

academic years with a total of 53 resident participants and

4 tutors. The learning objectives span both medical and

non-medical CanMEDS roles. Residents meet weekly in

small groups with their tutor, applying prior knowledge to

build a tentative understanding of the issues in each case,

and, after reading the provided resources, they return the

following week to discuss the case again, filling in

knowledge gaps. Tutors promote the residents'

capabilities as future experts by posing both 'what' and

'why' questions and encouraging them to wrestle with

areas of uncertainty and ambiguity.

Conclusions: While there are few examples in the

literature of case-based learning in postgraduate medical

education, our experience to date suggests that CBL is a

highly feasible way of engaging residents in learning about

and through complexity, while supporting their

development as adaptive experts.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OG3-1-4, 60839

Paediatric Project ECHO® for Complex Care: A Virtual

Education Model to Support Community Management

of Children with Medical Complexity

Catherine Diskin The Hospital for Sick Children, Eyal Cohen The Hospital

for Sick Children, Amos Hundert The Hospital for Sick Children, Annie

Jiwan The Hospital for Sick Children, Senthoori Sivarajah The Hospital

for Sick Children, Alyssa Gumapac The Hospital for Sick Children, Jennifer

Stinson The Hospital for Sick Children, Chitra Lalloo The Hospital for Sick

Children, Michelle Ho The Hospital for Sick Children, Julia Orkin The

Hospital for Sick Children, Jo-Ann Osei-Twum The Hospital for Sick

Children

Background/Purpose: The Project ECHO® model (didactic

and case-based learning), originally designed for adult

settings, was adapted to offer evidence-based mentorship

to community healthcare providers (HCPs) caring for

children with medical complexity (CMC). Paediatric

Project ECHO® for Complex Care is the first ECHO®

program dedicated to CMC. This study assessed the

performance-related outcomes of this ECHO® program.

Methods: Interprofessional HCPs who attended >1

monthly virtual ECHO® session, between January 2018

and December 2019, were eligible for this study. This

prospective mixed-methods study assessed acceptability,

knowledge, self-efficacy, and practice-level impacts. Using

REDCap, surveys were administered at baseline and 6-

months. Surveys used 7-point Likert scales (quantitative

data) and open-text fields (qualitative data), and

descriptive and inferential data analyses were conducted.

The study received ethics approval from the Hospital for

Sick Children.

Results: Participants represented over 10 health

professions and reported moderate-to-high program

acceptability, with acceptability scores ranging from 5.0

±1.1 to 6.4 ±0.6 at 6-months (n = 27). Self-reported

knowledge and self-efficacy increased across all probed

topics and skills (p-values ranged from <0.001 to 0.006).

Most participants perceived a 'positive' or 'very positive'

impact on clinical practice, including an enhanced ability

to provide quality care to CMC (n = 20, 74%).

Conclusions: Paediatric Project ECHO® for Complex Care

has demonstrated acceptability and satisfaction among

interprofessional community HCPs who care for CMC.

HCPs report improved knowledge, self-efficacy and

positive practice impacts following program participation.

We suggest that ECHO® is a worthwhile educational

model to support community-based care of CMC.

OG3 – 2 Wellness & Health Advocacy

OG3-2-1, 60925

Little 'a' advocacy: A novel workshop experience to teach

skills in health advocacy

Shazeen Suleman University of Toronto, Kimberly Young University of

Toronto, Kimberly Young University of Toronto

Background: Health advocacy is a core physician, resident,

and student competency as per the CanMEDS framework.

However, it remains a nebulous concept in competence-

by-design (CBD) medical education, from action at the

patient level to structural barriers. Learners and educators

alike may struggle to teach and learn health advocacy

using traditional pedagogical methods. Purpose: To teach

undergraduate medical students an approach to health

advocacy at the patient and societal level, using applied

case-based learning (CBL).

Summary of Innovation: Using a socio-ecological model to

define health advocacy from the interpersonal (little 'a') to

the structural (big 'A') level, a 90-minute workshop was

created. Following a brief lecture, students worked

through realistic cases in small groups, followed by large-

group debriefing. All students completed a pre- and post-

questionnaire exploring their own definitions of advocacy,

perceived importance of health advocacy, and their own

skill level in being a health advocate. Results: 81 medical

students participated in this workshop. Nearly all believed

it was important for them to be a health advocate, while

only 59% believed they had the necessary skills. After

participating, 89% reported they had the skills to be a

health advocate (p<0.05). Students rated the workshop

extremely favourably (3.67/4), with some even stating it

should be a mandatory component of medical curriculum.

Conclusions: We demonstrate a novel, interesting, and

effective way to teach skills in health advocacy at the

interpersonal level using case-based learning. This may

represent a reproducible method of teaching skills in

advocacy at other faculties.

OG3-2-2, 60508

Exploring Patient Mistreatment of Medical Trainees

Amanda Hu University of British Columbia, Geoff Blair University of

British Columbia, Laura Nimmon University of British Columbia

Background/Purpose: Mistreatment is defined as the

intentional or unintentional behavior that shows

disrespect for the dignity of others and unreasonably

interferes with the learning process. Patient mistreatment

of medical trainees is not well described in the literature.

We sought to determine whether patient mistreatment of

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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medical trainees occurs and how trainees manage these

experiences. Our goal was to provide insights that can

shape institutional responses to trainee mistreatment by

patients

Methods: Qualitative semi-structured interviews of

medical students at a large medical school in North

America were conducted using a constructivist grounded

theory approach. Interviews were audio recorded,

transcribed, and de-identified. Two separate researchers

coded the transcripts iteratively for themes and

theoretical categories

Results: Ten trainees (mean age 25, 70% male, 80% visible

minority) participated in the pilot study. Eight trainees had

personally experienced patient mistreatment and two had

witnessed patient mistreatment of another trainee.

Trainees described being mistreated based on gender and

ethnicity, and physical harm was threatened in two cases.

All were aware of the institution's official reporting

mechanism for mistreatment. Patient screening, patient

education, resident/attending advocacy, modelling

professional responses, and debriefing were all identified

as helpful responses and prevention strategies

Conclusions: Patient mistreatment of medical trainees in

this data occurred and often it was women and visible

minorities who were targeted. Medical schools must

proactively structure mechanisms to support trainees

who experience patient mistreatment

OG3-2-3, 60567

Placing the Patient at the Centre of the Learning

Environment: Effect on Agency for the Learner, the

Attending Physician and the Patient

Bavenjit Cheema University of British Columbia, Cheryl Holmes

University of British Columbia , Daniel Ho University of British Columbia,

Meredith Li University of British Columbia , Erica Amari University of

British Columbia , Heather Buckley University of British Columbia

Carolyn Canfield University of British Columbia , Cary Cuncic University

of British Columbia , Laura Nimmon University of British Columbia ,

Anneke Van Enk University of British Columbia , Kiran Veerapen

University of British Columbia Katherine Wisener University of British

Columbia

Background/Purpose: Although much has been written

about the medical learning environment, the patient, who

is the focus of our care, has been systematically excluded

from this discourse. The purpose of this study was to

explore the role of the patient as an active participant with

agency in an authentic medical learning environment from

the standpoint of the learner, the faculty and most

importantly the patient. We hoped to gain insight into the

reinforcement of positive professional values such as

patient-centred behaviours and a respectful environment.

Methods: The study recruited participants to adopt a

"patient-centered" clinic approach where case

presentations were conducted in examination rooms with

the patient. After each visit, participants took part in semi-

structured interviews to explore the impact of the patient-

present learning environment. We recruited 34

participants; 10 attending physicians, 12 learners, 10

patients and 2 family members. We analyzed the data

deductively using a conceptual framework of agency.

Results: Results revealed three themes: 1. The teaching

model allowed for a more patient-centered and inclusive

health care environment from the patient perspective; 2.

Attending physicians and medical trainees reported that

presenting cases with the patient present challenged

normal teaching practices and were differed on whether

it supported a more inclusive health care environment; 3.

There was a hidden curriculum of performance-based

view of professional behaviour.

Conclusions: Patient-present teaching engaged patients

and enhanced their agency by recasting the patient as the

central focus within the healthcare encounter. We

identified a tension between performing and learning.

This study adds new insights to the concept of patient

centredness and professionalism in the medical learning

environment.

OG3-2-4, 60930

Walking Learners: Enhancing Wellness without Impacting

Performance

Malgorzata Kaminska University of Northern British Columbia, Remy

Rikers Roosevelt Center for Excellence in Education, University College

Roosevelt, Utrecht University

Background/Purpose: Using walking workstations in non-

medical educational and work settings shows

improvement in cognitive abilities. Meanwhile,

worldwide, many medical learners do not meet exercise

guidelines. We investigated the boundaries of improved

cognitive performance with physical activity using real-life

tasks in participants having varying medical knowledge

and experience. We hypothesized that, irrespective of

expertise level, physical activity bolsters diagnostic

performance.

Methods: 30 family medicine residents (FMRs), 31

medical students (MS) and 31 psychology students (PS), all

in their Year 2 of studies were equally and randomly

assigned desk-sitting or treadmill-walking. Following

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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training slides showing a representative picture and brief

description of 4 skin conditions, participants named skin

conditions shown in 20 different pictures distributed

among those previously studied.

Results: A mixed 2-way 2x3 ANOVA with Expertise and

Exercise as factors found a main effect for Expertise,

F(2,85)=3.51, p=.034. Bonferroni post-hoc tests revealed

the difference in number of correct answers was

significant between PS and FMRs (p=.032), while no

significant differences were found between PS and MS

(p=.320) nor MS and FMRs (p=.944). No main effect was

found for Exercise, F(1,85)=0.57, p=.453 nor interaction

effect, F(2,85)=0.01, p=.986.

Conclusions: While an expertise effect exists, more

interestingly -- perhaps counterintuitively for some --

walking did not decrease performance at any expertise

level during this complex task requiring problem-solving

and short-term recall. When combined with studies

showing that treadmill-walking reduces task stress and

boredom while increasing arousal and mood, our study

suggests a way to promote and enhance wellness during

work hours without impacting medical learners'

performance.

OG3 – 3 Teaching & Learning - Methods

OG3-3-1, 60551

Intersectionality in Medical Education: A Meta-Narrative

Review

Maham Rehman Western University, Javeed Sukhera Western

University

Background/Purpose: There is significant focus on

improving equity, diversity and inclusion (EDI) in academic

medicine, however, little attention is given to understand

inequity from an intersectional perspective.

Intersectionality is a theoretical framework and

methodology that refers to the study of the dynamic

nature of social categories with which an individual

identifies. Although intersectionality provides a useful

framework for both research and practice, a better

understanding regarding how it has been applied in a

medical education context may inform future efforts to

advance social justice. We sought to explore how and why

intersectionality has been conceptualized and applied in

the context of medical education.

Methods: We employed a meta-narrative synthesis to

review existing literature on intersectionality theory and

intersectional methodologies and frameworks in medical

education. Three electronic databases were searched

using key terms yielding 40 articles. After title, abstract,

and full-text screening 28 articles were chosen for

inclusion. Analysis of articles sought a meaningful

synthesis of intersectional theory in relation to research

methodology and/or framework, and application of

intersectionality theory to medical education.

Results: Existing literature on intersectionality

reveals distinct meta-narratives regarding whether

intersectionality refers to theory or praxis. There are

contrasting narratives on the suitability of quantitative

intersectional methodologies and limited consensus on

the practical application of intersectionality to medical

education. 

Conclusions: The potential for intersectionality to

improve equity in academic medicine remains constrained

by tension between intersectionality as theory and

intersectionality as praxis. Drawing explicit attention to

the distinction between both meta-narratives may foster

complementary and integrative approaches to

understanding and applying intersectionality in a medical

education context.

OG3-3-2, 60689

Reflexivi-Tool: Development of a Practical Tool for

Fostering Reflexivity in Family Medicine

Marie-Claude Tremblay Université Laval, Anne Guichard Université

Laval, Christian Rheault Université Laval, Chantal Gravel Université

Laval, Julien Quinty Université Laval

Background/Purpose: In the last decade, reflexivity has

emerged as a key concept in family medicine as evidenced

by its increasing integration in competency statements

and frameworks in the field. However, the growing variety

of terms and definitions related to reflexivity have caused

vagueness and hindered the concept's full application in

training and professional practice. This project aimed to

develop an educational tool to support the learning and

teaching of reflexivity in family medicine.

Summary of innovation: The development of the tool is

based on a systematic approach to educational design

comprising five stages of development. The format and

content of the tool were designed based on a needs

assessment of clinical teachers affiliated with the Family

Medicine Residency Program at Université Laval (Canada),

as well as a rapid review on reflexivity in family medicine.

The tool was disseminated in the 12 family medicine

teaching clinics of the Université Laval network and then

evaluated six months later using a survey among clinical

teachers. Results: "Reflexivi-Tool" presents four types of

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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reflexivity (i.e. clinical, professional, relational, and

socially responsible) in a concise way with related

definitions, goals, processes, and sample question

prompts for each reflexivity type. Our follow-up survey

shows that Reflexivi-Tool is well appreciated by those

using it, with a moderate uptake rate (46.1%) in the

residency program.

Results: Tools such as Reflexivi-Tool are crucial for

supporting reflexive processes that target different

aspects of professionalism, allowing not only improved

clinical judgement and continued learning, but also a

sense of social responsibility and moral commitment

among practitioners.

OG3-3-3, 60004

The Prism Model: Advancing a theory of practice for arts

and humanities in medical education

Tracy Moniz Mount Saint Vincent University, Dalhousie University,

Maryam Golafshani University of Toronto, Lorelei Lingard Western

University, Carolyn Gaspar Dalhousie University, Nancy Adams Penn

State College of Medicine, Paul Haidet Penn State College of Medicine,

Javeed Sukhera Western University, Rebecca Volpe Penn State College

of Medicine, Claire de Boer Penn State College of Medicine

Background/Purpose: The arts and humanities (A&H)

have transformative potential for medical education.

However, questions persist about whether the A&H are

being effectively employed. A recent scoping review

described patterns and gaps in the published literature,

and revealed the need for additional analytical work to

integrate existing knowledge into a theory of practice for

the field. This research aims to provide such analysis, in

order that the A&H can realize their transformative

potential in medical education.

Methods: Additional analyses were conducted on the

records collected during the 2019 scoping review

addressing the question: how and why are the A&H used

to educate physician and interprofessional learners across

the developmental spectrum? We report the results of

discursive and conceptual analyses of 769 citations

included in that review, as well as 15 stakeholder

interviews.

Results: The literature positioned the A&H as additive to

medicine, and nearly half the records focused on their use

for mastering skills and/or perspective taking. Drawing

largely on the conceptual results, we propose an emerging

theory of practice--the Prism Model of four functions

(mastering skills, perspective taking, personal insight and

social advocacy)--to support more strategic and robust

use of A&H in medical education.

Conclusions: The A&H are not currently actualizing their

potential in medical education. Relevant across sub-fields

and applicable to all learning domains, the Prism Model

offers a foundation for shared language within the field.

The findings offer an approach to A&H teaching that

includes greater pedagogical flexibility and precision, thus

maximizing the transformative potential of A&H in

medical education.

OG3-3-4, 60746

Definitions and conceptualisations of context of

healthcare professionals: A scoping review

Catherine George McGill, Rebecca Ataman McGill, Annie Rochette

Université de Montréal, Christina St-Onge Université de Sherbrooke, Jill

Boruff McGill, Aliki Thomas McGill

Background/Purpose: The context in which healthcare

professionals (HCP) practice is believed to influence

enactment of competencies. Context is broadly defined as

the range of affordances and constraints that collectively

define situations that structure social practices. Despite

existing literature on the impact of context on

competency, the nature and role of contextual

characteristics and how context is measured are poorly

understood. The objectives are to map the breadth and

depth of the literature on 1) how context is

conceptualized and defined; 2) the contextual factors that

may influence professional competencies, and 3) how

context is measured in the health professions literature.

Methods: We conducted a scoping review based on

Arksey & O'Malley's framework. We comprehensively

searched MEDLINE and CINAHL with a date range from

2000 to 2019. To be included in the review, studies had to

report on: context; relationships between contextual

factors and professional competencies; or measure

context of HCP. We extracted data on context definitions,

contextual factors influencing competencies, context

measures, and their psychometric properties. We

performed numerical and thematic analyses.

Results: Of the 8530 articles, 297 were included for

review. We identified 25 contextual factors organized into

6 themes: organization, extra-organization, social

environment, leadership, physical infrastructure and

resources, and client features (e.g. client characteristics,

client interactions). We compiled a list of 67 context

definitions and 112 available measures, some with

psychometric properties other without.

Conclusions: The findings highlight which contextual

factors may influence the enactment of professional

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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competencies and point to areas that may be targeted in

HCP education and continuing professional development.

April 20

, 2021 - 15:30 EST

OH1 – 1 CPD COVID

OH1-1-1, 60791

COVID Corner - Changing Continuing Professional

Development in Response to Crisis

Dana Young University of Calgary, Chloe Burnett University of Calgary,

Rosario Villalobos-Gonzalez University of Calgary, Caitlin Ryan

University of Calgary, Alanna Wall University of Calgary, Susan

Limongiello University of Calgary, Elaine Chow Baker University of

Calgary, Kelly W. Burak University of Calgary

Background/Purpose: The COVID-19 pandemic

challenges all aspects of continuing professional

development (CPD). How can we rapidly meet education

needs of overwhelmed clinicians? After running two

COVID-19 updates webinars in mid March / early April, the

University of Calgary CME&PD Office transformed our

approach to dissemination of information, offering an

ongoing program called COVID Corner.

Summary of innovation: COVID Corner is a free

Wednesday evening webinar series, on the Zoom

platform, providing updates and explorations of various

healthcare areas affected by the pandemic in Alberta. The

planning committee selected topics with a just-in-time

approach, co-developed sessions with local experts, to

address the current situation and long-term impact of the

pandemic. Each webinar includes co-presentations from a

broad range of subject matter experts, followed by a

moderated panel conversation, promoting shared

learning across professions. To sustain this program, we

obtained funding from key stakeholders, as well as

continuously received individual donations. COVID Corner

became a trusted brand of CPD programming delivering

14 sessions to date. It has attracted over 100 local

presenters /panelists, and 9000 registrations, including

10% from outside of Alberta.

Conclusions: The extreme context of the pandemic

reinforces some key factors: impactful education should

be linked to the local delivery of healthcare; stakeholder

organizations and clinicians should share responsibility for

the learning to create community of practice. COVID

Corner's success resides in our adaptability, revising our

traditional understanding of CPD events, to support our

healthcare workforce in developing individual and

collective resilience during these extraordinary times.

OH1-1-3, 60290

Mission Critical: COVID-19 Virtual Simulation CME for

Rural Interprofessional Teams

Clare Cook Northern Ontario School of Medicine, James Goertzen

Northern Ontario School of Medicine, Sarah Newbery Northern Ontario

School of Medicine

Background/Purpose: With COVID-19 onset, Northern

Ontario rural physicians and interprofessional teams faced

the possibility of providing care to critically ill COVID-19

patients. A sense of rural isolation, paucity of collegial

support, and possible knowledge and skills gaps from

emerging evidence contributed to individual and

collective unease. An immediate educational intervention

was needed to allay fears and provide relevant

professional development.

Summary of innovation: Within 3 weeks, regional HSC

simulation centre staff collaborated with NOSM CEPD on

a 2-hour virtual simulation program addressing COVID-19

PPE donning/doffing and airway management. Rural

hospital clinical teams enrolled as interprofessional

communities of practice. Prior to session, participants

reviewed 30-minute training video and equipment list and

could submit questions. Sessions were facilitated by

regional HSC physician with live video link to rural hospital.

Format included procedure presentation; direct

observation and coaching participants practicing

procedures; Q&A; discussing protocols; reviewing best

practice resources. Physicians were eligible for

CFPC/RCPSC high level credits. Program evaluation

included: participant survey capturing feedback, learning

reflection and implementation plans; facilitator debriefs;

rural site lead interviews; review of reinforcing resources.

Conclusions: Addressing community-specific needs

resulted in changes to ER protocols and procedures;

acquiring COVID-19 related equipment to optimize care;

and local education. Program enhanced regional support

networks. By providing a port in the storm to support rural

physicians and healthcare teams, education reduced

clinical anxiety due to COVID-19's evolving threat. Key

informant interviews outlined impact for each

community-of-practice informing on-going CME needs.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OH1-1-4, 60537

ALONG CAME COVID: LESSONS LEARNED AS A

LONGITUDINAL INSTRUCTIONAL DEVELOPMENT

PROGRAM WENT VIRTUAL

Umberin Najeeb University of Toronto, Danny Panisko University of

Toronto

Background/Purpose: The Master Teacher Program is the

University of Toronto, Department of Medicine's 2-year

certificate course which provides advanced training for

clinician-teachers to enhance their teaching effectiveness.

With the COVID-19 pandemic, university regulations

based on public health policy did not allow for large

gatherings, so the program urgently needed to go virtual.

Summary of innovation: Course Directors contended with

four thematic decisions to enable this: 1) "To Pause or To

Continue": There was a sense of responsibility toward

participants who expected to advance their teaching skills

and provide evidence of teaching scholarship to their

academic leaders. 2) "To Use or Not to Use": A virtual

platform was optimized based on cost, availability,

administrative support, and technical/educational

features. 3) "To Have or Not to Have": Content delivery

and instructional design were impacted in a virtual format.

Interactivity needed to be maintained. 4) "To do or Not to

do": The usual class format, including a brief collaborative

reflective discussion of participants' recent teaching

experiences, was modified to share personal

experiences/reflections in a challenging time.

Conclusions: Five key messages emerged for faculty

developers engaged in longitudinal virtual curriculum

delivery and teaching: 1) Be humble: acknowledge

limitations for both teachers and learners. 2) Be flexible:

adapt teaching methodologies, instructional design, and

modify curriculum. 3) Be collaborative: involve learners in

curriculum planning and virtual session structure. 4) Be

responsible: cancellations impact learners, ongoing

learning is vital. 5) Be nurturing: a virtual faculty

development community is a supportive environment for

learning, teaching, and educational practice in a

challenging time.

OH1-1-2, 60622

The COVID CPD Landscape: Market Research and Insights

for Planning Programmatic Offerings

Eleftherios Soleas Queen’s University, Jenny Debruyn Queen’s

University, Katherine Evans Queen’s University, Kate Kittner Queen’s

University, Richard van Wylick Queen’s University

Background/Purpose: The COVID Pandemic forced CPD

offices to begin to enact the recommendations of The

Future of Medical Education in Canada- CPD (FMEC-CPD;

Campbell & Sisler, 2019). In a rapid series of events

stemming from the inability to hold in-person

programming, CPD offices hurriedly transitioned to an

online paradigm, well outside their comfort zone. This

study is a chronicle of one office's lessons learned.

Methods: This mixed-methods market research and

program evaluation consolidates a program of

anonymous surveys taking place pre/post program (15

webinars/6 asynchronous modules) CPD offerings totaling

2784 respondents at Queen's University. The surveys

asked Likert, demographic (age, gender, practice location,

health profession), and market research open-ended

questions relating to learner preference, comfort,

knowledge gain, barriers to practice, and intent to change

metrics. These were analyzed thematically using ATLAS.ti

and using inferential statistics (SPSS).

Results: Our thematic findings show learners increasingly

adapting to online learning. Learners reported preferring

asynchronous as compared to the same duration of online

synchronous learning. The analyses of pre-post responses

showed that asynchronous offerings resulted in greater

change metrics than asynchronous programing. Learners

across professions tended to select programs with similar

reasoning: upfront topic relevance, involving a member

my profession, time-conservative, and reacting badly to

biased or non-compelling speakers and topics.

Conclusions: CPD offices must continue to learn from their

successes and failures and we will need to decide whether

we will be biding our time to return to in-person primary

programming or elect to embrace the possibilities

afforded to us by the pandemic-shifted paradigm.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OH1 – 2 Teaching & Learning

OH1-2-1, 60566

Going against the grain: an exploration of learner agency

in medical education

Christopher Watling Western University, Emily Field Western University,

Shiphra Ginsburg University of Toronto, Kori LaDonna University of

Ottawa, Lorelei Lingard Western University

Background/Purpose: Self-directed learning relies on

learner agency. While attractive in principle, the actual

exercise of agency is a complicated process, potentially

constrained by social norms and cultural expectations. In

this study, we explored what it means to be an agentic

learner in medicine, and how individuals experience and

harness agency in their learning.

Methods: Using a constructivist grounded theory

approach, we interviewed 19 physicians or physicians-in-

training who identified as 'learning mavericks'; this

strategy facilitated recruiting participants with a strong

sense of themselves as agentic learners. We asked them

about atypical learning choices they had made, about

support and resistance they encountered, and about how

they managed to carve a distinct path for themselves.

Data collection and analysis were concurrent and

iterative, grounded in the constant comparative

approach.

Results: We identified one overarching idea: agency is

work. The work of exercising agency was compounded by

a system of professional training that was perceived to

promote conformity and to resist individual learner

agency. Individuals' capacity to exercise agency appeared

to be bolstered by social capital, self-knowledge, and

mentorship.

Conclusions: Our work extends the understanding of

learner agency in medicine, and highlights that the

exercise of agency is often a counter-cultural act that

requires learners to resist pressure to conform to social

and professional expectations. Agency may come more

easily to strong learners who have established their ability

to succeed within the system's expectations. Enhancing

learner agency thus requires careful attention to learner

support to facilitate the work that agency demands.

OH1-2-2, 60612

Residents as Teachers in the Ambulatory Setting: a

possible solution for fragmented learning?

Cary Cuncic University of British Columbia, James Tessaro University of

British Columbia, Harp Nagi University of British Columbia, Aman Nijjar

University of British Columbia

Background/Purpose: Historically, medical students have

learned internal medicine on well-established inpatient

clinical teaching units, including significant learning from

residents. In contrast, teaching medical students in the

outpatient setting is less well-described but just as

necessary, given the scope of ambulatory care. Our

undergraduate ambulatory structure had relied on a

clinical preceptors volunteering for half days when they

were able, resulting in a fragmented curriculum for

students.

Summary of innovation: We created a "junior attending"

rotation where a PGY-4/5 resident was added to the third

year medical students' 2-week internal medicine

ambulatory rotation. Nine residents completed this 4

week rotation between February 2018-June 2019. They

provided the bulk of teaching and clinical supervision to

the students. Two clinical faculty members served as the

preceptors. Patients were given a "Who is my Doctor"

handout to describe the structure of the teaching clinic.

Semi-structured interviews were conducted with both

preceptors, all nine fellows, and 13 medical student focus

groups. Interviews were analyzed in an iterative manner

to explore the educational implications.

Conclusions: The major themes identified emerging from

the initial analysis of the interviews included: 1) increased

time, focus and individualized attention to the students'

learning than compared to the inpatient setting, 2) unique

teaching and feedback skills acquired by the residents 3)

increased job satisfaction for faculty preceptors 4)

creation of a supportive learning environment for all. We

propose that the junior attending role be expanded from

the inpatient clinical teaching unit to the ambulatory

setting given the benefits to all stakeholders.

OH1-2-3, 60154

Flexing Creative Muscles in Medical School.

Carol-Ann Courneya University of British Columbia, Rebecca Lumley

University of British Columbia Andrew McDonald University of British

Columbia, Braedon Paul University of British Columbia

Background/Purpose: FLEX is a multi-year course at UBC

that promotes personalized clinical/basic science research

and educational scholarship for medical students. Offering

arts/humanities FLEX projects, however, provides

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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students with an alternative, but no less important,

scholarly opportunity. At the onset of the COVID19

lockdown, I advertised a general FLEX ARTS opportunity.

Three students signed up and created two very different

projects.

Summary of innovation: • Two students working together

composed and produced an album containing 12 original

pieces of music that explored their responses (both

adaptive and introspective) to the COVID lockdown and

isolation. The album, including detailed liner notes, was

posted to Bandcamp.com and received 2200 streams.

Subsequently, they were invited to an interview with the

CBC host of "Q", a national arts magazine show. • One

student explored the ramifications of contemporary

pandemic movies, through a medical/public health, as

well as a film studies lens. Her richly reflective essay,

informed by an extensive literature review, was

subsequently published in the national online "CMAJ

Blogs".

Conclusions: In contrast to educational innovations with a

defined intervention, these FLEX ARTS projects involved a

metaphorical space where students could exercise their

creative scholarship. The students conceived of and

implemented their own projects. They required only

regular check-ins and a sounding board, off which to

bounce their thoughts, progress, and in the case of written

work, a willingness to read and edit drafts. What I learned

as faculty was that medical students benefit from

encouragement to apply their research skills broadly, and

with an aim for creative and scholarly growth.

OH1-2-4, 60582

Exploring Residents' Perspectives of Competency-Based

Medical Education Across Canada

Vivesh Patel Queen’s University, Heather Braund Queen’s University,

Stephen Mann Queen’s University, Nancy Dalgarno Queen’s University

Background/Purpose: Despite the implementation of

Competence by Design (CBD) within Canadian residency

programs, little is known about how residents perceive

competency-based medical education (CBME), even

though they are greatly affected. This study examined

Canadian residents' perceptions of CBME.

Methods: An online survey including Likert-type items and

open-ended questions was administered to residents

across Canada. 105 residents enrolled in a CBD program

and 270 residents enrolled in a traditional ("pre-CBME")

program responded to the survey. Quantitative data were

analyzed in SPSS using the Mann-Whitney test and

qualitative data were analyzed thematically using NVivo.

Results: Three themes emerged: program outcome

concerns, changes, and emotional responses. Residents in

both groups were concerned about administrative

burden, assessment challenges and feedback quality. The

pre-CBME group had greater concerns that faculty time

constraints will affect assessment completion (Mean =

4.13) than residents in CBME (Mean = 3.91), U = 11663.50,

z = -2.88, p = 0.004, r = -0.14. Pre-CBME residents (Mean =

3.46) generally agreed more that faculty would spend

greater time administering CBME than on learning

experiences than residents in CBME programs (Mean =

2.91), U =9705.50, z = -1.095, p = .000, r = -0.26. Residents

enrolled in CBME reported increased self-reflection and

proactiveness in their own learning. Both groups

expressed strong emotional responses (e.g. stress and

frustration).

Conclusions: Residents across Canada have mixed feelings

and experiences regarding CBME. Although residents

perceive they are more self-directed learners as a result of

CBME, the results suggest that programs will need to

address specific challenges to increase stakeholder buy-in

and attend to well-being.

OH1-2-5, 59954

A Target Population Derived Method for Establishing

Radiograph Interpretation Competency

Michelle S Lee University of Toronto, Martin V. Pusic Division of Pediatric

Emergency Medicine, Department of Pediatrics, Boston Children's

Hospital, Harvard University, Mark Camp University of Toronto, Jennifer

Stimec University of Toronto, Andrew Dixon University of Alberta,

Benoit Carrière Université de Montréal, Joshua E. Herman University of

Toronto, Kathy Boutis University of Toronto

Background/Purpose: Clinical skills competency

standards are often developed in an ad hoc method, with

a poorly delineated connection to the target clinical

population. Using pediatric musculoskeletal (MSK)

radiograph interpretation as an example, we inserted the

Ebel criterion-referenced method into an end-to-end

standard setting procedure to derive a performance-

based standard.

Methods: This was a multi-center prospective mixed-

methods study. Emergency physicians interpreted 1,835

pediatric MSK extremity radiographs using an on-line

platform. This generated 195,321 data points, which were

used to determine case difficulty terciles (easy,

intermediate, hard). Cases were also ranked by clinical

significance (low, medium, high) and each case was

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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plotted in a three-by-three matrix of difficulty and

significance. A multidisciplinary panel of physician and

parent stakeholders then determined acceptable accuracy

for each of the nine cells. An overall competency standard

was derived from the weighted sum.

Results: The median difficulty rating was -1.8 logits (IQR -

4.1, 3.2), with significant differences between body

regions (p<0.0001). There were 1,055 (57.8%) low, 424

(23.1%) medium, and 356 (19.1%) high risk cases. The

panel's acceptable scores across the nine cells ranged

from 76% to 95% and the sum of equal weighted scores

yielded an overall performance-based competency score

of 85.5% accuracy.

Conclusions: Using a purposeful sample of radiographs

and the Ebel method of standard setting, we derived a

performance-based competency standard for the skill of

radiograph interpretation. This method could be

generalized to drive evidence-based competency

standard-setting for other image sets and can be tailored

to specific levels of professional accountability.

OH1 – 3 Curriculum

OH1-3-1, 60891

Knowledge and Attitudes on Artificial Intelligence in

Healthcare: A Provincial Survey of Medical Students

Krish Billimoria University of Toronto, Felipe Morgado University of

Toronto, Marcus Law University of Toronto, Sunit Das University of

Toronto, Shiphra Ginsburg University of Toronto, Nishila Mehta

University of Toronto, Vinyas Harish University of Toronto

Background/Purpose: There is growing

acknowledgement that undergraduate medical education

(UGME) must play a formal role in instructing future

physicians on the promises and limitations of artificial

intelligence (AI), particularly as these tools are integrated

into medical practice. Despite calls to integrate AI

education into UGME, there remains a paucity of tangible

learning objectives and frameworks to guide curricular

development. Gauging learner sentiment and opinion on

topics in AI is integral to identifying priority areas for

curricular development.

Methods: We conducted an exploratory survey of medical

students' knowledge of AI, perceptions on the role of AI in

medicine, and preferences surrounding the integration of

AI competencies into medical education. The survey was

completed by 321 medical students (13.4% response rate)

at four medical schools in Ontario.

Results: Medical students are generally optimistic about

the future capability of AI to carry out many clinical and

administrative healthcare functions, with reservations

about specific tasks such as personal counselling and

empathetic care. Students believe AI will raise novel

ethical and social challenges relevant to health equity.

Students are concerned about how AI will affect the

medical job market, with 25% responding that it is actively

impacting their choice of specialty. Students agree that

medical education must do more to prepare them for the

impact of AI in medicine (79%), with the majority (68%)

believing this training should begin in UGME.

Conclusions: Medical students expect AI will be widely

integrated into healthcare and are enthusiastic about

obtaining AI competencies in UGME.

OH1-3-2, 60600

Spiralling pre-clerkship concepts into the clinical phase:

Augmenting knowledge transfer using innovative

technology-enhanced curriculum activities.

Keyna Bracken McMaster University, Anthony Levinson McMaster

University, Meera Mahmud McMaster University, Ilana Allice McMaster

University, Meredith Vanstone McMaster University, Lawrence

Grierson McMaster University

Background/Purpose: We sought to enhance knowledge

transfer in the Family Medicine clerkship by developing a

series of theory-driven online activities that integrate pre-

clerkship problem-based learning (PBL) cases into more

complex clinical scenarios. We hypothesized the new

curriculum would increase students' ability to apply

foundational knowledge, result in improved exit

examination scores and be favourably received by

students and faculty.

Methods: A series of asynchronous modules were

developed, building on pre-clerkship problems and

incorporating evidence-based instructional design. These

were sequenced alongside synchronous PBL-style

webinar-delivered tutorials. Students entering their core

Family Medicine clerkship from May 2019 participated in

the curriculum. A three-armed parallel, convergent mixed

methods design was employed using both quantitative

and qualitative methods that included review of student

performance on knowledge tests and interviews with

students and faculty to ascertain their perceptions.

Results: The curriculum was well-received by students.

Knowledge test scores increased from pre- to mid-

rotation; the difference from mid- to end-rotation was not

significant. Exit exam scores showed a trend upward

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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compared to previous cohorts, but the difference was not

significant. Students and faculty perceived the curriculum

as beneficial. Tutor training is critical to effective remote

content delivery and student engagement.

Conclusions: The curriculum gave students more

opportunities for knowledge translation and could be

adapted for other clerkships. High quality online learning

activities have become critical as medical schools have

had to pivot away from direct clinical experience. The

investment in e-learning has had positive benefits, and will

continue to anchor the clerkship learning experience. The

curriculum gave students more opportunities for

knowledge translation and could be adapted for other

clerkships. High quality online learning activities have

become critical as medical schools have had to pivot away

from direct clinical experience. The investment in e-

learning has had positive benefits, and will continue to

anchor the clerkship learning experience.

OH1-3-3, 60552

The Companion Curriculum: An evaluation of arts and

humanities in medical education.

Charlotte Axelrod University of Toronto, Connor Brenna University of

Toronto, Ariel Gershon University of Toronto, Joyce Nyhof-Young

University of Toronto, Allan Peterkin University of Toronto

Background/Purpose: The key contributions of arts and

humanities to medical education are known, but Canadian

medical schools vary widely in their offerings. The

Companion Curriculum (CC) is a student-curated set of

humanities content, available optionally for medical

students at the University of Toronto. This study is the first

to evaluate the CC teaching model and to identify key

challenges and motivators for its use.

Methods: A mixed-methods evaluation gauged uptake,

perceived effectiveness, and student experiences with the

CC across 4 years, using an online survey and focus groups.

Narrative data were analyzed thematically and supported

by descriptive statistical analysis of numeric data.

Results: Our survey response rate was 12% (128/1036

students). Roughly half of respondents were aware of the

CC (n=67, 51.54%), and half had engaged with it at least

once (n=69, 53.49%). Among students who did engage,

80% (n=55) reported learning something new and most

relevant to the CanMEDS roles of Communicator, Health

Advocate, Collaborator and Professional. Student

perspectives were captured in two 3-4 person focus

groups. Emergent themes were: The Value of Medical

Humanities, Student Attitudes, Institutional Neglect,

Integration Challenges, and Recommendations. The CC

was valued, but an educational culture prioritizing

objectivity seemed a fundamental barrier to its uptake.

Students likewise felt there was insufficient time for what

is perceived as "additional work".

Conclusions: Despite demonstrated student interest in

medical humanities, engagement with the CC is poor.

Encouraging meaningful student engagement with arts

and humanities requires institutional buy-in and

promotion, with a focus on early and sustainable

curricular integration.

OH1-3-4, 60919

Teaching medical students a new way of seeing: a

curricular innovation for virtual care delivery

Shazeen Suleman University of Toronto, Clare Hutchinson University of

Toronto, Nirit Bernhard University of Toronto, Azadeh Moaveni

University of Toronto, Angela Punnett University of Toronto

Background: The COVID-19 pandemic has necessitated an

abrupt shift in education and clinical delivery. To comply

with necessary public health measures, many clinical

programs have shifted to virtual patient care. Although

both virtual and in-person consultations are forms of

clinical assessment, there are important differences that

require specific skills and preparation. Purpose: To teach

medical students about virtual care models and develop

an approach to clinical assessments virtually using a

webinar and standardized patient (SP) encounter.

Summary of Innovation: A multi-disciplinary team with

clinical experience in virtual care created a 1-hour webinar

for clinical clerks. The webinar reviewed types of virtual

care, barriers to and facilitators of the different modalities

in addition to challenges regarding confidentiality, equity,

professionalism and technical troubleshooting. Students

participated in a 30-minute small group case discussion

with a preceptor and SP, designed to test commonly

encountered difficulties. Results: 258 students

participated in the webinar and small-group discussions,

with 15 SPs and 37 small-group preceptors. Students

appreciated the practical nature of the tips provided in the

lecture. The virtual encounter with an SP was described as

engaging and allowed students to feel more comfortable

with this care delivery model. The webinar received an

overall score of 3.69/5 (n=56) and the small group

discussions 4.07/5 (n=60).

Conclusions: We successfully developed a curricular

intervention to teach clinical skills in virtual care,

successfully utilising SP encounters. Future directions

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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include long-term follow-up of the impact on actual virtual

care delivery.

April 20

, 2021 - 16:30 EST

OH2 – 2 Works in Progress

OH2-2-1, 60720

A Joint Approach to Cannabis CPD: Integrated,

Multimodal, and Living Education

Sarah Tajani University of British Columbia, Vivian Lam University of

British Columbia, Jennie Barrows University of British Columbia, Simon

Moore University of British Columbia

Background/Purpose: With its recent legalization, health

providers are increasingly approached by patients for

information on recreational and medicinal cannabis.

Public awareness of benefits and harms varies widely, and

providers must be confident engaging in conversations

about cannabis consumption. To meet this need, the UBC

Division of Continuing Professional Development

partnered with the Ministry of Mental Health and

Addictions to provide multimodal accredited cannabis

resources and education on topics with the greatest

impact on care.

Summary of innovation: Cannabis Education for Health

Care Providers adopts a tiered approach to equip

providers with the knowledge, resources, and tools to

make informed and shared decisions with patients. This

educational strategy is longitudinal, modular and

iterative, releasing content in various yet integrated

modalities to enable and incentivize learner participation.

Modalities include an introductory webinar, self-directed

online course, small-group case-based workshops

employing a flipped classroom model, and interactive,

continually updated 'living' point-of-care resources. Being

sensitive to time constraints providers face, educational

design allows learners to build their own pathways (i.e.

engage in one or multiple activities).

Conclusions: The iterative approach applied to Cannabis

Education for Health Care Providers facilitates the

gathering of specific learner needs post-delivery. Needs

identified are used to inform subsequently produced

education. Further, as evidence supporting use of medical

cannabis is continually changing, providers require up-to-

date education as evidence emerges. 'Living' POC

resources are continuously updated to address needs,

ensuring new evidence is appropriately integrated. The

approach adopts best practices in adult learning to offer

practical, relevant options learners may select in

accordance with their goals.

OH2-2-2, 60734

What's the Problem? Collaborating Across Specialties to

Develop a Novel PGY-1 Medical Psychiatry Case-Based

Curriculum

Natasha Snelgrove McMaster University, Michael Brown McMaster

University, Sandra Westcott McMaster University, Sheila Harms

McMaster University, Alim Pardhan McMaster University, Kaif Pardhan

McMaster University

Background/Purpose: Until 2019, PGY-1 psychiatry

residents at McMaster University participated in academic

learning sessions that were held with numerous other

specialties, leaving psychiatry residents feeling that these

sessions lacked applicability to their own learning. Due to

changes at the postgraduate level, our program

developed an independent PGY-1 medical psychiatry

curriculum to address resident needs and improve the

learning gap between psychiatry and medicine.

Summary of innovation: A scoping assessment was

completed by collating focus group feedback and rotation

assessments from the previous curriculum. This data

grounded the planning and development of a case-based

PGY-1 psychiatry curriculum with a medical focus. This

innovation relies on a group of interdisciplinary educators

from Psychiatry, Emergency Medicine, Neurology and

Internal Medicine who actively participated in curriculum

development. 15 case-based sessions, including

simulation sessions, were created focusing on core topics

including cardiac emergencies, seizures, neurological

issues, and chronic health issues, situated within

psychiatric settings. Significant depth of medical

information is provided including labs and images,

enhancing learning across both medical and psychiatric

objectives. Triple-jump style cases allow for learning and

application of knowledge within sessions and aim to

improve knowledge retention and application. Each

session concludes with formal learning reflections,

designed to consolidate knowledge and promote lifelong

learning.

Conclusions: This session will discuss the cross-disciplinary

collaborative process involved in curriculum

development, provide examples of cases developed, and

discuss how attendees can use this method to develop

robust, cross-disciplinary curricula relevant to learners

within their own settings.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OH2-2-4, 59662

Development and Evaluation of a Multisource Feedback

(MSF) Form for Residency Program Director

Competencies

Armand Aalamian McGill, Theresa Beesley McGill, Evelyn Constantin

McGill, Mara Kontopoulos McGill, Patricia Wade McGill

Background/Purpose: Program directors (PDs) have

complex roles in residency education and are expected to

demonstrate competence in multiple areas specifically,

leadership. However, PDs can receive minimal to no

feedback on their leadership performance. McGill

University's Postgraduate Education team aimed to

develop a program evaluation process using a multisource

feedback (MSF) form to provide feedback from multiple

perspectives within the residency program to PDs.

Summary of innovation: The MSF form was developed

using an iterative and scholarly approach, including a

literature review to identify PD competencies,

identification of PD roles from the PGME job description

and mapping to the CanRAC Standards. Prior to

implementation, the form was pilot tested with 5

residency programs ensuring applicability, relevance, and

value of the MSF form items. Feedback was incorporated

into the final version of the form. The MSF form was

distributed to the Department Chair, PD, Program

Administrator, Faculty Member, and Chief/Senior

Resident(s) to gather standardized performance data of a

residency program PD who completed 12-24 months of

service. Data were analyzed to provide an aggregate score

for the PD's performance. Scores were matched to an

analytical rubric allowing the PGME Office to provide a

one-page report with formative feedback and strategies

to enhance PD performance.

Conclusions: The MSF form establishes a formal and

standardized QI process to provide PDs with formative

feedback on their competencies that can potentially

enhance performance. The form will undergo a meta-

evaluation at year 1, 3 and 5. Additionally, the form

provides an opportunity to highlight the performance of

PDs with effective leadership and informs the PGME

Leadership and Department Chairs of competencies that

result in effective leadership of residency programs.

OH2–3 Teaching & Learning- Undergraduate

OH2-3-1, 60772

Interpretation Training for Multilingual Medical and

Dental Students: A Pilot Study of a Virtual Interactive

Workshop

Darya Naumova McGill, Kenzy Abdelhamid McGill, Xinyu Ji McGill,

Kedar Mate McGill, Bertrand Lebouché McGill

Background/Purpose: Language barriers pose a serious

obstacle to the delivery of healthcare services. Evidence

for language barriers is accumulating, especially in

multicultural countries such as Canada. Professional

interpretation services are not widely implemented in

Canadian hospitals. Training multilingual medical students

in the basics of interpretation is a potential strategy for

addressing language barriers.

Summary of innovation: This is a pilot study examining

the impact of a single 2-hour virtual, interactive workshop

on the knowledge and comfort of multilingual medical and

dental students with the role of an interpreter. Through

ZOOM, each workshop consisted of a theoretical, practical

and feedback session, engaging >12 students with 2

moderators. Anonymously and voluntarily participants

completed online pre- and post-questionnaires to

evaluate knowledge of the basics of interpretation, and

the change in self-perceived comfort and qualification

with taking this role. Secondary outcomes included

workshop feasibility and satisfaction.

Conclusions: 72 multilingual students, including 49 study

participants, were trained over 10 workshops. Participants

varied in gender, age, ethnicity, immigration status and

year of study; together they declared fluency in 23 non-

official Canadian languages. None had received previous

training, but over half have interpreted in the past. The

workshop resulted in a significant increase in knowledge,

self-perceived comfort and qualification in performing

medical interpretation. The participants were satisfied

with the virtual training, found it necessary and judged the

online platform, duration, and training group

arrangements to be appropriate. Thus, a short, virtual,

interactive, peer-led medical interpretation workshop for

multilingual trainees is feasible, effective and well-

received.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OH2-3-2, 60027

Introduction of the National Electives Diversification

Policy: A McGill University Case Study

Alexandra Cohen McGill, Sonia Macfarlane McGill

Background/Purpose: At CCME 2018, the 16 Canadian

Faculties of Medicine endorsed the creation of a national

electives policy. This policy would enforce a maximum of

eight weeks in any entry-level discipline, with the goal of

diversifying clerkship training and promoting parallel

career-planning. Medical students are facing significant

concern over the increasing number of unmatched

Canadian Medical Graduates. When the national electives

policy was first introduced at McGill, student response

was subjectively negative. We thus sought to elicit both

quantitative and qualitative feedback, with the goal of

advocating for the student perspective prior to and

throughout policy implementation.

Methods: Two anonymous online surveys were sent to all

McGill medical students in September and December of

2018. Narrative feedback was collected in four town hall

meetings.

Results: Seventy percent (First survey, N=165) and 66%

(Second survey, N=179) of survey respondents voted in

favor of the national electives policy. Students expressed

support for the following reasons: 1) Uniformity across

Canada; 2) The opportunity to pursue multiple career

paths; 3) Predicted financial benefits due to perceived

decreased travel needs. Students reported concerns

regarding the following issues: 1) Potential decreased

exposure to clinical supervisors; 2) Uncertainty about

residency selection criteria; 3) Concern for country-wide

policy enforcement. Students were tentative with regards

to implementation of the policy.

Conclusions: Despite the initial negative response, McGill

students were predominantly in favor of the national

electives policy. Given the shifting Canadian landscape of

residency positions, students expressed interest in

maintaining collaboration with policy-makers throughout

the implementation and review process.

OH2-3-3, 60617

Internal Medicine Resident Observership Program: Near-

Peer Learning on the CTU for Pre-Clerkship Medical

Students

Shaima Kaka University of Ottawa, Marie-Eve Mathieu University of

Ottawa, Deeksha Kundapur University of Ottawa, Alexandre Pratt

University of Ottawa, Hamza Mahmood University of Ottawa, Kevin Hill

University of Ottawa, Aimee Li University of Ottawa,

Background/Purpose: Pre-clerkship clinical observerships

at Canadian medical schools are typically limited to certain

clinical environments. The internal medicine (IM) clinical

teaching unit (CTU) is not currently one of these settings

due to high pre-existing teaching expectations placed on

staff physicians. The CTU is a mandatory component of

clerkship and is a common source of anxiety for students.

Near-peer (medical student-resident) shadowing has

demonstrated numerous benefits including facilitating

learning and lowering learner apprehension. At uOttawa

there was IM resident interest in mentoring students.

Summary of innovation: We developed a no-cost

"Internal Medicine Resident Observership Program"

where second year medical students at uOttawa

completed 5 hours of resident shadowing on the CTU or

IM consult service. We assessed students' perceptions of

resident shadowing, IM residency, and knowledge and

anxiety towards CTU.

Conclusions: We compared pre- and post-program survey

responses from 26 participants using one-tailed Wilcoxon

signed-rank testing of deidentified Likert scale data.

Benefits of near-peer learning were demonstrated by

significant improvements in students' impression of

resident teaching and improved perceptions of their

understanding of IM residency and the role of a resident

in patient care (p<0.05). Lastly, exposure to CTU

significantly improved students' self-rated understanding

of CTU and decreased anxiety towards CTU as an

intimidating learning environment (p<0.001). This

program highlights the value of near-peer resident

shadowing in fostering comfortable learning

opportunities for pre-clerkship medical students.

Implementing similar programs across Canadian medical

schools may address similar gaps in pre-clerkship clinical

exposure.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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OH2-3-4, 60064

Discovery Healthcare: Encouraging Highschool Students

in South-Western Ontario to Pursue Careers in

Healthcare

Julia Petta Western University, Arita Alija Western University, Vivian Tia

Western University, Richard Yu Western University

Background/Purpose: South-Western Ontario (SWO)

continues to face challenges recruiting healthcare

professionals, particularly to rural sites. In order to

combat this, healthcare careers can be promoted among

highschool students in SWO, as they are still in the midst

of deciding on their future career, with the intention of

them returning to their community. These objectives were

executed through Discovery Healthcare (DHC); a summer

camp aimed to expose highschool students in SWO to a

broad spectrum of healthcare careers to promote interest

in these fields and retention in their communities.

Summary of innovation: Five-day long camps were held in

Leamington, Sarnia, Chatham-Kent and Wingham

throughout July 2019 facilitated by four medical students.

There was a total of 77 students with the majority going

into grades 9 and 10. Students heard from local guest

speakers in fields such as medicine, nursing, and allied

health. Some spent an afternoon shadowing healthcare

professionals in community hospitals, and did an

ambulance tour with a paramedic. They had the chance to

learn clinical skills such as vitals, casting, and suturing.

Students also worked through case diagnoses and learned

about social determinants of health.

Conclusions: Surveys were distributed to students at the

beginning and end of each camp in order to gauge their

understanding of pathways to different healthcare

careers, and their interest in pursuing them. After the

camp, they had a greater understanding, but an increase

in interest depended on local availability of speakers. They

were also interested in additional careers that they had

not previously considered. DHC aspires to further its

impact by inspiring more highschool students in SWO to

pursue healthcare careers. We hope that this initiative will

launch similar programs in other underserved areas.

OH2-3-5, 60305

Cultivating Connection: Medical Mandarin for and by Pre-

clerkship Medical Students

Jin Sheng Zhou University of Toronto, RuiQi Chen University of Toronto,

Yu Yang Feng University of Toronto, Yao Lu University of Toronto, Joyce

Nyhof-Young University of Toronto

Background: Language discordance between patients and

healthcare providers adversely affects health outcomes.

Medical students at the University of Toronto (UofT)

created a peer-led program for classmates with basic

Mandarin skills to learn and practice medical Mandarin.

The Medical Mandarin Education Program (MMEP) helps

students prepare for delivering culturally competent and

linguistically concordant care to future patients.

Summary of innovation: Ten sessions with 25 unique

participants - 1st and 2nd year MD students - were held

over an academic year. Eight student-led sessions taught

content paralleling the pre-clerkship curriculum; two

physician-led sessions promoted cultural understanding

and practice tips. Focus groups and a post-program survey

explored participants' perceptions of program delivery,

motivations to participate, and resulting personal and

professional development.

Conclusions: Two focus groups (n=12 participants) and 19

surveys (response rate=76%) were included. Students'

motivations to participate in MMEP included witnessing

language discordance, recognizing medical Mandarin as

an asset, and community expectations. Students reported

high program satisfaction and improved comfort speaking

Mandarin in both casual and professional settings. Other

outcomes included increased comfort with and likelihood

of using clinical Mandarin in future patient care, a

developing sense of peer linguistic and cultural

community, and increased understanding of cultural

diversity. This novel collaboration between students and

physicians appears to help bridge linguistic gaps in our

medical education. These results provide a curriculum

framework and lessons learned for health professions

students and faculty interested in developing similar

language programs.

April 17

, 2021 - 10:00 EST

WA1-1-60616

Considerations for Online Synchronous Learning

Environments (SOLE)

Heather MacNeill University of Toronto, Susan Glover Takahashi

University of Toronto, Suzan Schneeweiss University of Toronto, Latika

Nirula University of Toronto, Jana Lazor University of Toronto, Heather

MacNeill University of Toronto, Susanna Talarico University of Toronto,

Lindsay Baker University of Toronto

Rationale/Background: The COVID-19 pandemic has

brought a rapid shift to online-teaching and learning,

however many faculty have little to no experience in

navigating these contexts1. There is a clear need to

support and provide guidance to faculty, particularly in

SOLE. In response, a group of education leaders from

across the medical education continuum (undergraduate,

post-graduate, continuing professional development)

used a collaborative and iterative design process to create

a faculty development (FD) resource. Drawing from

evidence-informed pedagogical principles such as active

learning and purposely attending to principles of equity

and universal design for learning, the resource centres

around six key considerations: • Accessibility • Equity &

inclusivity, • Collaboration • Learner Engagement •

Educational Context • Privacy, Security & Copyright

Workshop participants will explore these considerations

as they relate to their own virtual learning contexts and

designs.

Methods: This workshop will introduce participants to

Garrison's Community of Inquiry framework2 for online

learning and the six considerations for SOLEs highlighted

in the FD resource. Learners will work in small breakout

groups organized by each consideration to create,

explore, and solve case examples using the "build-a-case"

method3, through collective personal experiences,

curated resources, and facilitated discussion. Each group

will then compare with the larger group on their questions

and discoveries, generating further discussion.

Target audience: Healthcare educators and

administrators, transitioning to SOLE

Learning objectives: 1. Describe key considerations when

transitioning teaching to SOLE 2. Apply these key

considerations to build an educational case example,

informed by best practices and practical solutions.

WA1-2-60482

Teaching Virtual Care in Canada

Kyle Carter Western University, Reyhaneh Keshmiri Western University,

Daniel Grushka Western University, Obaidullah Khan Western

University

Rationale/Background: Virtual care is defined as "any

interaction between patients and /or member of their

circle of care, occurring remotely, using any forms of

communication or information technologies, with the aim

of facilitating or maximizing the quality and effectiveness

of patient care." (1) Prior to the COVID-19 pandemic, 4%

of patient interactions across Canada were virtual. This

scalable method of care delivery quickly shifted to 60%,

thanks to infrastructures already in place. (2) However,

educators and providers have limited training in both how

to perform and teach virtual care.

Methods: This workshop aims to help bridge this gap by

first conducting a needs assessment of participants

through live polling, followed by discussion of the

fundamentals of virtual care delivery, teaching, and

evaluation using a combination of Socratic and didactic

teaching methods based on learners' needs. Participants

will then be separated into small breakout groups to

engage in hand-on virtual care assessment and teaching

methods. Clinical cases, role-play scenarios, and group

discussions will be used and centred around the objectives

of this workshop.

Target audience: Physicians, educators, and allied health

professionals considering or currently engaging in the

delivery of virtual care in Canada.

Learning objectives: 1. Understand the current state of

virtual care delivery and use in Canada. 2. Gain confidence

in the implementation of virtual care tools in medicine. 3.

Acquire skills to teach and evaluate learners delivering

virtual care to patients.

Workshops

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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WA1-3-60908

Providing Care for LGBT2SQ+ Patients: Healthcare

Provider Allyship Workshop

Michael Scott University of Toronto, Tehmina Ahmad University of

Toronto, Miranda Schreiber University of Toronto, Jeremy Cygler

University of Toronto, Wilson Kwong University of Toronto, Jacqueline

James University of Toronto

Rationale/Background: Lesbian, gay, bisexual,

transgender, two-spirit, and/or queer (LGBT2SQ+) people,

especially those who are Black or Indigenous, experience

disproportionately poorer health outcomes. Some

disparities can be explained by negative encounters with

healthcare providers, who may lack knowledge on queer

and trans-specific health issues. Allyship refers to taking

action on behalf of an underserved group one does not

belong to. This workshop offers a solutions-focused

framework for educators to provide LGBT2SQ+ patients

compassionate, dignified care.

Methods: The workshop begins with an overview of the

historical, philosophic context of LGBT2SQ+ health

disparities, looking at how systemic racism and

colonialism have harmed these communities. Clinical

scenarios addressing practical aspects of LGBT2SQ+ care

(using videos with standardized patient actors) are then

discussed with facilitators, with scenarios designed to

emphasize opportunities for allyship. Attendees will

identify and address their own biases and assumptions,

and learn about concrete actions in order to provide

patient-centred, intersectional care for LGBT2SQ+

patients. Topics covered include a study of how to provide

LGBT2SQ+ sexual healthcare and informed gender-

affirming hormone therapy for trans patients.

Target audience: Medical educators who seek to

incorporate LGBT2SQ+ health content into their

educational programmes for healthcare professionals or

trainees (at all levels).

Learning objectives: 1. Describe systemic health

inequities faced by LGBT2SQ+ patients, especially those

who are Black, Indigenous, and/or disabled 2. Know

options for providing safe and dignified care to LGBT2SQ+

patients and how to teach about it 3. Construct an

approach to content delivery of this curriculum using the

toolkit provided

April 17

, 2021 - 11:30 EST

WA2-1-60214

Discovering Cultural Humility in Healthcare Education

Dalia Al Mouaswas The Michener Institute of Education at UHN,

Mohammad Salhia Michener Institute of Education at UHN

Rationale/Background: Organizations have witnessed a

vast increase in the number of diverse learners, patients

and providers that bring different lived experiences and

ideas of culture. Our organizations, by default, are shifting

towards becoming increasingly diverse in their makeup.

Arguably however, there seems to be a disconnect

between the structures we work in and the populations

they serve. The workshop explores the notions of cultural

humility, implicit bias and belonging and how they can

enhance our practices as clinicians, educators and

learners. The workshop also focuses on the importance

and power of language in the fostering a culture of

humility and belonging. By looking at their personal

experiences and the use of case studies and small group

discussions, participants will be encouraged to challenge

their personal lens as well as current systems and

philosophies.

Methods: Workshop style with group discussions and case

studies

Target audience: Healthcare providers, educators,

administrators, leaders and learners

Learning objectives: Explore the concepts of cultural

humility, implicit bias and belonging and how they can

enhance our practices as providers, educators and

learners - Explore the impact of culture and language on

our lens as educators, providers and learners - Challenge

current ways of thinking, systems and philosophies

WA2-2-60669

Capacity Building for Case-based Quality and Safety

Education using QuaCC: the Quality Care Curriculum

Siobhán Neville University of Limerick, Ireland, Julie Johnstone

University of Toronto, Brie Yama University of Toronto, Zia Bismilla

University of Toronto

Rationale/Background: Quality Improvement and Patient

Safety (QIPS) teaching is becoming widely accepted as a

vital aspect of modern medical education1. Despite this,

there exist several barriers to its effective implementation

in the clinical context, including limited skills, resources,

and opportunities for applied and interactive learning2.

Many institutions rely on a combination of didactic

lectures with mandatory QI projects for residents or

medical students3. We have designed an innovative,

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longitudinal, case-based QIPS curriculum, which

addresses learning needs across undergraduate, post-

graduate, and faculty development levels. Each session

focuses on the application of a quality, safety or

leadership concept to a real case, which is identified and

presented by the learners, followed by a facilitated,

clinically relevant discussion.

Methods: The workshop will build capacity to facilitate

case-based QIPS education sessions through the use of

small group activities. Groups will be provided with

preparatory materials and be coached through delivering

and participating in fun, interactive, and adaptable sample

sessions. An approach to the implementation and

evaluation of such a curriculum will be explored.

Target audience: Clinical educators (Faculty, Fellows,

Senior Residents) with an interest in QIPS.

Learning objectives: By the end of this session,

participants will be able to 1. Develop a curriculum for

case-based learning of QIPS materials 2. Deliver QIPS

rounds to engage learners at all levels 3. Evaluate the

success of their case-based QIPS curriculum in a clinical

context

WA2-3-60658

Improving Feedback Conversations: A Novel Professional

Development Approach for Preceptors and Learners

James Goertzen Northern Ontario School of Medicine, Erin Cameron

Northern Ontario School of Medicine, Clare Cook Northern Ontario

School of Medicine

Rationale/Background: Although feedback improves

clinical and educational performance, giving and receiving

feedback can be challenging and evokes emotional

responses for both preceptors and learners. While faculty

development has previously focused on improving

preceptor feedback skills, effective feedback is now being

envisioned as a two way conversation. Approaches to

professional development that engage both preceptors

and learners in practicing feedback skills together is

showing early signs of building educational alliances which

are key for coaching bidirectional feedback conversations.

Informed by education and business literature and

patterned after NOSM preceptor/learner sessions,

attendees will have a chance to: a) experience a new

professional development approach to feedback; b)

identify strategies to implement this approach in their

educational context.

Methods: Through facilitated discussions, participants will

share experiences giving and receiving feedback and

discuss the importance of creating safe, collaborative

learning environments. A short video will illustrate the

Ask-Tell-Ask framework which can be applied to

undergraduate, postgraduate and faculty development

settings for generalist, family medicine and specialist

preceptors and learners. Participants will practice

feedback scenarios applying the Ask-Tell-Ask framework,

assuming preceptor, learner or observer roles. Learnings

will be debriefed. Strategies for implementing feedback

professional development in attendee educational

contexts will be explored.

Target audience: Students, residents, preceptors,

educational leaders

Learning objectives: 1. Apply strategies to build

preceptor-learner trust and rapport during feedback

conversations. 2. Identify strategies to support further

development of learner and preceptor feedback giving

and receiving competencies.

April 17

, 2021 - 15:30 EST

WB1-1-60554

Responding to the Opioid Crisis by Designing and

Developing a National UGME Competency-Based

Curriculum on Pain Medicine, Addictions and Substance

Use Disorder in Canada

Lisa Graves Western Michigan University Homer Stryker M.D. School of

Medicine, Fran Kirby The Association of Faculties of Medicine of Canada,

Richard van Wylick Queen’s University, Jeanne Mulder Queen’s

University, Klodiana Kolomitro Queen’s University

Rationale/Background: In 2018, the Association of

Faculties of Medicine of Canada undertook a substantive

initiative, supported by Health Canada, originally titled

"Academic Medicine Responds to the Opioid Crisis:

Developing a Canada wide, competency-based online

curriculum for future physicians in pain management,

substance abuse and addictions". This workshop provides

participants with an approach for addressing the largest

current public health crisis in Canada by creating an

educational opportunity targeting undergraduate medical

students to gain knowledge, confidence, competence and

motivation to diagnose, treat and manage pain with an

understanding of addictions, substance use disorder and

harm reduction, while supporting the social accountability

mandates of medical schools. Details of the pilot launch

and expansion into phase 2 including postgraduate and

continuing professional development will be included.

Methods: This workshop will begin with an introduction

to the development of the curriculum, then a

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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demonstration of the design elements used such as the

spiral curriculum and adoption of formative and synoptic

assessments. Participants will engage in an interactive

large group discussion on the strengths and challenges of

instructional design that promotes national collaboration

and a standardized educational program. Small group

discussion will focus on strategies for curriculum

implementation with various models of medical

education. An important focus will be on lessons learned

throughout the project.

Target audience: This session is best suited for medical

educators and students who have an interest in teaching

methods related to pain management, substance use,

harm reduction, and/or curriculum development with a

focus at the undergraduate medical level.

Learning objectives: At the end of this workshop, you will

be able to: 1. Describe how AFMC's Response to Opioids

Project can impact the largest public health crisis in

Canada. 2. Identify the challenges and opportunities in

building a national competency-based online bilingual

curriculum for undergraduate medical learners with an

emphasis on lessons learned. 3. Explore high-impact

practices for engaging health and education stakeholders

to support consensus building.

WB1-2-60542

Successful "in-the-moment" feedback and coaching

conversations in the era of CBME and workplace-based

assessment

Jocelyn Lockyer University of Calgary, Joan Sargeant Dalhousie

University Heather Armson University of Calgary, Jessica Trier Queen’s

University Subha Ramani Harvard Medical School, Mary Grace Zetkulic

Hackensack Meridian School of Medicine at Seton Hall, Karen Könings

Maastricht Univesity, Amanda Roze des Ordons University of Calgary

Rationale/Background: Feedback is a dynamic and co-

constructive interaction in the context of a safe and

mutually respectful relationship for the purpose of

challenging a learner's (and educator's) ways of thinking,

acting or being to support growth (Ajjawi & Regehr, 2019).

The R2C2 model for feedback and coaching, with four

phases in which supervisors and learners build

relationship, explore reactions and reflections, determine

content, and coach for change to co-create an action plan,

was developed as a model to facilitate such conversations.

It was based on theory and research related to self-

assessment, cognitive domains, humanism, commitment

to change and implementation science. It has been tested

and found effective for work with physicians in practice,

nurse practitioners, and residents across several countries

and disciplines. Recently, the researchers have modified

the R2C2 model for use with in-the-moment feedback and

coaching that occur in the clinical environment. This

workshop will provide participants with an opportunity to

explore and practice the R2C2 in-the-moment model

(https://medicine.dal.ca/departments/core-

units/cpd/faculty-development/R2C2.html) and discuss

its applicability within their own context.

Methods: This interactive workshop will draw upon

participants' experiences through: 1. Introductions and

large group discussion of participant experiences (10

minutes) 2. Presentation and demonstration of the model

(15 mins) 3. Small group discussion of the model (10 mins)

4. Coaching practice with case scenarios and debriefing

(40 mins) 5. Large group discussion of R2C2 in-the

moment coaching and feedback and take-home messages

(15 mins)

Target audience: Faculty members and those involved in

providing feedback at point of care

Learning objectives: Participants will: 1. Share

experiences providing "in-the-moment" feedback within

clinical settings. 2. Practice applying the R2C2 ITM model

to case scenarios. 3. Identify the utility of and barriers to

integration of the R2C2 in-the moment (ITM) feedback

and coaching model and its application within their work.

WB1-3-60742

Work-Life Harmony: Utilizing practical tools to harmonise

time, emotions, energy, and purpose while practicing

medicine

Seyara Shwetz University of Saskatchewan, Anurag Saxena University of

Saskatchewan

Rationale/Background: In a profession that is dedicated

to healing others, many health care professionals feel torn

as they attempt to balance work demands with their

personal lives. The internal struggles between work, life,

and self is a significant driver of burnout. While other

Wellness Champions focus on moral injury and workload

as drivers of burnout, this workshop will explore how a

focus on individual core values can shape the

management of time and energy, simultaneously

empowering the physician to juggle the demands of work,

life, and self in a harmonious way. We will offer ideas to

consider for transformation of time management that

simultaneously encourage personal fulfillment and social

responsiveness.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Methods: This interactive workshop will alternate

between brief didactic sessions and active, interactive,

experiential learning. Participants will build tools that

enhance management of their most important, but

severely limited resources: time and energy. With a

deliberate exploration into specific domains of wellness,

including physical, mental, emotional, and spiritual, the

participant will feel empowered to prioritize competing

obligations in a way that constructively utilizes time and

energy. Following a brief overview of key concepts, the

participants will engage in paired, small group, and large

group exercises to explore personal application of the

principles and behaviours to their own lives. Employing

gratitude, meditation, and joy as additional tools to

further fortify emotional strength, the session will

encourage the participant to reflect positively on how

they dedicate their time and energy. Finally, the session

will end with a personal reflection and continuing goal to

strive for harmony in juggling the demands of work, life,

and self.

Target audience: Postgraduate Residents; content is

applicable to all levels of training and practice.

Learning objectives: After this session, participants will

feel empowered to: 1. Apply practical strategies to

harmonizing time, emotions, and energy while juggling

demands from both external sources and self. 2. Further

develop and utilize methods for consciously preserving

and lifting energy. 3. Describe and apply adaptive self-

reflection to ensure a consciously orchestrated,

purposefully driven life. 4. Restore focus on the self-

identified tenants that provide meaning and purpose to

practicing medicine.

April 18

, 2021 - 11:00 EST

WC1-1-60539

Creating a Community of Care: Supporting Racialized

Medical Students Through Equity-Based Mentorship

Umberin Najeeb University of Toronto, Chantal Phillips University of

Toronto, Shannon Giannitsopoulou University of Toronto

Rationale/Background: Mentorship is a critical

component of medical education. However, literature

identifies a relative lack of formal mentorship

opportunities for racialized and other minoritized medical

learners. In response, the Faculty of Medicine's Office of

Inclusion and Diversity created a formalized equity-based

mentorship program called the Diversity Mentorship

Program (DMP), which connects medical students from

racialized and other marginalized groups with Faculty

mentors of similar backgrounds or faculty members who

self-identify as practicing allies. The DMP employs anti-

oppression principles and a decolonial lens. Equity-based

mentorship supports racialized medical students in

overcoming systemic barriers in education, and provides

bidirectional learning for mentees and mentors.

Methods: The workshop will include a didactic

presentation interspersed with facilitated interactive

small group discussions. The workshop will be

spearheaded by a land acknowledgement and an

introduction to anti-oppression principles. Then, a mentee

and mentor from the DMP will share their mentorship

experiences along with the challenges and opportunities

identified in their mentorship relationships. Experiential

exercises and methodological approaches will also be

offered. Participants will have the opportunity to

brainstorm how they might use the equitable approaches

being presented in ways relevant to their own workplace

or educational setting.

Target audience: Beginner to intermediate level

workshop intended for teachers/educators who are

involved in education and training of racialized and

marginalized medical learners at undergraduate and

postgraduate level.

Learning objectives: 1. Recognize equity-based

mentorship as an effective strategy to support minoritized

learners in our education spaces. 2. Gain insights on how

to develop, implement and evaluate an equity-based

mentorship program.

WC1-2-60810

Practical Strategies for Meaningful Allyship in Indigenous

Health and Beyond

Ming-Ka Chan University of Manitoba, Lisa Richardson University of

Toronto, Marcia Anderson University of Manitoba, Javeed Sukera

Western University, Jerry Maniate University of Ottawa

Rationale/Background: Well intentioned efforts towards

healthcare equity and diversity may backfire and erode

trust and allyship. Existing frameworks and instructional

strategies have shortcomings or limitations. Allyship is a

concept that may have relevance to advance efforts for

healthcare equity into the future yet is under-explored in

healthcare and health professions education. This session

will introduce the concept of allyship, how it is distinct

and/or complementary to other concepts (e.g. cultural

humility, anti-oppressive practice, etc.), while co-creating

practical strategies for participants to build and practice

allyship within their own contexts.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Methods • Icebreaker/reflection exercise through think-

pair-share activities • Brief didactic with handout for

introduction to terms and concepts • Storytelling and co-

creation • Small group case discussion with large group

debrief NB: if virtual, these strategies will be integrated &

augmented through breakout rooms, polls, chats &

whiteboard use.

Target audience: Anyone interested in developing as allies

including learners, faculty, administrative staff or leaders

Learning objectives: Upon completion of this session,

participants will be able to: 1) Define the concept of

allyship and how it is distinct or complementary to other

related concepts in medical education 2) Provide

examples of how to enact allyship as it relates to

indigenous health 3) Describe and practice strategies to

build and enact allyship within own organizations

WC1-3-60633

Simulation to assess for collective competence

Anne Kawamura University of Toronto, Briseida Mema University of

Toronto, Dominique Piquette University of Toronto

Rationale/Background: Physicians routinely work as part

of large teams and as a result, patient outcomes are rarely

related to the competence of an individual physician, but

rather are related to the competence of the team. Despite

this, assessments within CBME frameworks are focused

on the competence of the individual trainee. In this

workshop, presenters will discuss circumstances in which

trainee's actions, decisions, and performance are mainly

independent (individual) of team functioning and

compare this to circumstances where intra-dependent

(team) functioning dominates. This then sets the stage for

the need for innovative assessment strategies that

examines individual competence within a team context.

Presenters will discuss the challenges of assessing for

collective, team performance in the complex clinical

environment. They will share their experience with using

simulation scenarios that assess along the spectrum of

individual to collective performance and two strategies for

assessing individuals whose performance is dependent on

other team members. One of these assessment strategies

is based on studies in educational measurement and

provides an approach for assessing collaboration and

interactions amongst different team members and their

contributions to outcomes. The second strategy is based

on Multi Source Feedback (MSF) and uses team members'

assessment of the individual trainee on a particular case

to capture trainee's and team members' contributions.

These assessment strategies attempt to determine the

contribution of the trainee to the final clinical outcome

rather than attributing the clinical outcome to the

individual trainee. Using simulation scenarios we present

two assessment strategies that might be better suited to

capture the "Collective Competence"

Methods: Large group discussion to review examples of

Independent (individual) vs. intra dependent (team) •

Mini lecture and small group work to design simulation

scenarios that assess along the spectrum of independent

vs. intra dependent • Case study in small groups to review

current assessment tools for individuals and teams in

simulation • Mini lecture and large group discussion on

collective competence

Target audience: Health professions teachers and

educators who are responsible for assessing trainees'

within the context of a team

Learning objectives: 1. Discuss clinical situations where

the clinical outcome is as a result of individual

performance or a team performance 2. Describe

strategies to assess individual and team contribution to

the final performance and clinical outcome 3. Discuss the

need for innovative assessments that look at the

individual trainee within a team context

April 18

, 2021 - 11:30 EST

WC2-1-60835

Alone in the Ring: Research-based Theatre to promote

equity and inclusion for people with disabilities in

healthcare programs

Laura Yvonne Bulk

Rationale/Background: Healthcare has the lowest

representation of workers with disabilities, suggesting

that unaccommodating systems may be more prevalent in

this sector than in others. The main barriers students with

disabilities face are attitudes towards disability, stigma,

lack of appropriate policies, and lack of knowledge of how

to accommodate in the healthcare educational programs.

Methods: In our recent work, we used the innovative

method of Research-Based Theatre to facilitate attitudinal

change. A theatrical production is an accessible and

experiential form of art-based knowledge translation. We

have created a 40-minute play called Alone in the Ring,

displaying students' and clinicians' lived experiences with

disabilities in healthcare professions. The play was already

shared with 1,000 students, faculty, and staff in

healthcare programs and received outstanding feedback

as engaging and thought-provoking. We will share the full

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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play, which was adapted into an online version presented

by four actors. Following the play, and based on the

stories presented, the actors who are also healthcare

students and faculty with and without disabilities will

facilitate an interactive workshop to explore ways to

remove barriers and increase the participation of people

with disabilities in healthcare programs.

Target audience: Healthcare students, staff, faculty, and

other stakeholders with and without disabilities.

Learning objectives: (A) Participants will gain awareness

of the barriers for inclusion and equity for people with

disabilities in healthcare professions (B) Participants will

reflect and identify their attitudes and perspectives of

people with disabilities in healthcare professions. (C)

Participants will learn about the actions they can take to

increase the inclusion of people with disabilities in their

own environments.

WC2-2-60606

A moment of fame for a lifetime of pain? Successfully

navigating social media and advocacy in healthcare

Lyn Sonnenberg University of Alberta, Ming-Ka Chan University of

Manitoba, Simon Fleming British Orthopaedic Trainees Association

(BOTA), Jamiu Busari Maastricht University | Dr. Horácio E. Oduber

Hospital, Lyn Sonnenberg University of Alberta, Jamiu Busari Maastricht

University | Dr. Horácio E. Oduber Hospital

Rationale/Background: Successfully navigating social

media can be overwhelming for many, troublemaking for

some, and provide a far-reaching platform of incredible

advocacy for others. Social media discussions in medical

education seem to focus on either its promise as a new

and exciting learning tool or as an endless pit of potential

professionalism lapses. As a self-regulating body, we must

ensure that, while modelling and teaching professional

behaviour, we hold each other accountable. But how do

we go about doing just that?

Methods: We will actively engage participants throughout

the four sections of our session: 1) benefits of engaging

with social media; 2) navigating controversy; 3) guiding

principles of practice, and 4) calls to action that will lead

us toward social media advocacy success. Unlike the

average workshop, this session will be riddled with

provocative social media polls and our own

crowdsourcing, such as the #medbikini challenge and

consequences for propagating #fakenews. Anticipating

that this session could be happening online, we are

prepared to use breakout sessions, polling, and the chat

feature to ensure a high level of engagement.

Target audience: All levels, as this workshop is designed

for educators, learners, faculty, and others involved in

influencing medical education culture, teaching, and

curriculum development.

Learning objectives: 1. identify common professionalism

concerns related to social media use 2. develop awareness

of social media practices at an individual, team, program,

and institutional level that influence professionalism 3.

promote a positive culture of professionalism relating to

social media use that can be modeled by everyone

WC2-3-60337

How to Lead a Simulation Session Online: Learning from

the Virtual Resus Room

Sarah Foohey University of Toronto, Teresa Chan McMaster University,

Alim Nagji McMaster University, Yusuf Yilmaz McMaster University,

Matthew Sibbald McMaster University, Sandra Monteiro McMaster

University

Rationale/Background: Replacing in-person simulation

sessions with virtual equivalents, as has been required by

many educators during the COVID-19 pandemic, has been

challenging. The Virtual Resus Room (VRR), developed by

the lead author, is an online solution that uses Google

Slides and Zoom to create an interactive environment for

simulation training. Learners complete tasks by making

synchronous edits to their "room", a shared Google Slide

document consisting of a patient silhouette surrounded

by moveable images of resuscitation equipment. Learners

communicate via Zoom and collaborate as a team to do

these tasks, introducing the opportunity for the rehearsal

of crisis resource management skills. Facilitators type in

vitals and update the case progression in response to the

learners' decisions, creating an adaptable learning

experience. Using the VRR as an example, we hope to

demonstrate how to run an effective online simulation

with a free, simple solution.

Methods: The workshop will begin with a brief didactic

component outlining various online simulation strategies

and our rationale for the development of and experience

using the VRR. Participants will be given a brief

demonstration about how to use the interface. Next,

participants will be divided into groups of 4-6 to run a VRR

case. The workshop will end with a discussion of their

experience using the VRR.

Target audience: Students or educators interested in

online simulation education.

Learning objectives: 1) Discuss the options for delivering

online simulation sessions. 2) Understand how to use the

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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VRR to run a collaborative online simulation. 3) Run a VRR

case and debrief about this experience.

April 18

, 2021 - 15:30 EST

WD1-1-60937

Beyond Nice: using the science of happiness to

improve medical education

Julie Johnstone University of Toronto, Kevin Weingarten University of

Toronto

Rationale/Background: Medicine is struggling with a

perceived lack of empathy among physicians and worries

around wellness. While common techniques to tackle

these challenges include wellness or resilience programs,

there is more to be done regarding how we structure the

everyday learning environment. As medical educators,

there is an opportunity to examine how our field can

champion changes that will lead to greater happiness

among our trainees and ourselves. By using evidence-

based techniques from positive psychology and

neuroscience we can model a culture where not only are

we producing intelligent and efficient physicians, we are

also supporting the development of empathy, optimism,

and gratitude in an effort to improve lifelong enjoyment

of our careers in medicine.

Methods: This session will alternate between

presentations of evidence and small groups activities to

explore concepts as they relate to the learning

environment. Illustrated examples and guided questions

will help participants consider how to integrate

techniques. Emphasis will be placed cognitive errors that

impede positive learning environments. This session will

provide opportunities for larger group discussions around

challenges that exist in changing the current learning

cultures in medicine.

Target audience: This session is designed for any

conference participants. It will be designed at a beginner

level.

Learning objectives: 1. outline the evidence for positive

psychology as it relates to the learning environment 2.

describe how perspectives of success, purpose, and

productive struggle impact happiness 3. develop practical

strategies to bring kindness, empathy, gratitude, and

civility into medical culture

WD1-2-60739

Countdown: Empowering medical educators to promote

and enact planetary health principles

Sonja Wicklum University of Calgary, Martina Kelly University of Calgary,

Clark Svrcek University of Calgary, Celina Dharamshi University of

Calgary

Rationale/Background: The concept of Planetary Health

(PH) reflects understanding that human health and

civilization depend on flourishing natural systems. Many

influential health organizations-including our own

students (CFMS)-have issued policy statements and calls

to action for the healthcare sector and medical education.

As educators we are obliged to listen, to make meaningful

space in curriculum, and robustly and sincerely engage in

this topic. Join us for a workshop designed to explore PH

and experience a flipped-classroom teaching technique.

Methods: 1) Overview of PH concepts and a review of

seminal articles (15 min). 2) Utilize a jigsaw method to

collaboratively tackle key PH challenge topics. Working as

a team, each group will learn (25 mins) and then teach (15

mins) about a topic in PH from their chosen physician role

perspective, summarizing three educational and two

actionable points for change. 3) New groups formed will

then discuss their knowledge, knowledge sources, and

perspectives on this topic (e.g. What are "co-benefits",

eco-anxiety? Should PH be in the medical school

curriculum?) (20 mins). 4) Wrap-up (15 mins). This

workshop can be done in-person and virtually. Using

Padlet ®, teams record responses on a virtual whiteboard

allowing us to synthesize material quickly and group-think

actionable/educational items. Educators may continue to

post after the conference - creating a new PH community

of practice.

Target audience: Students, physicians, and educators.

Learning objectives: 1) Explain the core concepts of PH. 2)

Apply the evidence base available in the literature. 3)

Identify ways to make changes to promote PH. 4) Gain

experience with a jigsaw method of teaching a complex

subject.

WD1-3-60766

Incorporating medical humanities curriculum in your

program: art as a window to clinician' psyche

Briseida Mema University of Toronto, Anne Kawamura University of

Toronto, Dominique Piquette University of Toronto, Kay Min Johns

Hopkins University, Andrew Helmers University of Toronto

Rationale/Background: Medicine unites science and art;

its mandate is to heal patients rather than to fix

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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disembodied problems with evidence-based precision.

Such healing demands a scientific method that is coupled

with the myriad elements that collectively form the living

Art of medicine. There are many who practice medicine

and - privately or publicly - strive to capture the images,

the stories, the poetry, and even the music of those

moments of joy, tragedy, loss, recovery, life, and death.

This effort to reflect upon and articulate the universal

human condition through the lens of health, of sickness,

and of death, constitutes the medical humanities, and

exemplifies the convergence of Science and Art intrinsic to

every clinical encounter. Within the discipline of the

medical humanities, narrative medicine and reflective

writing in particular can deepen our understanding of our

patients and our experiences caring for them [1]. And just

as physiology is applied to understand and address a

patient's blood pressure or head trauma, so too the

medical humanities invite an applied humanism: a

technology-as-tecno (from the ancient Greek: craft, art)

that serves the whole person and their human values. This

workshop describes incorporating a medical humanities

curriculum in your program.

Methods: Large group discussion on importance of

Humanities curricula to encourage applied humanism and

resilience of healthcare providers Case study followed by

small group discussion on building and incorporating

curricula in training programs Mini lecture and large group

discussion in ways to evaluate and maintain humanities

curricula in the program

Target audience: Educators planning to incorporate

Medical Humanities curricula in their program

Learning objectives: Describe the importance of

incorporating Medical Humanities Curricula in the training

program Demonstrate ways to build Humanities curricula

Discuss methods to evaluate Humanities curricula

April 19

, 2021 - 10:00 EST

WE1-1-60749

Making waves in our teaching practices: Applying

motivational theory to optimize learner engagement,

success and wellbeing

Greg Malin University of Saskatchewan, Adam Neufeld University of

Calgary

Rationale/Background: As teachers, we focus on

cognitive strategies to support student learning (e.g.,

retrieval, dual coding). However, an ingredient we often

overlook is motivation, which facilitates student

engagement in learning. Self-determination theory (SDT),

a motivational theory, can be applied in tangible ways to

support learners' basic psychological needs and support

intrinsic motivation to learn - associated with better recall,

deeper learning, desire for optimal challenge, and even

improved well-being. The purpose of this workshop is to

apply SDT principles to understand how teachers support

or hinder learner motivation, to implement strategies to

support greater learner motivation, and to avoid

approaches that hinder it.

Methods: This workshop blends large group discussion

and small group interactive components. Participants will

be introduced (15 mins) to the basic tenets and three basic

psychological needs of SDT. Participants will actively

engage in 3 facilitated small group discussions (15 mins

each) brainstorming teaching strategies that support each

of the 3 basic needs and teaching strategies to avoid that

hinder each need. We will have a large group discussion

(30 mins) summarizing the rationale for why certain

teaching approaches are more or less supportive of

learner motivation based on SDT.

Target audience: Faculty Teachers, Education Leaders,

Residents, Students

Learning objectives: -Describe the principles of SDT,

including the three basic needs of autonomy,

competence, and relatedness, and how they affect

motivation. -Describe teaching practices that support or

hinder learner motivation. -Implement strategies to

intentionally support learner motivation.

WE1-2-60828

Responsive Action: The Process of Engaging Community

Partners in Evaluating a Service Learning Program for

Undergraduate Medical Students and Applying the

Results

Ian Whetter University of Manitoba, Karen Cook University of Manitoba,

Nina Condo Elmwood Community Resource Centre, Felicien Rubayita

Welcome Place, Roger Berrington CanU, Chelsea Jalloh University of

Manitoba

Rationale/Background: Student experiences of

educational initiatives are important sources of

information to evaluate and improve education programs.

In regards to Service Learning, while student perspectives

about the program provide valuable insights into quality

improvement, community partners who work with

students also have unique and highly valuable

perspectives to share. However, formalized mechanisms

to collect feedback about educational programs from

community partners often are not in place. Receiving and

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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responding to community partner feedback is imperative

to inform ongoing Service Learning program

improvements, and to ensure collaborative educational

initiatives are reciprocally beneficial for both community

and university partners.

Methods: This workshop will be developed and delivered

collaboratively between university and community

partners involved with Service Learning experiences for

undergraduate medical students. Following a brief

presentation of results from a recent survey of 36

community partner organizations involved in Service

Learning, whole group and break out discussions will be

used to address workshop learning objectives. Small

group discussion topics may include: * Why is seeking

community partner feedback about educational

initiatives, such as Service Learning, an important action

for universities to undertake? How does this action

connect with concepts such as social accountability,

health equity, and community engagement? * What are

considerations that could both facilitate and/or impede

universities engaging community partners in evaluation of

educational programs? How might potential

challenges/impediments be mitigated? * What are factors

that could facilitate and/or impede universities being able

to act upon the recommendations and feedback from

community partners? How might these challenges be

mitigated? * What is the role of "power" in community-

university collaborations such as Service Learning? * In

addition to engaging community partners in program

evaluations, what are other ways universities could

engage community partners in medical education

initiatives such as Service Learning? (e.g., collaborations to

develop learning objectives, assessment methods, sharing

expertise as guest speakers, etc.).

Target audience: Service Learning coordinators; faculty

involved with Service Learning design, implementation

and evaluation; community organizations involved in

Service Learning.

Learning objectives: 1. Highlight and discuss the

importance of seeking community partner feedback

regarding Service Learning programs. 2. Identify

important considerations when designing and

implementing approaches to seek feedback about Service

Learning from community partners. 3. Discuss how to

apply and respond to feedback from community partners

to improve Service Learning programs. 4. Explore and

discuss how universities can build and strengthen

reciprocal working relationships with community

partners.

WE1-3-60898

The COVID-19 Pandemic Virtual Revolution in Medical

Education: No Going Back?

Dominique Piquette University of Toronto, Briseida Mema University of

Toronto, Anne Kawamura University of Toronto

Rationale/Background: The COVID-19 pandemic

triggered a mini "virtual revolution" as educational

programs had to rapidly adapt their formal curriculum to

virtual modalities. Although many programs reported

having successfully transitioned to virtual platforms,

others struggled because of lack of resources.

Additionally, educators and learners have raised concerns

about the shortcomings of virtual learning in fostering a

sense of community among learners and in substituting

for real-life experiences. The virtual shift has however

created new educational opportunities for synchronous

and asynchronous learning, international and inter-

institutional collaborations, active learning, and home-

based simulation. Now is the time to pause and reflect on

what was gained and what was lost with this virtual

revolution, and on how virtual learning should be

integrated with in-person learning in the post-COVID-19

pandemic educational world. This workshop will explore

the use, opportunities, and limitations of virtual learning

in three domains of competence: medical decision-

making, procedural skills, and communication.

Methods: After a brief review of the literature on the

virtual transition during the COVID-19 pandemic (10 min),

participants will be divided in three groups. Each group

will be presented with a case study of a program wanting

to combine virtual and in-person learning into an

integrated curriculum for one domain of competence. The

groups will also be provided with publications of

educational initiatives published during the COVID-19

pandemic to guide their discussion (30 min). A facilitated

large-group discussion will allow participants to share

their reflections and develop a consensus on important

principles to respect for balancing virtual and in-person

learning (40 min).

Target audience: Program directors, educators, and

teachers interested in the integration of virtual learning

into learning activities.

Learning objectives: By the end of this workshop,

participants will be able: (1) To discuss how virtual

learning can complement in-person learning; (2) To

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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compare the benefits and limitations of virtual learning for

different domains of competence.

April 19

, 2021 - 11:30 EST

WE2-1, 60323

Best Practices in CPD - Creating Effective Scientific

Planning Committees

Suzan Schneeweiss University of Toronto, Valerie Schulz Western

University, Janice Harvey The College of Family Physicians of Canada

Rationale/Background: When planning continuing

professional development (CPD) activities, the importance

of having an effective Scientific Planning Committee (SPC)

is paramount.1,2 The need for planning committees with

superb skills and knowledge capacities is essential to a

highly functional CPD system. Guidelines about the roles

and best practices of the SPC are rare in the Canadian

context, but necessary in order to meet the needs of

health professionals lifelong learning. The goal of this

workshop is to discuss educational and ethical principles

for SPCs to use as they develop relevant and effective CPD

while meeting national accreditation standards.

Methods: Using a combination of brief presentations and

interactive learning techniques, we will review the role of

the SPC for both online and in-person learning

environments. Active learning techniques will include

web-enabled audience participation techniques and case-

based facilitated discussions. Tools and resources for

effective SPC practices will be shared. Participants are

welcome to bring CPD program ideas for discussion.

Target audience: Health professionals interested in

developing CPD educational opportunities would benefit

from an organized approach for effective SPC practices.

Learning objectives: 1. Describe the essential roles of the

SPC members in the planning, development, and delivery

of CPD activities. 2. Discuss unique considerations for SPCs

to use when developing virtual CPD activities. 3. Apply the

ethical principles of the National Standard for Support of

Accredited CPD activities (2018) as well as the Canadian

Medical Association Guidelines for Physician Interaction

with Industry (2007).

WE2-2, 60506

FACILITATE: Acting-Based Course to Improve the

Communication & Interpersonal Skills of Healthcare

Professionals

Alexis de Vecchio Mayo Clinic, James Homme Mayo Clinic, Phillip

MoschellaPrisma Health – Upstate

Rationale/Background: Communication underlies

physicians' scope of practice. CanMeds lists

communicator as a core competency for medical practice

and education. Various models of communication training

have been proposed in medical school and residency

training. Acting provides a unique approach to developing

such skills. Our acting-based communication skills course,

taught by a Canadian-American professional actor and

physician, has been taught to hundreds of medical

students, nursing students, and medical residents at

multiple institutions in the United States and

internationally.

Methods: We will conduct eight acting exercises, targeted

to the unique needs of healthcare professionals,

especially physicians. This workshop is hands-on,

participatory, interactive. We start with a brief

introduction about educational theory and evidence

underlying this initiative. Our hand-picked exercises

develop skills such as nonverbal communication, active

listening, presence in the moment, situational awareness,

and self-awareness. Each exercise is followed by clinical

correlates and debrief with participants. The workshop

culminates in a standardized patient vignette in which

participants play a patient and provider, and apply skills

developed. We also provide a communication toolbox

with tools they can implement on their next shift.

Target audience: Healthcare professionals at every level

of training. This is an inter-professional initiative. We

welcome a mixed audience of medical students, resident

physicians, consultants/attendings, and allied members of

the healthcare team.

Learning objectives: Upon completion, participants will

be able to apply acting skills to facilitate patient-centered

communication, utilize specific tools to improve their

clinical practice, and practice skills of non-verbal

communication, self-awareness, and active listening.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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WE2-3, 60873

Teaching Rebooted: Strategies for Facilitating Virtual

Learning through a Pandemic

Susanna Talarico University of Toronto, Hosanna Au University of

Toronto, Robert Goldberg University of Toronto, Jana Lazor University

of Toronto, Angela Punnett University of Toronto

Rationale/Background: The COVID-19 Pandemic has

presented us with numerous challenges, including

rethinking where and how our learners will acquire

essential competencies. In many cases, we will have to

think about how to create meaningful, engaging, and

effective virtual learning experiences. This practical

workshop will allow participants to explore various

strategies for facilitating synchronous and asynchronous

virtual learning. Common challenges such as how to adapt

existing teaching and learning experiences, engage

learners, teach clinical skills, and create e-learning

resources will be explored, with practical examples and

strategies offered. Key principles and concepts from

education theory will be highlighted.

Methods: Following an interactive large group

presentation, participants will have the opportunity to

practice adapting existing materials or creating new e-

learning resources using small group case-based learning.

Small group discussions will allow for the sharing of

strategies, successes and challenges around virtual

teaching and learning. Following an interactive large

group presentation, participants will have the opportunity

to practice adapting existing materials or creating new e-

learning resources using small group case-based learning.

Small group discussions will allow for the sharing of

strategies, successes and challenges around virtual

teaching and learning.

Target audience: Medical Educators across the continuum

and encouraged to attend. If this workshop is held in

person, participants are encouraged to bring a mobile

device.

Learning objectives: By the end of this session,

participants will be able to: 1. Describe principles and

concepts that can inform an approach to adapting to a

virtual learning environment 2. Apply these principles and

concepts in adapting curricular materials to engage

learners, when teaching clinical skills, and creating e-

learning resources 3. Share strategies, successes and

challenges around teaching and learning online with

participants from different contexts.

April 19

, 2021 - 15:30 EST

WF1-1, 60880

Blueprinting - Cooking Up Recipes for Valid Assessments

Kien Dang University of Toronto, Katina Tzanetos University of Toronto,

Carla Garcia University of Toronto, Susanna Talarico University of

Toronto

Rationale/Background: Content validity in assessments is

necessary to ensure learners have achieved the

knowledge and skills outlined in a curriculum's learning

objectives. However, assessments are often compiled in

inconsistent ways. Blueprinting assessments avoids a

haphazard or inconsistent approach to test generation,

and helps to create the most effective tests to measure

the success of students in mastering the material in a

course. Blueprinting assessments promotes content

validity, optimizes alignment between learning objectives

and assessment, and ensures consistency of tests

between iterations. In this workshop, participants will

engage in a process of blueprinting an assessment, with

the eventual goal of creating a blueprint for assessments

for their course.

Methods: The workshop will begin with discussion

regarding participants' current practices in test creation,

followed by a short didactic presentation of the rationale

for and demonstrate a process for creating a blueprint,

highlighting important considerations. Participants will

then have the opportunity to work in small groups to

discuss their current practices in creating exams and

engage in the process of creating an assessment blueprint.

Target audience: The target audience includes

undergraduate course directors, junior faculty involved in

test creation, residents.

Learning objectives: By the end of this workshop,

participants will be able to: 1. Define blueprinting. 2.

Discuss the reasons for blueprinting an assessment. 3.

Describe a process for creating a blueprint. 4. Engage in

the initial steps of blueprinting.

WF1-2, 59508

Leveraging open scholarship in medical education with

Wikipedia

Denise Smith McMaster University, Lane Rasberry University of Virginia

Rationale/Background: In conventional health

communication and education, expert organizations take

for granted that the quality of their information is high.

However, the distribution and dissemination of this

information to relevant audiences can be challenging.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Wikipedia has the opposite challenge. It has a large

audience requesting particular information but seeks

expert partnerships to develop its content. English

Wikipedia is the 7th most accessed web page in Canada

and at the end of 2013, its medical content had

collectively received 4.8 billion page views (Heilman,

2015). We will review the precedent of experts and

organizations sharing medical information through

Wikipedia and measure the impact of these efforts. We

will provide participants with an opportunity to explore

Wikipedia's medical information, their potential to help

build its medical content, and its utility as a tool in

educating medical students who can learn to find,

critically appraise, and summarize in plain language, high-

quality evidence.

Methods: A brief introduction to the utility of Wikipedia

as an educational tool (12-15 minutes) followed by small-

group editing training with guidance from the instructor(s)

Target audience: Anyone curious about Wikipedia, its role

in medical education, its internal review system, its

reliability and utility, or a gentle introduction to editing.

No experience required. Experienced editors are

welcome.

Learning objectives: Participants will be able to add one

sentence and one citation to Wikipedia and access

Wikipedia's specialized educator tools. Skills taught

include: Monitoring students during editing projects;

Publishing in Wikipedia; Measuring readership and

impact; How to query Wikipedia's general reference

structured data

WF1-3, 60249

Practicing Structured Feedback For Clinician Teachers

Through Simulation

Quang Ngo McMaster University, X. Catherine Tong McMaster

University, Sharon Bal McMaster University, Krista Dowhos McMaster

University, Aaron Geekie-Sousa McMaster University, Isla McPherson

McMaster University

Rationale/Background: The Advocacy-Inquiry(A-I) model

of debriefing has been well described in the simulation

literature and has been proposed as a framework for

structured feedback. A-I has theoretical underpinnings in

the ideas of Reflective Practice. This theory of learning

suggests that the learner reflects on a gap or problem that

may be identified during a new experience or unexpected

difficulties encountered during a familiar experience. This

reflection is rooted in a constructivist paradigm, where a

learner integrates and interprets new knowledge in the

context of past experiences, previous knowledge and

attitudes. Giving learner feedback is one of the most

important tasks of the clinician teacher. Very few teachers

have the opportunity to be directly observed giving

feedback, and to receive real-time constructive advice on

their techniques. Our team aims to provide a safe and

simulated environment, where participants will have a

valuable simulated experience in giving feedback

effectively, especially in more challenging scenarios.

Methods: In this workshop, we first provide a background

on elements of effective feedback, and review A-I as a

feedback technique. We bring trained standardized

learners to the workshop (virtually or in-person). We

allocate the majority of our time to small group case work.

Participants will watch short videos of standardized

learners performing a clinical task, then be asked to give

them feedback in real time immediately afterwards. We

start with a simple exercise to clarify the technique. We

then move on to common challenging scenarios, including

learners displaying professionalism issues and learners

lacking insight. Experienced facilitators provide coaching

and feedback to the participant and allow for

opportunities of repeated attempts. Participants also

benefit from receiving feedback directly from the

standardized learners. The workshop is well suited to run

in person or virtually, where participants will be organized

into smaller groups with paired facilitator and

standardized learner.

Target audience: All teachers who provide feedback to

learners.

Learning objectives: At the end of the workshop

participants will be able to: 1. Identify characteristics of

effective feedback. 2. Define Advocacy-Inquiry as a

technique for providing feedback. 3. Apply Advocacy-

Inquiry technique with standardized learners in a

simulated interaction.

April 20

, 2021 - 10:00 EST

WG1-1, 60884

Ready to Act: Using Storytelling and Role Play to Build

Action-Oriented Equity Competencies in Undergraduate

Medical Education and Continuing Professional

Development

Lloy Wylie Western University, Lana Ray Lakehead University, Danielle

Alcock Western University

Rationale/Background: Systemic racism in the health care

system undermines access and quality care for Indigenous

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e262

people. The consequences of this can mean life or death,

as we have seen for Joyce Echaquan and Brian Sinclair.

Research has demonstrated a range of gaps in addressing

the varied health care needs of Indigenous populations

(Alan and Smylie, 2015; Wylie and McConkey 2019). The

aim of this workshop is to demonstrate ways to use

storytelling and arts to build competencies among medical

students, residents and physicians to advance health

equity. There is a need to improve knowledge and practice

through targeted educational initiatives that give

providers concrete recommendations to improve equity

in practice. Such actions include understanding and

correcting their own biases, improving their knowledge,

and ensuring system-wide supports for culturally safe and

appropriate care. We explore the use of storytelling and

arts based education as a way to build understanding and

among health professionals and students (Ray 2012).

Methods: This workshop uses storytelling, role play and

interactive case exercises to demonstrated strategies for

building competencies in providing culturally safe, quality

health care for Indigenous people. This workshop will

provide experiential learning opportunities that

demonstrate strategies that build concrete skills. In

addition, the workshop will support participants to

develop storytelling and theatre-based training activities

in their own health service settings. The presenters will

illustrate a range of challenges facing Indigenous people,

both within the health care system and more broad social

determinants of health. Narratives drawing on examples

from health care experiences that demonstrate challenges

will be presented. Participants will work in teams to

explore the issues in the cases, reflecting on determinants

of health through role play exercises. The workshop

facilitators will guide a reflection and explore ways

participants can apply this approach to their own settings.

Target audience: This workshop is oriented to health care

providers, health care educators, and others involved in

training health professionals.

Learning objectives: 1. To identify the range of challenges

that undermine health equity. 2. To demonstrate

evidence based exercises that can improve health care

providers' attitudes, knowledge and skills in promoting

culturally safe changes in health care delivery 3. To

support participants in developing educational and

workplace strategies applicable to their own setting

WG1-2, 60638

The Art of Recruiting Patient Partners

Annie Descoteaux Université de Montréal, Marie-Pierre Codsi

Université de Montréal, Philippe Karazivan Université de Montréal,

Clara Dallaire Université de Montréal, Alexandre Berkesse Centre

d'excellence sur le partenariat avec les patients et le public (CEPPP), Luigi

Flora Centre d'innovation du partenariat avec les patients et le public

(CI3P), RETINES, Université Côte d'Azur, Vincent Dumez Université de

Montréal

Rationale/Background: The field of patient partnership

represents a major paradigm shift in medical pedagogy by

considering the patient as an expert of life with illness

(Karazivan et al. 2015). Actors in healthcare education are

now faced with finding experienced patients to contribute

to course and curriculum development in a meaningful

way. The Center of Excellence on Partnerships with

Patients and the Public (CEPPP) of University of Montreal

have developed a workshop to train for patient partner

recruitment, based on the CEPPP's patient partner

competency framework (PCF) and patient partner

recruitment guideline. This workshop has been the object

of a publication (Jackson & al., 2020).

Methods: This workshop is adapted from the Learning by

Concordance (LbC) model (Fernandez, 2016). It uses LbC

as an in-presence discussion tool focused on the possible

interpretations of audio-visual recordings, framed by the

PCF. After a brief presentation of the context, participants

are given a copy of the PCF and a series of questions in the

LbC format. Participants then watch a short video

recording of a patient recruitment interview. A group

discussion is facilitated for each question, focusing on the

PCF. This is repeated with three video recordings.

Target audience: All healthcare professionals responsible

in health care organization for a patient partnership unit,

all researchers in the field of patient oriented research and

all faculty members developing new pedagogical content

or restructuring academic cursus.

Learning objectives: Acquire basic understanding and

basic skills of competency-based patient partner

recruitment.

WG1-3, 60287

Culinary Medicine: Cooking-up Nutrition Competence

and Wellness Among Physicians

Joel Barohn University of British Columbia, Lee Rysdale Northern

Ontario School of Medicine, Chelsea McPherson University of Toronto,

Julia MacLaren Alberta Health Services

Rationale/Background: Building on the CCME John Ruedy

Education Innovation Symposium (2019) by the Northern

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Ontario School of Medicine (NOSM), there is growing

interest and opportunity to integrate Culinary Medicine

(CM) into Canadian medical education and faculty

development. The objective of CM as a component of

medical school curricula is to simultaneously increase

nutrition competence of medical trainees and improve

their health behaviours. As a proven interprofessional

education model used in over 50 US medical schools, CM

is an innovative therapeutic lifestyle medicine approach

that supports positive dietary and psychosocial patient

outcomes. This virtual or face-to-face workshop will

illustrate the value of CM as a layered knowledge

translation strategy for physicians, medical trainees and

educators, and demonstrate application in clinical practice

settings. Attendees will learn to use simple recipes

alongside core food and nutrition messages to build

fundamental food skills and nutrition knowledge to

influence behaviour change. Additionally, they will learn

strategies on how to make their CM program practical and

sustainable.

Methods: A team of registered dietitians and chefs will

facilitate an introductory CM workshop including a food

skills demonstration followed by participants preparing

two quick and healthy recipes. While participants enjoy

the prepared dishes, a mini-lecture on a nutrition

topic/condition will be delivered with polling quizzes,

small and large group discussions, and case studies.

Target audience: Physicians, residents, medical students,

educators

Learning objectives: 1. Identify how CM can improve

medical learner and physician nutrition competence and

support dietary behaviour change. 2. Describe the

opportunities and challenges to implementing a CM

program in Canadian medical education. 3. List three

components of successful CM programs.

April 20

, 2021 - 11:30 EST

WG2-1, 60917

Fostering a Humanistic Culture of Care: Understanding

Interprofessional Teams as Complex Adaptive Systems

Wendy Stewart Dalhousie University

Rationale/Background: Healthcare is primarily delivered

using team-based care. Each discipline has their own

distinct training and clinical practice framework, and

strongly identifies with their own profession leading to

conflict and tribalism in teams. This in turn impacts patient

care and the health and wellbeing of team members. The

culture of healthcare is challenging, with an ongoing

hierarchy and lack of support for one another. The

pressures of 24/7 connectedness through technology and

increasing demands is causing burnout. We need to

consider ways in which to care for one another as well as

our patients if we are to maintain our own health and

passion for our respective professions. Changing culture is

challenging and can begin with our immediate colleagues.

This workshop will provide participants with opportunities

to engage in humanistic interactions with one another and

consider practical strategies to change culture in their own

workplace from the perspective of complex adaptive

systems theory.

Methods: A brief didactic presentation will introduce

participants to complex adaptive systems theory, identify

the challenges of healthcare culture and frame how this

might be changed from a humanistic perspective. Using

pair share, participants will consider different aspects of

working in teams from a complex adaptives systems

perspective. In small groups, they will apply humanistic

approaches to engaging one another in real-life based

scenarios and apply one of the approaches to a

challenging situation in their own workplace setting. The

workshop will conclude with a facilitated larger group

discussion to allowing sharing of ideas.

Target audience: Learners and practitioners involved in

teams based care

Learning objectives: 1. Define what is meant by a complex

adaptive system 2. Identify what it means to feel

supported in an interprofessional team setting. 3. Practice

humanistic approaches for engaging interprofessional

colleagues in a productive and supportive dialogue 4.

Apply one of the approaches to an issue in their own

workplace setting

WG2-2, 60667

Leveraging Data Visualization and Data Storytelling in

Programmatic Assessment and Program Evaluation

Richard Pittini University of Toronto, Yuxin Tu University of Toronto,

Pauline Pan University of Toronto

Rationale/Background: Research in cognitive sciences

indicates that humans have been telling stories for

thousands of years and human brains are wired to process

and respond to them. However, limited research focused

on the interplay between data storytelling and medical

education. Both Programmatic Assessment and Program

Evaluation in medical education require collecting a large

volume of data and making informed decisions using such

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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data. Currently, the ways of presenting and

communicating student assessment data to stakeholders

and program evaluation data to decision-makers are still

lacking. In the past four years, our office explored using

data visualization and storytelling tools and techniques in

data analysis and presentation to support high-stake

student progress decision-making and identifying areas of

improvement as a part of the Program Evaluation Model.

Methods: We will spend the first 5 minutes presenting the

theories and best practices in data visualization and data

storytelling. We then will spend the next 15 minutes

displaying a few visualization examples and highlighting

the lessons we learned from our journey. We will divide

participants of different levels of expertise into small

groups of 4-6 to engage in two visualization and

storytelling design activities that will last 60 minutes. We

then will host a 10-minute Q&A session.

Target audience: Senior executives, department heads,

scientists, data practitioners, staff who are involved in

Medical School assessment and evaluation

Learning objectives: • data visualization and storytelling

opportunities in student assessment and program

evaluation • Identify Learn tools and techniques present

quantitative information effectively • Feel confident in

engaging and persuading your audience with storytelling

WG2-3, 60593

Owning Allyship: Leading through the tensions of racism

and relationship

Lyn Sonnenberg University of Alberta, Victor Do University of Toronto,

Constance LeBlanc Dalhousie University, Jamiu Busari Maastricht

University | Dr. Horácio E. Oduber Hospital

Rationale/Background: Now, more than ever, we need to

actively address racism within medical education and

healthcare delivery. However, many educators are left not

knowing what to do or say. Allyship is the practice of

emphasizing social justice, inclusivity, and human rights by

those in a privileged position or group, to advance the

interests of an oppressed or marginalized group. Being an

ally does not mean you fully understand what it feels like

to be oppressed; it means you're taking on the struggle

alongside those directly impacted. Since allies often have

and recognize more privilege, they are powerful voices

alongside oppressed ones. Together, we will explore three

powerful racial themes (microaggressions, moral injury,

and implicit bias) and provide their counterbalance

response (vigilance, near-peer support, and advocacy)

within the medical education and healthcare contexts. We

will conclude with practical calls to action for

implementation into circles of influence.

Methods: We will actively integrate the audience's

perspective through dialogue and narrative, using case

studies, powerful stories, and lived experiences. Using

challenging cases, we will highlight the tensions between

being an ally and maintaining relationships with those we

are aiming to enlighten. Participants will be invited to

share their experiences and stories, integrated within

case-study discussions. In this safe space we can explore,

acknowledge, and reflect collectively, while co-creating

tools to address racism and create allyship.

Target audience: All

Learning objectives: 1. explore what is meant by allyship

2. identify actionable strategies to address the tensions

between addressing racism while preserving relationships

3. recognize privilege and use it to amplify

underrepresented voices

April 20

, 2021 - 15:30 EST

WH1-1, 60920

Bias and Residency Selection - Supporting Diversity in

Postgraduate Medical Education

Amanda Condon University of Manitoba, Jackie Gruber University of

Manitoba, Ming-Ka Chan University of Manitoba, Sara Goulet University

of Manitoba, Lisa Monkman University of Manitoba

Rationale/Background: Increased focus in recent years on

diversity in Undergraduate Medical Education - changes to

admissions processes have helped to increase

representation of historically underrepresented groups in

Medical School. What is being done to ensure that this

approach carries on into Post Graduate Medical

Education? How is diversity being supported during the

residency selection process? What policies are in place

that may disadvantage certain candidates in their

applications to different programs? This workshop will

explore bias and how bias may influence residency

selection policies and decisions.

Methods: The workshop will consist of an introduction to

diversity in medical education and health workforce

followed by a brief review of bias and implicit bias training

(IBT). Workshop participants will then complete an IBT

exercise and debrief as a group. A discussion about

implicit bias and how this may impact residency selection

process and policy will occur, with participants working

together to highlight opportunities to mitigate bias within

the processes within their own institutions. Finally,

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participants will review elements of the CaRMS "Best

Practices for Applicant Selection" through the lens of

potential bias and consider how programs may optimize

their criteria to support diverse learners. This workshop

will consist of a short didactic component and will

primarily be focused on discussion and application of

implicit bias training to resident selection process.

Target audience: Program directors and all involved in

resident selection

Learning objectives: Identify policies and processes

related to resident selection that may disadvantage

diverse applicants.

WH1-2, 60704

Supporting Wellness through Reflection and Dialogue

Nirit Bernhard University of Toronto, Susanna Talarico University of

Toronto

Rationale/Background: The Royal College challenges

educators to prepare physicians who are able to balance

personal and professional priorities, incorporate self care,

and develop personal and professional awareness and

insight. Never has this concept been more critical than

during the current pandemic. This workshop will present

our approach to supporting learner wellness through

reflection and dialogue within a longitudinal curriculum.

Students engage with residents and faculty and the formal

curriculum during scheduled group meetings over 4 years.

Participants are provided with a description of the

thematic session and companion pieces, and come

prepared to describe an experience and their reflection on

it. Students are also required to meet with faculty twice

yearly for progress review meetings, and wellness is

discussed as an important element of their personal

learning plan. The informal curriculum, of relationship

building, is perhaps the most effective component of the

curriculum.

Methods: Our approach to supporting wellness through a

Portfolio curriculum will be described through a didactic

presentation. Participants will then have the opportunity

to simulate a small reflective practice group. Following a

demonstration, they will also engage in a coaching

conversation around wellness. Participants will discuss

how this approach might be adapted to their own

education context.

Target audience: Medical educators and trainees at all

levels

Learning objectives: As a result of attending this

workshop, participants will be able to: 1. Describe the key

components of a curriculum that supports student

wellness 2. Participate in/facilitate a small reflective

practice group and coaching conversation 3. Leave with

the ability to implement a similar curriculum within their

own program

WH1-3, 60586

Teaching Resilience through Peer Group Reflection.

Mairi Scott Centre for Medical Education, School of Medicine, University

of Dundee

Rationale/Background: The Covid-19 pandemic crisis with

the inherent uncertainly around clinical decision making

has led to a significant increase in work-related stress,

sickness absence and burnout. Medical educators can

make a difference by focusing on educational solutions to

shift healthcare culture towards one of learning rather

than overwhelm. This workshop will enable medical

educators to develop additional skills in enabling their

learners to undertake critical reflection of patient care in

a creative and interactive way and so become more

resilient

Methods: Delegates will explore effective methods of

small group peer learning using a 'values-based' Balint

style approach to reflection, analysis and understanding of

their own clinical experiences and enabled to develop

facilitation skills needed to achieve deep learning. The

workshop will be delivered in phases (all interactive); 1.

Explanation and exploration of the technique known as

Balint type case-based learning 2. Small group work 1 & 2

plus de-brief on process and facilitation 3. Whole group

review of learning with agreed plans for further self-

development.

Target audience: Medical Educators involved in teaching

undergraduates, postgraduate specialty trainees and

established professionals undertaking CPD activities.

Learning objectives: Participants will experience and gain

skills in teaching others to; • Develop an approach to

optimizing resilience to enhance professional practice and

development. • Gain high level skills in reflective practice

based on enabling group discussion and critical analysis of

the uniqueness of the clinician-patient interaction. •

Develop small group leadership skills in using awareness-

raising questions (ARQ's) to enable in-depth critical

analysis and reflection.

Assessment

LP1 - 02, 60301

Assessment of pink elephants.

Jinelle Ramlackhansingh Memorial – University of Newfoundland, Fern

Brunger Memorial – University of Newfoundland

Background/Purpose: Medical students learning about

CanMEDS roles can be assessed using written reflection

assignments. Reflection on learning is important for

identifying learning needs and integrating knowledge.

Assessment regulations require rubrics detailing the

outcomes and assessment of assignments are to be

provided to students. Education best practices are that

faculty feedback then corresponds to the expectations

outlined in the assessment rubric. This presentation looks

at the use of rubrics in assessment.

Methods: This paper is based on findings from a

longitudinal study examining professional development

amongst pre-clinical medical students at an Atlantic

Canadian university. The study employed a critical

ethnographic design using a combination of participant-

observation research and monthly focus groups over two

years. The study involved collecting student accounts of

their formal and informal learning experiences, including

their observations of and opinions on faculty assessment

of reflective assignments.

Results: The students reported having rubrics was a

disadvantage. The students spoke about how abstract

their writing was like pink elephants, to address the

expectations of the rubrics. The assignments failed in their

usefulness as a tool to help the students develop critical

thinking. Instead, the students chose to write to fit the

rubric and pass the assignment. The students found the

feedback they received was too limited to help guide their

learning and correct their mistakes.

Conclusions: The rubrics instructed the students on what

to write rather than allowing the students to reflect on

their learning. The lack of useful feedback could be due to

those teachers themselves are not trained to give

constructive feedback.

LP1 – 03, 60711

Theoretical or Practical? Evaluation of Entrustable

Professional Activities (EPA) in the 2019−2020 Internal

Medicine Cohort

Lorenzo Madrazo Western University, Jennifer Theresa DCruz Western

University, Dr. Sheri-Lynn Kane Western University, Natasha Correa

Western University

Background/Purpose: Implementation of competence-

by-design (CBD) through completion of Entrustable

Professional Activities (EPA) aims to enhance resident

performance and ultimately, patient outcomes. Whether

electronically completed EPAs translate into meaningful

learning assessment remains uncertain. We aimed to

evaluate the quality of EPA feedback completed by faculty

and residents.

Methods: We assessed the quality of feedback from all

EPAs for PGY1 Internal Medicine Residents from July

2019−May 2020 at Western University. Based on

literature review, we assessed feedback quality on four

domains: timeliness (<7days duration from clinical

encounter to EPA completion), task-oriented (yes or no),

actionability (very, semi, or not actionable), and polarity

(positive, negative, mixed, or neutral). Four independent

reviewers were blinded to names of evaluators and

learners, and were randomized to assess the four

variables outlined.

Results: A total of 2,471 EPAs were initiated, 80% were

completed, of which 39% were completed by faculty and

61% by residents. Of all feedback received, 47% of EPAs

were timely, 85% were task-specific, 83% consisted of

positive feedback, 4% mixed, and 12% neutral. Thirty

percent were semi- or very actionable.

Conclusions: In the first year of implementation a cohort

of 34 PGY1s attempted 2,471 EPAs with a completion rate

of 80%. Feedback is generally task-oriented, not timely,

and only actionable 30% amount of time. Residents bear

a large burden for both obtaining and assessing EPAs. The

timeliness and actionability of feedback will require more

resident and faculty development in order to achieve the

goals of CBD.

Learner Posters

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LP1 – 04, 60753

Developing validity evidence for a clerkship competency-

based written communication skills rubric

Avrilynn Ding Queen’s University, Eleni Katsoulas Queen’s University,

Cherie Jones-Hiscock Queen’s University, Michelle Gibson Queen’s

University, Theresa Nowlan Suart Queen’s University, Andrea Winthrop

Queen’s University

Background/Purpose: Although written communication

skills are a key physician competency taught in

undergraduate medical education, it remains challenging

to assess, particularly in clerkship. This study contributes

to the validity argument for a competency-based written

communication assignment (WCA) rubric by providing

evidence for purpose & construct validity.

Methods: A semi-structured focus group was conducted

with the graduating 2020 class, audio-recorded, &

transcribed verbatim. Questions were designed to

stimulate discussion on the rubric's purpose, fitness for

purpose, & factors impacting its effectiveness. The

transcript was coded by one reviewer with a constructivist

approach, using Stobart's validity framework as a

theoretical framework. The codebook was modified

iteratively. A second reviewer coded a random 25%

transcript sample with high agreement. Codes were

grouped into themes that reflected the student

experience. Member checking verified findings.

Results: Six students participated in the one-hour focus

group. They represented 17 completed WCAs, including

discharge summaries, consult notes, & clinic notes. Three

core themes emerged: (1) Students accurately understand

the rubric's purposes; (2) The rubric captures most skills

involved in medical documentation; (3) Preceptor

feedback habits, documentation processes, & student

approaches to assessment requests influence the value of

feedback the rubric produces. Suggested improvements

were to incorporate adequacy of documentation for

medicolegal purposes & pertinence to discipline into

rubric criteria, & add submission guidelines.

Conclusions: These findings suggest that the rubric

measures what it was intended to measure, & captures

intended purpose. The analysis will inform future revisions

of the rubric, including triangulation with faculty

perspectives.

LP1 – 05, 60907

Examining resident-entered vs preceptor-entered low

stakes workplace-based assessments in Competency-

based edical Education

Shelley Ross University of Alberta, Jonathon Lee University of Alberta

Background/Purpose: While assessment by preceptors in

competency-based medical education (CBME) is crucial

for resident development, CBME is also intended to

improve accuracy of learner self-assessment. Despite

continued adoption of CBME as a preferred approach to

physician training, it is unclear to what extent residents

should be responsible for their own assessment. Our study

contrasted the content of fieldnotes (low stakes narrative

assessments) that were learner-created (i.e., self-

assessments) vs preceptor-created. We compared these

two categories of fieldnotes to shed light on the value of

self-assessments in CBME. We hypothesized that learner-

created and preceptor-created fieldnotes would; 1) differ

in quality of the narrative feedback; 2) not greatly differ

with respect to a resident's progress level in a

competency, and; 3) address competencies with

comparable frequency.

Methods: This study used secondary data analysis of

archived fieldnotes generated by residents and preceptors

in a family medicine residency program in Canada. Non-

parametric statistical tests were used to evaluate

differences between learner self-assessment fieldnotes

and preceptor-entered fieldnotes in feedback quality,

indicated progress level, and competencies addressed.

Results: Quality of feedback documented by residents in

self-assessments was significantly lower than that

documented in preceptor assessments. Second year

residents overestimated their own progress levels in self-

assessments in a small but significant manner. Some small

but significant differences were found between residents

and preceptors in the frequency of specific competencies

addressed.

Conclusions: Resident self-assessments were reasonably

consistent with preceptor assessments, suggesting that

the benefits of guided low-stakes self-assessment (e.g.,

training in self-regulation, program efficacy monitoring)

outweigh the potential risks.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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LP1 – 06, 60489

EPAs in core Internal Medicine: from the concept to the

implementation

Jean-Philippe Rioux Université de Montréal, David Bélanger Université

de Montréal, Jean-Michel Leduc Université de Montréal

Background/Purpose: Entrustable professional activities

(EPA) have been introduced in core internal medicine

residency programs in Canada in July 2019. Studies show

that the implementation of EPAs is facing a lot of

challenges and that the benefit of this method has to be

closely evaluated. The perception of core internal

medicine residents of Université de Montréal (UdeM)

about the content and the implementation of EPAs was

assessed.

Methods: An online survey was distributed by email to all

PGY1 core internal medicine residents of UdeM with

questions regarding EPA frequency in different

subspecialty rotations, general perception of EPAs.

Relevance, feasibility and understanding of EPAs were

assessed using Likert-scales. Descriptive statistics and

frequency distributions were then computed and

compared between rotations.

Results: Our response rate was 65%. Results show a

variability in the number of EPAs completed by week, from

an average of 0.5 in endocrinology to 1.6 in nephrology.

86% of participants noted that their work burden was

increased by EPAs, with lack off comprehension by the

supervisors identified as an important issue by 71 %. Our

results identified EPA 2.7 (reflective work about learning

needs) as difficult to understand, with lower relevance

and a too high quantity of observations needed. Some

other EPAs were identified with low feasibility due to few

supervised clinical opportunities.

Conclusions: Implementation of EPAs is variable among

subspeciality rotations in internal medicine, possibly

related to the familiarity of the supervisors with the

concept. Changes could still be made to reduce the

complexity and the required number of some of the EPAs.

LP1 – 07, 60498

Field Notes: Factors Impacting Residents' Learning in

Manitoba

Gayle Halas University of Manitoba, Teresa Cavett University of

Manitoba, Nicole Zaki University of Manitoba

Background/Purpose: Family Medicine (FM) Residency

Programs are tasked with developing competent

physicians, covering multiple domains of patient care and

an extensive body of medical knowledge situated in

diverse settings. In accordance with Competency-Based

Medical Education principles, FM programs employ

multiple assessment modalities including resident self-

assessment through Field Notes (FNs). This study explored

the use of FNs at the University of Manitoba and how

these have shaped residents' learning.

Methods: This multi-method study examined 520 FNs

from 16 recent graduates. Quantitative analysis

(frequencies and means) enabled descriptions and

comparisons between residency training sites; four

themes emerged from inductive content analysis.

Results: Residents' FNs explored 91 of 99 of the CFPC

Priority Topics. The most frequently described Topics

were Skin Disorders, Infections, Depression, and Pain

Management. Topics addressing complex psychosocial

issues (Domestic Violence, Grief, Infertility, Lifestyle,

Obesity, Parkinsonism, Rape/Sexual Assault and

Somatization) were absent from this data set. Few FNs

addressed the domains of Care of First Nations, Inuit, and

Metis; Care of the Vulnerable and Underserved; and

Behavioural Medicine and the CanMEDS-FM roles of FM -

Procedural Skill, Leader/Manager, and Professional. Four

themes (Patient-Centered Care, Patient Safety, Achieving

Balance, and Confidence) were identified from residents'

narratives.

Conclusions: Vygotsky's Sociocultural Theory of Cognitive

Development was utilized as a lens to examine factors

influencing resident learning. Residents' discomfort with

certain topics is demonstrated through avoidance of

reflecting upon certain competencies in FNs thus

impacting skill acquisition. Further research should

explore factors influencing residents' selection of FN

topics and how to best assist residents in becoming

competent, confident practitioners.

LP1 – 08, 60563

The self-feedback of overconfident and underconfident

medical residents: a qualitative analysis

Maryam Bagherzadeh Queen’s University, Heather Braund Queen’s

University, Tim Chaplin Queen’s University

Background/Purpose: 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

explored the qualitative themes provided in the self-

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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assessment rationale between over- and underconfident

residents.

Methods: Following the completion of a simulation-based

resuscitation course in 2017, 41 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.

Conclusions: 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.

LP1 – 09, 60724

Analyzing patterns of performance across the clerkship

learning environment

Avik Sharma University of Alberta, Chaitanya Gandhi University of

Alberta, Hollis Lai University of Alberta

Background/Purpose: Clerkships traditionally span two

years of medical school where students integrate their

basic science knowledge and skills in clinical rotations.

There is evidence in the pre-clerkship setting that a score

received by a medical student in weekly team-based

learning (TBL) assessments influences their performance

in the subsequent assessment. However, the investigation

of such trends has not yet been conducted in the clerkship

context. This is relevant because, unlike TBL, clerkship

assessments have a higher weighting towards final

clerkship grades.

Methods: A secondary analysis of anonymized clerkship

assessment data was conducted on six core clerkships

between 2018 and 2019. A total of 10325 form

submissions for 139 medical students were analyzed for

the study. After modelling, repeated measures ANOVA

and Paired t-tests analyzed for performance within

clerkships, while time-series analyses were used to

analyze trends across clerkships. Odds ratios were also

used to determine the likelihood of score improvement

between the first and each successive clerkship.

Results: The score patterns of students in clerkship

evaluations indicate that there is a significant

improvement as they progress through a clerkship.

Similarly, improvement in performance is also noticed

across successive clerkships and for different

competencies. Lastly, the likelihood of students that

obtain the highest score possible on clerkship assessments

increases with subsequent clerkships.

Conclusions: These score patterns are concordant with

pre-clerkship patterns of performance and suggest that

students may modulate their future performance based

on previously received evaluation scores.

LP2 – 01, 60488

Establishing a Holistic Framework for Physician Stress

Sydney McQueen University of Toronto, Melanie Hammond Mobilio

University of Toronto, Carol-anne Moulton University of Toronto

Background/Purpose: Physician stress has been identified

as destructive to individual and system wellness and

performance, however we continue to struggle to address

stress in practice. Challenges arise from the lack of a

shared definition of 'stress'-which is idiosyncratic and

multifaceted-as well as limitations to traditional,

reductionist approaches to understanding stress that seek

linear cause-effect relationships. We require a cohesive

framework for organizing multidisciplinary knowledge for

studying and tackling stress. The present study builds on

the cognitive appraisal theory of stress to establish a

holistic physician stress framework.

Methods: Constructivist grounded theory was used to set

aside preconceived definitions of 'stress' and explore the

holistic subjective experience with the individuals

experiencing the stress. 24 semi-structured interviews

were conducted to explore distress, followed by 19

interviews on eustress. Participants were staff surgeons at

the University of Toronto, purposively sampled for

experience levels and practices. Data were coded and

analyzed iteratively by three researchers until no new

themes relating to the emerging model were identified.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Results: We present a conceptual framework for physician

stress that includes: 1. Distress and eustress as two holistic

experiences; 2. The multiple dimensions contributing as

both antecedents and components of the stress

experience (physiological, cognitive, emotional,

sociocultural, environmental) and; 3. Interrelationships

and dynamic feedback between component parts.

Conclusions: A holistic framework may be used in

conjunction with methods from complexity science to

identify novel approaches to stress research, and to

organize efforts for countering distress while supporting

eustress in practice.

LP2 – 02, 60573

Perceptions of Health and Wellness Impacts on Residents

in their Certification Exam Year

Tara Riddell McMaster University, Natasha Snelgrove McMaster

University, Michelle Onlock University of Toronto, Laila Nasser

McMaster University, Kaif Pardhan University of Toronto

Background/Purpose: Residency training in Canada

includes a certification exam administered by the Royal

College of Physicians and Surgeons of Canada or the

College of Family Physicians of Canada. Residents work

clinically while studying. Studying for this exam may

impact residents' health and wellness. Our objectives

were to explore (a) the residents' certification exam year

experiences, (b) mitigating strategies used to enhance

health and education, (c) retrospective perceptions of

faculty on their certification exam year, and (d) faculty

perceptions of certification exam year experiences of

current residents.

Methods: Qualitative description methodology was used

for this study. Participants were residents and supervisors

from McMaster University and the University of Toronto.

In depth, semi-structured one-on-one interviews were

conducted by one of the investigators. Each was

transcribed, reviewed and coded using content analysis by

two members of the investigating team.

Results: Fear and stress were identified in residents'

personal and professional lives including finances, career

planning, and relationships. Health impacts were

identified with heightened anxiety, loss of interest, weight

gain, and poor eating habits. Negative impacts were

exacerbated by observing predecessors' stress, high

stakes nature of the examination, and expectation of peak

clinical performance while studying. Mitigating factors

included supportive personal and professional networks,

norming of the examination as creating knowledge

foundation for practice and shared community goal of

resident success.

Conclusions: This study has identified unique challenges

that residents face in their exam year. A focus on

mitigating factors will be helpful to ensure physician

wellness during transition to practice.

LP2 – 03, 60256

Infographic to optimize the learning environment in the

operating room for medical students undergoing their

anesthesia rotations

Dong An University of Toronto, Anita Sarmah University of Toronto

Background/Purpose: Mistreatment of medical learners

is pervasive and well documented. A 2014 meta-analysis

of 59 studies examining the prevalence of mistreatment

found that 59.4% of medical trainees had experienced at

least one form of mistreatment during their training.

Mistreatment leads to decreased performance, increased

burnout, and worse patient care. Medical students

perceive mistreatment to include both "incident-based"

and "environment-based" types, where the latter is more

common and associated with an overall suboptimal

learning environment.

Summary of innovation: To optimize the learning

environment for medical students undergoing their

anesthesia rotations, the University of Toronto Anesthesia

Undergraduate Medical Education Committee created an

infographic titled "Medical Learners Belong in the OR".

The infographic contains five key recommendations to

ensure that the operating room is a safe and welcoming

environment for medical students. The recommendation

headings are "Respect Diversity", "Communicate Clearly",

"Orientate Students", "Be Attentive", and "Welcome

Questions", and include brief elaborations below each

heading. The development of the recommendations was

based on a conceptual framework that learning

environments encompass personal, social, organizational,

and physical components, which can all be improved to

create a more optimal learning environment. Input was

obtained from faculty, residents, and medical students.

The infographic was disseminated to faculty and students

via email and social media.

Conclusions: Feedback on the infographic from faculty

and students have been positive, noting an improvement

in the culture for learners in the operating room. Future

directions include creating additional infographics for

different healthcare settings outside of the operating

room.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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LP2 – 04, 60686

Balint Groups: An Initiative to Help Residents Better

Understand the Clinician-Patient Relationship

Sarah Lord University of Toronto, Joanna Humphreys McMaster

University, Justin Lam University of Toronto, Warner Finstad University

of Toronto, Dayae Jeong University of Toronto, Catherine Diskin

University of Toronto

Background/Purpose: Balint sessions are an educational

tool which allow residents to reflect on challenging

experiences with the doctor-patient relationship. Guided

by trained facilitators, residents consider these cases from

the doctor, patient and doctor-patient perspectives

together with their colleagues. Balint groups can support

the recognition of the emotional complexity underlying

these interactions, which in turn reduces burnout,

improves patient care and team dynamics, and

strengthens professional identities.

Summary of innovation: The University of Toronto

Pediatrics Residency Program incorporated Balint groups

into the curriculum in 2018. Supported by faculty,

residents led their introduction and improvement using

Quality Improvement methodology. Outcome measures

included perceived comfort levels in navigating and

supporting peers through challenging patient-physician

encounters, and the perceived culture of support within

the program. Rates of group participation were collected

as a process measure. All outcome measures improved

between the first and second year of Balint group

implementation. Residents' comfort levels in navigating

difficult patient-physician encounters increased from a

mean of 2.5 (out of a 5-point likert scale) to 3.0, in

debriefing complex scenarios from 3.1 to 3.9, and in

supporting peers from 3.2 to 3.8. The perceived culture of

peer support improved from a mean of 3.5 to 4.2.

Conclusions: Balint groups are a reflective educational

tool which have a positive impact on residents'

experiences navigating patient relationships. Introducing

these sessions at our institution has shown an

encouraging trend in improving residents' comfort levels

with difficult clinical encounters and fostering a culture of

support.

LP2 – 05, 60805

Fostering medical student wellness and resilience in a

virtual environment

Christine Wu University of Toronto, Caroline Park University of Toronto,

Setti Belhouari University of Toronto, Lisa Vi University of Toronto,

Grace Xu University of Toronto

Background/Purpose: Committed to promoting wellness

within the University of Toronto's Medicine program,

Student Health Initiatives and Education (SHINE) works in

collaboration with students and faculty to facilitate events

that address the unique challenges faced by medical

trainees, and best supports their well-being. With the

emergence of COVID-19, students faced new challenges

such as: disruptions to regular routines, academic anxiety

from curricular changes, and risk of loneliness due to

social isolation. An increased need for programming

necessitated reassessment of our strategies for promoting

wellness and building resiliency, most of which were

originally created for a non-virtual environment.

Summary of innovation: SHINE re-imagined the delivery

of support and resources by hosting regular virtual events

such as fitness workouts, virtual talent shows, physician-

led seminars, and games nights. Feedback from students,

collected both informally and formally through post-event

evaluation forms, highlighted the positive impact of our

events on social facilitation, interaction, and team-

building opportunities, particularly through encouraging

incoming medical students to meet each other.

Conclusions: Through redesigning our programming, we

learned to capitalize on the advantages of an online

environment, which include equitable access to all events,

convenience for speakers, increased attendance online

(lower commitment, no travel time), and increased

engagement (i.e., reduced fear of engagement due to

anonymized polling). However, there are aspects of

wellness that cannot be nurtured in a virtual environment,

such as organic in-person connectedness; therefore,

future goals of programming include providing students

the tools for resilience and self-care that can help them

cultivate these aspects in their personal lives. In

conclusion, our approach to SHINE initiatives demonstrate

the value of redesigning wellness programming to better

support student needs during uncertain times.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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LP2 – 06, 60861

Finding Flow: A Systematic Review of Cognitive Flow in

Healthcare

Stephanie Jiang Queen’s University, Sydney McQueen University of

Toronto, Aidan McParland University of British Columbia, Carol-Anne

Moulton University of Toronto

Background/Purpose: Cognitive flow is a state in which

individuals experience heightened focus, awareness,

performance, and satisfaction in their work. Although this

state has been deeply explored and applied in elite sport

for optimal performance, little is known about the flow

state in healthcare settings. This systematic review sought

to summarize the current information on flow in

healthcare and identify gaps in knowledge on this

concept.

Methods: An initial search using keywords related to

cognitive flow, positive psychology, clinical practice, and

healthcare was conducted in MEDLINE, PsychINFO and

EMBASE. All articles discussing flow in healthcare

disciplines published between 1806 to July 9 2019 were

considered. Two independent reviewers screened all

articles, and extracted data pertaining to study location,

population, measures, key findings, and manuscript type.

Results: 4824 unique abstracts were identified. After title

and abstract screening, 207 articles were included for full-

text review. In total, 15 articles were included. Overall,

there was a paucity of literature on flow in healthcare.

Publications described the experience of flow in

healthcare workers, potential benefits of flow, and the

relationship between flow and other positive states,

namely work engagement.

Conclusions: Flow is an understudied concept in

healthcare. Understanding flow states in healthcare may

help combat burnout, enhance career satisfaction, and

promote wellness among providers. Further research is

needed to more deeply understand how flow is

experienced in clinical settings, and how we can support

flow in individuals and institutions.

LP2 – 07, 60872

The Role of Creative Arts in Medical Education:

Perspectives from Contributors of the Journal of Art and

Healing

Yu Fu University of Ottawa, Hui Yan University of Ottawa, Rahul Kapur

University of Ottawa, Farhan Mahmood University of Ottawa, William

Tran University of Ottawa, Francis Bakewell University of Ottawa, Laura

Nguyen University of Ottawa

Background/Purpose: While still an emerging field, there

has been an increasing inclusion of the arts and

humanities in medical curricula. The arts and humanities

have been suggested to provide valuable contributions to

the personal and professional development of medical

students in various domains, including self-reflection, self-

expression, and observational and critical thinking skills.

There have been a variety of ways in which art has been

introduced into medical education, such as through

formal courses in narrative medicine, museum visits, and

art-making workshops. Similarly, student-led initiatives

that encourage engagement in creative endeavors, such

as a creative arts publications, have also been suggested

to provide benefits such as building appreciation for

others' viewpoints and values, as well as providing a

productive outlet for stress.

Summary of innovation: Murmurs: The Journal of Art and

Healing is a literary and visual arts magazine organized by

medical students at the University of Ottawa. The

publication accepts contributions from medical trainees

across Canada, aiming to showcase creative talent as well

as provide a space to reflect on and share experiences in

medicine. Murmurs releases annual issues focused on a

key theme to inspire submissions, such as Celebrations,

Journey, and Reflection.

Conclusions: Testimonials gathered from the contributing

artists and writers of the sixth and seventh edition of

Murmurs suggest that involvement in the arts during

medical school can encourage self-reflection and allow for

the development of empathic abilities. This adds to the

growing body of evidence supporting the positive effects

of the creative arts on medical student growth and well-

being.

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LP2 – 08, 60896

Experiences from a new Women in Medicine club

Zhong Adrina Western University, Quint Elise Western University

Background/Purpose: While women account for more

than half of graduating medical students, women

physicians are outnumbered in leadership roles, more

likely to experience mistreatment or harassment, and

report higher burnout rates. In an effort to mitigate

gender bias in medicine and promote well-being in

women medical trainees, a Women in Medicine student

club was established to create a safe space to discuss

unique issues that affect women in medicine, share

resources and provide support.

Summary of innovation: Events held by the club included

informal discussion groups, several lunchtime talks, and a

week of events surrounding International Women's Day.

The club worked together to provide recommendations to

change student mistreatment policies. An active Facebook

group where club members post news and event links

contributed to the development of a sense of community.

The inaugural year of the club culminated in a mentorship

event which brought together female physicians and

medical students in a speed networking format.

Anonymous qualitative feedback was solicited at the end

of the event.

Conclusions: The mentorship event was met with

excellent feedback from both physicians and students.

Physicians enjoyed meeting students and providing career

advice. Some physicians reflected that they wished there

was a similar initiative in place when they were in medical

school. Students appreciated insights from a variety of

medical specialties, especially as it pertains to career

exploration. Students and physicians alike praised the

relaxed nature of the mentorship event held at a local

coffee shop without the demand of clinical duties. Next

steps for this new club include continuing the mentorship

event in upcoming years as well as continuing to develop

community and support among women medical students.

LP2-09, 60536

Development of a Policy for Addressing Resident

Harassment and Discrimination by Patients and Families

Leora Branfield Day University of Toronto, Tarek Abdelhalim University

of Toronto

Background/Purpose: Despite the high prevalence of

resident harassment by patients and families in the clinical

environment, as few as 4% of incidents are formally

reported. Barriers to reporting include lack of knowledge

of who to report to, concerns about confidentiality, and

perceived lack of institutional support. Existing hospital

policies to protect hospital employees are often

ambiguous in their wording and application to residents.

Accordingly, we developed a Harassment Working Group

comprised of engaged faculty and trainees in the

Department of Medicine (DoM) at the University of

Toronto. Our goal was to update existing policies for

reporting and addressing incidents of harassment of

Internal Medicine residents by patients and their families.

Summary of innovation: We undertook an iterative

process to policy development and reviewed existing

policies and achieved widespread stakeholder

engagement. We then involved human resource

specialists and lawyers and adapted all existing

procedures into a streamlined DoM policy. The policy

contains a clear reporting structure and process involving

the resident supervisor ("incident manager") and site

manager ("trainee manager") and ensures accountability

and confidentiality. The policy outlines resolution

procedures focused on 1) resident support 2) resident

safety and 3) filing an incident report through existing

hospital mechanisms. Resident and faculty education is

currently ongoing as we pilot the policy in the inpatient

setting.

Conclusions: Through an iterative approach to policy

development, we updated and instituted a new policy for

reporting and addressing resident harassment from

patients and families, with the potential to increase the

ability of hospitals to appropriately identify and manage

these harmful incidents.

Postgraduate

LP3 – 01, 60722

Supporting the Transition from Junior to Senior Pediatric

Resident: Implementation of an Online Case-Based

Interactive Educational Resource

Erin Boschee University of Alberta, Jennifer Walton University of

Alberta, Jessica L. Foulds University of Alberta, Karen L. Forbes

University of Alberta

Background/Purpose: The transition from the role of

junior to senior resident is an important milestone in

pediatric residency training. A needs assessment survey of

University of Alberta pediatric residents suggested that

the junior to senior transition is a significant source of

anxiety for pediatric trainees. There is a paucity of formal

educational resources for helping residents to develop

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skills and foster confidence as they prepare for overnight

and daytime senior responsibilities.

Summary of innovation: We developed an asynchronous

online interactive case-based resource to support

pediatric residents transitioning to the senior role. Six

modules were developed in an online learning platform,

each focused on a transition-related skill identified as

important in the needs assessment. Modules addressed

triaging and prioritization, time management and

efficiency, handling acute situations, working with

learners, acting autonomously, and managing personal

stress. The resource presented realistic, non-prescriptive

clinical scenarios where residents assumed the role of

senior. Scenarios allowed trainees to experience common

demands and challenges faced by senior residents in a

simulated virtual setting, and encouraged critical thinking

and self-reflection. 80% of residents accessed at least part

of the voluntary resource.

Conclusions: A retrospective pre-post survey of pre-

transition pediatric residents demonstrated reduction in

self-reported transition-related anxiety after use of the

resource (n=7, survey response rate 70%). Residents also

reported increased confidence in the six transition-related

skills addressed suggesting that an online case-based

interactive educational resource can be effective in

helping pediatric trainees to feel more confident and less

anxious about this key transitional stage.

LP3 – 02, 60797

Perceptions of and Barriers to Competency-Based

Education

Sean Taylor Dalhousie University, Nicholas Cofie Queen’s University,

Damon Dagnone Queen’s University, Laura McEwen Queen’s University,

Lindsay Crawford Queen’s University

Background/Purpose: Competency-based education

(CBE) has been implemented across Canadian post-

graduate medical training programs through Competence

By Design (CBD). We describe our initial experiences,

highlighting perceptions and barriers to facilitate

implementation at other centers.

Methods: An anonymous online survey was administered

to faculty and residents transitioning to CBE (138

respondents) including 1) Queen's Residents (QR)[n= 102],

2) Queen's Faculty (Program Directors and CBME Leads)

[n=27]and 3) Canadian Neurology Program Directors

(NPD)[n = 9] and analyzed the data using descriptive and

inferential statistical techniques.

Results: Perceptions were favorable (x̄ = 3.55, SD = 0.71)

and 81.58% perceived CBE enhanced training; however,

perceptions were more favorable in faculty. QF indicated

that CBE did not improve their ability to provide negative

feedback. NPDs did not perceive their institution had

adequately prepared them. QR did not perceive improved

quality of feedback. There was variability in barriers

perceived across groups. NPDs were concerned about

access to information technology. QF were concerned

about resident initiative. QR felt assessment selection and

faculty responsiveness to feedback were barriers.

Conclusions: Our results indicate Faculty were concerned

about reluctance of residents to actively participate in

CBE. Residents were hesitant to assume such a role due to

lack of familiarity and perceived benefit. This discrepancy

indicates attention should be devoted to: 1) institutional

administrative/educational supports, 2) faculty

development around feedback/assessment and 3)

resident engagement to foster ownership of their learning

and familiarity with CBE.

LP3 – 03, 60815

Static in the line or a full disconnect? Exploring resident

perceptions and interpretations of initial competency

based medical education (CBME) implementation

compared to the core components of CBME

Andrea Davila-Cervantes University of Alberta, Shivani Upadhyaya

Western University, Anna Oswald University of Alberta, Marghalara

Rashid University of Alberta

Background/Purpose: CBD is a hybrid competency-based

model that focuses on residents' abilities in relation to the

competencies needed for success in practice. This model

is based on five components: framework of competencies,

sequenced progression, tailored experiences,

competency-focused instruction, and programmatic

assessment. There has been limited exploration of

residents' experiences of implementation of CBD thus far.

We explored residents' mental models in relation to the

core components and their general experiences to identify

if CBD implementation in the first 8 disciplines is occurring

as it was conceptualized.

Methods: A descriptive qualitative design was used to

explore and better understand the resident experiences.

All residents who had exposure to CBD implementation

were invited to participate. We conducted face-to-face or

telephone semi-structured interviews. Interviews were

digitally recorded and transcribed verbatim. Thematic

analysis was used to create data-driven codes and identify

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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themes and subthemes. We used an iterative consensus-

building process to reach saturation. Research Ethics

Board approval was obtained.

Results: A total of 20/50 (40%) residents representing 6

different disciplines from the 1st(n=4) and 2nd(n=16)

cohorts of CBD implementation were interviewed. Five

main themes emerged: i) value of feedback; ii) strategies

for successful Entrustable Professional Activity(EPA)

completion; iii) challenges encountered in CBD; iv) general

perceptions regarding CBD; and v) recommendations to

improve on existing challenges.

Conclusions: Exploring residents' mental models of CBD

core components and understanding their experiences on

the implementation will help identify/disseminate

successes, challenges, and future directions from the

residents' perspective to assist programs at different

stages of CBD implementation.

LP3 – 04, 60040

A cross-sectional analysis of application requirements for

residency programs in Canada under pass/fail grading

Mohamad Ourfali Dalhousie University, Sean Nurmsoo Dalhousie

University, Michael Bezuhly Dalhousie University

Background/Purpose: Canadian medical school graduates

are matched with residency programs through the

Canadian Residency Matching System (CaRMS). Students

apply to programs of interest through an online system at

carms.ca, and upload required materials. These materials

typically include a Medical School Performance Record

(MSPR), Curriculum Vitae, letters of recommendation, and

medical school transcripts. In recent years, some Canadian

medical students have reported that Canadian residency

programs have begun requiring undergraduate transcripts

from residency applicants. To the best of our knowledge,

the prevalence of this practice among all residency

programs in Canada has not been investigated. This

requirement may be in response to a shift in Canadian

medical education toward pass/fail grading systems and

away from letter grades, making differentiation between

applicants on the basis of academic performance more

difficult. Most applicants do not take the Medical Council

of Canada Qualifying Examination Part I until after

matching.

Methods: We built a database of residency program

application requirements using data retrieved from the

CaRMS website (Data was retrieved between May 1st and

July 15, 2017). Requirements for residency programs with

multiple sites were recorded separately. Residency

programs were organized by specialty. We recorded the

specific requirements of each residency program using

Microsoft Excel. We then analyzed the proportion of

residency programs that request transcripts in each

specialty. We also considered the differences in program

size by using total quota of positions available to compare

institutions and specialties with differently-sized

residency programs by weighting transcript requirements

by the number of positions available in each residency

program and institution. From this we calculated both the

proportion of residency programs and the proportion of

residency positions that require submission of an

undergraduate transcript in order to apply.

Results: There was wide variability in requirements across

Canadian residency programs. 13 of 15 ophthalmology

programs required results of a comprehensive eye exam

conducted by an ophthalmologist. Among otolaryngology

programs, 2 required or strongly recommended inclusion

of an ophthalmological report with the application. After

weighting by the number of available positions in each

residency program, we found that 31% of Canadian

residency positions required submission of an

undergraduate transcript in order to apply. Of the 514

CaRMS-rankable residency programs we identified in

Canada in 2017, 28% of programs required undergraduate

transcripts from applicants. This requirement varied

widely by specialty and institution. A majority of positions

in public health, radiology, nuclear medicine and

dermatology required the undergraduate transcript, while

it was not required anywhere for applications in

neurosurgery, pathology, and medical microbiology. 9% of

programs did not require a medical school transcript. 1

residency program required applicants' MCAT score.

Conclusions: Requirements to include an undergraduate

transcript may be an unintended consequence of the

widespread shift in Canadian medical education away

from numerical and letter grades, in favour of a pass/fail

system. This may also be related to 9% of residency

programs not requiring medical school transcripts. The

requirement for submission of a comprehensive eye exam

in order to apply to residency programs in ophthalmology

and otolaryngology may not be known to many medical

students considering career options in the earlier years of

their undergraduate medical education.

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LP3 – 05, 60310

Understanding the perspectives of Indigenous medical

students as they approach opportunities for

postgraduate medical training

Brittany Schroeder University of Alberta, Kristin Black University of

Alberta, Cassandra Felske-Durksen University of Alberta, Rebecca Rich

University of Alberta

Background/Purpose: Indigenous Peoples are

underrepresented in Euro-Canadian medicine. In an effort

to address the need for substantive equality in

postgraduate training, the University of Alberta Ob/Gyn

residency program has developed an Indigenous

Admissions Pathway (IAP). The objective of this study is to

understand the postgraduate training goals of Indigenous

medical students.

Methods: Self-identified Indigenous students currently

enrolled in a Canadian medical school were invited to

participate in an electronic survey. Analysis included

descriptive statistics and a thematic analysis of open-

ended questions.

Results: Thirty-six participants responded to the survey.

Family medicine (66.7%), internal medicine (44.4%), and

Ob/Gyn (38.9%) are the most common intended

specialties. Factors that would influence trainee choice of

specialty include personal interest, work-life balance, and

community need. Trainees identified mentorship from

Indigenous physicians, community engagement, and

Indigenous Health electives as important complements to

an IAP. Participants were asked to describe factors which

would influence their choice to apply through an IAP and

eight themes were identified. All participants thought that

an IAP would have a positive impact on health care for

Indigenous patients.

Conclusions: This study supports the ongoing use of the

Ob/Gyn IAP. It highlights the goals and priorities of

Indigenous students and provides direction for medical

educators. An IAP must be accompanied by a robust

program of Indigenous professional development and

other effective, community driven initiatives to decolonize

postgraduate medical education. This study will be used

to improve the IAP with the ultimate goal of increasing

Indigenous representation in Ob/Gyn and improving

access to culturally safe care for Indigenous women.

LP3 – 06, 60740

Predictors of Matching Success for International Medical

Graduates in Canada and the USA: a Scoping Review

Natalia Reiner University of Toronto, Ryan T. Sless University of Toronto,

Umberin Najeeb University of Toronto,

Background/Purpose: A large number of International

Medical Graduates (IMGs) apply to Canadian and

American residency programs each year. However, there

is minimal information on objective criteria to guide IMGs

postgraduate application process. This scoping review

aims to guide future IMGs in residency applications, assist

postgraduate programs in the selection of IMG candidates

and identify areas for future research.

Methods: We conducted a scoping review of the literature

on IMG residency matching process in North America

based on the framework of Arksey and O'Malley. Three

electronic databases and grey literature were searched

using key terms yielding 799 articles. Following titles,

abstract and full-text screening 40 articles were chosen for

inclusion. Articles were analyzed to develop a meaningful

understanding of the criteria used for the IMG selection

process.

Results: There is heterogeneity of study designs and

selection programs. All the articles included identified

standardized test scores (United States Medical Licensing

Examination and Medical Council of Canada Exams) as

contributory factors to acceptance. Other important

factors included letters of recommendation from known

physicians, discussed in 60% of the papers, and clinical or

research experience in the country of application,

discussed in 53% of papers. However, findings also

indicate that despite achieving the above criteria IMG

status is strong dissuading factor in the matching process.

Conclusions: This review has identified several

contributing factors to the IMGs matching process.

However, there is limited literature from a Canadian

context. Further research is necessary to guide future IMG

applicants and postgraduate residency programs.

LP3 – 07, 60764

Training in Soft-Tissue Resection Using Real-Time Visual

Computer Navigation Feedback from Surgery Tutor: A

Randomized Controlled Trial

Boris Zevin Queen’s University, Gabor Fichtinger Queen’s University,

Joshua Del Papa Queen’s University, Tamas Ungi Queen’s University,

Meredith Poole Queen’s University

Background/Purpose: In competency-based medical

education (CBME), surgery trainees are often required to

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learn procedural skills in a simulated setting before

proceeding to the clinical environment. The Surgery Tutor

computer navigation platform allows for real-time

proctorless assessment of open soft-tissue resection skills;

however, the use of this platform as an aid in acquisition

of procedural skills is yet to be explored.

Methods: In this prospective randomized controlled trial,

20 final year medical students were randomized to receive

either real-time computer navigation feedback

(Intervention, n=10) or conventional simulation training

(Control, n=10) during simulated non-palpable soft-tissue

tumor resections. Real-time computer navigation allowed

participants to see the position of their scalpel relative to

the tumor. Each participant performed 7 resections. The

Surgery Tutor platform collected assessment metrics for

each resection.

Results: Training with real-time computer navigation

feedback resulted in a 0% positive margin rate as

compared to 30% with conventional simulation training (p

= 0.06). Participants in the Intervention group also

performed resections with less excised tissue [12.1(10.5-

15.4) vs. 20.3(15.6-22.9) g; p = 0.005], shorter distance

moved by the scalpel [8.95(7.84-11.0) vs. 11.6(10.3-12.4)

m; p=0.02] and fewer scalpel motions [163(139-212) vs.

226(213-254); p=0.01] as compared to the Control group.

After removal of computer navigation feedback, the

Intervention group maintained a 0% positive margin rate

indicating retention of learned skills.

Conclusions: Real-time visual computer navigation

feedback from Surgery Tutor resulted in superior

acquisition and retention of procedural skills as compared

to conventional simulation training.

LP3 – 08, 60812

Development of a Paediatric Residency Professionalism

Curriculum

Larissa Shapka University of Toronto, Simon Haney University of

Toronto, Marie-Pier Lirette University of Toronto, Shannon Willmott

University of Toronto, Gabriel Tse University of Toronto, Amy Zipurksy

University of Toronto, Natalie Jewitt University of Toronto, Michael

Weinstein University of Toronto, Adelle Atkinson University of Toronto,

Angela Punnett University of Toronto

Background/Purpose: Perceived lapses in professional

behaviours are becoming increasingly common in

residency programs. Research supports that skills in

professionalism can be taught through role-modelling and

structured curricula. To enhance professionalism in the

Paediatric Residency Program at the University of

Toronto, a novel curriculum was developed. The

curriculum aims to cover content that is immediately

relevant to residents, to facilitate recognition that

expectations and practice culture may differ, and to

incorporate evidence supporting professionalism training

through reflection, mentorship, and small-group learning.

Summary of innovation: The curriculum is comprised of

five case-based sessions/year. Each session focuses on a

different professionalism issue (requesting time off, use of

technology and social media, interprofessional

interactions, patient care, and boundaries). These themes

were generated from real-life examples of perceived

professionalism issues that were anonymously submitted

by residents and faculty and then framed by the

professionalism objectives outlined by the American

Board of Pediatrics. The curriculum aims to bring

residents, fellows, and faculty together to discuss

perceived lapses in professionalism in order to generate

open discussion, a shared understanding, and approaches

for promoting professional behaviours moving forward.

Conclusions: Professionalism is an essential component of

medicine and has been identified as a core competency in

medical education that improves patient outcomes. Our

novel curriculum aims to enhance professionalism training

by bringing staff and trainees together to facilitate

interactive, case-based professionalism discussions. The

curriculum is generalizable across a variety of subspecialty

programs and can be easily implemented. Participants

endorsed open discussion involving staff and residents,

cases that accurately reflected real life situations, and

effective take-home points.

LP3 – 09, 59474

Improving Residency Admissions using a Digital Tool

Sung Min Cho University of Toronto, Sebastian Kosch Plank

Optimization, Inc, Quincy Poon Plank Optimization, Inc, Fok-Han Leung

University of Toronto, Vanessa Rambihar University of Toronto

Background/Purpose: Residency admissions and

selection processes are a major responsibility of post-

graduate medical education programs. Coordinating and

evaluating hundreds of applicants can demand

tremendous financial and human resources on an annual

basis and significant amounts of time. Selection

committees must also simultaneously ensure that the

entire operation remains fair and reliable. A robust, online

admissions tool to coordinate the large scope and volume

of applications can help to address such challenges.

Summary of innovation: The Department of Family and

Community Medicine at the University of Toronto has

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undertaken a process to revolutionize our admissions

process by improving time efficiency for faculty, residents

and applicants, and increasing the reliability of our file

review and interview scores. These improvements have

been facilitated by the development of a dynamic, web-

based software platform designed to coordinate the

application, scheduling, scoring and ranking processes

involved in residency admissions processes, effectively

minimizing human error and improving efficiency of time

and available resources. Key features of our program are

as follows: 1) Automate the Recruitment and Assignment

of Reviewers and Interviewers; 2) Display Data to Staff in

Real-Time; 3) Facilitate Candidate Evaluation with One

Centralized Interface; 4) Guide Reviewers' Scoring with

Anchors and Interactive Cues; 5) Prevent Missed, Delayed

and Inaccurate Data; 6) Allow Score Revisions; 7) Flag

Extreme Score Discrepancies and Identify Hawks and

Doves.

Conclusions: Although every residency program has its

own unique challenges, the lessons learned in the

development of our software platform are generalizable

to programs across Canada given the overall similarities in

residency application and selection processes.

Undergraduate

LP4 – 01, 60510

Explaining Mental Illness Stigma in Canadian Medical

Students: A Nationwide Study

Angelo J. Canty McMaster University, Morgan L. Glass McMaster

University, Rebecca Voth McMaster University

Background/Purpose: 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.

Methods: 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.

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.

LP4 – 02, 60837

Differences in debt load of Canadian medical students by

race, ethnicity, and rurality

Rishad Kan University of Toronto, Shannon Sibbald Western University,

Goli Reza-Rashti Western University, Ji Yun (Jenny) Lee Western

University, Khalidha Nasiri Western University,

Background/Purpose: The cost of medical education has

risen significantly in Canada. The aim of our study is to

explore the differences in socioeconomic status,

indebtedness, and financial behaviours and stress

between various ethnic groups, and by rurality.

Methods: We conducted a cross-sectional survey among

medical students at fourteen English-speaking medical

schools across Canada. We used descriptive statistics and

chi-square tests to identify covariates significantly

associated with our primary outcome measure:

anticipated total debt above $100,000 upon graduation.

Multivariate logistic regression models were fit to

determine whether race and ethnicity and rural status

were significant predictors of medical student debt. Due

to insufficient sample size, regression analyses did not

include Black and Indigenous students.

Results: In total, 830 (62.8%) of students reported an

anticipated debt of over $100,000. By race and ethnicity,

641 (67.1%) were White; 11 (50%) were Black; 88 (57.9%)

Chinese; 27 (56.3%) Indigenous; and 68 (56.7%) were

South Asian. By rural status, the proportions were Urban

(547; 64.9%) and Rural (283; 59.1%). Compared to White

students, Chinese (OR: 0.44, 95% CI: 0.30, 0.65) and South

Asian ethnicities (OR: 0.48, 95% CI: 0.30, 0.68) were

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associated with lower odds of anticipated debt exceeding

$100,000. There was no statistically significant difference

in debt levels between urban and rural status.

Conclusions: Chinese and South Asian medical students

were significantly less likely to report anticipated debt

compared to White students.

LP4 – 03, 60866

Experiences of Physicians in Rural Practice: A Human

Library Approach

Rebecca Malhi University of Calgary, Javeria Shafiq University of Calgary,

Aaron Johnston University of Calgary

Background/Purpose: Medical institutions across Canada

have implemented various strategies to address the

critical shortage of rural physicians. It is important to

encourage urban-origin medical students to consider rural

practice. However, many urban-origin medical students

have little knowledge of rural life, often relying on

generalizations and stereotypes. Such inaccurate or

negative beliefs may dissuade them from considering rural

practice. We are evaluating a novel medical education

approach - the Human Library - to increase medical

students' knowledge of rural medicine and rural life.

Methods: The Human Library mimics the format of a

regular library with readers borrowing books, except that

the books are human volunteers who share personal

experiences. To test the concept in medical education, we

hosted two online Human Library events in October 2020.

We recruited 9 Books - physicians in rural practice - to

discuss a particular aspect of their lives. Interested

Readers (medical students, faculty, etc.) were able to ask

questions about each Book's experiences. Post-session

surveys were used to determine the appeal and

effectiveness of the Human Library approach, and to

highlight areas for improvement.

Results: Our preliminary analysis found that attendees at

the online events were highly satisfied, and indicated that

they received valuable information from the Books. This

suggests the validity of using the Human Library concept

for medical education purposes.

Conclusions: An in-person Human library event is planned

for Spring 2021 for undergraduate medical students.

Residents have also expressed interest for a similar

session. Successful Human Library events challenge the

perceptions and attitudes of medical learners, perhaps

opening their eyes to new possibilities in rural practice.

LP4 – 04, 59688

Parental Leave Policies in Canadian Undergraduate

Medical Education: A Policy Review

Elizabeth Burden University of British Columbia, Rohit Singla University

of British Columbia, Laura Farrell University of British Columbia

Background/Purpose: Canadian medical schools have

increasingly diversified their admissions processes to

allow for a demographic mix. Successful progression of all

students requires supports such as parental leave policies.

This work reviews the current parental leave policies in

Canadian Undergraduate Medical Education (UGME),

determines existing gaps, and provides recommendations

for pan-national consistency and support.

Methods: We obtained any applicable policies and any

other relevant information regarding parental leave from

12 Canadian UGME programs. Two coders then

individually reviewed all information, extracted core

themes, and identified positive and negative aspects.

Findings were compared across medical schools. Results

were reviewed by a senior faculty member.

Results: Key themes included issues pertaining to

confidentiality, inclusive diction, duration, and

accommodations. Two institutions acknowledged non-

traditional parental dynamics. The duration of short-term

leave before necessitating a full year Leave of Absence

(LOA) was variable with a median of 5 weeks (range 1-8

weeks). Three institutions have policy on

accommodations (eg. lactation rooms); however, this was

not consistent across the country.

Conclusions: To support the increasingly diverse UGME

classes, it is recommended that Canadian medical schools

include policy that provides clarity and maintains

inclusivity with support to the student as the ultimate

priority. There are discrepancies across programs which

indicate a need to develop comparable policies. Academic

plans detailing planning and returning from the parental

LOA, including accommodations (on-call shifts, ER shifts,

lactation rooms), would be beneficial to students if

represented in policy.

LP4 – 05, 59886

Investigating Medical Student Technology Readiness and

the Role of Technology on Career Planning

Thomas A. Skinner Dalhousie University, Eric Poon Dalhousie University,

Wyatt MacNevin Dalhousie University

Background/Purpose: Technology Readiness (TR) is a

metric which quantifies an individual's inclination to use

and interact with new technology. Although technology

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use in healthcare and medical education is rapidly

increasing, the TR of medical students has yet to be

thoroughly examined. Furthermore, the role of

technology use on career planning and specialty interest

exists as an area in medical education which has yet to be

explored. This study examines TR of 2nd year medical

students before entry to clerkship, and investigates

technology use as a career factor.

Methods: A survey assessing 2nd year medical student TR,

specialty interest, and the influence of technology use on

career planning using a Likert scale was distributed at a

Canadian Medical School (Dalhousie University).

Demographic factors, TR scores, and specialty interest

were analyzed using Chi-square analysis and descriptive

statistics.

Results: Students identifying as male were more likely to

be influenced by technology use when making career

decisions when compared to female students (3.62/5.00

vs 2.84/5.00, p < 0.05). Students identifying as male were

also more likely to be technology ready compared to

female (95.2% vs 68.8%, p < 0.05). As a cohort, 79% of

students were technology ready. When analyzing

specialty interest, interest in Urology was associated with

students with positive TR scores (94.4%, p < 0.05).

Conclusions: With knowledge of technology use as a

career factor, medical student career counseling

approaches can be better designed to align with student

interests. Furthermore, educational initiatives focused on

technology use may be implemented for identified

student groups to improve comfort and best prepare

students for clerkship and future practice.

LP4 – 06, 60534

Ready or not? Investigating student perspectives on the

transition to clerkship at the University of Ottawa Faculty

of Medicine

Stefan de Laplante, University of Ottawa, Neel Mistry University of

Ottawa, Craig Campbell, University of Ottawa

Background/Purpose: The transition from pre-clerkship

to clinical clerkship is a pivotal moment for many medical

students. At the University of Ottawa Faculty of Medicine,

Unit IV (final unit of pre-clerkship) and the Link Block

(preliminary unit of clerkship) are designed to facilitate

this change. Improvements to the current medical

curriculum may help to better prepare students for

clerkship. This includes prioritizing active learning over

passive learning, focusing on cognitive integration in pre-

clerkship, building on subject complexity via a life-cycle

approach, and associating weekly clinical skills sessions

with case-based learning. This study aimed to (1) identify

and synthesize literary evidence on the transition from

pre-clerkship to clerkship in a four-year medical program,

and (2) design a survey to obtain student feedback on

clerkship preparedness at the University of Ottawa Faculty

of Medicine.

Methods: Two literature searches were conducted in

PubMed. Articles were restricted to those published in the

last decade; containing an abstract and full text; involving

human subjects; and written in the English language. 14

records were included in the combined literature review.

An anonymous survey, consisting of multiple-choice

questions; Likert-type scale (1 = "strongly disagree" or

"not at all confident" to 5 = "strongly agree" or "extremely

confident"); and free text questions, was created using

Survey Monkey.

Results: Studies were classified into three categories:

needs-assessment only, needs-assessment with next

steps, and quality improvement. Students with clinical

skills training reported an easier transition to clerkship. A

survey assessing students' comfort with the existing

curriculum and recommendations for curricular reform

was designed for dissemination to second-, third-, and

fourth-year medical students, as well as MD/PhD

students, in both the Anglophone and Francophone

streams at the University of Ottawa.

Conclusions: Based on our literature review, the transition

to clerkship was described as difficult and one requiring

quality improvement. Student responses to the survey will

help guide curricular reform to improve clerkship

preparedness at the University of Ottawa Faculty of

Medicine.

LP4 – 07, 60699

Perceived academic workload and its relationship

between the real and declared academic workload

José Peralta Doctor of Medicine, Universidad de Chile, Natalia Harden

Sociologist, Universidad de Chile, Carla Codoceo Sociologist, Universidad

de Chile, Sebastián Buzeta Sociologist, Universidad de Chile

Background/Purpose: Academic Workload (AW) is a

central phenomenon in management processes of higher

education institutions. Several studies show discrepancies

between declared workload in course programmes and

the workload students experience, also called real

workload. Nevertheless, literature emphasizes students'

perceptions of AW as a better measure of workload.

Disclosing eventual discrepancies between these three

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types may help detect curricula problems threatening the

quality of processes. This study sought to characterize the

relationship between perceived and declared AW and

between perceived and real AW of undergraduate

students of University of Chile's Faculty of Medicine.

Methods: We applied a survey to 500 students and used

institutional data to compare these results with the

workload declared in their course programmes. To test

this, descriptive statistical analysis were performed.

Results: Perceived AW shows a mean that sets the

perception between adequate and high. A positive

relationship was found between all three types of

academic workloads. Perceived AW correlates with real

AW (0.596) higher than with declared AW (0.380). Looking

closely at real academic workload, non-contact hours

revealed a more significant correlation with perceived AW

than contact hours (0.557 and 0.475 respectively).

Conclusions: Although literature generally indicates that

perceptions of workload are weakly related to real hours

of work, our findings say otherwise. Furthermore, the fact

that non-contact study hours are the ones that correlate

the most with perceived AW, suggests the relationship

between real AW and perceived AW is worthy of deeper

examination. Future research should explore real AW

considering which factors are negatively affecting the

autonomous work.

LP4 – 08, 60607

Descriptive analysis of the medical student population at

the University of Ottawa

Julia Lauzon University of Ottawa, Etienne Rheaume University of

Ottawa, Nicholas Brunet-Filion University of Ottawa, Salomon Fotsing

University of Ottawa, Manon Denis-Leblanc University of Ottawa,

Kathryne DesAutels University of Ottawa

Background/Purpose: A diverse medical school

population enhances student preparedness and

motivation to care for underserved communities. We

recognized a lack of information regarding class profiles of

the University of Ottawa medical students compared to

statistics released by other Canadian medical schools. Our

purpose was to collect and report this data to increase

transparency of diversity amongst medical students.

Methods: An online questionnaire was developed to

encompass the demographic, educational and socio-

economic background of uOttawa cohorts MD2020-

MD2023, with the link distributed from February to May

2020.

Results: The response rate was 63%, and 65% were

female. The most represented age group was 21-23 (71%).

A majority completed a 4-year degree (59%) and 80% had

a GPA of 3.9-4.0. There was an under-representation of

Black and Aboriginal students (2.7%, 0.5%), and an over-

representation of Asian/Pacific Islanders (22%), as

compared to data from the latest Canadian census. Only

8% of students overcame financial barriers, with 55%

having a household income of over $100,000. 24%

overcame social barriers and 8% educational barriers.

Respondents were diverse in spoken language (23%),

immigrant status (20%) and visible minority status (36%).

A majority of students (63%) wished to know more about

uOttawa's medical candidates at the time of their

application.

Conclusions: While the medical student population at the

University of Ottawa is indeed diverse, noticeable

differences remain when compared to the Canadian

population. Increasing the transparency of medical

student diversity is desirable by the majority of

respondents and could promote the University's social

accountability.

LP4 – 09, 60882

The diversity of medical school applicants and students at

the University of Ottawa: a retrospective cohort study

Itai Malkin McMaster University, Timothy J Wood University of Ottawa,

Isabel Eisen University of Ottawa, Genevieve Lemay University of

Ottawa, Chantal Renaud University of Ottawa

Background/Purpose: It is critical to have medical

students who are reflective of the Canadian population.

Medical students from underrepresented groups are

more likely to become physicians for minority populations

and patients experience better quality of care when their

physicians have similar backgrounds to their own. Despite

these benefits, Canadian medical student and applicant

demographics are not well defined. The purpose of this

study was to explore medical student and applicant

diversity at the University of Ottawa from 2013-2019.

Demographics explored included: age, race, ethnicity,

socioeconomic status, sexual orientation, gender identity,

disability and rurality.

Methods: Voluntary diversity surveys were provided to

medical students and applicants. Survey data was

analyzed using descriptive statistics.

Results: From 2013-2019, 465 medical students and 5007

applicants completed the survey. Majority of medical

students and applicants were 21-25 years old (87% and

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77%) and few identified as LGBTQ+ (7% and 13%) and had

a disability (6% and 5%). Compared to 2016 Canadian

Census data, medical students and applicants were less

likely to be Indigenous, Black and Filipino and have a

disability (p<0.05). Medical students (62%) were more

likely to have a parental income of >$100000/year

compared to Canadian households (32%). Medical

students and applicants did not differ on Indigenous (3%

and 1%), Black (2% and 4%) and Filipino (0.4% and 0.9%)

identity and disability (p>0.05). Compared to applicants,

medical students were more likely to live in a rural area

(14% and 8%) (p<0.05).

Conclusions: Although applicants and medical students

were similar, both differed from the Canadian population.

Considering the results, more initiatives should be

implemented to encourage a more representative

applicant pool and student body.

Impacts of COVID-19

LP5 – 01, 60918

Impacts of COVID-19 on Curricular Changes on Medical

Student Wellness

Celeste Suart McMaster University, Rachel Trites Queen’s University,

Anique Le Roux Queen’s University, Renee Fitzpatrick Queen’s

University, Theresa Nowlan Suart Queen’s University

Background/Purpose: 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.

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 responses. 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.

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.

LP5 – 02, 60618

The Impact of COVID-19 on Resident Medical Education

in Canada: A Systematic Review

Stewart Spence University of Ottawa, Miranda Wan University of

Calgary, Sabrina Spence Brock University, Melissa Wan Queen’s

University

Background/Purpose: The novel coronavirus pandemic

(COVID-19) has had an unprecedented impact on the

Canadian medical education system, particularly for

resident trainees. This systematic review aimed to explore

the impact of COVID-19 on resident physician training in

Canada.

Methods: The PubMed, MEDLINE, and CENTRAL

databases were queried using keywords (COVID-19, SARS-

CoV-2, residency, medical education, Canada). Articles

from December 2019 to September 2020 were included.

Literature screening and data extraction were conducted

by two independent reviewers. A descriptive summary of

the themes, goals, challenges, and response strategies to

the COVID-19 pandemic was generated.

Results: After screening 141 articles, 8 articles met

inclusion criteria. Thematic analysis demonstrated three

main goals: 1) maintenance of training; 2) promotion of

wellness; and 3) reducing trainee exposure. The most

common challenges were: 1) reduction of exposure during

clinical encounters; 2) avoiding unnecessary exposures;

and 3) redeployment to auxilary rotations. The most

common response strategies were: 1) transitioning to

virtual teaching; 2) reducing cross-site coverage with

back-up call systems; and 3) improving communication

between leadership and residents. Additionally,

innovative solutions developed in response to the

pandemic improved gaps in healthcare pre-pandemic.

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Conclusions: The COVID-19 pandemic has significantly

impacted the medical training of physicians in Canada. The

main goals, challenges, and successful response strategies

implemented by various residency programs across

Canada were identified. As the COVID-19 pandemic

continues to evolve, residency programs will need to

continue to adapt, innovate, and implement strategies to

continue to provide exceptional medical training.

LP5 – 03, 60745

Initial Impact of COVID-19 on Postgraduate Pediatric

Trainees: What We Know So Far.

Ereny Bassilious McMaster University, Michelle Schneeweiss McMaster

University, Mohammad Zubairi McMaster University

Background/Purpose: The COVID-19 pandemic has

impacted medical education, including increased reliance

on virtual consults and the requirements to wear Personal

Protective Equipment (PPE) for in-person settings. We

sought to understand how the changes brought on by

COVID-19 affected the learning environment of

postgraduate trainees.

Methods: A web-based questionnaire consisting of 15

questions was sent to postgraduate trainees within the

Department of Paediatrics at McMaster University over 6

blocks of clinical rotations. The survey was designed as a

quality improvement initiative.

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%), scheduling challenges (29.9%)

and a lack of teaching (27.3%). Many trainees expressed

that low patient volumes and lack of physical exam

practice hindered their learning. Some trainees found the

use of PPE during in-person consults to hinder verbal

communication, and that it was challenging not to

physically connect with patients.

Conclusions: Most trainees felt their learning goals were

met despite abrupt program changes. A number of

challenges were identified, and recognition of these may

help curriculum developers to adapt educational

programs and mitigate disruptions during subsequent

'waves' of COVID-19. These changes may be especially

important to implement as the transition to Competency

By Design Programs becomes more prominent.

LP5 – 04, 60298

Level of Knowledge in the COVID-19 Pandemic: A Cross-

Sectional Survey of Canadian Medical Students

Kacper Niburski McGill, Keith Todd McGill, Rachel Vaughan McGill

Background/Purpose: During health crises medical

education is often derailed as was the case during the

current COVID-19 pandemic. Medical trainees face the

daunting task of having to gather, filter and synthesize

new information about the evolving situation often

without the standardized resources they are used to.

Methods: We surveyed Canadian medical students, in the

hardest hit province of Quebec, on how they were

acquiring knowledge as well as what they knew of the

pandemic. Google Forms was used, with the survey being

distributed to each medical school in Quebec (McGill,

ULaval, Udem) both through email and through social

media pages for each class year. Two analyses, Mann-

Whitney and ANOVA tests, were performed for year of

study and degree obtained.

Results: We received responses from 111 medical

students from three universities, which represents 5% of

the students invited to complete the survey. Students

reported using mass media most frequently (83%) and

also had a high rate of use of social media (to gather

information about the pandemic. They rated these

resources low in terms of their trustworthiness despite

the high rates of use (average 2.91 and 2.03 of 5

respectively). Medical students also endorsed using more

formal resources like public health information, scientific

journals and faculty-provided information that they

trusted more, however, they accessed these resources at

lower rates. Of note, medical students had correct

answered 60% of COVID-19 prevention strategies, 73%

clinical correct answers, 90% epidemiological correct

answers. Additionally, students who were training in the

larger city of Montreal, where the worst of the outbreak

was focused, tended to significantly perform better

(p<0.0001) than their colleagues who were not located

there.

Conclusions: These finding indicate a wide use of

information resources intended for public consumption

rather than more rigorous and trustworthy sources.

Furthermore, there seems to be a knowledge gap amongst

medical students responding to this survey that suggests

an opportunity to improve the delivery of educational

content during this rapidly evolving pandemic.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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LP5 – 05, 60775

Introducing a COVID-19 ethics curriculum for medical

students, by medical students: harnessing an integrative

and collaborative approach

Jane Zhu University of Toronto, Alexandra Florescu University of

Toronto, Bernice Ho University of Toronto, Grace Xu University of

Toronto, Erika Abner University of Toronto, Clare Hutchinson University

of Toronto, Angela Punnett University of Toronto

Background/Purpose: During the COVID-19 pandemic,

debates have arisen surrounding the equitable allocation

of scarce resources. Regulatory frameworks often reflect

different principles and values, creating moral dilemmas

for healthcare providers. With this in mind, our goal was

to provide a "Return to Clerkship" (RTC) program to third-

year medical students on ethical considerations

surrounding the COVID-19 pandemic, focusing on issues of

resource allocation and equity. We formed a diverse

working group consisting of medical students and faculty

leads, with curricular content spearheaded by a group of

medical students who developed a COVID ethics resource

repository.

Summary of innovation: Our instructional approach

consisted of an introductory lecture surrounding the

ethics of resource allocation during COVID, a small-group

case-based discussion to engage students in applied

decision-making, and an expert panel to highlight real-life

ethical dilemmas in the pandemic. Just-In-Time teaching

was implemented by providing students and tutors with

materials to ensure preparedness for the sessions.

Conclusions: This curriculum highlighted the role of

integrating a multi-modal approach in medical education

and the important role of medical students in co-

developing curricula. Overall, while students seemed to

enjoy the discussion and real-life application of ethics

afforded by the case analysis and panel, they had mixed

responses to the theoretical content of the introductory

lecture. Differing levels of ethical and medical knowledge

led to discrepancies in understanding, but preparatory

materials and seminars contributed to better learning.

This project provides a strong basis for future

collaborative endeavours between faculty and students in

medical education and reinforces the importance of

education on timely ethical issues.

LP5 – 06, 60725

Using Virtual CPD to Build Addictions Capacity in Ontario

during COVID-19

Megha Vatsya Centre for Addiction and Mental Health, Sarah Bonato

Centre for Addiction and Mental Health, Jenny Hardy Centre for

Addiction and Mental Health, Sanjeev Sockalingam University of

Toronto, Nitin Chopra University of Toronto, Alysha Prata Centre for

Addiction and Mental Health, Jean-Paul Michael Unity Health Toronto,

Wiplove Lamba University of Toronto, Nitin Chopra University of

Toronto, Cheryl Pereira Centre for Addiction and Mental Health, Jennifer

Carroll Centre for Addiction and Mental Health, Natalie Kelly Centre for

Addiction and Mental Health

Background/Purpose: The COVID-19 pandemic has left

individuals who use substances (IWUS) more vulnerable.

Increased susceptibility to infection, alongside limited

clinical addictions expertise, has exacerbated challenges

with access to appropriate care, and highlighted need for

capacity building in addictions care.

Summary of innovation: Project Extension for Community

Healthcare Outcomes-Ontario Addiction Medicine and

Psychosocial Interventions (ECHO-AMPI) is a virtual

continuing professional development (CPD) program

supporting healthcare professionals (HCPs) working with

IWUS during COVID-19. ECHO-AMPI connects an inter-

professional team of subject matter experts with Ontario

HCPs weekly to discuss client cases and best practices in

supporting IWUS. ECHO-AMPI's impact on building

addictions care capacity was evaluated using Moore's

evaluation framework for CPD. Satisfaction was assessed

after each session using a five-point Likert scale. For

learning/competence, participants rated their confidence

in competencies pre- and post-participation using a 0-100

confidence scale. Competencies reflected assessment,

treatment and management of addictions. Post-ECHO,

participants self-reported whether ECHO-AMPI

participation changed their practice, and described these

changes, both in general and in the context of COVID-19.

ECHO-AMPI comprised of 79 HCPs from 62 organizations

across Ontario. Average session attendance was 54

participants. Mean satisfaction scores were high

(>4.24/5), and there was a 12% improvement in

participants' confidence in addictions care (p<.001). 77%

of participants reported changing their practice following

participation.

Conclusions: Our findings suggest ECHO-AMPI is an

effective educational intervention that builds HCP

confidence and capacity to support IWUS during COVID-

19. High participant engagement and satisfaction scores

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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demonstrate that addictions care-focused CPD can be

successfully delivered virtually during COVID-19.

CME & Faculty Development

LP6 – 01, 60929

Assessing the Environment for the Implementation of a

Global Health Continuing Professional Development

(CPD) Program in Africa: An Environmental Scan.

Elizabeth Wooster University of Toronto, Jean Marc Bourque University

of Ottawa, Christiane Hache University of Ottawa, Manon Lacelle

University of Ottawa, Marc Gaudet University of Ottawa, Lesley Buckley

University of Ottawa

Background/Purpose: In 2019, a radiation oncology team

at a Canadian urban medical centre was asked to develop

and implement a global health continuing professional

development (CPD) program in Africa. To inform program

development, a narrative literature review was

conducted. The following questions were examined: what

is the current environment for global health education

(GHE)continuing professional development programs and

which programs exist in the radiation oncology specialty,

what roles do they fulfill and what are their theoretical

and structural underpinnings.

Methods: MedLine, ERIC and the Cochrane Database

were searched using the following terms: global health,

global health education, African healthcare, continuing

professional development, blended learning, guidelines.

Relevant articles were reviewed in their entirety.

Results: The literature review yielded the groupings:

current environment of global health, global health

education and global health education in the field of

radiation oncology. Furthermore, this review identified

deficiencies in the current literature. These include: no

consensus on a definition for global health, the focus of

GHE on undergraduate and post graduate medical

education, focus on development of GHE competencies,

lack of description of the structures and theoretical

underpinning of current GHE initiatives, and finally, a lack

of grounding of the GHE programs in local environmental

factors.

Conclusions: While there has been an increase in the

number of publications focusing on GHE and GHE CPD,

there remain numerous deficits in the current literature.

These gaps provide opportunities and areas of focus for

those interested in GHE research and program

development

LP6 – 02, 60326

Evaluating the impact of a trauma-informed care

workshop for palliative care providers

Katherine Liu University of Calgary, Simon Colgan University of Calgary,

Amanda Roze des Ordons University of Calgary

Background/Purpose: Traumatic experiences have

physical and psycho-spiritual implications for patients

with palliative care needs. It can affect their ability to trust

others, exacerbate symptoms, and lead to avoidance of

conversations related to end-of-life. Previous research in

other disciplines suggests the benefit of education for

clinicians on trauma-informed care (TIC). TIC recognizes

the impact of trauma and its' impact on health, and

responds by adapting practices to facilitate healing and

prevent retraumatization. This study evaluated the impact

of an interprofessional workshop on trauma-informed

approaches to palliative care on participants' self-rated

measures of working with patients who have a history of

trauma.

Methods: Participants completed a pre-workshop needs

assessment, a pre-post workshop survey of self-rated

measures of impact, and a 2-month post-workshop survey

to evaluate longer-term impact. Responses were analyzed

using statistical and thematic analysis.

Results: In total, 37 palliative care clinicians (a

combination of nurses, physicians, residents, and grief

counsellors) attended the session. Triangulation of survey

responses and qualitative data showed an increase in

participants' self-reported awareness and understanding

about the importance of TIC, their knowledge and

confidence in applying a TIC approach, and attitudes

towards incorporating TIC in their practice.

Conclusions: This study demonstrated that a TIC

workshop had a favourable impact on participants' self-

reported measures of applying a TIC approach in their

clinical palliative care practice. Future research is

warranted to examine the impact of the workshop on

patient outcomes.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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LP6 – 03, 60716

Navigating physician education: Curriculum mapping

gives new directions to continuing professional

development courses

Robert Parson University of Ottawa, Paul Hendry University of Ottawa,

Jessie Thuswaldner University of Ottawa, Heather Lochnan University of

Ottawa

Background/Purpose: Family physicians must maintain

competence over a broad range of topics to ensure quality

care for their diverse populations. Continuing professional

development (CPD) courses provide one avenue for family

physicians to stay up-to-date in their knowledge and skills.

Curriculum mapping is a useful way to analyze the course

offerings and determine to what extent the objectives

align with the vast array of competencies required of

family physicians. The map can be used by planning

committees as part of their needs assessment process.

Methods: Using Microsoft Excel, we compiled a total of

547 individual presentations from the 36 different CPD

courses that took place between 2017-2019. We mapped

these courses to a list of competencies for family

physicians developed by consensus of stakeholders. We

assigned a single point to each time a competency was

addressed in a presentation's learning objectives. Analysis

of these results was done to inform future planning.

Results: Among the 547 presentations reviewed,

competencies met most often were within the broad and

overlapping categories of "Care of the Adults" (85.9%) and

"Family Medicine Expert" (90.4%). Competencies met the

least often were mapped to the categories of "End-of-life-

care" (0.9%) and "Maternity and Newborn care"(2.4%).

Within the nonmedical expert CanMEDs categories Health

Advocate (4.9%) and Professional (5.7%) were lowest.

Conclusions: Curriculum mapping is a useful tool to

identify gaps in competencies. This can be used as a

guideline when designing learning objectives for future

CPD courses. The results can also facilitate reflection on

why some competencies are over or under-emphasized.

LP6 – 04, 60611

Development of a mobile application to increase

motivation, engagement and teaching activity of clinical

faculty using gamification principles.

Aazad Abbas University of Toronto, Sarah McClennan University of

Toronto

Background/Purpose: A fundamental pillar of an

academic healthcare institution is a commitment to

excellent medical education. However, compared to

research and patient care roles, clinician teachers have

historically felt undervalued and under appreciated.

Research has shown that clinician teachers are intrinsically

motivated for their work, but there is a lack of institutional

recognition for their contributions to medical education.

In our large community hospital with an academic

mandate, we propose to recognize and reward the efforts

of clinician teachers using a mobile application based on

gamification algorithms.

Summary of innovation: Together with Google's Firebase

console API and the cross platform and open-source

development framework Ionic, we developed a mobile

application named TutorTracker. Teaching data is

extracted from the education office spreadsheets and

algorithmically synchronized with the secure online

database. Currently available on both the iOS and Android

application stores, physicians may easily track their clinical

teaching using various parameters such as hours of

teaching, date, subject and course. The application

rewards physicians using virtual badges, for quantity and

diversity of teaching and provides a summary of the

physician's clinical teaching history. This allows physicians

to easily submit yearly hospital and university renewals, as

well as document yearly continuing medical education

(CME).

Conclusions: Gamification principles have been effectively

implemented to construct a mobile application allowing

clinician teachers to track and be rewarded for their

educational responsibilities. Next steps would be to

evaluate the application utilization and satisfaction, assess

change in physician teaching and implement higher level

gamification algorithms.

LP6 – 05, 60662

Exploring the experiences of healthcare leaders from

diverse professional backgrounds

Beverly Bulmer University of Toronto, Stella Ng University of Toronto,

Emilia Kangasjarvi University of Toronto, Ryan Brydges University of

Toronto, Betty Onyura University of Toronto, Alannah Mulholland

University of Ottawa, Susan Lieff University of Toronto

Background/Purpose: The professional profiles of senior

healthcare leaders have grown increasingly diverse in

recent years. However, research in other domains has

shown that diversifying membership does not necessarily

address equity and inclusion. Our intent was to

understand the experiences of leadership executives that

come from professional backgrounds other than medicine

and nursing.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Methods: We conducted a phenomenographically

informed qualitative study, interviewing 14 participants.

Inclusion criteria included 1) holding a senior leadership

position in an Ontario hospital and 2) having a professional

background outside of nursing or medicine.

Results: Common identities and journeys to leadership

were identified as three overlapping categories: the

emancipatory journey of the champion leader, the

unexpected journey of the discovered leader, and the

practical journey of the utilitarian leader. Participants had

diverging perspectives on the importance of clinical

knowledge, and felt their individual expertise contributed

to their success. Generally, participants with healthcare

experience tended to disregard their previous identity,

while those possessing business backgrounds embraced

theirs.

Conclusions: If health sciences genuinely value

professional diversity, opportunities to support

experiences of professionals with non-health and allied

health backgrounds in hospital settings need attention.

Mentorship supports focusing on individuals are required,

but this isn't enough. To promote unique and diverse

perspectives in healthcare leadership spaces, cultural and

structural changes must lead the way. Leadership

programs may need to attend not only to developing

diverse teams but also to genuinely embracing this

diversity in hospital settings.

LP6 – 06, 60922

Barriers and Facilitators to Participating in Research at a

Distributed Medical School Campus

Jennifer Tsang McMaster University, Maroof Khalid McMaster

University, Jennifer Leigh Queen’s University

Background/Purpose: Michael G. DeGroote School of

Medicine (McMaster) is a Canadian medical school with

multiple distributed campuses. These campuses provide a

unique learning experience, with core training and

research opportunities driven by local faculty. Little is

known about differences in research participation at

distributed compared to central campuses. Our study

explores students' perceptions of research and perceived

facilitators and barriers. Our primary objective was to

determine if significant differences exist in attitudes

between campuses.

Methods: Medical students at McMaster voluntarily

participated in this cross-sectional study. A survey of 39

closed-ended questions was distributed via email and

social media. Descriptive statistics were used along with

Mean Likert scores, with responses grouped in agreement

(Likert 4/5) and disagreement (Likert 1/2). Univariate

analysis with Mann-Whitney test determined statistical

differences.

Results: Attitudes towards research were similar between

campuses. Research was motivated by goals of obtaining

residency (63%). Barriers included lack of time (31.5%),

and difficulty in finding a project (44.5%). Many felt

training in research methodology and scientific literacy

was inadequate (93.1% and 89% respectively). More main

campus students thought research was important for

their future career goals (75% vs 65.5%), and that it should

be an important criteria in attaining residency (17.1% vs

8.6%); however, neither of these were statistically

significant.

Conclusions: This study is one of the first to find that there

are similarities in research participation and attitudes

between main and distributed campus medical students

in Canada. As enrollment increases, medical schools are

likely to increase distributed sites and our findings may

help with future planning.

Teaching & Learning with Technology

LP7 – 01, 60306

Assessing clinical reasoning via virtual technology

Veronique Phan Université de Montréal, René Wittmer Université de

Montréal

Background/Purpose: The UGME of Université de

Montréal has been offering to students suspected to have

clinical reasoning difficulties a session at the simulation

center. During the session, a student is observed by two

experienced clinicians during a history and physical

examination (PE) of two scripted clinical scenarios using

standardized patients. Clinical reasoning is assessed at

three different moments (after the history taking, the PE

and the final communication with the patient). At the end

of the session, feedback is communicated to the student.

Due to social distancing during COVID-19, all simulation

activities at the sim center were suspended.

Summary of innovation: Supervisors from the program

conducted an adapted simulated session using Zoom ®

with a referred student. Clinical reasoning was evaluated

using the same clinical scenarios which did not need to be

adapted. PE had to be modified since it could not be

observed. Instead, the student had to explain the

rationale for selecting examination techniques relevant to

the case. No standardized patient was used. Each

supervisor played in turns the role of the patient while the

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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other observed the simulated clinical encounter. Results:

Assessment of clinical reasoning, as well as

communication were successfully assessed via virtual

technology. PE assessment was adapted but clinical

reasoning associated with the selection of appropriate

exams relevant to the case could be assessed.

Conclusions: Assessment of clinical reasoning of medical

students using virtual technology is a feasible alternative

when availability of the simulation center is limited or

when social distancing is required.

LP7 – 02, 59670

The Use of "Patchwork Text" Written Assignments

Encourage Reflective Practice in a Simulation-based

Resuscitation Curriculum

Timothy Chaplin Queen’s University, Mirna Attalla Queen’s University

Background/Purpose: Learners are actively engaged if

they are involved in their assessment process. Simulated

learning provides a safe environment to encourage

reflective practice. The Patchwork Text (PT) assignment

format encourages self-assessment and demonstration of

reflective practice. The aim of this study was to assess the

quality of self assessment after the implementation of

assigned written reflections.

Methods: 50 junior residents participated in the

Nightmares Course-a longitudinal multidisciplinary

simulation-based curriculum for training in resuscitation.

Participants completed a pre-course questionnaire to

identify their learning goals. 25 residents were allocated

to the Patchwork Text group and 25 were allocated to the

control group. Following each simulation session, the PT

group were assigned written reflections based on their

identified learning goals. After completing the course,

participants completed a survey to provide their self-

assessment. A thematic analysis was conducted to identify

differences in the number and quality of themes that

emerged. The PT group also completed a survey regarding

the impact of the assignments.

Results: In the PT group, the major themes that emerged

regarding leadership skills included "Communication

Skills", "Approachability" and "Decisiveness". For

teamwork skills, the major themes included

"Adaptability," "Engaging in Role," and "Communication

Skills." In the control group, the major theme that

emerged for both leadership and teamwork skills was

"Communication Skills". 21 (84%) of PT participants

indicated that the assignments helped achieve their

personal learning goals and 16 (64%) found that it

augmented their feedback during their post-simulation

debrief. The benefits that the PT group identified included

encouraging reflective practice and clear identification of

and focus on learning goals. 18 (72%) of the PT group

recommended including written reflection for the future

Nightmares Course.

Conclusions: The Patchwork Text assignment format can

be used to encourage reflective practice and higher

quality of self-assessment regarding the development of

teamwork and communication skills in simulation-based

learning of resuscitation.

LP7 – 03, 60793

"The Airwayve Podcast": a novel, accessible, student-led

anesthesia podcast for medical students

Puru Panchal McMaster University, Alexa Caldwell McMaster

University, Grace Martin McMaster University, Nicholas Timmerman

McMaster University, Jordan Albaum McMaster University, Sean Xia

McMaster University, Gwendolyn Lovsted McMaster University, Daniel

Cordovani McMaster University

Background/Purpose: Medical students remain

underexposed to anesthesiology before clerkship. There is

a paucity of accessible educational materials in anesthesia

geared towards medical students and the COVID-19

pandemic has compounded this issue further by

restricting clinical access to anesthesia. Together, these

factors pose a barrier to foundational learning and career

exploration.

Summary of innovation: As the first of its kind, "The

Airwayve Podcast" teaches fundamental anesthetic

concepts using succinct, student-generated episodes that

are reviewed by senior medical students, residents and

staff physicians. Episodes are recorded to a hosting

platform and distributed internationally via podcast apps.

Episodes explore topics using a stepwise approach to

content that may be unfamiliar to medical students (e.g.

general anesthesia). Recognizing that students typically

encounter anesthesia later in their training, episodes also

include tips for learners and feature guest speakers to

provide insights into the scope of practice and career

exploration. For episodes and summaries, visit

www.airwayvepodcast.com

Conclusions: Four medical students, three residents and

one faculty member have collaborated on the podcast.

Each episode undergoes a three-step editorial process and

contributes to a repository of content at the medical

student level. With the first series, entitled "Introduction

to Anesthesia", now complete, there have been 320

downloads across five continents since September 2020.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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The podcast is endorsed by the McMaster University

Department of Anesthesia and has been shared nationally

with program directors and medical school interest groups

with commitments for distribution. The podcast is listed in

the McMaster Anesthesia Clerkship curriculum page and

has been well received by faculty and students.

LP7 – 04, 60033

Building International Bridges and Alliances Through

Virtual Platforms: An Online Pediatric Lecture Series

Vicky Breakey McMaster University, Michelle Schneeweiss McMaster

University, Ranu Malhi McMaster University, Robin Mackin Western

University, Fredrick Sinyinza University of Namibia, School of Medicine

Background/Purpose: Electronic learning (e-learning) has

become an important resource to facilitate learning

during the COVID-19 pandemic. Globally, e-learning

provides a unique avenue to support medical education

beyond geographical boundaries and allows students

from different institutions to learn collaboratively.

Summary of innovation: An online 'Pediatric Lectures

Series' was developed for medical students locally and at

the University of Namibia (UNAM) to supplement their

learning during interruption to their clinical duties. Live,

hour-long online lectures were offered twice-per-week for

a one-month pilot. All recorded lectures were made

available to students for review at their convenience.

After the pilot, 83 students completed a survey to gauge

reactions and engagement. Post series quizzes were sent

out 2, 4 and 6 months after the pilot to assess knowledge

retention.

Conclusions: Student feedback highlighted the use of

Zoom polling, Kahoot quizzes, and assignment of two

lecturers per session as important to their learning. The

additional lecturer allowed for synchronous clarification

without disruption to the presenter. 86.8% agreed or

strongly agreed that their knowledge base changed after

the series and 79.5% reported comfort with approaching

a pediatric patient after the series. 71% expressed interest

in continuing the series after returning to clinical duties.

The most reported barrier to attendance was internet

connection (44%) but 72% of learners still preferred being

able to attend the live lectures. This project shows

promise that e-learning can support medical education in

low resource settings both during and after COVID-19. It

also offers an avenue for students to learn collaboratively

and gain appreciation for variation in practice and

resources globally.

LP7 – 05, 60620

OB-G in YEG: Availability and creation of a medical

education podcast in obstetrics and gynecology

Lindsay Drummond University of Alberta, Kristin Black University of

Alberta, Venu Jain University of Alberta, Margaret Sagle University of

Alberta

Background/Purpose: Podcasts have emerged as a

popular means of knowledge acquisition and have been

demonstrated to be an effective medical education tool.

The uptake of podcasts is high in many areas of medicine,

however there is limited information about podcast use in

obstetrics and gynecology. The purpose of this project was

to determine the availability of medical education

podcasts in OBGYN, and to create a podcast specifically

designed for Canadian learners.

Summary of innovation: A comprehensive search of

commonly used podcasting platforms was performed to

identify podcasts for learners in OBGYN. We identified

eight podcasts; two were currently active and none were

specific for Canadian learners. In response to the lack of

content for Canadian OBGYN learners, a medical

education podcast "OB-G in YEG" was created and

released in January 2020. The podcast is freely accessible

on podcast hosting sites or through the show's webpage

and references guidelines from the Society of

Obstetricians and Gynaecologists of Canada. Individual

podcast episodes were created by identifying relevant

topics, developing a podcast script, recording episodes,

and uploading to the platform.

Conclusions: The project currently has ten episodes and

1427 unique downloads as of October 2020. Current

topics include relevant clinical presentations that learners

encounter including pelvic pain, ectopic pregnancy, and

vaginal discharge. The project is currently monitoring

usage, assessing barriers to use and evaluating the

effectiveness podcasts in medical education. In the era of

remote learning, technology will become more important

than ever in medical education, and it is important that

women's health topics are appropriately represented.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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LP7 – 06, 60834

How a Web app helps medical students practise for the

OSCEs

Samuel Leduc Université Laval, Fannie Tremblay Université Laval,

Philippe Marineau Université Laval, Antoine Bergeron Université Laval,

Frédérique Boisvenue Université Laval, Valérie Bouchard Université

Laval, Chloé Grenon Université Laval, Louis-Bénédict Landry Université

Laval, Julien Mercier Université Laval, Louis Miazga Université Laval,

Éliane Pelletier Université Laval, Sophianne Samson Université Laval,

Valérie Séguin Université Laval, Anne-Julie Simard Université Laval

Background/Purpose: Medical students, while preparing

for the OSCEs, feel the need to practise their medical

interview in real time with their peers. However, for an

individual, creating such clinical scenarios requires a

significant amount of time and effort and can increase the

exam-related stress. Therein, the Groupe de

perfectionnement des habiletés cliniques (GPHC) at

Université Laval (UL) felt a need for an alternative study

tool that would allow students to properly practise for the

OSCEs.

Summary of innovation: Our committee launched a Web

app in 2015 which provides students with 240 clinical

cases for practice. The cases, organized in systems and

reasons for consultation, contain all the required sections

of a complete medical interview. Three years later, the

committee established a partnership with pharmacists to

create pharmacology multiple-choice questions which

currently add up to 228. Sections on a physical exam and

medical notes are the most recent additions to the app.

Conclusions: The app has been immensely popular

amongst UL students. In fact, in a recent limited survey,

99.3% of responders stated that they would recommend

the app to another medical student in their program.

Some faculty members decided last year to use the

platform as part of their weekly classes. With members

from four medical schools in Quebec, our web app not

only promotes innovation and the development of

effective educational tools, but also encourages

collaboration between students and teachers from the

medical community.

LP7 - 07-60838

Approaching the clinical environment through virtual

simulations as students in preclinical training

Louis-Bénédict Landry Université Laval, Fannie Tremblay Université

Laval, Philippe Marineau Université Laval, Antoine Bergeron Université

Laval, Frédérique Boisvenue Université Laval, Valérie Bouchard

Université Laval, Chloé Grenon Université Laval, Samuel Leduc

Université Laval, Julien Mercier Université Laval, Louis Miazga Université

Laval, Éliane Pelletier Université Laval, Sophianne Samson Université

Laval, Valérie Séguin Université Laval, Anne-Julie Simard Université

Laval

Background/Purpose: Medical students have limited

access to clinical and hospital settings throughout their

first years of training, especially during the COVID-19

pandemic. They learn fundamental science and basic

medical concepts but have few opportunities to test their

knowledge and abilities in an actual clinical context.

Summary of innovation: Accordingly, the Groupe de

perfectionnement des habiletés cliniques (GPHC) at

Université Laval launched the virtual simulation project.

These simulations are computerized modules, where the

user plays the role of a physician and must make all the

decisions regarding the medical interview, the physical

exam, the investigations needed and the patient care in

general. While the first simulations were filmed, thus

requiring actors and equipment, the next simulations will

be animated illustrations. Using customized artworks

produced through a partnership with a local artist, the

GPHC plans to address racial profiling issues by including

cultural diversity within the simulations.

Conclusions: The first two simulations having been very

well received by both students and professors at

Université Laval, they are now officially approved by the

Faculty of Medicine and part of the curriculum. This

project helps the GPHC reinforce students' knowledge

about the clinical features of diseases, care, and

treatment, and thus familiarizing them with their future

responsibilities as physicians. Therefore, this project

promotes learning innovation in medical education, by

heeding students' needs and promoting innovative e-

learning in the medical curriculum.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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LP7 - 08-60823

Development of an Online Rural Medicine Self-Learning

Module (SLM) for Medical Students-

Celina DeBiasio University of Ottawa, Charles Su University of Ottawa,

Craig Campbell University of Ottawa, Timothy Wood University of

Ottawa

Background/Purpose: There is a discrepancy between the

number of Canadians living in rural communities versus

the number of physicians available to meet their health

needs. Educational strategies aimed to rectify this

imbalance have included mandatory undergraduate

medical rural rotations. However, standardized training

methods designed to prepare students for different

clinical and cultural interactions are limited. In response,

we developed and implemented an online pre-departure

SLM for first-year medical students.

Summary of innovation: An interdisciplinary team

including distributed medical education and social

accountability experts collaborated to create a pre-

departure training rural SLM for first-year medical

students. The SLM's content focuses on cultural safety and

educational design includes video interviews, clinical

scenarios, quizzes and reflective exercises. 136 students

voluntarily completed the pre and post-SLM surveys,

which included rating scales and comment boxes. Post-

SLM items related to rural medicine interest and self-

assessed knowledge, showed an increase in all categories,

including interest in pursuing a career in rural medicine for

students who had lived in rural areas (M=3.4; M= 3.5) and

those who did not (M= 2.8; M= 3.0). Student comments

were largely positive, contributing to enhancing the

effectiveness of the module for future students.

Conclusions: With the interdisciplinary collaboration of

numerous experts, we discovered that a comprehensive

virtual pre-departure training SLM can be developed and

successfully implemented to promote interest about rural

communities and rural medicine. This standardized

training can be expanded to other Canadian medical

schools to help prepare medical students for rural

medicine experiences and ultimately increase interest in

rural medicine and related career opportunities.

LP7 - 09-60868

Artificial intelligence in undergraduate medical education:

A scoping review

Annie Wu University of Toronto, Juehea (Lucia) Lee University of

Toronto, David Li University of Ottawa, Kulamakan (Mahan)

Kulasegaram University of Toronto

Background/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.

Conclusions: 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.

Curriculum

LP8 - 01-60549

The Development and Evaluation of the Edmonton Frail

Scale Training Course

Hartley Perlmutter University of Alberta, Darryl Rolfson University of

Alberta, Vijay Daniels University of Alberta, Jananee Rasiah University of

Alberta, Thomas Jeffery University of Alberta

Background/Purpose: With a growing population of older

adults with complex health issues, assessing for and

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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quantifying frailty are important competencies for health

professionals. The Edmonton Frail Scale (EFS) is a

multidimensional tool that supports the delivery of frailty-

inclusive care across the care continuum. Developing an

educational-framework informed EFS training course

would complement the pre-existing training video and

"Tool Kit" and aid in implementation of frailty inclusive

care. Evaluation of these resources would help ensure

their effectiveness and determine their suitability in

diverse health professions settings.

Summary of innovation: The 12-module training course

includes practice activities and a simulation-based final

assessment to assess trainees' ability to administer the

EFS in a clinical setting. Using the Backward Design

framework, we mapped out course content and

assessment. We then turned to Kane's framework to

collect validity evidence for our simulation-based

assessment. In parallel with the training video and Tool

Kit, the training course was evaluated quantitatively using

trainee performance metrics and Likert items, and

qualitatively with user feedback. Users also reported their

times to complete training.

Conclusions: Mean first-attempt simulation-assessment

scores were >90% for both training groups. Likert items

and comments supported high user satisfaction with the

EFS training course. We attribute user performance and

satisfaction to our grounding in conceptual frameworks in

a collaborative environment. Backward design helped us

align course content and assessment with our learning

objectives, and Kane's framework helped us provide

validity evidence for our assessment.

LP8 - 02-60867

Quality of life in hospice: Interactions among temporal,

occupational, and relational dimensions

Gil Kimel University of British Columbia, Laura Nimmon University of

British Columbia , Laura Yvonne Bulk University of British Columbia

Nigel King University of Huddersfield

Background/Purpose: Temporality, occupation, and

relationships are identified as discrete factors impacting

quality of life for individuals at the end of life (EoL) and

families; however, educators and practitioners require

insight regarding whether their interaction shapes quality

of life for these people. This study is framed by an

understanding that meaning is negotiated between

people through social interaction and occupational

engagement in temporal contexts.

We conducted in-depth interviews with 9 patients and 10

family members followed by an iterative analysis process

involving open, axial and selective coding.

Summary of innovation: The data highlights variants on

temporality related to participants' occupational and

relational experiences, and ways that temporality impacts

relational and occupational experiences. We explore this

within three main processes: 1) experiencing temporal

rupture, 2) diminishing significance of clock time, and 3)

shifting occupational priorities.

Conclusions: This session provides insight into complex

interactions between temporal, occupational, and

relational aspects of dying in hospice from patient/family

perspectives. Educators, scholars, learners, and

practitioners require patient/family insights in order to

foster enriching and meaningful EoL experiences. It is

important that we are attentive to patient priorities at

EoL. By focusing on individuals' reoriented priorities -

occupations focused on being, becoming, and belonging -

we can address what individuals find to be most

meaningful. With these insights in mind, educators may be

able to better prepare future and current healthcare

professionals to be attuned to the temporal, relational

and occupational needs of patients and families at EoL,

based not only on our own "expertise" but also that of the

people we care for.

LP8 - 03-59486

Identity formation, mentorship, and paradigm shift of

learners to educators: Building a foundation for future

medical educators through a Students-As-Teachers

curriculum

Joshua Stanley University of Toronto, Ilan Fellus University of Ottawa,

Karen Leslie University of Toronto, Susanna Talarico University of

Toronto, David Rojas University of Toronto, Seetha Radhakrishnan

University of Toronto

Background/Purpose: With increasing expectations for

medical students to teach, there is greater focus on

medical education training for them. While mounting

evidence supports various benefits of Students-As-

Teachers (SAT) curricula, limited SAT electives are offered

across Canada. We developed a four-week SAT selective

for fourth-year medical students at University of Toronto

to enhance medical education knowledge and teaching

skills. This study aimed to evaluate the SAT program and

its impact on students' development as educators, their

experience as both learners and educators, and their

future involvement with medical education.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Methods: Students participated in highly interactive small

group teaching sessions along with teaching opportunities

in non-clinical and clinical environments. Course

evaluation consisted of pre and post-selective surveys and

reflective assignments describing their selective

experience and future career aspirations. A theory-based

evaluation approach was utilized to compare the SAT

program's theory with course outcomes.

Results: Post-SAT selective, students self-reported greater

knowledge and confidence in teaching methods, provision

of feedback, medical education scholarship, and interest

in further medical education training. Student reflections

highlighted three key themes. Identity formation as

educators and the importance of mentorship in medical

education aligned with the initial goals for the SAT

elective, while unexpected outcomes included a shifting

perception on teaching and feedback from the lens of a

learner to that of an educator.

Conclusions: This study's findings demonstrate the ability

of a SAT curricula to build capacity for future medical

educators. Further studies could utilize realist evaluation

to determine what contextual and mechanistic factors

influence such outcomes.

LP8 - 04-59928

Alignment of Regulatory Examinations and Public Health

Priorities: Exploring the representation of Cancer in the

MCCQE-1

Meredith Giuliani University of Toronto, Maria Martimianakis

University of Toronto, Kulamakan Kulasegaram University of Toronto,

Janet Papadakos University of Toronto, Eleni Giannopoulos Cancer

Education Program, Princess Margaret Cancer Centre, Marissa

Sherwood University of Toronto

Background/Purpose: Medical education should be

coordinated with patient and health care system needs.

Cancer is a relevant health priority. Unfortunately,

oncology education has long been perceived by learners,

educators, and physicians as inadequate. The Medical

Council of Canada (MCC) is Canada's national standard of

assessment of medical graduates. This study aimed to

view oncology education with a focus on assessment, by

determining the representation of health priorities,

including cancer, in the Medical Council of Canada

Qualifying Examination - Part 1 (MCCQE 1).

Methods: The MCCQE 1 lists CanMEDS roles for medical

graduate competency. The focus of this study was the

Medical Expert role and associated clinical objectives.

These objectives were categorized for oncologic,

cardiovascular, cerebrovascular, and chronic lower

respiratory disease. Two coders analyzed data to increase

objectivity and reduce bias.

Results: The MCCQE 1 objectives list 190 topics in the

Medical Expert role. Oncology content was found in 57

(30%), cardiovascular diseases in 56 (29.5%),

cerebrovascular diseases in 21 (11%) and chronic lower

respiratory diseases in 7 (3.7%). Within the objectives

containing oncology content, frequently mentioned

cancers were gastrointestinal (16, 23%), nonspecific

indicators of cancer (7, 12%) and

genitourinary/musculoskeletal cancers (6, 10.5%). All

disease coding had interrater agreement greater than

99%, with Kappa values from 0.73 - 1.00, indicating

substantial agreement.

Conclusions: Oncology was highly represented in the

MCCQE 1. To understand the mismatch between

curricular representation and assessments with

perceptions of preparedness for practice, future work

should investigate components of medical education

beyond knowledge expertise and assessment.

LP8 - 05-60057

In Anticipation of CBD: Building an Integrative, Skills-Based

Transition to Practice Curriculum in Psychiatry

Natasha Snelgrove McMaster University, Sheila Harms McMaster

University, JoAnn Corey McMaster University

Background/Purpose: Residents in the psychiatry

program at McMaster University indicated a desire for a

practical, skills-based transition to practice curriculum.

With the transition to competency-based medical

education and its focus on having a robust transition to

practice year, our program was invested creating a novel,

pedagogically robust curriculum.

Summary of innovation: A needs assessment was sent out

to the PGY-5 residents during the 2018-2019 academic

year. The results from this survey informed the

development of a 3-session curriculum focusing on: 1)

negotiating, contracts and business incorporation, 2)

billing and practice management, and 3) transition to

practice "nightmares" like audits and college complaints.

A curriculum based on cases was developed to reflect

these learning needs. External and internal experts,

including legal counsel, medical business and billing

experts, and experienced faculty were included as

teachers. The curriculum included didactic and interactive

components anchored to cases and concluding with

practical, concept-integration application exercises to

enhance knowledge retention and application.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Conclusions: Feedback was sought through session

evaluations and a survey following completion of the

curriculum. Residents felt the curriculum was helpful and

applicable, although noted a preference for earlier

delivery. Additional topics of interest were identified.

Using a quality improvement approach, the curriculum

has now been expanded to 8 sessions including additional

application exercises focused on billing, maintenance of

certification, and ethical issues. This presentation will

provide attendees with an understanding of how to create

a practical transition to practice curriculum and will

provide examples of the curriculum, including integration

exercises used to solidify learning.

LP8 - 06-60825

Using the Curriculum Densitometer to measure the

impact of curricular workload on students' mental health:

A pilot study.

Kalyani Premkumar University of Saskatchewan, Jeremiah Acharibasam

University of Saskatchewan

Background/Purpose: Curriculum overload (CO) is a

major 21st-century health science education problem,

partly due to ongoing curriculum reforms including the

growing wealth of knowledge, increasing diversity of the

student body, and expanding interdisciplinary

programming. Existing evidence indicates that CO has

adverse effects on student mental health, but little

research exists on practical solutions to address this

problem. Our study seeks to assess the feasibility of a new

mobile application (Curriculum Densitometer - CD app.)

for measuring curriculum load and student stress.

Summary of innovation: A new mobile-web application,

called Curriculum Densitometer (from now on referred to

as CD app.) was developed specifically to measure course

assignment course activity workload and student

perceived stress. The CD app. was conceptualized by Dr.

Kalyani Premkumar, designed by Jeremiah Acharibasam,

and developed by Thai Lee (MSc. student) under Dr. Ralph

Deters' supervision. The goal was to use the CD app. to

measure course assignment workload (i.e. time - in hours

- spent completing an assignment) and perceived stress

associated with the workload among students in various

courses within the Colleges of Nursing and Medicine at the

University of Saskatchewan. The CD app allows instructors

to create assignment task time trackers which students of

a given class can then use to measure the time it takes

them to complete those assignment tasks and rate the

related perceived stress involved in completing these

assignment tasks.

Conclusions: The data generated by the CD app. can keep

instructors informed of student stress experience and

help to promote student mental health.

LP8 - 07-59986

Virtual MacPeds: Leveling up to the new virtual reality of

medical education

Nina Mazze McMaster University, Anne Niec McMaster University,

Kristen Zahn McMaster University, Quang Ngo McMaster University

Background/Purpose: Virtual MacPeds is an online

curriculum created using Kern's six step approach to

curriculum development to supplement resident learning

during Covid-19. The curriculum included: online lectures,

a live teaching calendar that includes links to sessions

across rotations and subspecialties, and a resource

rolodex with links to online learning materials. The

purpose of this study is to evaluate the components of the

curriculum that were most useful to residents.

Methods: Virtual MacPeds was piloted from March 2020

to June 2020 to 51 core pediatric residents in PGY1-4 at

McMaster University. The Kirkpatrick Model for learning

evaluation was used to assess resident reaction to the

implementation of the curriculum. A voluntary online

survey was emailed to residents with the opportunity to

respond from June to July 2020. Descriptive statistics was

used to assess learner engagement and perception of the

curriculum.

Results: 95% of respondents (n=20) had reduced in-

person teaching sessions during Covid-19 and 80% had

impacted clinical rotations (self-isolation, virtual care,

patient volumes). 95% used the curriculum, all of whom

found it helpful in fulfilling learning objectives. 85% of

participants attended the online lectures - those who did

not attend noted schedule conflict. 100% would use

Virtual MacPeds in the future. Participants noted that

Virtual MacPeds should include a live teaching schedule

(100%), online lectures (84.2%), self-study modules

(73.7%), resource rolodex (52.6%) with suggestions for

recorded lectures (89.5%) and simulations (57.9%).

Conclusions: Virtual MacPeds is an acceptable and useful

supplement to resident learning during Covid-19. Useful

elements of the curriculum include online lectures, a live

teaching schedule, resource rolodex and self-study

modules.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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LP8 - 08-60827

Developing and evaluating the Professionalism Plus

longitudinal curriculum in a geriatrics residency program

Bernice Ho University of Toronto, Arielle Berger University of Toronto,

Edwin Wong University of Toronto

Background/Purpose: With high rates of burnout and

incivility among physicians and increasing evidence of

poor quality of care for marginalized populations, there is

a dire need to address professionalism in medical

education. A needs assessment in our program identified

little-to-no formal curricular time on professionalism, nor

other CanMEDS roles including Communicator, Advocate,

and Collaborator. We introduced a new longitudinal

curriculum for Geriatric residents, "Professionalism Plus",

addressing the non-medical expert CanMEDS roles, with a

focus on professionalism.

Summary of innovation: The curriculum utilized

workplace-based learning theory, ensuring that teaching

was relevant to the residents' context and provided

practical tools to implement immediately. The full

curriculum contained ten sessions offered over two years.

Experts from the offices of Resident Wellness and Person-

Centred Care Education collaborated with curriculum

development and teaching. Thus far, six of ten sessions

were implemented, addressing the following topics:

resilience, professional identity, communication skills,

leadership, and person-centred care.

Conclusions: Immediate learner reactions have been

positive, with an average teaching effectiveness score of

4.56/5. Medium-term outcomes were assessed via semi-

structured interviews with 8 graduated residents.

Interviews revealed three broad themes: 1) Content was

relevant to clinical practice and a welcome addition to the

formal curriculum, 2) Interactive format offered

opportunity to learn from peers and build community, 3)

Impact on Professional Development may be limited due

to late integration into training. Future work will integrate

these findings into future iterations of the curriculum and

adapt the curriculum to other residency programs.

Curriculum - Undergraduate

LP9 - 01-59547

Applied Theatre within Undergraduate Medical

Education: A Scoping Review

Bronte Johnston McMaster University, Hartley Jafine McMaster

University

Background/Purpose: 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.

However, there is no compilation of current publications

regarding applied theatre and undergraduate medical

education; this information would be valuable to further

understand the benefits of the intersections of drama and

health education. This project offers a scoping review of

the current available literature in order to gain a further

understanding of applied theatre initiatives and outcomes

within undergraduate medical education particularly in

relation to the CanMEDS framework.

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 through thematic analysis.

Results: The current literature demonstrates the positive

benefits of incorporating applied theatre within

undergraduate medical education based on a variety of

applied theatre initiatives. Thematic analysis

demonstrated the positive benefits of applied drama with

improving undergraduate medical students'

communication skills, education, and personal

development. The results demonstrated how applied

theatre activities overlap with the CanMEDS framework.

Conclusions: The results highlighted the diversity and

importance of applied theatre initiatives within medical

education and how it should be further incorporated in

curricula.

LP9 - 02-60780

A Rapid Review of Prescribing Education Interventions

Usmaan Omer Hull York Medical School, Paul Crampton Hull York

Medical School, Gabrielle Finn University of Manchester, Evangelos

Danopoulos Hull York Medical School, Martin Veysey Hull York Medical

School

Background/Purpose: Many studies conducted on the

causes and nature of prescribing errors have highlighted

the inadequacy of teaching and training of prescribers.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Subsequently, a rapid review was undertaken to update

on the nature and effectiveness of educational

interventions aimed at improving the prescribing skills and

competencies

Methods: 22 studies taking place between 2009 and 2019

were identified across nine databases. Out of 1,137

papers, 58 papers were selected for full-text screening,

from which 22 papers were included in the review.

Results: This review reinforced the importance of the

WHO Guide to Good Prescribing to prescribing curriculum

design as well as the effectiveness of small group teaching.

However, it also highlighted the lack of innovation in

prescribing education and lack of longitudinal follow-up

regarding the effectiveness of prescribing education

interventions.

Conclusions: Prescribing curricula needs to adapt and

evaluate the scope of implementing educational

approaches which utilize innovations such as virtual

reality and explore areas where students can commit

errors in a safe environment and learn from these to

better their prescribing skills in preparation for real-life

clinical practice.

LP9 - 03-59981

Women's Cardiovascular Health in the Undergraduate

Curriculum

Angela Brijmohan Queen’s University, Natasha Tang Queen’s University,

Nancy Dalgarno Queen’s University

Background/Purpose: Heart disease is the leading cause

of death among Canadian women. However, early heart

attack signs are consistently missed in up to 78% of

women, with providers identifying a need for increased

training in women's hearts (Heart & Stroke Foundation,

2018). In fact, the Heart and Stroke Foundation of Canada

recently called for Ontario medical schools to incorporate

gender considerations into the undergraduate curriculum.

We sought to evaluate our institution's pre-clerkship

cardiovascular unit for any gender-specific education

needs.

Methods: We identified all cardiovascular learning events

in our institution's pre-clerkship curriculum using

keywords including "acute coronary syndrome", "heart

failure" and "cardiovascular disease". Our analysis

identified eleven relevant learning events, which we

mapped to the Women's Health Competencies published

by the Association of Professors of Obstetrics &

Gynecology (APGO). Next, we reviewed management

guidelines from the Canadian Cardiovascular Society

(CCS), clinical trials and high-quality reviews in acute

coronary syndrome to summarize gender-specific

considerations across multiple cardiovascular disease

settings.

Results: Our curriculum mapping identified areas of

improvement in 5 of the 9 APGO Women's Health

Learning Objectives. Two of these learning objectives

focused on gender-specific differences in heart failure,

two were related to acute coronary syndrome and

atherosclerosis, and one covered epidemiological

differences. A review of all CCS guidelines revealed that

gender specific guidelines have been published for heart

failure and valvular disease in pregnancy. However, no

specific information has been published yet on the

presentation and management of ACS in women, despite

known differences in risk factors, symptoms, and

underlying pathophysiology. Finally, current research

indicates that there is a need to address provider bias

when ordering investigations, prescribing medications,

and referring to rehabilitation programs after acute

coronary events in women.

Conclusions: As medical students, we recognized gaps in

our training regarding care for women's hearts and

identified specific areas of improvement. We are currently

working with the curriculum coordinator to integrate

Women's Cardiovascular Health content throughout the

undergraduate curriculum, with lectures, small group

sessions and relevant clinical skills scenarios. We envision

that our methodology can be applied by other medical

students across Canada to ensure that gender

considerations are addressed in cardiovascular

curriculums across the country.

LP9 - 04-59983

Reviewing non-cancer pain & opioid prescribing

curriculum using INSPQ competencies

Michelle Gibson Queen’s University, Portia Tang Queen’s University

Background/Purpose: In view of Canada's opioid crisis, we

reviewed the undergraduate curriculum at our institution

to determine if it reflects current attitudes, beliefs &

knowledge in opioid prescribing & related topics.

Methods: Learning events within the 'Pain' and 'Substance

Abuse' integrated threads were extracted & analyzed

from our learning management system. Content in each

learning event was summarized & compared to medical

competencies published by the Institut National De Santé

Publique Du Québec (INSPQ) in non-cancer pain

management & opioid prescribing.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Results: 26 learning events related to 'Pain' & 12 learning

events related to 'Substance Abuse' were identified. The

INSPQ describes 4 clusters of competencies: 1. Basic

epidemiological, clinical & pharmacological knowledge

relevant to non-cancer pain & opioids, 2. Evaluation of

pain intensity & consequences of pain, 3. Evaluation of

substance abuse & misuse, & 4. Management & follow up

in patients using opioid therapy. Most (6/7) competencies

within the first cluster were covered in the curriculum.

Almost half (2/5) of competencies related to the second

cluster were not explicitly covered, & 3/7 of competencies

related to the third cluster were not covered. A third (3/9)

of competencies within the fourth cluster were not

explicitly covered.

Conclusions: Our curriculum addresses competencies

needed to manage non-cancer pain & prescribe opioids.

This initial review identified potential gaps in other core

competencies pertaining to opioids & related topics, such

as substance abuse. Limitations to our review are that we

could not analyze untagged learning events or new

sessions. Next steps will include consultation with

stakeholders to determine the extent of gaps in the

curriculum and how they can be filled.

LP9 - 05-59984

Optimizing Case-Based Learning: An evaluation of tutor

and first year MD student perceptions of group size and

format variations

Juehea (Lucia) Lee University of Toronto, Meghan Kerr University of

Toronto, Anne McLeod University of Toronto, Joyce Nyhof-Young

University of Toronto

Background/Purpose: 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 mixed-methods 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 experience.

LP9 - 06-60314

Student-Led Curriculum Innovation: Implementing

Training on Medication Safety in Transitions of Care,

Polypharmacy and High-Risk Situations in Undergraduate

Medical Education

Mohammed Tinwala University of Alberta, Tracey Hillier University of

Alberta, Joanne Rodger University of Alberta

Background/Purpose: Unsafe medication practices and

medication errors are a leading cause of injury and

preventable harm worldwide. In response, the World

Health Organization (WHO) launched its third Global

Patient Safety Challenge: Medication Without Harm.

Three key action areas associated with substantial

morbidity and mortality were highlighted for

improvement of medication safety - transitions of care,

polypharmacy and high-risk situations. As such, it is crucial

for medical students to achieve competency in medication

safety while prioritizing these three areas.

Summary of innovation: The current MD Program

curriculum was reviewed to determine coverage of the

content of interest. The review process revealed content

is sparse, with only limited material on medication safety

in polypharmacy in the year 4 Geriatrics clerkship.

Subsequently, a scoping review was performed to identify

best practices in medical education. Guided by the

literature, learning objectives and an eLearning module

were developed for integration in the clerkship

curriculum. Importantly, the use of case vignettes

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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resembling common clinical scenarios link theory to

practice and enable practical application of concepts.

Knowledge is assessed on the final, fourth-year

comprehensive examination. For evaluation, a pre-survey

determines students' awareness and a post-survey

assesses impact.

Conclusions: This innovation addresses a major

curriculum gap and equips medical students with early

and essential training to combat the significant risks

unsafe medication practices pose to patient health and

safety. This project will raise awareness at other

institutions who may also be lacking curriculum coverage

of this crucial topic, and it may serve as an effective model

to inform curriculum design and development.

LP9 - 07-60511

'Medical Education By and For Us': Using a Participatory

Approach to Address Learner Mistreatment in Medical

Education

Jordynn Klein University of Toronto, Neha Malhotra University of

Toronto, Gagan Singh University of Toronto, Oluwasemipe Oni

University of Toronto, Darby Little University of Toronto, Amr Hamour

University of Toronto, Morag Paton University of Toronto, Umberin

Najeeb University of Toronto, Joyce Nyhof-Young University of Toronto,

Anita Balakrishna University of Toronto, Reena Pattani University of

Toronto

Background/Purpose: Learner mistreatment is pervasive

in medical education. Despite institutional efforts, medical

students often report feeling disengaged or patronized by

traditional curricular initiatives to prevent mistreatment.

This is particularly true for learners from

underrepresented and minoritized groups, whose

experiences are seldom captured by dominant

institutional narratives.

Summary of innovation: Using a Freirean dialogical and

participatory approach, a team of diverse medical

students collaborated with faculty and staff to co-develop

a two-hour workshop on learner mistreatment. This novel

workshop is newly included within the second year

undergraduate MD curriculum; it features a didactic

lecture, facilitated small-group discussion, and

participatory interpersonal skills training. Using principles

of participatory scholarship, learners were actively

engaged from research to delivery: leading the literature

review, developing the learning objectives, and co-

facilitating small-group discussions.This approach enabled

early feedback and the generation of shared insights; it

challenged traditional power differentials of knowledge

production. The design aimed to capture students' lived

experiences and to reflect the nuances of navigating

hidden curricula of medical education through a

minoritized lens.

Conclusions: This Freirean-influenced model has

implications for our local approach to medical education

development. We advocate for the implementation of

participatory design in all medical education initiatives

that draws from lived experience, such as those related to

professionalism, wellness, and cultural safety. This model

could also be extended to development of 'medical

expert' content, which has historically estranged learners

and patients from the knowledge-production process.

Curriculum – Undergraduate

LP10 - 01-60517

The Art of Infographics: Design and Content Appraisal

Samin Dolatabadi University of Calgary, Christopher Rice University of

Calgary, Sonja Wicklum University of Calgary, Martina Kelly University

of Calgary

Background/Purpose: Infographics are visual

representations that present complex information

quickly, clearly, and effectively to an audience compared

to pure text (Picture Superiority Effect). Infographics are

becoming more prevalent as a learning tool in education,

to advise patients about their condition and treatments,

and to deliver public health messages. Although an

infographic can enhance patient's decision-making

capabilities and improve the physician-patient

relationship, information on how to create effective

infographics are not discussed as part of medical

education curriculum. The goal of this project was to

analyze current literature to determine characteristics of

an effective infographic that increases data cognition and

supports knowledge translation and physician-patient

communication.

Methods: As the preliminarily search revealed few papers

in medical education literature, the search (published and

grey) was extended to other disciplines, specifically

economics and science. Ten articles which discussed

characteristics of a high-quality infographic were

reviewed.

Results: Based on our results, five major themes on the

evaluation of infographics were identified:

purpose/message, audience, design (balance and visual

complexity), textual content, and organization. Next, a

rubric to evaluate infographics was developed, using a

Likert scale.

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Conclusions: In education, infographic development may

increase student engagement, retention, and

communication skills. This literature review led to the

creation of a rubric for infographic appraisal. This was the

first step in a larger project focused on designing an

educational intervention for medical students, which will

lead them through the development of infographics using

empathy and human-centered design theories to achieve

patient-centered communication.

LP10 - 02-60535

Psyched Up or Psyched Out? - Perspectives on Psychiatry

Recruitment in Canada

Alan Douglass University of Ottawa, Alexandra Morra Queen’s

University, Elliott Lee University of Ottawa

Background/Purpose: Previous research revealed that

many medical students solidify psychiatry as their

specialty during medical school. However, few studies

have explored the nature of assessments during

psychiatry clerkship and their impact on recruitment. We

postulated that schools with more mandatory encounters

(MCE's) in their clerkship psychiatry block would be

associated with higher psychiatry recruitment.

Methods: 2011-2019 data from the Canadian Residency

Matching Service (CaRMS) were examined from 25,558

students. The average psychiatry match rate was

calculated for each medical school and nationally. 95%

Confidence Intervals (95%CI) and trends from the highest

& lowest recruiting rates were determined. Psychiatry

Clerkship Rotation MCE's were obtained from each school

and analyzed for required diagnoses, amount of

exposures, & flexibility of completion in other rotations.

These data, as well as data from integrated clerkship

programs, were compared to recruitment rates for

potential correlations.

Results: The 2011-2019 national recruiting average was

5.23% (95%CI = 4.85%-5.73%), and R2=0.88. Schools

above the upper 95%CI include Calgary(6.8%),

Sherbrooke(6.3%), Laval(6.5%), and NOSM(6.8%).

McGill(3.4%), Western(4.0%), Queen's(4.1%), and

Saskatchewan(4.5%) were below the lower 95%CI. 88.9%

of schools below the national average allow for MCE

completion in other specialties; 71% offered integrated

clerkships for students. 8 schools required MCE

completion within a psychiatry rotation; 7/8 recruited

above the national average.

Conclusions: Despite MCE differences across universities,

there was no concrete association between quantity of

exposures and recruitment. However, a clear correlation

exists between flexibility of MCE completion in other

rotations and recruitment. A similar trend was noted for

schools offering integrated streams.

LP10 - 03-60561

What Should Medical Students Learn About Nutrition?

Evaluating the Quality of the University of Alberta's

Medical Nutrition Curriculum

Sietske Speerstra University of Alberta, Cassandra Warbeck University

of Alberta, Rabin Persad University of Alberta, Joanne Rodger University

of Alberta, Tracey Hillier University of Alberta

Background/Purpose: Nutrition education in

undergraduate medicine is insufficient. The purpose of

this review was 1) map the nutrition concepts in years 1

and 2 at the University of Alberta medical school (UofA),

2) identify ideal nutrition curriculum content and 3)

identify deficiencies of the UofA nutrition curriculum.

Methods: A literature review was conducted using search

terms "medical education", "nutrition", and "curriculum."

Selection criteria for review: Published since the year

2000; related to mandatory pre-clerkship education;

specifically related to curriculum content; and pertaining

to North American medical schools. The year 1 and 2

nutrition curriculum was mapped by searching all lecture

learning objectives for nutrition keywords. Lectures

containing nutrition concepts were reviewed. The

nutrition concepts identified in the curriculum were

compared to literature recommendations.

Results: Initial search identified 375 studies, 14 met the

search criteria. There was no ideal nutrition curriculum for

medical schools identified nor consensus on optimal

nutrition knowledge. However, four themes were

identified: i) nutrition should be incorporated

longitudinally into medical education, ii) students are

open to a variety of teaching methods; iii)

multidisciplinary teaching methods are valuable; and iv)

nutrition education should align with global

recommendations for sustainable and health promoting

dietary patterns. A 2002 compilation by the Curriculum

Committee of the Nutrition Academic Award Program

(NAA) contained the most comprehensive

recommendations for a nutrition curriculum. A total of

107 recommended learning objectives based on this guide

were compared to the UofA curriculum map. 58.0% were

addressed completely, 18.7% were partially addressed,

and 23.4% were not addressed.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Conclusions: The nutrition curriculum at the UofA medical

school is adequate, however, 42% of the curriculum needs

review based on the NAA curriculum. There is insufficient

data on optimal nutrition education for medical students

with no ideal unified curriculum identified.

LP10 - 04-60731

Evaluation of a User-Centred Design Session for

Undergraduate Medical Students

Daniel Dongjoo Lee University of Toronto, Rushil Chaudhary University

of Toronto, Joyce Nyhof-Young University of Toronto, Tia Thuy-Nga

Pham University of Toronto, Payal Agarwal University of Toronto,

Monisha Persaud University of Toronto, Javed Alloo University of

Toronto, Yousuf Ahmed University of Toronto, Joshua Herman

University of Toronto, Sasha Litwin University of Toronto, Daniel

Dongjoo Lee University of Toronto, Monisha Persaud University of

Toronto

Background/Purpose: User-centered design has emerged

as a novel problem-solving methodology centered around

empathy, creativity, and co-designing with end users, with

many applications in healthcare. Patient-centred

interventions are associated with patient safety and

clinical effectiveness in a wide range of diseases, settings,

and study types. Additionally, user-centred design has

been formally taught in other disciplines and at several

American medical schools.

Summary of innovation: In this study, we conducted an

educational intervention teaching 260 second-year

medical students at the University of Toronto the basics of

user-centred design.The intervention consisted of a 45-

minute didactic lecture on design thinking principles and

applications to healthcare, a 15-minute patient interview

describing the gaps in their healthcare journey, and a two-

hour small group workshop led by 15 healthcare

professionals who were trained as facilitators for the

session. During the workshop, students practiced the

principles of empathizing, defining, ideating, and creating

low-fidelity prototypes.

Conclusions: To our knowledge, this is the first time that

user-centred design has been incorporated into the

formal curriculum at a Canadian medical school.

Evaluation included post-workshop debriefs with

facilitators and post-workshop feedback by participants.

Students reported enjoying the creative problem solving

process but requested more specific themes or problems

to solve. Facilitators gave very positive feedback and felt

that the students were engaged. Suggestions for future

years included coupling smaller groups of students with

patients, having volunteer physicians as end-users or

evaluators, and implementing a showcase or pitch

competition. These lessons are important for anyone

seeking to teach user-centred design for medical

practitioners across the country.

LP10 - 05-60747

Global Health in Canadian Undergraduate Medical

Education: A Scoping Review of Best Practices and Call to

Action

Shawna O'Hearn Dalhousie University, Emma McDermott Dalhousie

University

Background/Purpose: Global health is becoming an

increasingly important field in our ever-changing global

climate and for more than a decade there have been calls

for increased global health education in undergraduate

medical curricula. This scoping review serves to provide an

update on the progress of Canadian undergraduate

medical education to incorporate global health

Methods: With the aim to identify the best practices and

existing knowledge gaps for integrating global health into

undergraduate medical curricula, we conducted a

comprehensive search of PubMed, Embase, CINAHL, and

ERIC in June 2020 yielding 195 articles. Inclusion criteria

included articles that focused on undergraduate medical

training in Canada, those that address global health topics,

and were published in the last ten years. Articles in both

English and French were considered. After the removal of

duplicates and screening, 33 articles remained. Grey

literature sources were also searched, adding additional

documents to the results.

Results: The final articles were synthesized based on three

themes: core curriculum, international electives, and

extracurricular activities. Out of the final 33 articles, 60%

focused on international electives, where about 1/3 of

these highlighted the ethical dilemma surrounding

international global health electives and 1/4 focused on

inconsistencies in pre-departure training. Only 7 of the

articles focuses on core undergraduate curriculum, all of

which were published in 2015 or earlier, which draw

further attention to a gap in current research.

Conclusions: These results re-assert the need for

improved global health education in medical education

and act as a call to action for medical educators. This has

led to further research analyzing global health education

programs.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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LP10 - 06-60801

Behind the Scenes; Workshopping an MD Learner

Mistreatment Workshop

Oluwasemipe Oni University of Toronto, Gagan Singh University of

Toronto, Jordynn Klein University of Toronto, Neha Malhotra University

of Toronto, Anita Balakrishna University of Toronto, Morag Paton

University of Toronto, Amr Hamour University of Toronto, Darby Little

University of Toronto, Joyce Nyhof-Young University of Toronto, Reena

Pattani University of Toronto

Background/Purpose: Medical student mistreatment is

an international issue spanning clinical training programs.

To reduce mistreatment, institutional/curricular

interventions are implemented and evaluated, but

development processes remain nebulous. We describe

our development process of an evidence-based

educational learner mistreatment intervention for an

undergraduate MD curriculum that considers contextual

needs. This process spans literature review, learning

objective identification, content curation, and delivery.

Summary of innovation: A working group of student and

faculty members implemented a three-phased process to

develop a Mistreatment Workshop and evaluation plan.

First, a student-led working group conducted a scoping

review of the literature to identify best practice in

content, assessment, and evaluation of curricular

interventions that address learner mistreatment across

health professions programs. Second, data gathered by

the MD program to understand the extent and nature of

learner mistreatment were reviewed. Finally, workshop

content and learning objectives were iteratively refined

through stakeholder (faculty members, learners,

workshop facilitators, MD program curriculum

committee) consultation.

Conclusions: Several interventions exist to address

learner mistreatment in medical education; however, the

process and reasons underpinning intervention

development and evaluation are infrequently described.

Using the development of the MD Learner Mistreatment

Workshop as a case example, we demonstrate how to

curate workshop objectives that are grounded in reported

literature, local institutional data, and meaningful

involvement of learner and faculty stakeholders. This

process could be adapted to other settings to address

mistreatment education.

LP10 - 07-60931

Educational Interventions Aimed at Teaching

Management of Patients with Obesity in Undergraduate

Medical Education: A Systematic Review

Boris Zevin Queen’s University, Nicholas Cofie Queen’s University,

Natasha Tang Queen’s University, Emma Neary Queen’s University,

Nathan Katz Queen’s University, Heather Braund Queen’s University

Background/Purpose: The growing obesity epidemic

requires an evidence-based approach to management of

patients with obesity. Two systematic reviews on obesity-

management interventions in undergraduate medical

education, both published in 2012, reported discrepant

findings. This study aimed to build on previous research by

identifying and systematically reviewing current literature

on educational interventions aimed at teaching

management of patients with obesity to medical students.

Methods: The authors systematically searched the

databases: Web of Science Core Collection, Embase

Classic + Embase, MEDLINE(R) via Ovid, PsycINFO, ERIC,

ProQuest Dissertations and Theses Global, and Cochrane

Central Register of Controlled Trials. No language or date

restrictions were applied. Retrieved records were

screened, critically appraised, and a narrative synthesis of

eligible articles was conducted.

Results: Database searching identified 6462 studies; 5373

(83%) were screened against title and abstract, 156 (2.4%)

full-text articles were retrieved, 31 (0.5%) met PICOS

eligibility criteria, and 17 (0.26%) were included after

critical appraisal. Study designs included 9 cohort-studies,

3 qualitative, 2 case-controls, 2 mixed-methods, and 1

RCT. Of the interventions described, 9 were a mandatory

part of the curriculum, 6 taught behaviour change

techniques, and 5 provided feedback to students. Overall,

findings demonstrated an increase in the number of

studies describing educational interventions aimed at

teaching management of patients with obesity to medical

students.

Conclusions: The results of this systematic review can be

used by medical educators to inform the design of

educational interventions focused on management of

patients with obesity in undergraduate medical curricula.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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IPE & Professionalism

LP11 - 01-59734

Exploring helping behaviours in complex clinical teams: A

scoping review of the literature

Erin Kennedy Western University, Sayra Cristancho Western University,

Don Eby Western University, Javeed Sukhera Western University, Sandy

DeLuca Western University

Background/Purpose: Contemporary healthcare teams

are complex and dynamic. Team members frequently

encounter challenges that require seeking assistance from

inside and outside the team. Despite how commonly help-

seeking behaviours are encountered, understanding the

complexities in the provision and receipt of help within

interprofessional teams is underdeveloped in the health

professions literature. The experiences of other team-

based professions, such as business and engineering,

might offer insight into these challenges.

Methods: We undertook a scoping review to explore how

helping behaviours in professional teams have been

studied and are understood. This methodology offers a

systematic way to identify, map and review existing

knowledge. We screened over 18,000 citations gleaned

from three databases. Once inclusion criteria were

satisfied, 49 articles for study inclusion remained.

Results: Our review suggested three features of the

helping phenomenon related to the provision or receipt of

help within teams: 1) ways that help is defined and

enacted, 2) personal, situational, and organizational

factors that shape how this occurs and, 3) discursive

contexts of help including ideas around reciprocity,

rationalization and resonance. Our review uncovered a

lack of literature that details naturalistic work teams (i.e.

not artificially created) in both health care contexts and

other professional domains of literature.

Conclusions: Understanding helping behaviours is

essential to encourage and support optimal functioning of

clinical teams. Insights derived from other team-based

professions adds to our understanding of how help is

sought and provided within teams. This knowledge can

influence initial education and professional development

initiatives to establish and enhance helping behaviours

within clinical teams.

LP11 - 02-60754

Addressing Cost-Related Nonadherence: Our

Experiences Supporting Patients in a Tertiary Healthcare

Organization

(Hardeep) Kimi Manhas Royal Roads University, Victoria, BC

Background/Purpose: The foundation of Canada's health

care system is the notion of universal access, which means

all citizens have access to medical care according to need

rather than ability to pay. This idea, however, does not

capture the system's complexities. While the system

covers the full costs of hospitalizations, diagnostic tests,

and physician visits, prescription medication is not

covered. When a patient cannot afford and therefore does

not take their prescribed medication, it is called cost-

related nonadherence (CRNA), which is the subject of my

study. My thesis explores organizational approaches to

supporting patients who face financial barriers to

medication. I ask how might an organization

systematically support patients facing CRNA to

prescription medication?

Methods: For my study I used action research and

knowledge translation as the methodological framework

and borrowed methods from design thinking, to engage

key stakeholders to explore solutions to CRNA. I engaged

multidisciplinary stakeholders from Vancouver General

Hospital including physicians, nurse practitioners,

directors, managers, nurses, social workers, pharmacists,

researchers and patients, in a two-day Medication

Affordability Workshop. The Design Thinking methods

included, expert presentation, brainstorming,

dotmocracy, S.W.O.T analysis, and road mapping.

Results: Data was categorized and themed, in order to

identify patterns. Based on the patterns, results found

that experts wanted to focus on drug plan enrollment

solutions, everyone engagement, and development of a

specialized role to support patients facing CRNA.

Conclusions: Addressing CRNA requires a collaborative

effort amongst key stakeholders which includes

education, engagement, and development of actionable

strategies to support patients.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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LP11 - 03-60222

A Pilot Study on the Effectiveness of an Interprofessional

Education Course at Teaching the Importance of

Choosing Wisely and Resource Stewardship

Yousef Bolous Dalhousie University, Emma McDermott Dalhousie

University, Samuel Campbell Dalhousie University, Bright Huo Dalhousie

University, Diane Ramsay Dalhousie University

Background/Purpose: Rising healthcare costs and an

increase in unnecessary testing has sparked interest in

resource stewardship (RS) and subsequently the Choosing

Wisely Canada (CWC) campaign. Currently, all Canadian

medical schools have student representatives for CWC,

however the same is not true in other health professions.

Interprofessional care learned through interprofessional

education (IPE) can lead to better patient outcomes. The

present study assessed whether an IPE course for health

profession students was effective in teaching

undergraduate students both interprofessional

competencies and CWC principles.

Methods: An approximately 7 hour long, 4 session course

was administered to Dalhousie University health

profession students (N= 30). A validated survey for IPE

competencies and a general survey about CWC principles

were administered to assess the course. Descriptive

statistics were used to assess the general CWC views, and

paired samples T-tests were employed to compare pre-

and post-IPE competencies.

Results: 25 students (83%) completed the full survey. Of

these, 52% were female, within five health disciplines, and

13 (52%) had heard of Choosing Wisely prior. Overall the

students agreed that CWC was important and was

relevant to their profession. They also reported significant

improvements in multiple interprofessional education

competencies, including communication, collaboration,

roles and responsibilities, patient-/family-centered care,

conflict management/resolution, and team function.

Conclusions: Participants in our pilot Choosing Wisely IPE

course valued the importance of the CWC campaign and

reported improvement in multiple IPE competencies. This

adaptable, simple, and low-cost course may be an

effective way to integrate RS teaching across multiple

health professions.

LP11 - 04-60632

Enhancement of Professional Values in medical

education: Expert opinion

Shima Tabatabai, Shahid Beheshti University of medical sciences

Professional values have important impact on Medical

practice and Internalization of these values is critical for

medical educators. This study aims to investigate the

medical education experts' viewpoint about the ways

professional values should be taught and learned as a step

towards the enhancement of professional values in

medical education.

Methods: The qualitative study focused on the

experiences of medical education experts on the values of

the medical profession and the way these values should

present in the medical curriculum in panel discussions in

Iran, 2019. All sessions were audio-recorded, transcribed,

and analyzed using thematic analysis.

Results: The analysis revealed four main themes related

to the Enhancement of Professional Values in medical

education: 1) integrating Professional values into the

general medical curriculum as a longitudinal theme, 2)

value-based Educational strategies, 3) contextual effect in

professional values education,4) strengthening the hidden

curriculum.

Conclusions: The concepts of value-based practice (VBP)

and value-based Medical education (VBME) should be

integrated into medical education as a longitudinal theme.

Specifically, the enhancement of teaching professional

values and its assessment in the clinical phase is

recommended. To address the Internalization of the

professional values in medical students, the main factors,

i.e., value-based teaching and learning strategies,

contextual values, and executive resources for

strengthening the hidden curriculum should be

considered. In conclusion, developing a VBP and VBME

would be necessary, and enhancing the professional

values in Medical education recommended.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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LP11 - 05-60527

Identifying the state of social accountability at the

University of Ottawa, Faculty of Medicine through an

internal environmental scan

Grace Zhu University of Ottawa, Sophie Lamontagne University of

Ottawa, Michael Fitzgerald C.T. Lamont Primary Health Care Research

Centre, Bruyère Research Institute, Nicole Kester C.T. Lamont Primary

Health Care Research Centre, Bruyère Research Institute, Craig Campbell

University of Ottawa, Melissa Forgie University of Ottawa, Paul Hendry

University of Ottawa, Lorne Wiesenfeld University of Ottawa, Claire

Kendall University of Ottawa

Background/Purpose: The social accountability of medical

schools is their obligation to address the priority health

concerns of communities they serve, as identified

together with governments, health care organizations,

health professionals, and the public. Canadian faculties of

medicine report regularly on their activities in this area,

but it is unclear if communities are able to identify their

needs in these processes.

Methods: We conducted a 10-week internal

environmental scan of social accountability at the

University of Ottawa Faculty of Medicine (FoM). We used

available data sources to collect activities across domains

of admissions, community outreach, curriculum, clinical

service, professional affairs, and innovation and research.

We analyzed data quantitatively by Faculty categories,

values expressed, populations, and social obligation. We

conducted thematic qualitative analysis of a small number

of solicited project descriptions.

Results: Of 729 data items collected, 560 related to social

accountability. Half of the items were classified in the

Education category (281/560, 50.2%), with the vast

majority falling under the curriculum domain (271/281,

96.4%). The values most frequently expressed were

"quality" (293/560, 52.3%) and "partnership" (265/560,

47.3%), and the most frequently mentioned populations

were "marginalized" (153/560, 27.3%), "Indigenous"

(96/560, 17.1%) and "Francophone" (76/560, 13.6%). Only

17.1% (96/560) of all items were deemed socially

accountable. In the qualitative analysis, partnership and

maintaining relationships was again recognized as

essential, as was a focus on priority health needs and

populations.

Conclusions: Some FoM activities are clearly socially

accountable. Other domains could benefit from a greater

emphasis on engagement and identification of priority

health needs.

LP11 - 06-60610

We have work to do! Medical learners and speaking up to

positions of power

Cathy Rocke University of Regina, Lukas Neville University of Manitoba,

Brenda Elias University of Manitoba, Jackie Gruber University of

Manitoba

Background/Purpose: In medical education the learner

environment has been identified as an area for

improvement. Environments where mistreatment exists

can have negative consequences for learning. For

instance, if learners do not feel safe to speak up, if they

are fearful of being humiliated by someone in a position

of power, or if they have concerns about negative career

consequences. Mistreatment can also limit learners in

reporting patient safety issues therefore, silence and self-

censorship may have serious consequences. This study

sought to identify medical learners' comfort level in

speaking up to faculty members, nurses, residents,

administrators and patients.

Methods: A cross-sectional online survey targeted 440

UGME learners at the University of Manitoba, (32%

participation rate). After data editing, a logistic regression

analysis was conducted on a sample of 123 learners.

Results: Male learners were more comfortable then

female learners in speaking up to faculty members

(OR=4.5), nurses (OR=2.6), residents (OR=2.4) and

administrators (OR=4.8). Caucasian learners were more

comfortable speaking up to administrators (OR=2.8) than

racialized learners. First generation learners were less

comfortable speaking up to both patients (OR=-2.9) and

residents (OR=-2.9).

Conclusions: This study showed that women learners,

racialized learners, and first-generation learners were less

likely to be comfortable speaking up to positions of power.

Given the increasing diversity of medical learners and the

importance of speaking up regarding mistreatment, this is

an important finding. It suggests a need for interventions

to increase learner comfort with speaking up, and to

address the conditions leading to the observed gender

disparity.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Teaching & Learning - Postgraduate

LP12 - 1-60735

Physicians first: simulating medical emergencies in

psychiatric settings

Sandra Westcott McMaster University, Kaif Pardhan McMaster

University, Natasha Snelgrove McMaster University, Michael Brown

McMaster University, Sheila Harms McMaster University, Alim Pardhan

McMaster University

Background/Purpose: Simulation is widespread in

medical education yet remains underutilized in psychiatry.

This technique may be particularly useful for practice

managing infrequent and emergent events, such as

medical emergencies in psychiatric settings. Psychiatry

residents at McMaster expressed a desire to increase their

knowledge and skills in encounters where acute medical

management is required. In response, an innovative

interdisciplinary simulation curriculum addressing these

needs was developed.

Summary of innovation: An interdisciplinary group of

educators from psychiatry and emergency medicine

developed a novel medical psychiatry curriculum for first-

year psychiatry residents. This involved two simulations of

common medical emergencies in psychiatric settings,

including seizures and undifferentiated tachycardia. The

focus was on medical expertise, communication, and

collaboration skills necessary for initial management. A

standardized format for communicating with consultants

was introduced, similar to those used in emergency

medicine training. A unique feature of these simulations is

that sessions were co-facilitated by educators from

psychiatry and emergency medicine and included

interprofessional staff as partners in the learning

experience.

Conclusions: Psychiatrists need to be prepared to manage

medical comorbidities in psychiatric settings and

simulation provides an opportunity to safely practice and

enhance these skills. This is the first use of simulation in

our psychiatry training program. Our work contributes to

a small but growing body of literature on the use of

simulation in psychiatry, with an emphasis on medical

psychiatry and the unique opportunities this presents for

interdisciplinary collaboration. This presentation will give

educators insights into our development process, which

they can then apply to their local curricula.

Enhanced clinical opportunities for Junior

Pediatric Residents during admissions from the

Emergency Department to the Clinical

Teaching Unit at the Alberta Children's Hospital

LP12 - 2-60916

Junior Pediatric Residents Satisfaction and Confidence in

Making Clinical Decisions

Laura Davies University of Calgary, Michelle Bailey University of Calgary,

Jovana Milenkovic University of Calgary, Roopa Suppiah University of

Calgary

Background/Purpose: To prepare physicians for

independent practice, residency training programs must

provide its trainees adequate opportunities to practice

making clinical decisions. The University of Calgary

Pediatrics Residency Program is working to enhance

clinical decision-making opportunities for junior pediatric

residents (JR). To date, the patient admission process from

the emergency department (ED) to the general pediatrics

clinical teaching unit (CTU) has been a senior resident-led

role, which ensures safety and efficiency; however, JRs

have not been optimally positioned with respect to their

role in admissions to practice making clinical decisions.

Summary of innovation: Using quality improvement

methodology, a series of interventions were implemented

into the Alberta Children's Hospital's ED to CTU admission

process from August 2019 to June 2020. Online surveys

administered to JRs assessed baseline, midway and final

time point levels of JR satisfaction with their role in the

admission process and JR confidence with their ability to

complete an initial patient assessment independently,

place admission orders and make decisions on patient

care for admissions.

Conclusions: Compared to baseline, final time point levels

of JR satisfaction and confidence were increased.

Importantly, perceived patient safety in and efficiency of

the admission process, measured via online surveys of

senior residents at baseline, midway and final timepoints,

were greatest at the final time point. These results suggest

the interventions implemented in this study were of

benefit to JRs. Residency training programs elsewhere can

apply the same or similar interventions to enhance clinical

decision-making opportunities for residents.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e306

LP12 - 3-60933

Narrative review of the use of the Motivated Strategies

for Learning Questionnaire in health professions

education

Alexandra Aquilina University of Alberta, Cassandra Pirraglia University

of Alberta, Shelley Ross University of Alberta

Background/Purpose: Exploration of the learning

strategies and approaches of learners is an emerging area

of interest in health professions education (HPE) research.

In studies about learning strategies and motivation of HPE

learners, validated measurement tools from the

educational psychology literature are often used. One of

the most commonly used instruments to measure

motivation and learning is the Motivated Strategies for

Learning Questionnaire (MSLQ). The MSLQ has been

validated for use with postsecondary populations.

Because of this, the MSLQ is assumed to be appropriate

for use with HPE learners; however, MSLQ items may need

to be adapted for this population. The purpose of this

narrative review is to come to a greater understanding of

how the MSLQ is being used in HPE research.

Methods: A literature search was carried out using the

following search terms, for articles published 2015-2019:

"Motivated Strategies for Learning Questionnaire" or

"MSLQ", "validity" or "valid" or "evidence of validity", and

"medical education" or "medical students". Searches also

included the use of the keywords "adapted questionnaire"

or "adapted". Identified articles were reviewed by two

researchers, and findings were entered into a database.

Results: Twenty-three articles met inclusion criteria. In all

but three studies, the MSLQ was either used with its

original wording, or items were reworded for the HPE

context but the validity of the adapted measure had not

been tested.

Conclusions: There is a need for a validated version of the

MSLQ that has been adapted for HPE contexts.

LP12 - 4-59931

Applicabilité et appréciation de l'utilisation de la méthode

de révision inversée par des résidents à l'urgence

Véronique Castonguay Université de Montréal, Éric Piette Université de

Montréal, Alexanne Champagne-Provost Université de Montréal

Background/Purpose: La révision des cas évalués par un

résident avec son superviseur se fait traditionnellement

par la méthode de supervision classique. Dans un contexte

d'urgence, les contraintes de débit rendent le temps

disponible à la supervision limité. La méthode de révision

inversée a l'avantage d'être efficace en amenant

l'étudiant à se prononcer et à justifier ses impressions

cliniques dès le début de la supervision. L'objectif de ce

projet est d'évaluer l'appréciation et l'applicabilité de la

méthode de supervision inversée par des résidents à

l'urgence.

Methods: Il s'agit d'une étude prospective unicentrique

impliquant vingt superviseurs et vingt-trois résidents. La

méthode de révision inversée fut utilisée pour tous les cas

rencontrés sur des quarts cliniques prédéfinis. Un

questionnaire était complété après chaque quart et un

sondage fut rempli à la fin du projet . Une analyse

qualitative thématique des commentaires et des

statistiques descriptives furent effectuées.

Results: 76% des résidents ont affirmé apprécier la

méthode et 72% ont noté que celle-ci leur procurait un

enseignement équivalent ou supérieur à la méthode

traditionnelle. 83% ont trouvé le processus de révision

plus efficace (temps). Plus de la moitié ont souligné que

cette méthode leur permettait de mieux explorer leur

processus diagnostic et leur procurait davantage

d'autonomie. Toutefois, plusieurs ont noté que cette

méthode était difficilement applicable pour les cas les plus

complexes ou en situation d'incertitude, surtout les

résidents juniors.

Conclusions: La méthode de révision inversée semble

appréciée par les résidents en contexte d'urgence. Son

applicabilité varie selon la complexité des cas rencontrés

et le niveau du résident.

LP12 - 5-59965

Beyond Skin Deep: Electronic Case-based Learning

Modules to Teach Multidisciplinary Care in Dermatology

among Clerkship Students

Marlene Dytoc University of Alberta, Chaocheng (Harry) Liu University

of British Columbia, Vivienne Beard University of British Columbia

Background/Purpose: Given the high prevalence of skin

conditions, understanding the basics of dermatology is

crucial for graduating medical students. Most Canadian

medical schools offer limited clinical dermatology training

as part of their clerkship curriculum. Medical students

have sparse opportunities to understand the strong

relevance of dermatology to other medical and surgical

areas of medicine.

Summary of innovation: To fill the educational gap, a

team composed of an academic dermatologist, a

dermatology resident, and a medical student co-designed

case-based learning modules for clerkship students. The

format of the modules was developed after an evaluation

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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of various frequently used online learning resources

among clerkship students. The learning modules are

stepwise and case-based, composed of 8-10 multiple

choice questions with detailed explanation, learning

objectives and take-home messages. The content

emphasizes multidisciplinary care in dermatology and

centers around patients with different socioeconomic

status and skin color. Some examples of the topics include

vulvar lichen sclerosus (gynecology), hair loss from

trichotillomania (psychiatry), cutaneous and ocular

rosacea (ophthalmology), and pemphigoid gestationis

(obstetrics). The modules have been launched on the

Division of Dermatology website of the University of

Alberta, with more modules being developed.

Conclusions: These are the first case-based learning

modules in North America designed to help clerkship

students better understand the multidisciplinary care in

dermatology. The modules would also help students

better approach, diagnose, and manage skin conditions,

leading to improved patient care. This innovation also

provides insight into ways that medical schools could

increase their dermatology education when clinic teaching

resources are limited.

LP12 - 6-59993

Teaching Low-Risk Obstetrics: Current Practices in

Canadian Residency

Russell Dawe Memorial – University of Newfoundland, Amanda Tzenov

Memorial – University of Newfoundland, Kaitlyn Stanford Memorial –

University of Newfoundland, Norah Duggan Memorial – University of

Newfoundland, Susan Avery Memorial – University of Newfoundland

Background/Purpose: Family Medicine Low-Risk

Obstetrics (FM LRO) has been shown to result in similar

health outcomes as that provided by obstetricians.

Women and families who have received FM LRO care

value the high level of continuity of care it provides

throughout their pregnancy and delivery. In 2007, a

national survey from the CPFC showed that only 11.1 % of

family physicians were offering intrapartum care, which is

attributed to multiple factors. The Family Centred

Maternity Care (FCMC) program at Memorial University

exists to provide quality care while training family

medicine residents to provide FM LRO care in order to

help elevate the role of FM LRO in medicine. As part of an

ongoing program evaluation of FCMC, a cross-Canada

environmental scan has been of Canadian family medicine

residency programs to characterize the FM LRO portion of

their postgraduate training

Methods: An online survey composed of 15 multiple

choice and free text response questions was distributed to

the program directors of the 17 family medicine residency

programs in Canada to determine if and how FM LRO is

incorporated into their programs. Online survey using

Qualtrics was distributed via email invitation to all

Canadian Family Medicine Residency Program Directors.

Results: Obstetrical teaching in FM residency was carried

out in various ways, with 65 % having exposure during

both years of residency, including 71 % with a designated

obstetrical block. Throughout this training 64 % have

simulations, 77% have procedural training, 89 % have

didactic lectures, and 56% partake in some other form of

training

Conclusions: FM LRO is an important and rewarding

component of family medicine, however training still

presents some difficulty. This qualitative study will help to

improve how FM LRO training is offered in residency.

LP12 - 7-60519

Impact of stress on the performance of neonatal

endotracheal intubation: a randomized controlled trial on

manikins.

Ahmed Moussa Université de Montréal, Evelyne Wassef Université de

Montréal, Thomas Pennaforte Université de Montréal, Michael-Andrew

Assaad Université de Montréal

Background/Purpose: Although a required skill in

pediatric residency programs, success rate of neonatal

endotracheal intubation (NETI) among trainees is low.

NETI is taught using simulation with limited short-term

retention of skill. In the clinical setting, NETI is associated

with stress, which effect on success is poorly studied. The

objective is to assess the impact of stress on the success

of simulated NETI.

Methods: Crossover randomized controlled trial. Pediatric

residents randomized to perform NETI in low (LS) or high

stress (HS) environment, and then crossover. Stress was

created using audio alarms, third party supervisors and

simulated manikin instability. Stress of participants was

assessed at rest, before and after each scenario. Stress

assessment included: salivary cortisol, heart rate and the

State Anxiety Inventory (STAI) questionnaire. Primary and

secondary outcomes include: success rate, time to

successful intubation and stress levels. Success rate was

analyzed using chi2 and continuous variables were

analyzed using paired t-test and repeated measures

ANOVA.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Results: 49 residents (97 NETI) have been recruited and

have completed the study. Success rate in the HS group

was 60% vs 51% in LS (p=0.41). There was no significant

difference with regards to duration of NETI, duration of

scenario or salivary cortisol. Heart rate was significantly

different between HS and LS groups (p<0.001). The STAI

result was also significantly different between HS and LS

groups (p=0.01).

Conclusions: Among stress markers, the heart rate and

STAI increase significantly more in the HS setting. The

stable cortisol level suggest that stress lived by the

resident does not create a sense of loss of control or

distress. These findings suggest that the HS setting is an

appropriate training tool for stress preparedness for

neonatal ETI.

LP12 - 8-60727

In Support of Meaningful Assessment and Feedback: A

Study of Reasoning Tasks Used During Clinical Case

Review in the Ambulatory Internal Medicine Clinic

Christina Valiaveettil Western University, Mark Goldszmidt Western

University, Kristen Bishop Western University, Jacqueline Torti Western

University

Background/Purpose: Most clinical teaching focuses on

completing clinical tasks, such as history taking and

physical exams. Less focus is placed on what we reason

about (reasoning tasks) and how that helps us learn to be

more effective clinicians. The purpose of this study is to

explore how clinical reasoning tasks are used by learners

versus attending physicians during case review in general

internal medicine (GIM) clinics.

Methods: Data consists of 29 audio-recorded case review

discussions, 21 new and 8 follow-up cases, between 7

attending internists and 13 trainees (medical students,

residents, and fellows). A framework of 27 clinical

reasoning tasks was previously developed and validated in

the setting of clinical teaching unit admissions. Transcripts

were analyzed using constant comparison and template

analysis.

Results: Expertise effects were evident in the use of

clinical reasoning tasks. Junior learners focussed on listing

presenting complaints, whereas fellows and attending

physicians would reprioritize complaints to identify the

most salient issues for the encounter. Attending

physicians and fellows were more likely to address how

risk factors and comorbid conditions impact the

presenting complaint, and reason around educational

strategies for patients. Only attending physicians

considered documentation and follow-up strategies.

Interestingly, goals of care and patient decision-making

capacity were only addressed in 2/29 and 0/29 cases,

respectively.

Conclusions: Clinical reasoning tasks provide a

standardized vocabulary to communicate case-based

reasoning during case review discussions. This can be a

valuable way of understanding seniority-dependent

differences in clinical reasoning and identify opportunities

for quality improvement and competency-based

education.

Teaching & Learning - General

LP13 - 01-59681

Quality maternity care? What do patients think?

Lisa Burke Memorial – University of Newfoundland, Russell Dawe

Memorial – University of Newfoundland, Susan Avery Memorial –

University of Newfoundland, Amanda Tzenov Memorial – University of

Newfoundland, Jessica Bishop Memorial – University of Newfoundland,

Norah Duggan Memorial – University of Newfoundland

Background/Purpose: Family physicians (FP) are

providing less low-risk obstetrics (LRO) care service across

North America in recent years. Nevertheless, FPs offering

LRO provide continuity of care which many pregnant

women value, and FPs' clinical outcomes are similar to

those of obstetricians. The objective of this project was to

explore the perceptions of women who have received

care from the Family Centered Maternity Care (FCMC)

program.

Methods: As part of a complete program evaluation of the

FCMC program, key informant interviews with women

who received care from the FCMC team were carried out.

Participants of the study were women who received care

from the FCMC group from July 1, 2017 to June 30, 2018.

Thirteen interviews were completed. A thematic analysis

was completed on the qualitative data using the

Framework Analysis Approach. The codebook was

developed by two authors independently coding three

initial interview transcripts and discussing to achieve

consensus. The remaining transcripts were coded by the

primary author, with any new codes or unclear passages

being reviewed in duplicate to ensure consensus.

Results: Themes clustered around the overarching

categories of FCMC qualities, services provided, continuity

of care, patient satisfaction, and other services/providers.

Overall, patients felt the FCMC provided a high level of

support and encouragement that may not exist in other

models of care. This occurred while maintaining

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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equivalent levels of perceived medical expertise and

safety for low-risk pregnancies, deliveries, and newborn

care.

Conclusions: Overall, women reported positive

perceptions about the quality of care provided by the

FCMC program. This project will eventually be integrated

with other data sources as part of the entire FCMC

program evaluation.

LP13 - 02-60334

Immersive virtual reality (iVR) improves procedural

duration, task completion, and accuracy in surgical

trainees: a systematic review

Lucy Lan McMaster University, Randi Mao McMaster University, Jeffrey

Kay McMaster University, Ryan Lohre University of British Columbia,

Olufemi Ayeni McMaster University, Danny Goel University of British

Columbia, Darren de SA McMaster University

Background/Purpose: With limitations on operating time

for surgical trainees and concerns for patient safety,

immersive virtual reality (iVR) has emerged as a portable,

low-cost, high-fidelity addition to competency-based

surgical education. This review explores current literature

and effectiveness of iVR in surgical skills training.

Methods: A systematic search was performed on

MEDLINE, EMBASE, CENTRAL, Web of Science and

PsycInfo for primary studies published between January 1,

2000 and May 13, 2020. Two reviewers independently

screened citations, extracted data, and assessed

methodological quality using the Medical Education

Research Study Quality Instrument (MERSQI).

Results: The literature search yielded 8,939 citations, with

13 articles included for qualitative synthesis. Ten studies

(three pre-post, seven controlled trials) measured time to

completion. iVR training improves post-intervention time

to completion, with iVR completing procedures 18% to

43% faster than control groups. Two of four controlled

trials that used task-specific checklists found iVR groups

completed significantly more steps than control post-

intervention. In one study, the iVR group scored 14 points

higher on a 30-point checklist (p<0.001). 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.

Conclusions: To our knowledge, studies on iVR have not

been systematically reviewed in the context of surgical

training. Given its efficacy, positive user ratings, and cost-

effectiveness, iVR has strong potential for widespread

adoption into surgical training programs.

LP13 - 03-60526

Former les étudiants en médecine à la téléconsultation

avec des patients simulés : de l'analyse des interactions à

l'identification de modes de présentation du scénario de

simulation

Sylvie Grosjean University of Ottawa, Maria Cherba University of

Ottawa, Amélie Gauthier-Beaupré University of Ottawa, Frédérik Matte

University of Ottawa, Isabelle Burnier University of Ottawa

Background/Purpose: L'essor de la télémédecine pose

des défis au niveau de la formation des futurs médecins.

Les téléconsultations simulées (TCS), impliquant des

patients simulés (PS), sont une méthode de formation

utilisée visant l'amélioration des compétences

communicationnelles chez les étudiants en médecine. Or,

les PS ont un rôle déterminant pour rendre la simulation

aussi réaliste que possible. Notre objectif est d'examiner

les interactions PS/étudiants lors de TCS afin d'identifier

les modes de présentation du scénario par les PS.

Methods: Les données analysées comprennent un corpus

de 74 enregistrements vidéo de TCS impliquant 13 PS et

les transcriptions de 2 groupes de discussion avec 7 PS.

Une analyse des interactions PS/étudiants a été effectuée

à partir des enregistrements, et ensuite nous avons

procédé à une analyse thématique des transcriptions de

groupes de discussion.

Results: À partir de l'analyse des interactions, nous avons

identifié deux modes de présentation du scénario par les

PS : la présentation « jouée » reposant sur une forme de

communication multimodale (langage, corps, intonation)

et la présentation « narrée » reposant sur une mise en

récit d'éléments contextuels du scénario. L'analyse des

groupes de discussion a permis de révéler le besoin pour

les PS d'adapter l'interprétation du scénario au contexte

de TCS.

Conclusions: Les modes de présentation du scénario par

les PS seront utilisés pour bonifier la rédaction des

scénarios de simulation et pour développer une formation

visant à permettre aux PS d'interpréter les scénarios dans

un contexte d'enseignement de la télémédecine.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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LP13 - 04-60544

Modules d'auto-apprentissage en dermatologie pour le

cours Multisystèmes en médecine à l'Université de

Montréal : Mise en place d'une nouvelle méthodologie

d'apprentissage et impact sur les étudiants

Darosa Lim Université de Montréal, Mélissa Nantel-Battista Université

de Montréal

Background/Purpose: L'enseignement de la dermatologie

est limité en médecine préclinique bien qu'elle recoupe

plusieurs spécialités médicales. Pour le cours

Multisystèmes en médecine, des modules d'auto-

apprentissage en dermatologie couvrant diverses

maladies systémiques ont été conçus pour les étudiants

utilisant la formation par concordance. Cette méthode

pédagogique sollicite le raisonnement et l'organisation de

l'information pour résoudre un problème. L'objectif est de

faciliter l'intégration de la dermatologie tout en faisant

des liens avec les autres cours. L'impact sur les étudiants

a été évalué.

Summary of innovation: Seize modules ont été réalisés

selon différentes maladies systémiques abordés dans le

cours. Dans chaque module, une vignette clinique

suscitant la réflexion est introduite, suivie de pistes

d'action parmi desquelles l'étudiant doit prioriser. Il

compare ensuite son raisonnement avec celui d'experts

(dermatologue). Les informations cliniques relatives à la

vignette sont ensuite présentées afin d'intégrer la matière

d'un point de vue clinique, notamment via des diagnostics

différentiels. Tous les étudiants ont rempli un sondage et

un suivi sur leur performance à l'examen sommatif a été

effectué.

Conclusions: Le sondage rempli par 276 étudiants a

montré que les modules ont été appréciés (93% en

accord) ainsi que la formation par concordance avec

vignettes (83%). 91% ont rapporté que les modules

permettent de faire des liens avec les autres cours. 89% se

disent plus à l'aise de reconnaître les signes

dermatologiques de maladies systémiques. 84% des

étudiants ont complété les modules d'au moins 80%. La

performance à l'examen sommatif en dermatologie a été

de 84,2% (médiane). Ce projet démontre donc l'utilité et

l'appréciation d'une telle méthode pédagogique.

LP13 - 05-60830

Assessment of Student Perceptions of the Importance of

Embryology in a Medical Curriculum

Alexa Hryniuk University of Manitoba

Background/Purpose: Basic science content hours have

been reduced in medical school curricula over the years

and it is therefore imperative that content covered be

clinically relevant to students. The purpose of this study is

to assess the student perspective of the importance of

teaching and learning embryology in the medical

curriculum.

Methods: At the end of first year, medical students at the

University of Manitoba (n=65) completed a questionnaire

containing likert scale and open-ended questions

regarding the embryology curriculum at the University of

Manitoba.

Results: The majority of students agree and strongly agree

that embryology is an important part of medical training

(53%, 20%) and helps to better understand clinical

conditions (33%, 40%) especially those with future

ambitions related to OBGYN specialties. Students ranked

topics relating to heart development, nervous system

development and eye development as most important to

learn in the medical curriculum. Interestingly, when

students ranked those same topics to clinical relevancy

urogenital development and pregnancy joined those

previously mentioned as most important. In open-ended

questions, students discussed the need to highlight the

clinical relevance of embryology more throughout the first

year curriculum. Additionally, many students commented

that since very little formal assessment related to

embryology topics students put little effort into learning

and understanding this information.

Conclusions: While students understand that the study of

embryology is important, a void in the teaching clinical

relevance and a need to develop more appropriate

assessment strategies to promote learning of embryology

topics has been identified.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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LP13 - 06-60692

Récits de soi récits de soins: Nouvelles perspectives

pédagogique et éthique

Melissa Taguemout Université de Montréal, Anne-Sophie Eymard

Université de Montréal, Philippe Karazivan Université de Montréal,

Annie Descoteaux Université de Montréal, Alexandre Berkesse Centre

d'excellence sur le partenariat avec les patients et le public,, Antoine

Payot Université de Montréal, Nathalie Orr-Gaucher Université de

Montréal, Amélie DuPont-Thibodeau Université de Montréal, Clara

Dallaire Université de Montréal, Mathieu Jackson Université de

Montréal, Marie-Pierre Codsi Université de Montréal, Vincent Dumez

Université de Montréal

Background/Purpose: L'enseignement de la

communication et des enjeux éthiques dispensé aux

étudiants reste un défi en éducation médicale. Depuis

2014, les étudiants de l'Université de Montréal

produisent, dans le cadre d'ateliers d'éthique clinique, des

vignettes portant sur des situations humaines complexes

vécues pendant leur externat. Plus de 1500 vignettes

écrites par les étudiants, ainsi qu'une trentaine de

vignettes écrites par les patients partenaires

coformateurs ont été le tremplin vers une initiative

pédagogique.

Summary of innovation: Certaines vignettes marquantes

ont retenu l'attention des coanimateurs et suscité intérêt

et discussions. Les membres de la Direction collaboration

et partenariat patient (DCPP), le Bureau de l'éthique

clinique (BEC) de la faculté de médecine de l'Université de

Montréal ainsi que des comédiens se sont réunis pour

coconstruire avec les étudiants et les patients une soirée

théâtre de mise en lecture de ces vignettes. L'importance

des thèmes, l'impact émotif du contenu et la puissance

pédagogique portés par ces vignettes ont mené l'équipe à

vouloir mettre en lumière les éléments éthiques. Cette

soirée a été présentée dans le cadre d'un colloque en

pédagogie médicale (SIFEM) en mai 2019 à Montréal.

Conclusions: Plusieurs apprentissages découlent de ce

processus de coconstruction à la fois pour les étudiants,

les patients, les cliniciens enseignants et le public. Cette

innovation pédagogique pourra inspirer d'autres

programmes universitaires pour l'enseignement de

l'éthique, de la communication et pour mieux naviguer

dans les situations relationnelles complexes et à intégrer

la réflexivité dans leurs pratiques professionnelles. Cette

activité pédagogique sera reprise à l'Université de

Montréal pour l'année 2020.

Teaching & Learning - Undergraduate

LP15 - 01-60315

Development of Netiquette (online etiquette) for

resident academic half day

Ainsley Kempenaar University of Toronto, Jason Liang University of

Toronto, Heather MacNeill University of Toronto

Background/Purpose: The current pandemic has caused a

rapid shift to "emergency" online teaching particularly in

synchronous (webinar) environments, with limited

preparation of teachers and learners. Face to face learning

rules are typically well established from an early age, but

in online learning are not quite so clear. Establishing

netiquette, or online learning rules such as webcam usage

and communication methods, can be limited by lack of

time, lack of knowledge, privacy, accessibility and

inclusivity considerations, many of which can be mediated

by facilitated discussion, consensus building and

collaborative/creative solutions.

Summary of innovation: Rooted in Garrison's community

of inquiry framework, this initiative outlines an approach

that can be considered when developing netiquette

amongst a learner group that is meeting frequently over

time. Learners (in this case medical residents) were

presented with netiquette considerations, followed by

discussion, online voting, and development of a

moderator guide for working with invited speakers. 69%

of residents felt that a reasonable percentage of face-time

(i.e. webcam on) to strive for during synchronous teaching

sessions was greater than 50% of the allotted time. 62%

agreed to use non-verbal feedback to identify their status.

69% felt that an ideal virtual break was 10 minutes. Polling

questions and breakout rooms were the preferred

methods of utilizing interactivity to maintain engagement.

Conclusions: This approach and associated resources may

be helpful in establishing netiquette for learner groups

transitioning to online environments, particularly in a

PGME context. References 1. Watermeyer et al. Higher

Education. Jun 2020. 2. Garrison et al. Internet and Higher

Education 13 (2010) 5-9 3. D'Alesandro, M. Nurse

Educator. 45 (5):243-247.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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LP15 - 02-60480

Think, pair-up, predict, justify, and now, practice: Using

the Student-Generated Reasoning Tool (SGRT) to

generate a bank of practice problems

Ivry Zagury-Orly Université de Montréal, Nicolas Thibodeau-Jarry

Université de Montréal, Edward Krupat Beth Israel Deaconess Medical

Center, Harvard Medical School, Jeannine Kassis Université de Montréal,

Bernard Charlin Université de Montréal, Nicolas Fernandez Université

de Montréal, Krisztina Fischer Department of Radiology, Brigham and

Women's Hospital, Harvard Medical School

Background/Purpose: Cognitive biases are largely

responsible for medical error and educational tools that

help guide students' critical thinking are limited. Using the

Student-Generated Reasoning Tool (SGRT) - a semi-

structured approach to guiding medical students' critical

thinking - objectives of this study were to determine the

feasibility of students using SGRT to create practice

problems and to compare the impact of individual vs.

teamwork with SGRT.

Methods: A proof-of-concept randomized controlled trial

(RCT) was conducted in Fall-2019 on second-year medical

students at Université de Montréal. Group-A (n=8)

generated SGRT practice problems and practiced with

them; Group-B (n=4) practiced with SGRT problems

generated by Group-A. We compared individual vs. team

responses to SGRT, administered surveys and conducted

interviews.

Results: Group-A students generated 12 practice

problems that both Group-A and B successfully used for

practice, within allotted time. In Group-A, teams

suggested a greater variety of diagnostic hypotheses and

predicted more findings compared to individuals.

Students' perceived usefulness was higher in Group A vs.

B (mean= 4.5±0.3 vs. 3.5±0.3, P=0.02). Thematic content

analysis revealed that students used numerous critical

thinking skills (n=6) when using SGRT.

Conclusions: Building on the learning science of team-

based learning and retrieval practice, this study offers a

feasible approach for students to collaboratively generate

a bank of practice problems using the SGRT, while making

use of multiple critical thinking skills. Ultimately, this study

justifies a larger-scale RCT comparing students who use

the SGRT to generate and practice to those that only

practice, isolating the relative impact of generation on

learning.

LP15 - 03-60652

Features of effective social media in undergraduate

medicaleducation: A systematic review

Mrudula Utukuri , Eliot Rees Keele University School of Medicine, Aqua

Asif Leicester Medical School, Timothy Chu Newcastle University,

Jonathan Guckian Leeds Teaching Hospitals Trust, Adam Oumeziane

Anglia Ruskin University, Joshua Adeyoju , Ollie Burton Warwick Medical

School

Background/Purpose: There are over 3.81 billion

worldwide active social media (SoMe) users. SoMe is

ubiquitous in medical education, with roles in

professionalism, blended learning, well-being and

mentoring. Previous reviews took place before surges in

popularity and revealed a paucity of quality empirical

studies assessing efficacy. This review aimed to synthesise

evidence regarding SoMe interventions in undergraduate

medical education, identifying features associated with

positive & negative outcomes.

Methods: We searched 31 key terms through 7 databases,

as well as references, citation & hand searching. We

included studies describing interventions and research on

exposure to existing SoMe. Title, abstract and full paper

screening were undertaken independently by two

reviewers. Papers were assessed for quality using the

Medical Education Research Study Quality Instrument

(MERSQI) and/or the Standards for Reporting Qualitative

Research (SRQR) instrument. Extracted data were

synthesised using narrative synthesis.

Results: 112 studies met criteria. Methodological quality

had not improved since 2013. Engagement and

satisfaction with SoMe platforms were described, with

hierarchy flattening & improved communication with

educators detailed. SoMe use was associated with

objectively & subjectively improved performance,

however evidence for long term knowledge retention was

limited. SoMe was linked to adverse impacts on mental &

physical health. Professionalism was heavily investigated

& considered important, though negative correlation

between SoMe use & professionalism may exist.

Conclusions: SoMe is enjoyable, may improve short term

knowledge retention & can aid communication between

learners and educators. However, long-term, high-quality

study is required to investigate professionalism concerns

& potential harms.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

e313

LP15 - 04-59495

Near Peer Tutoring in Medical Anatomy Education: A Pilot

Study

Rohit Singla University of British Columbia, Kurt McBurney University of

British Columbia Joana Gil-Mohapel University of British Columbia

Background/Purpose: Near-peer teaching has emerged in

the anatomy education literature as a model for having

senior students serving as tutors to junior students. This

approach has yet to see widespread use and integration in

undergraduate medical education. We launched a pilot

study involving Year 2 (Y2) medical students acting as

near-peer tutors (NPTs) in Year 1 (Y1) anatomy labs. We

evaluated the impact on Y1 learners and Y2 NPTs.

Methods: Y2 medical students at our local institution

were invited to act as NPTs in Y1 neuro- and gross

anatomy labs. Six NPTs participated in nine labs for 31 Y1

medical students. Lab content ranged from dissection and

overview of gross specimens, neuroanatomy micrograph

review, and clinical case discussion. NPTs performed

select demonstrations; assisted in dissections; answered

questions; and taught clinical cases. Post-lab, NPTs were

surveyed on their experience. At the end of term, Y1

learners were surveyed regarding their experience with

NPTs.

Results: NPTs self-reported increased comfort with

regards to teaching. In preparation, this opportunity

allowed NPTs to review previously learned material, and

the majority derived simplified approach for learners

and/or were able to anticipate potential questions. Y1

learners felt NPTs were able to identify knowledge gaps,

present information in a student focused manner, and

overall enjoyed the inter-year collaboration and

collegiality. Faculty interviews also revealed that having

NPTs did not significantly increase their lab preparation,

set-up and workload.

Conclusions: This initial pilot yielded promising results.

NPTs have the potential to positively impact multiple

stakeholders (Y1 and Y2 learners as well as faculty) in the

context of medical anatomy education. Future work will

investigate impacts of this educational strategy on

participants' knowledge retention and for medical

students without prior anatomy knowledge.

LP15 - 05-60223

The Early Introduction of Ultrasound in Undergraduate

Medicine

SamanthaStasiuk University of British Columbia, Angelina Marinkovic

University of British Columbia, Pete Tonseth University of British

Columbia, Alasdair Nazerali-Maitland University of British Columbia ,

Eleanor Good University of British Columbia , Anthony Sturgeon

University of British Columbia

Background/Purpose: At UBC, we have updated our

ultrasound curriculum over the past two years to include

an innovative early introduction to ultrasound

program. We have implemented strategies to deal with

challenges in uptake and faculty recruitment across our

main campus in Vancouver and distributed medical

education (DME) sites.

Summary of innovation: The ultrasound curriculum at

UBC has expanded over the past 2 years, driven by the

literature that demonstrates the importance of early

exposure alongside a desire from learners. Recently,

recommendations from the Canadian Ultrasound

Consensus for Undergraduate Medical Education Group

have described the growing importance of this curriculum.

At UBC, our current curricular suite includes 6 ultrasound

sessions and 2 ultrasound lectures. The expansion has

included the addition of introductory abdominal, cardiac,

and volume assessment sessions. These sessions occur

during the first year, in the first term of our Clinical Skills

program using hypothesis-driven technique as an

extension of the physical exam. This was born from a

desire to increase the overall number of scanning

opportunities from 3 to 6, to increase exposure and

comfort point of care ultrasound (POCUS). Student and

faculty feedback was extremely useful in fine-tuning these

sessions. Additional teaching support was obtained

through faculty development sessions that were run at

each of our DME sites. This consisted of an expert-

facilitated session with an opportunity to provide an

ultrasound curriculum refresher for faculty as well as

ongoing mentorship. Recruitment for the next semester's

teaching sessions was completed in record time.

Results: Students now have 6 different opportunities to

scan during their preclinical years with future plans to

have learners acquire images independently. Tutor

recruitment is complete months in advance with high

quality tutors. These interventions will better prepare our

students to scan in clerkship and residency.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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LP15 - 06-60324

The Big Bang: Developing a Virtual Subarachnoid

Hemorrhage Simulation for Preclinical Medical Students

Katie Harris Memorial – University of Newfoundland, Gillian Sheppard

Memorial – University of Newfoundland

Background/Purpose: Simulation-based learning is

important for rare, high mortality cases which are unlikely

to be witnessed during clinical rotations but are likely to

be encountered in during future practice, such a

subarachnoid hemorrhage. However, neurology case

simulations, especially those targeted at preclinical

learners, are underrepresented in simulation pedagogy.

We designed and are planning to test a virtual simulation

of subarachnoid hemorrhage for preclinical medical

students. We seek to answer the question: can we

enhance the delivery of neurology curriculum for

preclinical medical students using virtual simulation of a

subarachnoid hemorrhage?

Summary of innovation: We successfully designed a

virtual simulation which is 15 minutes long, and requires

only one standardized patient and one confederate, which

makes this simulation accessible to institutions with

limited simulation resources. We developed pre- and

post- simulation surveys to collect quantitative (Likert

scale) and qualitative (open-ended response) data on self-

assessed confidence in neurology history taking, virtual

physical exam and ability to generate a differential

diagnosis. The questions from the pre- and post-

simulation surveys can be analyzed to detect changes in

the students' level of confidence post-simulation.

Conclusions: The development of an accessible

subarachnoid hemorrhage simulation for preclinical

medical learning partially addresses the educational need

to create additional accessible neurology training tools for

preclinical students, especially during restricted access to

clinical experiences due to COVID-19. Student feedback on

this simulation will be collected in Winter 2021. Analysis

of student experiences will build upon the existing

literature surrounding the efficacy of simulation as a

training tool.

LP16 - 01-60533

Do "Teddy Bear Hospital Project School Visits" improve

pre-clerkship students' comfort communicating medical

topics to children?

Olivia Lemire University of Ottawa, Marc Zucker University of Ottawa,

StephanieLau University of Ottawa, Dr. Megan Harrison University of

Toronto, Anna Karwowska University of Ottawa, Hannah Kis University

of Ottawa, Kaitlin Endres University of Ottawa

Background/Purpose: The Teddy Bear Hospital Project

(TBHP) is an international initiative aimed at reducing

children's fears associated with healthcare visits by

modeling these interactions using teddy bears. uOttawa's

program has outlined an additional objective: increasing

pre-clerkship medical students' comfort communicating

medical topics to children. A preliminary analysis involving

only post-visit surveys suggested that this objective was

being met. However, this study aimed to assess for a

significant change in comfort communicating medical

concepts to children using pre- and post- visit surveys.

Methods: Pre-clerkship volunteers (n=36) participated in

24 kindergarten/grade one classroom visits from

September 2019-March 2020. Visits 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: 86.11% (31/36) of volunteers were included in

our study. There was a statistically significant increase in

volunteers' self-reported comfort communicating medical

topics to young children (Pre-Mean=6.96, SD = 1.51; Post-

Mean=7.62, SD=1.1; p=0.01). However, there was no

statistically significant difference in volunteers' reported

interest in pursuing a career with a pediatric-focus (Pre-

Mean=8.00, SD=1.54; Post-Mean=7.7, SD=1.96; p=0.24).

100% (36/36) of volunteers reported that they would

recommend TBHP to a colleague interested in pursuing

family medicine or pediatrics.

Conclusions: Our study suggests that TBHP met its

objective of increasing medical students' self-perceived

comfort in communicating medical topics to children. Our

study is limited by small sample size and a possible ceiling

effect. In future studies, we aim to further explore the

longitudinal effects that TBHP pre-clerkship participation

has on students' comfort throughout their clerkship

pediatric rotation.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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LP16 - 02-60634

Simulated Patient Encounters: An Online Medical

Education Tool to Train Clinical Reasoning Skills

Mark Grinberg McMaster University, Maxwell Ng McMaster University,

He Tian Chen McMaster University

Background/Purpose: Developing clinical reasoning and

decision-making is a key objective of medical education.

However, this skill set is generally not formally taught nor

assessed in pre-clerkship undergraduate medical

curricula. Furthermore, the virtualization of clerkship due

to COVID-19 has further limited students' direct exposure

to clinical patient care. These present a gap in the medical

curriculum where students lack practical experience in

navigating knowledge gathering and decision-making in

the clinical setting.

Summary of innovation: We have developed an online

tool that simulates a virtual clinical visit and a hospital

EMR, where students are presented with a patient and

chief complaint. Students autonomously gather history,

select and interpret physical exams and investigations,

generate a list of differential diagnoses, decide upon a

final diagnosis, and propose a management plan, at their

own pace. Each patient is procedurally generated to

enable a large repertoire of cases with varying

presentations that mimic a realistic patient population. On

completing the case, the student is provided automated

feedback on the pertinent aspects of the case. This

learning model complements traditional medical teaching

by encouraging application of the student's accrued

knowledge beyond rote memorization, as well as

developing intuition about patient variation and the

diagnostic utility of different findings.

Conclusions: We have developed a novel tool for self-

directed learning of clinical reasoning skills. We collected

qualitative feedback from medical students and faculty

members to inform its development and evaluate its

usefulness. This demonstrates the feasibility of

computerized simulations as a tool for enhancing medical

education.

LP16 - 03-60663

Seeing Colour: Representation of skin tones in

dermatological manifestations of illness in medical

education

Dharini Ilangomaran Western University, Kush Joshi Western University,

Javeed Sukhera Western University

Background/Purpose: Patients with skin of colour

experience worse health outcomes and receive poorer

quality of care within the healthcare system. There are

pervasive inequities entrenched within medical education

which influence these discrepancies. Understanding how

components of medical education contribute to inequities

is essential to address racial biases in healthcare at their

source. This study explored the role of didactic teaching of

skin manifestations of illness in perpetuating this disparity

in a Canadian context.

Methods: The authors reviewed 980 images across 643

lectures spanning 15 courses throughout two years of

preclinical curriculum from September 2018 to May 2020

at a Canadian medical school. Images were categorized

according to the Fitzpatrick Scale: Light Tone (LT),

Medium/Dark Tone (MDT), and Unclear Tone (UT). The

average number of LT and MDT images per lecture was

then compared within each core medical course, as well

as across the pre-clerkship curriculum in total using paired

two-tailed t-tests.

Results: The overall proportions of LT and MDT images

were 81.9% and 10.8%, respectively. Comparing the

average number of images in the LT and MDT categories

per lecture, LT images (1.25) were significantly more

abundant than MDT images (0.16) in an overall curricular

analysis (p=1.78 E-09). This difference was also observed

within the Skin course (LT = 23.4; MDT = 3.4; p = 0.0004).

Conclusions: The disproportionate amount of light skin

images in preclinical medical education reproduces

inequities and contributes to racial disparity. Medical

educators must recognize and address how illness is

depicted for diverse patient populations in order to

advance equity.

LP16 - 04-60750

Bridging the gap in clinical skills: A pilot study investigating

the use of respiratory clinical examination skills in practice.

Randi Mao McMaster University, Jason Profetto McMaster University,

Shreyas Sreeraman McMaster University, Janhavi Patel McMaster

University, Sophia Kerzner McMaster University,

Background/Purpose: There is a paucity of literature that

explores whether students use the clinical skills learned

during medical school in practice. This study aims to fill

this gap, as a greater understanding of clinically relevant

examination skills may better focus studying, increase

clinical competence, and ease student anxiety.

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 sought to determine the practical

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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use of respiratory examination skills in the McMaster

Clinical Skills guide. We conducted basic quantitative

analysis and descriptive content analysis to evaluate

results.

Results: From a total of 161 respondents, 148 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, except for auscultating for breath

sounds (100% useful). In qualitative analysis, the major

theme was that skills should be taught despite minimal

use as they help teach disease pathophysiology, help in

limited resource settings, and have usefulness in

particular situations (e.g., traumas or different

specialties).

Conclusions: There is a discrepancy between the clinical

skills taught to students and the ones actually used in

practice. Despite this, there is still utility in teaching these

skills to medical students. Rather than removing skills

from the curriculum, a better avenue would be to

emphasize maneuvers that are clinically important to help

guide preparation for clinical settings.

LP16 - 05-60767

MedExpo: A Novel Teaching Tool for Short and Long-

Term Retention of Medical Concepts

Deeksha Kundapur University of Ottawa, Trisha Kandiah University of

Ottawa, Alexandra Hughes-Visentin University of Ottawa

Background/Purpose: Currently, few outreach programs

have been developed to evaluate high school student

competency and familiarity with medical education. In

response, we have created a high school outreach

program called MedExpo, which provides invaluable

teaching experience to medical students while providing

high school learners with novel interactive learning

experiences in point-of-care ultrasound (PoCUS), vital sign

assessment, and cadaveric anatomy. We have set out to

determine whether MedExpo is a valuable educational

tool for high school students and if the program yields

long-term knowledge retention.

Summary of innovation: During each session, medical

students teach workshops to high school students in the

areas described above. To determine whether our

workshops resulted in knowledge retention, we surveyed

the participants at three time points (pre-, post-, and

three-months post-session). Overall, 218 high school

students participated, and completed identical pre-

session (n=218), post-session (n=218), and three months

post-session (n=116) quizzes. Average post-session scores

(82%) were significantly higher than average pre-session

scores (58%) (p<0.001). Average three-month post session

scores (67%) were also higher compared to pre-session

scores (p<0.001). A one-way ANOVA analysis on the

overall scores as well as the individual sections in the quiz

were calculated, all showing statistical significance.

Conclusions: Based on our initial data, we conclude that

MedExpo is a tool that positively modulates student

knowledge well beyond the outreach sessions themselves,

resulting in long-term retention. This suggests that

incorporating formative assessments in science outreach

programs can be extremely valuable to both participants

and educators.

LP16 - 06-60843

Clerkship students as teachers: The role for a student-led

bedside teaching program in medical school

Gurmun Brar University of Ottawa, Karima Khamisa University of

Ottawa, Sarang Gupta University of Toronto,

Background/Purpose: The ability to teach effectively is an

essential skill for physicians; however, medical students

may not receive sufficient opportunity to develop this skill

during medical school. In this study, we sought to

investigate the perceptions and potential benefits of

clerkship students engaging in an innovative peer-assisted

bedside teaching (PABT) program.

Summary of innovation: Over a three-year period,

clerkship students on their Internal Medicine block at

uOttawa were recruited to conduct a bedside teaching

session for pre-clerkship students. Tutors taught two 60-

minute small group sessions based on their choice of

patient admitted to the Internal Medicine ward. Each

session was organized to have a traditional teaching

component, a bedside teaching component, and a

debriefing component. After the session, tutors and

students completed a feedback questionnaire.

Conclusions: 32 clerkship students and 117 pre-clerkship

students completed an evaluation of the program. 94% of

tutors felt that they improved their teaching skills and 84%

felt they had increased levels of confidence in their

teaching abilities after their session. Only 34% of tutors

reported that they had many other opportunities to teach

during medical school. 94% of pre-clerkship students

found the sessions reinforced the clinical skills they had

learned in medical school, with 79% and 77% feeling more

comfortable taking a history and physical exam

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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respectively. Our study found that PABT is an effective

method for fostering teaching skill and confidence among

clerkship students, with the additional benefit of

reinforcing clinical skills taught to pre-clerkship students.

PABT may have potential to meet the demand for teaching

opportunities in UGME.

LP16 - 07-60844

How two books published by a student committee help

students prepare for practical exams

Valérie Séguin Université Laval, Fannie Tremblay Université Laval,

Philippe Marineau Université Laval, Antoine Bergeron Université Laval,

Frédérique Boisvenue Université Laval, Valérie Bouchard Université

Laval, Chloé Grenon Université Laval, Samuel Leduc Université Laval,

Louis-Bénédict Landry Université Laval, Julien Mercier Université Laval,

Louis Miazga Université Laval, Éliane Pelletier Université Laval,

Sophianne Samson Université Laval, Anne-Julie Simard Université Laval

Background/Purpose: It is a well-known fact that medical

students often trade their textbooks for alternative tools

such as summaries, charts and diagrams when preparing

for exams like the OSCEs. They seek structure and clarity

across the large amount of information they need to

assimilate.

Summary of innovation: With that in mind, the Groupe de

perfectionnement des habiletés cliniques (GPHC) at

Université Laval (UL) published, in 2013, the 1st edition of

the Petit guide des habiletés cliniques (PGHC) and, in

2016, the 1st edition of the Petit guide de l'entrevue

médicale (PGEM). The PGHC, a reference book developed

and reviewed by more than 200 students and 40

physicians from various specialties, focuses mainly on the

physical exam findings for 215 pathologies classified by

system. It was renewed in 2018 with a 2nd edition. The

PGEM, which addresses the medical interview and its

related skills, is currently being reedited to be more

consistent with the PGHC presentation.

Conclusions: The second edition of the PGHC sold more

than 1,400 copies across several francophone universities

in the province of Quebec, and both the PGEM and the

PGHC are available in select bookstores. In a recent limited

survey conducted among UL students, 98% of the

responders stated that they used the books at least once

to prepare for a practical exam. The GPHC is always

looking for recommendations and therefore opportunities

to improve their books. The creation of such a network

within the medical education community promotes

knowledge and student collaboration with their peers and

teachers, for purposes of teaching and learning

innovation.

Learning Outcomes

LP17 - 01-60257

Impact of the mini-schools of health on future healthcare

professionals' attitudes toward indigenous people

Anne-Sophie Thommeret-Carrière Université de Montréal, Richard

Rioux Université de Montréal, Éric Drouin Université de Montréal,

Christophe Moderie McGill, Jean-Michel Leduc Université de Montréal

Background/Purpose: Université de Montréal organizes

Mini-Schools (MS), during which voluntary

undergraduates of health sciences visit indigenous youth

and exchange about health topics. Undergraduates take

part to a pre-departure training one week before the MS.

The MS last one day (Wemotaci) or one week (Côte-Nord).

This study aims to assess the impact of these activities on

undergraduates' prejudices toward indigenous people.

Methods: Undergraduates completed the Old-fashioned

and the Modern Prejudiced Attitudes Toward Aboriginals

Scale (O-PATAS and M-PATAS) before the training

(baseline), after the training (T1) and after the MS (T2).

Scores were compared using repeated measures ANOVA.

Results: Among the 70 participants, 49 filled the

questionnaire at baseline, T1 and T2 (70% participation

rate). They were from 11 health & social sciences

programs, 77.6% were women, mean age was 21.8, 36.7%

were in medicine, 24.5% in nursing. There was a significant

reduction of prejudices as measured by the O-PATAS

(Baseline 23.1 ± 5.9, vs. T1 22.4 ± 5.5 vs. T2 18.9 ± 5.6;

Intervention effect : F (2, 96) = 12.4, p < 0.001). The

reduction was significant at T2 (F(1,48) = 12.7 p=0.001),

but not at T1 (F(1,48) = 0.7 p=0.4). Likewise, there was a

reduction of prejudices as measured by the M-PATAS

(Baseline 23.2 ± 6.0, vs. T1 23.6 ± 6.2 vs. T2 21.1 ± 5.5;

Intervention effect : F (2,96) = 5.3, p =0.009). The

reduction was significant at T2 (F(1,48) = 7.9 p=0.007), but

not at T1 (F(1,48) = 0.5 p=0.5).

Conclusions: In a group of voluntary undergraduates in

health and social sciences, opportunity for exchange with

indigenous communities, but not theoretical teaching,

appears to reduce prejudices. Maintenance of such

changes over time remains to be eluded.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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LP17 - 02-60759

Evaluating residency match outcomes of MD+ programs:

a Canada-wide survey

Tina Binesh-Marvasti University of Toronto, Siddharth Nath McGill,

Valera Castanov Queen’s University, Corey Lefebvre Western University,

Elina Cook Queen’s University, Adam Pietrobon University of Ottawa,

Sara Mirali University of Toronto

Background/Purpose: MD+ training programs are

designed to equip trainees with the knowledge and skills

necessary to pursue a clinician-scientist career pathway,

and following their completion, the next step in training is

typically postgraduate medical education. Examining

outcomes of MD+ trainees in the residency match is

crucial to determining the effectiveness of MD+ training

programs in producing clinician-scientists.

Methods: We conducted a survey of graduates of MD+

programs in Canada from 2016-2020. The survey

consisted of 17 questions targeted towards participation

and performance in the residency match process. All

questions were optional and data were collected through

an anonymous online Google Forms document. The

survey was open for completion from October 2019-

September 2020.

Results: We received 17 unique responses. 100% of

respondents participated in the Canadian Resident

Matching Service (CaRMS) match. Most participants

(29.4%) completed their training program and entered the

match in 2017. No respondents indicated that they

entered American residency match processes. 88.2% of

respondents matched to a postgraduate training program

in the first iteration of the CaRMS match and an equivalent

number to their top choice discipline. Notably, only 64.7%

matched to their top choice program. Only 43.8% of

respondents indicated they intended to pursue a career as

a clinician-scientist upon completion of their training.

Conclusions: Residency match outcomes of MD+

graduates are largely positive, however, there remains a

large disparity between the number of graduates and the

number intending to pursue research-focused careers.

Our work has important implications for advocacy,

curriculum design, and mentorship within MD+ programs.

LP17 - 03-60565

Turning out well-rounded oncologists: Are our residency

learning outcomes up to the task?

Cindy Lin Western University, Timothy Nguyen Western University,

Michael Sanatani Western University

Background/Purpose: Successful implementation of

Competency-Based Medical Education in residency

training relies on well-defined and holistic learning

objectives. The purpose of our study was to ascertain

whether our oncology residency programs' learning

objectives reflect a comprehensive spread of

competencies according to established learning

taxonomies, and to evaluate their quality.

Methods: All 1117 learning objectives from the Medical

Oncology and Radiation Oncology residency programs at

Western University were evaluated based on the SMART

rubric (Specific, Measurable, Attainable, Realistic, Timely).

Bloom's Taxonomy was used to map learning domains.

Objectives' clinical competency domains were categorized

according to Fink's Taxonomy and CanMEDS.

Results: Thirty-six percent of the objectives met all SMART

criteria. Sixty-eight percent of objectives targeted recall

and understanding in Bloom's cognitive domain while 66%

of objectives targeted receiving and responding in the

affective domain. All CanMEDS roles were represented

within 1117 objectives with 68% focused on Medical

Expert. Using Fink's taxonomy, 70% of objectives targeted

Foundational knowledge, 24% Application, 20%

Integration, 18% Human dimension, 5% Learning to learn,

and 2 % Caring.

Conclusions: Existing oncology objectives emphasize

CanMEDS medical expert competency, achieved through

lower levels of Bloom's cognitive domains. Using Fink's as

an alternative framework, a relative underrepresentation

of learning outcomes of Integration, Human dimension,

Caring and Learning to Learn becomes evident. These

findings will inform faculty dialogue about revision of

objectives using CanMEDS and other frameworks, to

ensure that learning outcomes target the broad spectrum

of competencies required of clinical oncologists.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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LP17 - 04-60691

Identifying Gaps in Critical Appraisal Skills development in

Undergraduate Medical Education: A Needs Assessment

Survey

Sarah Elias University of Ottawa, Rakesh V Patel The Royal College of

Physicians and Surgeons, Michael Reaume University of Ottawa

Background/Purpose: Critical appraisal skills are essential

for the provision of high-quality evidence-based patient

care. The learning needs of medical students must be

better understood in order to provide an education that

will ensure successful acquisition of medical literature

critical appraisal skills. The objective of this study was to

1) understand medical students' current medical

literature critical appraisal skill and 2) determine medical

students' education needs to help establish a foundation

for the acquisition of these skills.

Methods: An online survey was distributed to medical

students at the University of Ottawa over a 2-month

period. The survey collected background and

demographic information, as well as educational

experiences, learning preferences, and general opinions

on medical literature critical appraisal.

Results: Fifty-nine students completed the survey. Thirty-

four (57%) and forty-four (75%) of respondents reported

that they were lacking both competence and confidence

in critical appraisal, respectively. Lectures and seminars

were identified as the most common content delivery

methods for teaching critical appraisal skills while, journal

club, case-based learning and journal articles were

perceived as being the most effective content delivery

methods.

Conclusions: The majority of students recognize the value

of critical appraisal but report lacking competence and/or

confidence to apply these skills in clinical practice.

Interestingly, our survey identified a discrepancy between

students' preferred content delivery methods, and the

ones thought to be most effective for the teaching of

medical literature critical appraisal. This shortcoming in

teaching evidence-based medicine may contribute to the

difficulties encountered by medical students in the

application of their critical appraisal skills.

LP17 - 05-60655

A Flipped Classroom Approach to Teaching Medical

Students a Clinical Approach to Precocious and Delayed

Puberty

Elisa Christinck Queen’s University, David Saleh Queen’s University,

Eleftherios Soleas Queen’s University

Background/Purpose: Although 'flipped classroom'

educational approaches have shown promise, there has

been relatively little formal investigation of their

effectiveness in the pediatric context. We investigated the

effectiveness of an online interactive module to

supplement a clinical case-laden education session,

compared with a traditional didactic format in teaching

medical students a clinical approach to children

presenting with early or late puberty.

Methods: 127 third and fourth-year clinical clerks at an

Ontario medical school participated during their core

pediatrics rotation. The control group (n=60) read a

review article and then attended a traditional didactic

session. The experimental group (n=67) completed an

online interactive module before attending an interactive

clinical case-based learning session about children with

early or delayed puberty. Both groups completed 3

validated knowledge tests: a pre-test, a post-test, and a 3-

month post-test. ANOVAs were run to detect differences

between the 3 times and different conditions.

Results: ANOVAs showed no significant differences

between the pre and post-conditions. However, the

flipped classroom condition had a significantly higher

aggregate score (F=20.29; df=1, 98; p>0.0001; d=0.92;

large effect size) at the 3-month post-test time (m=8.41)

than the control group (m=7.47). This corresponds to a

large effect-size.

Conclusions: Our findings suggest that a flipped-

classroom approach, although initially statistically

indistinguishable in knowledge retention from the didactic

control group, in the long term yields a higher level of

knowledge retention and enduring learning. We propose

that a flipped classroom therefore be considered for more

types of learning situations where enduring learning is the

goal of instruction.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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LP17 - 06-60509

Spiralling Family Medicine Clerkship Curriculum to

Enhance Learning using Both Asynchronous and

Synchronous Modalities

Keyna Bracken McMaster University, Emily Allison University of

Toronto, Parth Sharma University of Toronto

Background/Purpose: The COMPASS curriculum was

initiated at the McMaster DeGroote School of Medicine in

2006 with the tenets: concept-oriented, multidisciplinary,

problem-based, practice for transfer, simulations in

clerkship, and streaming. The practice to transfer

component concerns the ability to transfer previous

knowledge, applying it in a different context which is

central in this innovative curricular project. The Family

Medicine clerkship program developed a new E-learning

platform by revisiting pre-clerkship Problem-based

learning cases, adding layers of complexity to foster

clinical knowledge translation in clerkship during which

the cases are completed asynchronously and in

synchronous tutorials.

Summary of innovation: Building on the foundation of

curriculum development strategies and influence of adult

learning theory, a Family Medicine integrated curriculum

was designed by modifying preclerkship cases to have a

practice to transfer focus. Students prepare for tutorial

using the new E-learning modular platform. The modules

integrate preclerkship and clerkship curriculum, including

knowledge-check questions to promote self-assessment.

The repetition of formative assessment aims to promote

learner self-assessment and preparedness for the clinical

decision making focused exit examination. The "super-

tutorials" were designed to enhance interaction between

clerks and a maestro (content expert), and the E-learning

platform to enhance student engagement using polling

questions and interactive features.

Conclusions: The development of asynchronous learning

modules and synchronous learning opportunities through

maestro-led "super-tutorials" allows for students to recall

previous knowledge concepts and apply them in more

complex situations thereby facilitating knowledge

transfer. The maestro challenges this knowledge by

guiding students through novel scenarios, which further

develops knowledge transfer, and prepares students for

diverse clinical scenarios.

Pot Pourri

LP18 - 01-60602

Development and Implementation of a Novel Pre-

clerkship Leadership Program

Ahmed Shoeib University of Ottawa, Michael Aw University of Ottawa,

Charles Su University of Ottawa

Background/Purpose: CanMEDS was updated in 2015

with the change from Manager to the Leader role.

Leadership is intrinsic to medicine. Poor communication

skills, leadership and professionalism have been linked to

poor patient outcomes, patient dissatisfaction, complaints

and medico-legal claims. Student feedback suggests

current Undergraduate Medical Education (UGME)

leadership training is insufficient. Currently, the uOttawa

MD program provides didactic lectures based on the

LEADS framework. However, we believe there is the

potential to enhance students' engagement through

experiential learning.

Summary of innovation: The Foundations in Leadership

program represents a yearlong curriculum (8 sessions, 15

hours total) which emphasises experiential learning

through self-learning, small group exercises, formative

evaluations, and role-play. Main topics covered include:

personal reflection and feedback solicitation, conflict

resolution, negotiation, influencing others, and leadership

in medicine. The course content incorporates objectives

from the CanMEDS and LEADS competency frameworks

linked to entrustable professional activities embedded

within the AFMC. Participants will be assessed prior to,

during and after program completion through various

measures including: self-reported skills assessments,

knowledge retention tests, program satisfaction and

formative OSCE scenarios.

Conclusions: By providing rigorous leadership training

early in their education, medical students may become

better suited to manage difficult situations and navigate

team dynamics in future clinical settings. Next steps

include program evaluation to help inform meaningful

institutional changes to the leadership curriculum within

the uOttawa UGME program.

LP18 - 02-60744

Recruitment of Healthcare Students to Rural Areas:

Interests and Perceived Barriers

Corin MacPhail University of British Columbia Sean Maurice University

of British Columbia

Background/Purpose: The Healthcare Travelling

Roadshow (HCTRS) aims to increase recruitment of

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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healthcare providers (HCP) to rural BC communities by

introducing healthcare students (HCS) to rural areas. In

this study, HCS' interests, or attracting factors, and

perceived barriers on rural practice were sought and

compared to literature on practicing HCP' views. This

examination will allow for targeted recruitment

strategies.

Methods: Ninety-five HCS from a variety of healthcare

disciplines in BC applied to the 2019 HCTRS; the top 36

were selected and 30 participated. Participants were

invited to complete an online survey after their HCTRS

trip, and 11 participants responded. Qualitative responses

to open-ended questions regarding interests and

perceived barriers were coded thematically to categories,

which were then grouped to main themes.

Results: HCS' reported interests and barriers fit into two

main themes: lifestyle factors and career factors.

Regarding attractions to rural practice, lifestyle factors

were reported more frequently than career factors, but

they were reported with approximately equal frequency

with respect to barriers. Participants reported that the

HCTRS increased awareness of rural healthcare needs,

accuracy of perceptions, and interprofessional

collaboration.

Conclusions: This study demonstrates that rural

recruitment initiatives must consider both career stage

and healthcare discipline. This study supports fostering

interest in rural practice through exposure to rural

communities, and suggests that community engagement

beyond clinical involvement should also be considered.

LP18 - 03-60335

Voisins de la rue

Claudianne Laurin Université de Montréal, Marie-Ève Villeneuve

Université de Montréal, Camille Dulude Université de Montréal, Audrey

Beaumier Université de Montréal, Romain Ouellet-Paradis Université de

Montréal, Valérie Schur Université de Montréal, Florence Vielhaber

Université de Montréal

Background/Purpose: L'incohérence entre la demande de

soins de santé de la population vulnérable et l'accès offert

par la communauté médicale est inconcevable. Pour les

étudiants, la création de liens avec cette clientèle est

confrontante. Les préjugés peuvent nuire à la qualité de la

relation, alors que cette dernière est essentielle à une

démarche de soins efficace et inclusive. L'initiative

étudiante « Voisins de la rue » offre l'opportunité

d'aborder la réalité complexe des populations vulnérables

dans un contexte sécurisant et encadré. Non seulement ce

projet permet de valoriser la responsabilité sociale du

futur médecin; mais il contribue à développer l'autonomie

et l'estime personnelle chez les personnes marginalisées

de Trois-Rivières, étant l'une des dix villes les plus pauvres

au Québec.

Summary of innovation: En septembre 2017, trois

étudiantes de l'UdeM au campus décentralisé de la

Mauricie ont d'abord collaboré avec les intervenants

d'organismes communautaires locaux. Ensemble, ils ont

identifié les besoins des usagers et créé des activités

rejoignant des objectifs variés : art, cuisine, musique,

relaxation et jeux. Annuellement, chacune des 7 activités,

où la communication est priorisée, permet d'établir des

liens significatifs entre 5 à 8 étudiants et un même nombre

de participants marginalisés. De plus, une collecte de dons

est effectuée à chaque Noël pour les gens en situation

d'urgence. À ce jour, 20% des étudiants entre l'année

préparatoire et la fin de l'externat ont participés.

Conclusions: Au quotidien, les étudiants sont sensibilisés

à la réalité des personnes vulnérables et peuvent adopter

une approche médicale personnalisée et collaborative. En

diffusant cette initiative au Canada, l'importance d'un

accès aux soins égal pour tous sera mis de l'avant.

LP18 - 04-59955

Canadians with unmet healthcare needs: Who are they?

Ken Fowler Memorial – University of Newfoundland, Lauren Winsor

Memorial – University of Newfoundland

Background/Purpose: Despite Canada's universal

healthcare system, its citizens do not have equitable

access to healthcare. This study aims to create a profile of

individuals within Canada that have reduced self-reported

healthcare access compared to the overall population and

aims to highlight current gaps in the national healthcare

framework.

Methods: Data from the Statistics Canada Canadian

Community Health Survey (CCHS) 2014 were analyzed to

determine the proportion of Canadians who report unmet

healthcare needs, what services were unavailable, and

why they were unable to access healthcare services.

Further, the data were analyzed to determine whether

there is variation in unmet healthcare needs based on

respondents' sociodemographic characteristics.

Results: 10.9% of CCHS 2014 respondents reported having

unmet healthcare needs. Younger respondents, female

respondents, individuals with poor health status,

respondents without a regular medical doctor, recent

immigrants, and individuals with low income were most

likely to report having unmet healthcare needs.

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Respondents in the territories were most likely to report

having unmet healthcare needs. Wait times, lack of

healthcare service availability when the service was

required, and lack of healthcare service availability in the

respondent's area were reported as the greatest

contributing factors to having unmet healthcare needs.

Conclusions: Limited access to healthcare experienced by

various subpopulations within Canada highlights the need

for the identification of marginalized individuals whose

health may benefit from improved access to healthcare.

With this knowledge, steps can be taken within the

healthcare system and government in order to improve

healthcare access and promote health equity across

Canada.

LP18 - 05-59711

Residents as research subjects : balancing resident

education with contribution to advancing educational

innovations.

Amelie Du Pont Université de Montréal, Ahmed Moussa Université de

Montréal, Benoit Carriere Université de Montréal, Genevieve Cardinal

Université de Montréal, Celine Huot Université de Montréal, Thuy Mai

Luu Université de Montréal, Louis-Philippe Thibault Université de

Montréal

Background/Purpose: Research in education is essential

to advance knowledge as well as to improve learning.

Medical residents can be solicited as subjects for studies,

however no literature defines how to protect their rights

as participants and to limit the impact of their

participation on their clinical training.

Methods: Through a nominal group technique (NGT)

approach, a group of 8 experts in Pediatrics at Université

de Montréal, (clinical educators, education researchers,

residents and IRB president) developed recommendations

to guide how the inclusion of residents as subjects in

medical education research can take place with the dual

goal of protecting residents' rights while also promoting

contribution of researchers' work to medical education

literature.

Results: Five issues and recommendations were

described. 1) Freedom of participation: participation or

non- participation, or withdrawal from a study should not

interfere with teacher-learner relationship

(recommendations on procedures for recruitment and

content of consent form) ; 2) Over-solicitation of residents

(recommendations on the process of limiting the number

of ongoing studies); 3) Management of time dedicated to

participation to research (recommendations on schedule

and proportion of time for study participation); 4)

Educational security: data collected during a study should

not influence clinical assessment of the resident

(recommendations on the role of the researcher as a

clinical supervisor); and 5) Emotional security of the

learner (recommendation on the requirement for

debriefing during simulation-based studies).

Conclusions: This guide is an essential tool to insure

respect of resident rights and completion of a robust

training program but also to support high quality research

in education that will enrich medical education literature.

LP18 - 06-59950

A modern approach to physician resource planning to

improve access to health care for Canadians

Dax Bourcier Université de Sherbrooke, Brandon Collins Memorial –

University of Newfoundland, Stuti Tanya Memorial – University of

Newfoundland, Aman Sayal University of Toronto, Siddiq Moolla

University of Toronto, Monisha Basu University of Toronto, Angela Dong

McMaster University, Owen Litwin McGill, Mathieu Doiron Université

de Sherbrooke, Natasha Larivée Dalhousie University, Alex Wong

Dalhousie University, Marie Vigneau Université de Sherbrooke, Ameer

Jarrar Dalhousie University, Jelisa Bradley Dalhousie University, Patrick

Holland Dalhousie University, Victoria Kulesza Dalhousie University,

Ryan Wade Memorial – University of Newfoundland

Background/Purpose: The Canadian health system is

vulnerable to disruption by advances in technology,

differing work expectations from incoming physicians, and

increasing patient involvement. To ensure the provision of

accessible and equitable health care services to

Canadians, physician resource planning (PRP) will be

fundamental. PRP is defined as ensuring the right mix,

distribution, and number of physicians needed by society.

Currently, each province follows a different approach as

there is no official national oversight. This results in

provincial authorities collecting and reporting data

differently, with only a few that use a physician

forecasting model.

Summary of innovation: One consequence of this

disjointed approach is that Atlantic medical students have

expressed as their top concern the limited access to data

on the current and projected physician workforce. To

address this issue, the Health Human Resource Task Force

(formerly Atlantic Task Force) of the Canadian Federation

of Medical Students has created a national interactive

platform that uses a map of Canada, a comparison table,

and a trend graph to illustrate the demand for physicians

in our society. Users can filter by year, specialty, and

province or territory (including regions) to personalize the

most relevant data on the physician workforce

amalgamated from several publicly available sources.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Conclusions: We believe that informing medical students

with workforce realities during pre-clerkship will guide

career choices based on both personal interests and social

accountability. Our group has also identified

collaboration, social accountability, and artificial

intelligence as the three fundamentals to modernise

physician resource planning strategy. Overall, these

efforts contribute to the vision of stewardship for an

integrated Canadian health care system.

LP18 - 07-60889

Do Canadian medical graduates perceive the process for

the selection for Family Medicine (FM) Residency training

in Canada as fair?

Sarah Kinzie McMaster University, Michelle Mayne The College of

Family Physicians of Canada, Rohini Pasricha Queen’s University,

Michelle Morros University of Alberta, Keith Wycliffe-Jones University

of Calgary, Alain Papineau Université de Montréal, Karlyne Dufour

Dalhousie University, Alicja Krol-Kennedy University of Calgary,

Mackenzie Mark University of British Columbia

Background/Purpose: Every year, Canadian medical

students apply to Family Medicine(FM) residency

programs. Organizational justice theory indicates

perceptions of fairness in selection are based on both

process and outcome. The job-relatedness of the

assessments used is also a factor. This study measures, for

the first time, students' perceptions of fairness in FM

Residency selection in Canada.

Methods: A survey was sent to participating final year

medical students who applied to FM following the first-

round match(2020 cohort). The survey was also sent to all

PGY1 FM residents(2019 cohort).

Results: 173 students and 164 Residents completed the

survey.(10% & 14% response rates). Only 35%(2020) and

20% (2019) indicated any Situational Judgement Test(SJT),

in all or most programs, related to the role of a Family

Physician(FP). In contrast, 88%(2020 & 2019) indicated a

traditional interview and 81%(2020) and 76%(2019) found

the multiple mini interview(MMI) content in all or most

programs related to the FP role. Only 41%(2020) and

23%(2019) felt the SJT was a fair selection tool compared

with 80%(2020) and 73%(2019) for traditional interviews

and 67%(2020) and 65%(2019) for MMIs in all or most

programs. Overall, 77% (2020) and 75% (2019) felt the

selection process for FM was fair in all or most programs.

Conclusions: The majority of Canadian medical students

found selection for FM Residency to be fair. Most found

traditional interviews and MMIs to be fair and job-related.

This was not the case for SJTs.

Assessment

P1 - 01-60595

Are different station formats assessing different

constructs in Multiple Mini Interviews? Findings from the

Canadian Integrated French Multiple Mini Interviews

(IFMMI)

Annie Ouellet Université de Sherbrooke, Christian Bourdy Université de

Montréal, Nathalie Loye Université de Montréal, Robert Gagnon

Université de Montréal, Sébastien Béland Université de Montréal, Jean-

Sébastien Renaud Université Laval, Jean-Michel Leduc Université de

Montréal, Philippe Bégin Université de Montréal

Background/Purpose: Multiple mini-interviews (MMI) are

used to assess non-academic attributes for selection in

medicine and other healthcare professions. It remains

unclear if different MMI stations formats (discussions,

role-plays, collaboration) can assess different constructs.

Methods: Based on station's format of the 2018-2019

IFMMI (5 discussions, 3 role-plays and 2 collaboration

stations), we performed confirmatory factor analysis

(CFA) using the lavaan 0.6-5 R package (Rosseel, 2012) and

compared a one-factor solution vs three-factor solution to

applicants of the 2018 (n=1438) and 2019 (n=1440)

cohorts of the IFMMI across three medical schools in

Quebec, Canada.

Results: The three-factor solution was retained, with

discussions, role-plays and collaboration stations all

loading adequately with their scores. Furthermore, all

three factors had moderate covariances together (range

0.44 to 0.64). The model fit was also excellent with a

Comparative fit index (CFI) of 0.983 (good if >0.9), a Tucker

Lewis index of 0.976 (good if > 0.95), a Standardized Root

Mean Square Residual of 0.021 (good if < .08 ) and a Root

Mean Square Error of 0.023 (good if < 0.08) for 2018 and

similar results for 2019. In comparison, the single factor

solution presented a lower fit (CFI=0.819, TLI=0.767,

SRMR=0.049 and RMSEA=0.070)

Conclusions: The IFMMI has a stable tridimensional

structure across two cohorts that was explained by station

formats, suggesting that different station formats are

assessing different but related constructs, reinforcing the

Posters

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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construct validity of an MMI with multiple station formats.

Further studies should try to characterize these constructs

and look for differential predictive validity according to

station format.

P1 - 02-60603

Comparison of the English and French versions of the

CASPer Test in a bilingual population

Genevieve Lemay University of Ottawa, Xin Wei Yan

Background/Purpose: The University of Ottawa MD

program has two different streams to which candidates

may apply: a francophone stream and an anglophone

stream. As the admissions office receives applications in

both French and English, they are required to ensure that

the tools used to assess candidates are psychometrically

equivalent across both streams. CASPer is a standardized

test they recently adopted to assess the non-cognitive

competencies of applicants and is offered in both English

and French. The objective of this study is to compare the

psychometric properties of the English and French

versions of CASPer.

Methods: We collected data from all CASPer test-takers

across three cohorts (n = 12,463; entry 2016, entry 2017,

entry 2018). We first compared the difficulty of the test

between the French and English version using proxy

indicators (i.e., time to completion, typing speed). We

then compared the psychometric properties of the two

versions based on their internal-consistency reliability and

applicant acceptability

Results: There were some indications that the French

version may be slightly more difficult than the English

version of the CASPer test. However, it is unclear whether

this difficulty is due to the difficulty of the individual test

items or to differences in the characteristics of the cohort.

Nevertheless, a comparison of the psychometric

indicators suggests that both French and English versions

of CASPer are psychometrically sound and equivalent.

Conclusions: Although CASPer scores cannot be directly

compared between the English and French versions, the

psychometric properties of the assessment were retained

across the two versions. These results provide preliminary

evidence that the psychometric strengths of the English

version of CASPer likely extend to the French version of

the assessment.

P1 - 03-59484

Pharmacy students use guided reflection and

entrustment (EPA) assessments to appraise 'secret'

patient/pharmacist encounters in the selfcare

community workplace

Debra Sibbald University of Toronto

Background/Purpose: Pharmacists are entrusted to help

patients minimize risks and maximize benefits when self-

selecting treatment for minor ailments. Patients often

initially access the Internet for advice. Undergraduates

must understand and assimilate both patient and

pharmacist perspectives on their path to self-regulated

practice.

Methods: Second year (pre-clinical) students (n= 240)

posed as patients seeking a pharmacist's advice in a

community pharmacy, after having reviewed Internet

sources. Using structured guided reflection, they analyzed

relevant aspects of the encounter, completed an EPA

assessment of the observed pharmacist and proposed

measures to personally optimize implementation of this

responsibility when in practice. Perceptions were

analyzed from observations, reports, surveys, class

discussions and interviews. EPA rankings (anchored to 5

levels of supervision) were tabulated.

Results: Student reflections, as patients, highlighted

themes of entrustment and confidence in the pharmacist

as an authoritative resource. As prospective pharmacists,

they evaluated the clinician in terms of best practice

guidelines, competencies demonstrated, barriers

observed during the consultation and feelings about their

future professional role. EPA reports rated the majority of

pharmacists able to practice independently/unsupervised

and 20% as role-models/able to supervise others. Time

constraints for communication, rather than content

expertise, was the primary obstacle.

Conclusions: Students valued this contextual opportunity

to directly experience competencies required for patient

care prior to their clinical year: subject expertise,

communication, collaboration, professionalism, advocacy

and scholarship. Assessing practitioners' level of

entrustment was considered transformative in reinforcing

the importance of expertly performing this professional

role with appropriate time management once in practice.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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P1 - 04-60598

Assessing medical students' communication skills in using

Electronic Medical Records during simulated patient

encounters from the patient's perspective

Douglas Archibald University of Ottawa, K Jean Chen University of

Ottawa, Debra Pugh Medical Council of Canada, Isabelle Dejardins

University of Ottawa, David Topps University of Calgary, Ilona Bartman

Medical Council of Canada

Background/Purpose: Given the widespread adoption of

Electronic Medical Records (EMRs) in medicine , attempts

have been made by educators and policy leaders to

introduce EMR education into Canadian medical school

curricula. Despite efforts being made to introduce EMR

learning, there is little literature related to the assessment

of EMR-related competencies. As such, we have

developed and piloted an objective structured clinical

examination (OSCE) station aimed at assessing EMR

communication competencies in medical students. This

abstract reports on the feedback from standardized

patients (SPs) involved in pilot.

Methods: This study was conducted at University of

Ottawa as part of a third year OSCE. An EMR pilot station

was developed, built in OpenLabyrinth and designed to

were assessed by Standardized Patients (SPs) and

physician examiners using checklists and ratings scales.

Three SPs then participated in a one-hour focus group,

facilitated by one of the investigators to discuss their

experiences in the pilot.

Results: Transcripts of the focus group were inductively

coded by three investigators. Resulting themes included

perceptions around technology (changes in technology,

acceptance of technology, contrasting EMR vs. paper, age

of students and patients); competency in communication

(non-verbal communication, importance of

communication skills, impedance/distractors of effective

communication); case design (SP training, engagement, SP

reluctance to evaluate students); ownership of health

information (clinician-patient relationship, patient health

literacy/numeracy); and charting/EMR usage.

Conclusions: Involving SPs in the OCSE assessment

complicated logistics of the station. The SP perceptions

around student-patient communication will be used to

refine the EMR pilot station OSCE.

P1 - 05-60639

How to measure utilization of Electronic Medical Record

(EMR) in patient-physician communication from a patient

perspective

K. Jean Chen University of Ottawa, David Topps University of Calgary,

Isabelle Desjardins University of Ottawa, Debra Pugh Medical Council of

Canada, Ilona Bartman Medical Council of Canada, Doug Archibald

University of Ottawa

Background/Purpose: The American Medical Association

recommends soliciting patient feedback on physician EHR

use. In Canada, national statistics indicate that physicians

who use EMR report they are more efficient and patients

with access to their health information feel better able to

manage their health. This study's goal was to evaluate a

rating scale measuring medical students' utilization of

EMR from the patient's perspective.

Methods: This study was conducted at University of

Ottawa as part of a 3rd year OSCE. A rating scale assessing

candidates' use of EMR while counselling a patient (EMR

Utilization) was added to an existing standardized patient

(SP) scoring grid which included four rating scales. Data

from 99 students was collected.

Results: SPs covered the entire scale range for EMR

Utilization. This scale had the most spread among the four

scales and the lowest mean (3.7/5). EMR Utilization

correlated with the remaining three SP ratings;

Communication being the strongest (corr = 0.644). It also

correlated with Information Giving scale filled out by

physician examiners. (corr = 0.224). Employing some

graphical presentation included in the EMR during the

consultation was a predictor of the SP total score (t(97) =

-2.079, p = 0.041).

Conclusions: This pilot not only demonstrates feasibility

but also indicates that SPs can reliably assess physician's

effectiveness of EMR utilization in counselling.

P1 - 06-60649

Evaluation of Entrustable Professional Activities

Assessment in Undergraduate Medical Education using

Mobile Technology

Norah Duggan Memorial – University of Newfoundland, Heidi Coombs

Memorial – University of Newfoundland, Vernon Curran Memorial –

University of Newfoundland, Katherine Stringer Memorial – University

of Newfoundland, Nicholas Fairbridge Memorial – University of

Newfoundland, Diana Deacon Memorial – University of Newfoundland,

Steve Pennell Memorial – University of Newfoundland

Background/Purpose: Memorial University introduced

Entrustable Professional Activities (EPAs) into an

undergraduate clerkship curriculum as formative

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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assessments. This study applies the Norcini et al. (2018)

consensus framework for good assessment to evaluate a

mobile system in assessing undergraduate EPAs during

clerkship.

Methods: An electronic clinic card was developed for

mobile use by both clerks and preceptors. Clerks were

tasked with transcribing in-the-moment coaching and

assessment discussions with preceptors. Assessments

were collated and analyzed by ordinal regression, and

users were surveyed on satisfaction with the new

modality.

Results: The mobile eClinic Card system enabled 80 clerks

and 624 preceptors to document 6,850 submissions that

included 18,661 EPA scores across 47 clinical sites over a

48-week core clerkship curriculum. The rating system was

found to be generally consistent, reliable and equivalent

between preceptors, clinical sites, or the specific activity

assessed. Clerks documented progressive improvement.

Some differences between disciplines were found in

rating odds, in preceptor composition and workload.

Student odds of success did not correlate to subject

examination scores. Preceptors and students were

satisfied with ease of use and dependability of the eClinic

Card mobile app; however, clerks suggested the quality

and utility of formative coaching feedback could be

improved. Preceptors felt enhanced faculty development

would be beneficial.

Conclusions: Findings support the utility, feasibility and

acceptability of a mobile system in assessing work-based

Entrustable Professional Activities within clerkship

curriculum. Change management is a major determinant

of success and user engagement is essential for uptake of

mobile technologies for work- based assessment.

P1 - 07-60713

How to measure "Fit": Standardized comparison of

program and applicant alignment of values and priorities

Jill Derby Altus Assessments, Kelly Dore Altus Assessments, Heather

Davidson Altus Assessments, Nimo Jama Altus Assessments, Harold

Reiter Altus Assessments

Background/Purpose: As USMLE Step 1 scores transition

to Pass/Fail, GME selection may need additional

standardized data points. NRMP surveys of programs and

applicants indicate "goodness of fit" as one of the most

important factors influencing ranking. However, little

consensus exists on what "fit" is and the factors that

influence its perception.

Methods: This study sought to understand the factors

influencing the concept of applicant/program alignment

across GME programs, with a goal of creating a

standardized measure of fit. Various perspectives of key

stakeholders and subject matter experts including

residency program directors, applicants and current

residents were examined.A modified Delphi survey was

conducted across 2 rounds, consisting of 47 potential

factors, based on SME interviews and the literature.

Diverse stakeholders (DIOs, Program Directors, Faculty,

Residents, & Medical Students) participated in the Delphi

and were asked to each factor on a Likert-type 4 point

scale.

Results: 38 SMEs responded to the 1st round of the Delphi

survey Of the 47 factors, 34 reached consensus with a-

priori ranking determined to be a threshold of 55%

consensus. In the 2nd round consensus was reached on 4

additional factors. After integrating feedback on

redundancy and terminology, 30 factors remained. The

factors were then organized into 3 themes: culture,

pedagogy and work environment for the assessment use

in GME selection.

Conclusions: The results of the Delphi survey will be used

to populate a paired-comparison ranking tool used in GME

selection during the Fall of 2020 across thousands of

applicants and multiple programs. This standardized

method of evaluating fit will provide a more objective

measure of including this important factor in selection.

P1 - 08-60547

Do high grades prior to MD studies lead to higher

academic achievement during the MD curriculum and

higher scores on licensing examinations?

Margaret Henri Université de Montréal, Geneviève Grégoire Université

de Montréal, Christian Bourdy Université de Montréal, Jean-Michel

Leduc Université de Montréal, Robert Gagnon Université de Montréal

Background/Purpose: Until 2018, at our institution,

student applying to the MD program were selected for

admission based on 2 criteria: a standardized grade point

average (GPA) and a multiple mini interview (MMI) score.

The GPA accounted for 50% of the total score for

admission. With this study, we wished to answer this

question: is the standardized GPA a reliable performance

predictor for grades during the MD curriculum, and for the

Medical Council of Canada Qualifying Examination Part I

(MCCQE I)?

Methods: From 2008 to 2015, data were prospectively

collected from all students entering the MD program. Data

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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included: GPA from pre-university or university studies,

mean grades in years 0 (pre-med) 1 and 2, grades from

project-based learning and courses throughout MD

studies (eg: basic anatomy, digestion and nutrition, heart

and circulation), end-of-curriculum written exam and

OSCE scores, and MCCQE I results. Pearson's coefficient

was used to analyse the relationship between these

scores.

Results: GPA showed weak correlation to year 0 (r=0.296,

n= 646, p<0.001), year 1 (r=0.231, n=1113, p<0.001), and

year 2 (r=0.258, n=1098, p<0.001) mean grades. GPA

presented no correlation to end-of-curriculum written

examination scores (r=-0.034, n=579, p=0.416) or OSCE

scores (r=0.008, n=838, p=0.813). GPA also correlated

poorly (r=0.202, n=1805, p<0.001) with results at MCCQE

Conclusions: While high grades are still considered an

important standard for admission to our MD program,

they do not demonstrate a strong correlation to high-

stakes, end-of-curriculum and licensing examinations.

Further analysis will help to determine if different

weighing assigned to GPA and MMI scores, or if additional

criteria for admission to our MD program would yield

improved results.

P1 - 09-60548

Low-stakes progress test results are excellent predictors

for success at the Medical Council of Canada Qualifying

Examination part I

Margaret Henri Université de Montréal, Geneviève Grégoire Université

de Montréal, Jean-François Gobeil Université de Montréal, Robert

Gagnon Université de Montréal

Background/Purpose: At Université de Montréal,

progress tests (PT) are formative assessments which are

administered on the final 2 years of the curriculum. We

sought to assess the value of these tests for predicting

success to the Medical Council of Canada Qualifying

Examination part I (MCCQE I).

Methods: Five compulsory, formative PTs have to be

taken by students during clerkship, the first 3 in year 3,

and the last 2 during year 4. From 2013 to 2018, student

scores from PTs and MCCQE I were prospectively

gathered, and Pearson's coefficient was used to look for a

relationship between the two. PT scores were also divided

into deciles and analysed for risks of failing the MCCQE I.

Results: Results of 1496 students were analysed. A strong

correlation was shown between PT scores and MCCQE I

scores (r=0.635, n=1496, p<0.001). A good correlation of

PT and MCCQE I scores was demonstrated from PT #3

(Pearson's r > 0.500). Students with mean PT scores in the

lower decile were 6 times more likely to fail the MCCQE I

(RR=6.4673, 95%IC 3.7727-11.0872, Z=6.788, p<0.0001)

than those with mean scores in the higher deciles.

Compared to those with no PT score in the lower decile,

students with 2 PT scores in the lower decile had a RR of

20.9804 (95% CI 7.3114-60.2038, Z=5.659, p<0.0001), and

those with 3 PT scores or more in the lower decile had a

RR of 42.2716(95% CI 15.8893-112.4586, Z= 7.500,

p<0.0001) of failing the MCCQE I.

Conclusions: Progress tests, as low-stakes assessments,

are good predictors of MCCQE I scores. Moreover,

students with very low PT scores are at higher risk of

failing the MCCQE I. Analysis of PT scores can help to

identify, as early as 1 year ahead of licensing

examinations, students who could beneficiate from

additional academic support.

CME & Faculty Development

P2 - 02-60100

Working towards practice improvement: An examination

of context, mechanisms and outcomes impacting QI

action plans

Marguerite Roy Medical Council of Canada, Claire Touchie Medical

Council of Canada, Jocelyn Lockyer University of Calgary

Background/Purpose: The Medical Council of Canada

national multisource feedback (MSF) program is an

assessment for quality improvement (QI) that focuses on

collaborator, communicator, and professional roles.

Interpreting MSF data, translating it into QI plans, and

enacting change depends on multiple factors (Sargeant et

al., 2015). This study used realist inquiry methods (Dalkin

et al., 2015; Pawson & Tilley, 2001) to assess the context,

mechanism, and outputs of MSF data when coupled with

a facilitated feedback discussion for QI plan creation and

enactment.

Methods: Data included linked demographics, MSF

ratings and comments, reports summarizing a phone

conversation between the physician and facilitator, two to

three physician generated action plans, and 6-month

follow-up status of plan implementation for 50 family

medicine physicians. A realist inquiry methodology was

used to iteratively review, identify, and code factors

related to context, mechanisms, and outcome

configurations of MSF data use.

Results: Physicians who completed all of their plans had

plans that tended to be co-constructed, drew on data with

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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repeated messages, and had messaging about where the

physician could 'do better' in the narrative data

component. For those who completed at least one plan, it

didn't seem to matter whether the changes were simple

or difficult. For those who didn't implement any plans,

action plan difficulty was an important factor.

Conclusions: MSF data acceptance, use, and QI

implementation is moderated by multiple contextual

factors. However, having consistent messaging from

different perspectives coupled with a discussion with a

peer reinforces the formulation of realistic and actionable

plans.

P2 - 03-60770

Continuing Professional Development Scholarship in

Canada: A scoping review.

Francesca Luconi McGill, Elizabeth Wooster University of Toronto,

Morag Paton University of Toronto, Meron Teferra McGill, Andrea

Quaiattini McGill, Suzan Schneeweiss University of Toronto

Background/Purpose: Continuing professional

development (CPD) as an agent of change in healthcare

reform could contribute to resolving misalignments in the

Canadian healthcare system which is struggling to manage

economic, political and epistemological challenges but

little is known about areas of focus within Canadian CPD

scholarship. This study aims to identify terminology,

conceptual frameworks, methods, and themes reported in

the CPD literature over the last decade.

Methods: Guided by a 6-stage framework (Arksey &

O'Malley), this scoping review included white literature

related to CPD, targeting physicians, and published in

Canada in English/French between 2008-2019. Five

databases were searched, and data-charting was

iteratively developed. Studies were coded independently

and reviewed in pairs to ensure accuracy and reliability.

Results: Of the original 3978 identified references, 595

met our inclusion criteria. Publications primarily targeted

family physicians (49%). Most focused on research (48%)

and evaluation (21%) while only 11% cited a theoretical

framework. Seventy-three percent focused on education

techniques/ approaches compared to 10% focused on

organization and systems level concerns. Terminology

included CME (34%) and CPD (27%).

Conclusions: The CPD literature focuses attention on

physicians alone, with limited discussion on physicians

within intra- or interprofessional settings. The shift in

terminology indicates moving from a medical-centric

individual (CME) to a broader approach addressing

multiple competencies (CPD). The limited use of theory

may impact the ability of CPD scholarship to act as an

agent of change in health reform. This review contributes

to an understanding of areas of focus and potential gaps

in the CPD literature.

P2 - 04-60288

Overcoming Barriers to Safe Opioid Prescribing:

Extending the reach during the COVID-19 Pandemic

Clare Cook Northern Ontario School of Medicine, Pam Haight Northern

Ontario School of Medicine

Background/Purpose: In early 2020, NOSM CEPD

launched an online CPD module "Overcoming Barriers to

Safe Opioid Prescribing" (OBSOP) to a target audience of

Northern Ontario primary care providers ("providers"),

funded by Health Canada. With COVID-19's onset OBSOP

registration and engagement plummeted as providers

responded to the emerging crisis. Simultaneously resident

electives were cancelled (travel restrictions, preceptor

availability). As Northern Ontario is disproportionately

affected by the ongoing opioids epidemic, OBSOP was an

opportunity to increase resident non-clinical education in

a high clinic need area.

Summary of innovation: Collaborating with Post

Graduate Education, CEPD offered OBSOP to current

NOSM residents. There were no registration restrictions

or content changes. Impact was evaluated by existing pre-

/post-module evaluations and meta-data.

Conclusions: NOSM CEPD pivoted quickly to offer key

curriculum to residents safely and effectively. Resident

data showed: • Course was accessible; content was

relevant. All but two outlined impact on future practice. •

Five learning themes emerged: Understanding of opioids;

knowledge/skills for patient communication; prescribing

knowledge/attitudes; tapering strategies/skills; and

tools/resources. • Residents and providers emphasized

distinct areas of value. Residents most often identified

tools to be most valuable, followed by tapering

strategies/skills. Providers more often focussed on

changes to prescribing knowledge/attitudes, and to

patient communication. Pandemic circumstances

highlighted opportunities to provide common curriculum

beyond CPD's "regular" mandate for faculty. By engaging

residents, OBSOP increased uptake and extended reach.

Evaluation supports CPD's potential to offer value to a

continuum of learners, which should be considered during

development.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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P2 - 05-60564

Strategies to assess unperceived educational needs of

physicians: A Scoping Review

Elizabeth Shaw McMaster University, Stefanie Roder McMaster

University, Meghan Lofft McMaster University, Heather Armson

University of Calgary

Background/Purpose: Assessing needs prior to

developing continuing medical education (CME) programs

is a crucial step in the education process. A previous

systematic literature review (Myers 1999) described a lack

of objective evaluation for learning needs assessments in

primary care physicians. This scoping review updates the

literature on objective strategies to assess physicians'

unperceived needs in CME.

Methods: The scoping review approach by Arksey and

O'Malley (2005) was used to systematically map the

literature on approaches to unperceived needs

assessment. Academic literature was searched using

electronic databases Ovid MEDLINE, EMBASE, ERIC and

Cochrane. Grey literature was searched using a Google

Custom Search Engine following the Grey Matters

protocol. Focus was on physicians in a CME context.

Results: The search identified 2403 articles, 76 articles

were identified for inclusion in the study (54 research, 10

theoretical, 12 grey literature). Research studies

predominantly reported knowledge assessment strategies

(multiple-choice tests), where theoretical literature

promoted performance evaluations (chart audits) and the

grey literature emphasized secondary data assessment

approaches (environmental scans).

Conclusions: Performance-based assessment strategies

are highly recommended in non-research articles yet have

low levels of implementation in published studies. In grey

literature, analysis of secondary data through patient

input or environmental scanning is emphasized more so

than in peer-reviewed theoretical and research articles.

These gaps between theory-based recommendations and

research studies are likely due to resource constraints

rather than lack of awareness. Future evaluations should

incorporate multiple needs assessment strategies and

make assessments actionable by describing the

implementation process and resource management.

P2 - 06-60316

Creation of just in time videos for healthcare educators on

using synchronous technologies (zoom)

Suzan Schneeweiss University of Toronto, Heather MacNeill University

of Toronto

Background/Purpose: The current pandemic has caused a

rapid shift to "emergency" online teaching, with little

preparation of teachers and learners on best practices,

particularly in synchronous (webinar) environments. To

our knowledge, no comprehensive resources exist for

faculty development in synchronous teaching for a

healthcare context. When transitioning to synchronous

learning, educators need to develop self-efficacy and

comfort level in using technology as well as incorporate

the same effective principles that are important in face to

face (F2F) teaching, (e.g. interactivity, feedback,

repetition, reflection, social learning).

Summary of innovation: Using Agile software

development methodology, we discuss the creation of 2

videos series (for educators and for learners), each with

7X 5min videos. This presentation will discuss 1.

background, and design of the project 2. scripting, and

Agile process 3. synergistic collaborations and

dissemination 4. usage analytics to date (YouTube) We

chose video to allow bite sized, on the go, just in time,

repetitive, practical hands-on and reflective learning

across multiple devices, for busy physicians, already

overwhelmed by pandemic changes. Inter-institutional

and national collaborators were engaged to ensure the

content was applicable across multiple contexts and

locations.

Conclusions: This iterative approach using an Agile

framework for video creation may assist others in building

technology enhanced faculty development. These videos

and associated resources may also help faculty

development in synchronous education, through knowing

"what buttons to push" in these environments but also

examining the pedagogical reasons for choosing them.

P2 - 07-60846

Certificate Program on global health equity

Robert Glynn Memorial – University of Newfoundland, Vernon Curran

Memorial – University of Newfoundland, Nicholas Fairbridge Memorial

– University of Newfoundland, Anuj Charon Memorial – University of

Newfoundland, Cindy Whitton Memorial – University of Newfoundland,

Jill Allison Memorial – University of Newfoundland

Background/Purpose: Global health learning should be a

continuum from medical education through professional

practice, focusing on structural and health inequities.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Methods: Among undergraduate and post-graduate

training opportunities and certificates offered in global

health few programs combine the local and the global

through an equity lens. This certificate program takes a

social medicine approach, putting social determinants at

the forefront and encourages participants to think about

the structural obstacles to health equity around the world.

Results: The Certificate in Local and Global Health Equity,

an accredited program offered through the Office of

Professional and Educational Development at Memorial

University is an online, interdisciplinary, interactive

opportunity for professionals and learners. The program

covers social determinants, globalization, disease, inner

city issues, addictions, women's health, children's health,

humanitarian response, Indigenous health and Newcomer

health, development theory with both local and global

perspectives. Assessment is participation and reflection

based.

Conclusions: Global health educational opportunities

among health professions and learners are important in

light of increasing globalization, population migration and

the COVID 19 pandemic. Participants gain insights into

political and social factors that shape the burden of

disease. In its fourth iteration, program evaluations

indicate that module objectives are met and narrative

comments are consistently positive. Participants reflect

on the value of the curriculum content and the rich

interactive discussions. This program is an innovative

learning opportunity that encourages dialogue on

complex issues that shape global health to strengthen the

basis for advocacy and policy change both locally and

globally.

P2 - 08-60862

Leader effectiveness and leadership development in

physician leaders

Anurag Saxena University of Saskatchewan, Preston Smith University of

Saskatchewan, Graham Dickson Royal Roads University, John Van Aerde

Canadian Society of Physician Leaders, Loni Desanghere University of

Saskatchewan

Background/Purpose: Leadership is a critical element in

the outcome(s) of any organization, with these outcomes

often dependent on the leader's skills, knowledge,

abilities and competencies. The purpose of this project

was to conduct a study of physician leaders across Canada

to investigate the effects of age, gender, and experience

on leadership development and self-perceived leader

effectiveness.

Methods: 151 physician leaders from across Canada

completed an online survey. Participants were asked to

rate their leader effectiveness (LE) in their current

leadership role and complete the LEADS self-assessment

questionnaire. Independent samples t-tests and one-way

ANOVAs were used to explore demographic variables on

leadership development (LD) and LE.

Results: Older participants showed greater LD across all

LEADS domains (ps<.05); this was particularly true

between leaders in the oldest age group (55+) and the

youngest (<45). As well, older participants had

significantly higher self-perceived LE than both the

youngest and mid-aged groups (ps<.05). Females rated

themselves lower on average than males on all but one

leadership variable (develop oneself), and the differences

in several of these were significant (ps<.05). Overall, male

participants had higher LE than females (p<.05).

Participants in senior leadership roles perceived

themselves to be more effective leaders than both

frontline or mid-level leaders and showed significantly

higher LD on most of the LEADS items (ps<.05).

Conclusions: Demographics were found to play a

significant role in perceptions of LE and LD. These results

hold significance for health organizations to enhance

individual and collective leadership within their areas of

influence and mandates.

COVID

P3 - 01-60571

Teaching in the context of a pandemic: a faculty

development activity supporting clinician-teachers

Julie Grandmaison Université de Montréal, Veronique Castonguay

Université de Montréal, Ahmed Moussa Université de Montréal, Emilie

Sandman Université de Montréal, Veronique Phan Université de

Montréal

Background/Purpose: COVID-19 has changed the practice

of clinician-teachers and has put barriers to traditional

bedside or operation room teaching methods. Challenges

lie in maintaining clinical exposure while ensuring

students' safety. Our faculty development program has

developed an online course based on best practices in

clinical supervision adapted to the pandemic to support

the needs of our teachers. We aimed to assess the

satisfaction of our teachers and applicability of the

suggested modified teaching methods in their practice.

Summary of innovation: A one-hour, pre-recorded faculty

training course was available to all Université de Montréal

teachers. The topics covered were: orientation of

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students/residents, use of telemedicine, clinical

supervision and rounds, teaching procedural skills, and

well-being. Participants were invited to answer a mixed

methods questionnaire after completing the course.

Descriptive statistics and thematic analysis were carried

out. Of the 47 participants who took part in the training,

25 responded to the survey (25/47: 53%). Twenty-three

participants (92%) stated that they had achieved the main

objectives of training. The majority of participants (23/25;

92%) reported that the different strategies discussed

could be applied in their practice and several reported the

intention to apply these strategies.

Conclusions: A one-hour online course on suggested

alternative and modified teaching methods to implement

during the pandemic was a relevant and appreciated

course for our faculty. The majority of participants

reported that these methods were easily transposed to

their teaching practice.

P3 - 02-60771

An Online Faculty Development Course on Teaching

During COVID: Lessons Learned

Andrew Warren Dalhousie University, Jennifer Hall Dalhousie

University, Susan Love Dalhousie University, Stephen Miller Dalhousie

University, Lara Hazelton Dalhousie University

Background/Purpose: COVID-19 has had a significant

impact on the learning environment and brought with it

the need for timely and effective faculty development to

help medical teachers adjust to the challenges associated

with online teaching and remote supervision.

Summary of innovation: Dalhousie Medical School offers

online, asynchronous faculty development courses on a

variety of educational topics. In July 2020, we introduced

a course to our Fundamentals of Teaching Series to

address the needs of clinical and didactic teachers

operating under the restrictions imposed by the

pandemic. Entitled "A Practical Approach to Teaching

During COVID", the course comprised a series of four

modules with assigned readings, moderated discussion

boards, and webinars. In total, 50 faculty registered for

the program and 25 completed all the required

components. Other participants only accessed certain

components of the course, such as the webinars. Analysis

of comments on the discussion boards identified areas of

concern including navigating technology, attending to

learner wellness, and building community in a virtual

setting. 15 participants responded to a program

evaluation survey sent out following completion of the

course. All agreed that they would be able to use the

information they learned, and there were positive

comments regarding the emphasis on applicable

strategies as well as the opportunity to interact with other

educators.

Conclusions: Our experience shows that an online course

on teaching during COVID can be popular and well-

received. These findings provide insights into the needs of

medical teachers which may be useful for quality

improvement and program development related to this

topic.

P3 - 03-60570

Pivoting in a Pandemic: Rapid Development of a Virtual

Comprehensive COVID Curriculum

Stacey Bernstein University of Toronto, Clare Hutchinson University of

Toronto, Shibu Thomas University of Toronto, Angela Punnett University

of Toronto

Background/Purpose: The COVID-19 pandemic

necessitated the immediate removal of all clerks from the

clinical environment. The conversion of in-person

clerkship seminars to a virtual format allowed students to

continue learning from home, yet significant changes to

the provision of health care occurred in their absence.

With only a few months to prepare, a just-in-time

curriculum was developed to address these changes and

prepare students for a safe and successful return to

clinical practice.

Summary of innovation: Informal needs assessments with

MD program leadership guided development of our two-

week virtual curriculum which combined 12 hours of large

group lectures, 3 small group sessions requiring over 100

preceptors, and mandatory in-person PPE donning and

doffing simulation. Clinical curriculum included COVID

care across the age continuum; palliative care delivery in

COVID patients; and a boot camp on virtual patient care

with a small group virtual standardized patient encounter.

A group of medical students co-created a 3-part series on

ethical considerations in resource scarcity in COVID, with

a lecture, small group virtual debate, and panel discussion

with experts in the field. Student experience and well-

being were addressed by lectures on resilience, practical

tips for hospital life during a pandemic, and navigating

new tensions in the learning environment. Course

evaluations were overall positive. Students preferred the

small group work over the lectures.

Conclusions: Since its development this curriculum has

also been delivered to the incoming fall 2020 clerks, with

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plans to imbed elements into established courses such as

pre-clerkship and Transition to Clerkship.

P3 - 04-60604

The COVID Pivot in Family Medicine: a national survey of

undergraduate family medicine clerkship directors

Martina Kelly University of Calgary, Maria Hubinette University of British

Columbia Martina Kelly University of Calgary, Alexandra Thomas

University of Calgary, Lynn Power Memorial – University of

Newfoundland

Background/Purpose: The COVID pandemic led to

dramatic changes in undergraduate medical education.

The aim of this poster is to describe the challenges faced,

responses enacted and anticipated adaptations required

in Canadian undergraduate family medicine as medical

education evolves in response to the ongoing COVID crisis.

Methods: On line survey of Canadian Undergraduate and

Clerkship directors in family medicine. The survey

consisted of a mix of quantitative and qualitative

questions.

Results: 15 out of the 17 Canadian schools responded.

While developing virtual curricula was initially challenging,

many schools rapidly developed on line material, which is

being shared across schools, building on the shared on-

line LEARN-FM curriculum

(https://sites.google.com/site/sharcfm/). The biggest

challenge both in the initial return to clinical teaching and

ongoing, is capacity for learners in family medicine. The

transition to virtual care, requirements for social

distancing in clinic and concerns for population safety in

rural communities requires FM Clerkship directors to re-

double their efforts to retain and recruit preceptors for

undergraduate medical students. Personal and protective

equipment was provided to students but at some schools

community preceptors had to secure and apply for re-

imbursement. All the schools who responded are

providing PPE for community based learners. Concerns for

capacity are compounded as a number of schools juggle

double - or larger cohorts of clinical learners. A further

concern is graduates competency as some FM clerkships

are reduced in length.

Conclusions: Adapting to virtual visits requires ongoing

creative solutions in family medicine to ensure medical

student exposure to comprehensive and community

based care

P3 - 05-60543

Procedural Simulation of Adult Surgical Cricothyrotomy

for Anesthesiology and Acute Care Residents: Adapted

for COVID-19

Mathieu Asselin Université Laval, Alexandre Lafleur Université Laval,

Pascal Labrecque Université Laval, Hélène Pellerin Université Laval,

Marie-Hélène Tremblay Université Laval, Gilles Chiniara Université

Laval, Claudie Michaud-Couture Université Laval

Background/Purpose: In a CICO (cannot intubate, cannot

oxygenate) situation, anesthesiologists and acute care

physicians must be able to perform an emergency

cricothyrotomy (front-of-neck airway procedure). In

COVID-19 airway management guidelines, bougie-

assisted surgical cricothyrotomy is the recommended

emergency strategy for CICO situations.

Summary of innovation: CICO are high-acuity situations

with rare opportunities for safe practice. We designed a

four-hour procedural simulation workshop for sixteen

medical residents. They were given pre-requisite readings,

a lecture, and videotaped demonstrations. Two clinical

scenarios introduced deliberate practice on partial-task

neck simulators and fresh cadavers. We surveyed thirty-

two residents in anaesthesiology and emergency

medicine who reported that the workshop was well

structured, appropriate for their level, and authentic.

Participants were confident that the workshop improved

their technical skills. We analyzed narrative comments

related to three domains: preparation for the procedure,

performing the procedure, and maintaining the skills.

Participants highlighted the importance of performing the

procedure many times and mentioned the

representativeness of fresh cadavers.

Conclusions: To complete an infrequently performed

procedure within 60 seconds, participants must

remember instantly its basic steps and pitfalls. To prevent

cognitive overload, we provided a silent video

demonstration. We segmented the procedure and asked

participants to verbalize the five steps of the procedure on

multiple occasions. Mental imagery, live video feeds,

telesimulation and 3D printers can be used to adapt the

workshop to physical distancing recommendations. In this

case, we suggest allocating 30 minutes to each participant

to allow the supervision of at least five successful

procedures.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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P3 - 06-60516

COVID-19 Palliative Care Teaching in a Return to Clerkship

Session

Giovanna Sirianni University of Toronto, Risa Bordman University of

Toronto, Donna Spaner University of Toronto, Sarah Yip University of

Toronto, Shivani Patel University of Toronto

Background/Purpose: During the start of the COVID-19

pandemic, in-person clinical clerkship was paused. To

prepare students returning to clinical spheres, a novel

Return to Clerkship curriculum was developed with one

session focused on palliative care in the context of the

pandemic.

Summary of innovation: A small, interprofessional

working group, including MD Program palliative care

education leads, a clinical nurse specialist and a medical

student came together to develop these sessions.

Objectives included 1) Recognizing and treating symptoms

related to COVID-19 at end-of-life 2) Identifying those at

risk for complicated grief 3) Explaining and counselling

patients on goals of care (GOC) using a serious illness

conversation (SIC) framework. A one hour virtual didactic

session was followed by a one hour small group learning

session. One common clinical case was developed to link

the two sessions. The small groups were facilitated by a

palliative care clinician using VitalTalks video clips and a

group debrief. The small group focus was on learning a

framework for GOC conversations and addressing

potential challenges faced by students in the provision of

patient care during the COVID19 pandemic.

Conclusions: Student feedback rated the didactic lecture

at 3.55/5 (n=57). The small group sessions were rated

higher at 4/5 (n=63). Narrative feedback included that the

sessions were 'helpful,' 'relevant' and 'engaging.' These

sessions came together in a very short period of time with

over 30 small group facilitators recruited. Overall, this was

an excellent and timely way to include further palliative

care content into the undergraduate curriculum while

supporting students returning to clerkship.

P3 - 07-60905

Creating a pre-clerkship bootcamp in the midst of a

pandemic

Geneviève Grégoire Université de Montréal, Véronique Phan Université

de Montréal, Margaret Henri Université de Montréal, Tania riendeau

Université de Montréal

Background/Purpose: At Université de Montréal, the

pandemic forced the interruption of clinical patient

encounters for 2nd year undergraduate students. During

this period, students usually progress from direct to

indirect supervision for medical history taking. A pre-

clerkship bootcamp was created to palliate for this loss

and to better prepare students to the reality of medical

practice during a pandemic.

Summary of innovation: A bootcamp course committee

including academic directors, education leads, and

students was formed in June 2020. The course was

constructed on learning objectives centered on cancelled

clinical activities, students' perceived needs to prepare for

clerkship and critical information about COVID. The

objective was to hold a 4-week bootcamp starting August

2020 ending with a formative assessment. The curriculum

included in-person history-taking and physical

examination in an outpatient setting followed by case

history redaction and virtual feedback sessions by clinician

educators, and a telehealth consultation with a patient-

educator focusing on communication skills. E-learning

modules on telehealth issues, perioperative asepsis,

pediatric examination skills and approach to common

musculoskeletal complaints were also created. Lectures

on current knowledge of COVID-19, workshops on dealing

with uncertainty and distant learning, and student led

sessions on maximizing learning opportunities during

clerkship were held. All 292 students successfully

completed the course and assessment.

Conclusions: Pre-clerkship students were able to attend a

mixed modality bootcamp created in a short time.

Although data on student perceived benefit after the

beginning of clerkship has yet to be obtained, immediate

appreciation of the course was excellent, and students felt

safer prior to starting their clerkship.

Works in Progress

P4 - 01-60292

Virtual Culinary Medicine Labs: A Northern Ontario

School of Medicine (NOSM) and University of British

Columbia (UBC) Collaboration

Joel Barohn University of British Columbia, Lee Rysdale Northern

Ontario School of Medicine

Background/Purpose: Building on the CCME John Ruedy

Education Innovation Symposium (2019), NOSM's

Culinary Medicine (CM) program aims to increase

undergraduate medical student nutrition and lifestyle

medicine competence while improving their health

behaviours. A proven teaching strategy in over 50 US

medical schools, CM is an innovative approach with

positive dietary and psychosocial patient outcomes.

Front-runners in CM have adapted education approaches

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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to mitigate the COVID-19 challenges including a NOSM

and UBC partnership to assess the feasibility,

acceptability, and impact of virtual versus previously

successful in-person programming.

Summary of innovation: A CM curriculum including

Canadian clinical nutrition practice guidelines and virtual

education best practices were used to develop and deliver

two different two-hour sessions in April and May 2020.

Sessions were promoted to medical students (Years 1 and

2) and dietetic interns at both schools via electronic

flyers/newsletters, emails and word of mouth. Students

pre-registered online including their nutrition questions

which were incorporated into session content/resources.

A voluntary online post-session evaluation assessed

nutrition knowledge, planned health behaviour(s)

changes, future practice confidence and overall session

satisfaction.

Conclusions: A total of 52 participants (21 medical and 31

dietetic students) attended one of two sessions. While in-

person was preferred, students enjoyed learning with

other schools and programs while gaining additional

knowledge and experiences through shared faculty

expertise from both schools. Positive attendee feedback

and faculty experience demonstrated virtual CM

programming was feasible and effective during the

pandemic and beyond; five additional sessions will be

delivered in fall/winter 2020-21. Tailored inter-school CM

programs yielded higher participation rates, enhanced

interdisciplinary learning including practical food skills

linking nutrition science and medical education while

effectively utilizing limited faculty resources.

P4 - 02-60654

Digital Health: Interdisciplinary engagement to foster

industry growth

Gerard Farrell Memorial – University of Newfoundland, Heidi Coombs

Memorial – University of Newfoundland, Vernon Curran Memorial –

University of Newfoundland, Nicholas Fairbridge Memorial – University

of Newfoundland

Background/Purpose: Healthcare and education in the

21st century must transcend physical walls. Technologies

can support patient/client self-care behaviours and

enable more timely access to patient/client information

and consultations with other interprofessional healthcare

team members. Digital Health is a multidisciplinary field

that involves the use of information and communications

technologies to facilitate healthcare delivery and address

the health information needs faced by patients and health

care professionals.

Summary of innovation: A provincial symposium brought

together researchers and experts in the field of digital

health, governmental and health delivery stakeholders,

health care professionals, and representatives from

professional associations and industry to help nurture

opportunities for growing interdisciplinary digital health

research programs to advance the health of the people

and communities we serve. Topics included clinical

applications of digital health, demonstrations of

innovations, interactive/panel discussions, patient

perspectives and business model implications.

Conclusions: The event was well-received and highly rated

by participants who felt their learning needs were met and

expanded their knowledge on initiatives and

opportunities throughout the province while remaining

relevant to their practice. The prevalent suggested

improvement to future events would be to expand the

schedule and scope of such an event to bring increased

government, industry and medical allied health voices into

the discussion. The success of this event lead to additional

funding and the delivery of a regionalized digital health

symposium focused on public engagement, rural

innovation and delivery.

P4 - 03-60895

The centre is not always in the middle: The power of

knowledge brokering in social accountability.

Jill Allison Memorial – University of Newfoundland, Rachel Brown

Northern Ontario School of Medicine, Erin Cameron Northern Ontario

School of Medicine, Pauline Sameshima Lakehead University, Brian Ross

Northern Ontario School of Medicine

Background/Purpose: Social Accountability (SA) has been

recognized globally as a key value in Medical Schools and

emphasizes the importance of partnerships, particularly

with the communities that are served. A fundamental

aspect is the need for communication and the brokering

of knowledge across the various domains where what

constitutes knowledge is different and takes on different

values in context. In our research we explore the role of

knowledge brokering (KB) and social accountability.

Specifically we ask, how can socially accountable

institutions ensure that communications with all partners

are productive and reciprocal?

Summary of innovation: As part of a larger funded

project, Stories and Art of Learning and Transformation in

Health Education (SALT-HE), we utilize arts integrated

research methodologies to delve deeper into the meaning

of both SA and KB as processes of fundamental connection

and reparative curriculum. We work with dialogue and

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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interpretive approaches as we strive to enhance the way

we see schematics such as the Partnership Pentagram

associated with SA. Through dialogue we explore the

necessary conditions for enhanced models and the

supports required for knowledge generation and

exchange across partnerships.

Conclusions: We argue that when it comes to

communication, the "centre" is not always in the middle

as access to power and voice is unequal. We seek

authentic ways to engage knowledge brokers in SA

institutions, increase receptivity for understanding and

communication, develop ways of facilitating the flow of

knowledge in many directions, and support actionable

goals between partners. We emphasize the importance of

engaging across community partners in ways that enable

networked support of mutual priorities.

P4 - 04-60160

Experiential nursing rounds: An opportunity for graduate

nurses to process challenges, develop coping strategies,

and experience social support within the academic

curriculum

Nicole-Ann Shery McGill, Camila Velez McGill

Background/Purpose: Nurse trainees experience a variety

of stressors in academic and clinical environments,

including heavy workloads, challenging patient

interactions, and conflict between staff. Occupational

stress may lead to burnout, powerlessness, isolation, and

attrition from nursing. It is imperative to provide trainees

with coping resources to deal with stressors, prevent

negative outcomes, and foster emotional well-being.

Social support, within the context of support groups, has

been found to have a beneficial effect on health outcomes

within the nursing population.

Summary of innovation: The WELL Office in the Faculty of

Medicine and Health Sciences at McGill University

developed the Experiential Rounds, a series of two

confidential support groups for nurse trainees

(N=20/each), which are offered as part of the academic

curriculum. The Experiential Rounds are designed and

facilitated by a Wellness Consultant and Registered

Psychotherapist, with the goal of helping trainees share

their clinical experiences, develop strategies to overcome

hardship, build confidence and community. Evaluation

results revealed that most students found the sessions

useful and helpful to their academic and clinical journeys.

Thematic analysis further revealed that students were

able to: a) normalize challenges experienced, b) learn

practical tools to manage stress, c) alleviate

perfectionism, and d) share experiences in a confidential

and safe venue. Suggestions included to have more

sessions with smaller student groups.

Conclusions: Experiential rounds may be a promising tool

to enhance nurse trainees' ability to cope with stress.

Embedding experiential rounds within the curriculum can

validate the importance of emotional well-being for a

healthier nursing workforce. Recommendations and

feedback for implementation of sessions will be shared.

P4 - 05-60653

NOBL FIIISTT: Framing concepts for the beginner learner

in surgery

Geoffey Blair University of British Columbia

Background/Purpose: Learning the concepts of surgery,

like any specialized field, can be hard work. Its technical

language, diagnostic and procedural concepts, unique

problems and solutions, and even the surgeon's mindset

can easily confuse and intimidate the beginner surgical

learner. Most medical students are reduced to

memorizing an overwhelming list of words and facts

rather than developing a meaningful understanding of the

underlying principles.

Summary of innovation: NOBL FIIISTT is an easily

understood conceptual framework for the early surgical

learner at the threshold of the more intensive surgical

education encountered in their clinical years of training.

NOBL FIIISTT is an acronym for those elements of

diagnosis and care in which surgeons, as physical

interventionists, may play a key role: N-Neoplasms, O-

Obstructions, B-Bleeds, L-Leaks, F-Function disorders, I-

Inflammatory conditions, I-Infections, I-Ischemia, S-

Structural disease, TT-Trauma/Tissue damage. These are

the elements of surgical disease and are not confined

within organ systems or surgical disciplines, nor are they

mutually exclusive. It can help connect the anatomic,

physiologic and diagnostic elements that might initially

appear conceptually far apart.

Conclusions: NOBL FIIISTT has shown utility as an

educational tool in the pre-clinical and clerkship years and

also as a pre-graduation surgery review course. The

presentation, study and discussion of the NOBL FIIISTT

elements helps create meaning for the early surgical

learner.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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P4 - 06-60944

The Times They are a-Changin': A Pediatric Bootcamp for

Medical Students

Jessica L. Foulds University of Alberta, Melanie Lewis University of

Alberta, Karen L. Forbes University of Alberta

Background/Purpose: Pediatric medicine is traditionally

underrepresented, or at least disproportionately

represented in pre-clinical components of traditional

curriculum designs. As a result, the majority of pediatric

focused medical content is taught during the core

pediatric clerkship. Our Pediatric Bootcamp was

developed to respond to changes in the clinical

educational opportunities for clerkship students due to

COVID-19. Given the need to shorten core pediatric

clerkship to avoid the potential overlap of the 2021 and

2022 cohorts, the bootcamp took advantage of the

current crisis to lay a solid foundation in pediatric

knowledge and skills prior to return to clerkship.

Summary of innovation: A Pediatric Bootcamp consisting

of 14 half-days of core pediatric content was created and

delivered in June 2020 while students were displaced from

their clinical educational experiences. Clerkship students

(Class of 2021) who had not yet completed their pediatrics

clerkship, and pre-clerkship students (Class of 2022) were

invited to attend and participate in synchronous virtual

teaching sessions. Guiding concepts for curriculum

development included (1) theme days, (2) case-based

focus, (3) approaches to core pediatric clinical

presentations, (4) active learning with interactive

components, (5) flipped classroom to allow for application

during live sessions, and (6) adult learning principles.

Conclusions: Throughout the 3-week period, over 100

students consistently participated in online learning.

Student feedback was generally positive, including

expressed desire to have a pre-clinical dedicated and

consolidated pediatric block. Over the upcoming year we

will be monitoring the Bootcamp's impact on learning

given some students will experience quite a time gap

between the bootcamp and their core pediatric rotations.

P4 - 07-60596

Preparing to teach: Psychiatry residents' journey to their

role as teacher.

Linda Jones University of Dundee, Mandy Esliger Dalhousie University

Background/Purpose: Preparing residents for their role as

teacher is essential to learner and patient education,

meeting accreditation standards, supporting

development of residents' teacher identity, improving job

satisfaction and attitudes toward teaching, enriching

patient care, and increasing the chances students will

learn residents' professional behaviour and values.

Limited literature exists regarding residents' perceived

needs and how they inform resident-as-teacher programs.

This study explored how a psychiatry departments'

residents' experiences prepares them for their role as

teacher.

Methods: In this phenomenologically informed study,

psychiatry residents (grouped by postgraduate year) and

education directors participated in separate semi-

structured group interviews (one interview per group).

Data were analyzed using Interpretative

Phenomenological Analysis (IPA) to identify themes, then

interpreted by the researchers to portray the residents'

lived experiences.

Results: Ten residents and three education directors

participated. Participants value the resident-as-teacher

program deeming it prepares residents for their teaching

role. Five themes capture the findings: residents' sense of

self, conceptions of teaching, perceived student types,

conceptions of feedback and impact of the learning

environment. Despite valuing the program, participants

suggested various improvements: increased observation

of residents teaching, improved feedback on teaching

skills, protected time for training and teaching

opportunities and support across the department for the

teacher role.

Conclusions: This study highlights the importance of

fostering residents' educational skills to develop their

teacher identity and prepare them for their teaching role.

It provides insight on residents' perceived needs and how

they can inform resident-as-teacher programs. Numerous

recommendations are suggested for curricular

improvements.

P4 - 08-60660

Rural Medicine eMentoring BC (RMeMBC)

Takaia Larsen Selkirk College

Background/Purpose: The RMeMBC program connects

Rural Pre-Medicine Program (RPM) students at Selkirk

College with medical students in the Rural Medicine

Interest Group (RMIG) at UBC. Due to geographic barriers,

it is difficult for rural students to find "near peer" mentors.

Likewise, medical students interested in rural practice are

often studying in urban settings and feel disconnected

from rural communities. The RMeMBC program provides

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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a platform where these students can form mentoring

relationships online.

Summary of innovation: In collaboration, RPM, RMIG and

the Rural Education Action Plan (REAP) developed a

curriculum of eight modules highlighting the transition

from undergraduate studies to medical education

training. Once mentoring matches have been made based

on common interests and experiences, students access

the curriculum through an eMentoring software platform,

and it helps to guide their conversations.

Conclusions: Early results from the program indicate that

mentors and mentees find the experience valuable.

Interactions on the platform are generally focussed on the

topics students identified as being important to them: the

transition to medical education training and the needs of

rural communities. One challenge which has presented

itself is that portions of the curriculum are sometimes left

unaddressed. Currently, we are exploring ways to

encourage greater engagement with the curriculum while

still allowing for organic conversations driven by

participants' interests. Upon review, all partners view

RMeMBC as successfully providing a resource that

supports participants with rural backgrounds or affinities,

and it could be replicated to support rural students across

Canada.

Teaching & Learning with Technology

P5 - 02-60531

Dynamicity in response to COVID: Reconfiguring the

infectious disease clinical skills sessions for preclinical

medical students

Ramzi Sabra American University of Beirut, Umayya Musharrafieh

American University of Beirut, Zakia Dimassi Saint George Hospital

University Medical Center

Background/Purpose: Responding to covid while

maintaining a dynamic and relevant clinical skills

curriculum was a challenge and impetus to be creative. At

the American University of Beirut medical school, we

already trained Medicine 1 students in universal

precautions as part of their infectious disease (ID) block,

in addition to ID-focused history-taking sessions. The

challenge was how to A- implement these sessions

virtually and B- make the content more relevant to the

pandemic while maintaining the overall course learning

objectives.

Summary of innovation: We instructed the students to

record videos from home on hand washing, using ink or

any colored materials (to ensure thoroughness), and using

their own wardrobe items to demonstrate the process of

doning and doffing of personal protective equipment. We

also replaced the two ID history-taking sessions with a

session on tracing one's journey to the store and back to

identify the surfaces one comes in directly contact with,

and another session (teamwork-based) where the

students had to make a presentation to convince

government officials of the necessity to implement a

country-wide lockdown, using arguments based on

infection control and public health measures.

Conclusions: The output by the students was impressive

and the teaching faculty's adaptation to the abrupt

modification of the sessions was laudable. Thinking

outside the box and taking bold steps proved rewarding

and feasible. Additionally, more public health content

should be integrated into clinical teaching to inculcate a

more global understanding of health and disease.

P5 - 03-60923

Developing Interviewing and Clinical Reasoning Skills with

a Novel Low-Cost Virtual Patient Simulator

Richard Franke Athabasca University, Malgorzata Kaminska University

of Northern British Columbia

Background/Purpose: Good interview skills are crucial in

medicine. Interview skills are usually taught and

developed during clinical skills (CS) sessions in a group

setting. Such settings can limit students' ability to access

their own unique knowledge base and to reflect on their

clinical reasoning patterns. More recently, there have

been added restrictions to CS sessions, due to the COVID-

19 pandemic, that further limit students in their access to

standardized patients (SPs).

Summary of innovation: A low-cost virtual patient

history-taking simulator operating in PowerPoint 2013

with custom Visual Basic programming was piloted during

a Respiratory Exam session. The simulator mimicked a

Jeopardy format, incorporated multimedia, and required

no prior preparation by students. It was used by student

dyads playing the role of interviewer and patient. Only the

patient-student was able to see the computer screen and

relied on the software to provide answers to questions

asked. The program provided feedback to the interviewer-

student regarding areas that should have been addressed

but were missed. A post-intervention anchored Likert-

scale survey was completed by 15 students (100%

response rate) who used this software. Student responses

indicated the software was of educational value (100%), a

useful tool for practicing history-taking (86%), and an

efficient use of their time during the session (93%).

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Overall, 93% requested that this software be part of future

CS sessions.

Conclusions: Students valued using this novel, low-cost,

easy-to-use simulator to practice interviewing in an

individual, guided manner, with immediate feedback, and

without need for additional preceptor, SPs, or

preparation. Additionally, the tool promotes individual

expertise development while incorporating differential

diagnosis, data interpretation, and management skills.

P5 - 05-60886

Learning analytics as a means to evaluate student

collaboration and engagement

Craig Thompson University of British Columbia, Patricia Gerber

University of British Columbia, Kerry Wilbur University of British

Columbia, Robert Pammett University of British Columbia, Morgan

Garvin University of British Columbia

Background/Purpose: Learning analytics refers to the

collection, evaluation, and analysis of data about learners

to understand and optimize the learning environment.

Threadz is learning analytics software available at our

institution that can be applied to our online course

discussions to help us examine learners' contributions and

interactions within our learning management system.

Summary of innovation: We explored the use of Threadz

within online course discussions in the fourth-year

distance-based Advanced Topics in Pharmacy Practice

seminar course of the UBC Entry-to-Practice Doctor of

Pharmacy Program. Learners configured in groups of 6-7

participated in online course discussions pertaining to

topics related to current events and issues in pharmacy.

We activated the software within the course learning

management system and retrospectively generated

visualizations to help us analyze learner engagement. We

identified data that enables instructors to act in real-time

course delivery to support teaching and learning. Quick

identification of "orphan" discussion posts and indicators

of low learner engagement (timing, quantity and

connectedness of contributions) permit instructors to

efficiently and purposefully intercede to assess content

and concept understanding and offer guidance to specific

learners.

Conclusions: Learning analytics software has the potential

to transform the way we moderate and evaluate online

course discussions, and should be considered for health

professional educators who use this modality to educate

students.

P5 - 06-59678

Evaluation of an on-line transgender health training

program

Michael Lee-Poy McMaster University

Background/Purpose: TransEd is an online transgender

health education curriculum developed to address the

paucity of training in transgender health in healthcare

professional schools. A study of six medical schools in

Canada found that only two devoted more than eight

hours of instruction to transgender related curriculum

while the remaining allocated less than 4 hours of

instruction. Self-reported comfort level showed that only

7% of students across Canadian medical schools actually

felt "sufficiently knowledgeable" to assist a patient

requesting hormonal therapy. TransEd is an innovative

online curriculum that was developed through a grant

from the Ministry of Training Colleges and Universities in

2015 to address this gap in education in medical training.

This project looks at evaluating the effectiveness of an

online TransEd program to address the knowledge gap,

attitudes and comfort level in providing transgender

healthcare.

Methods: This project used the Kirkpatrick's four levels of

training framework which is considered a gold standard

for evaluating training programs. A mixed-methods

approach using surveys and focus groups was

implemented. After completion of the TransEd modules,

Family Medicine residents completed a survey addressing

knowledge and attitudes on transgender health. In

addition, a focus group with a experienced and trained

facilitator conducted a small group guided session

exploring TransEd's effectiveness in meeting educational

needs, perceived gaps in the modules and effectiveness in

increasing comfort level in addressing transgender

healthcare needs.

Results: This abstract focuses on the qualitative analysis.

A total of 6 Family Medicine residents participated in the

focus groups. General themes that emerged including

appreciating videos of true narratives that personalized

the transgender journey and stories, a logical step wise

approach to the modules, the practical approach to

management options and the link to resources. Overall

participants felt TransEd was a great foundation for

transgender health knowledge and helped increase

comfort levels. Suggestions for improvement included

having more case examples that would model how to

implement the guidelines in a practical manner and

receiving ongoing training in these areas. Another

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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limitation identified was the ability to transfer this

knowledge into real life situations and the need to pair

TransEd with clinical exposures and experiences.

Conclusions: TransEd is an online education program that

is an effective way to deliver curriculum on transgender

health. Medical residents appreciated the practical

approach that helped to increase their comfort levels in

providing transgender care. However, pairing this with

clinical rotations and experiences would further enhance

the effectiveness of TransEd. Further research is needed

to study the affect of TransEd on behavioural change in

medical professionals providing transgender care.

Teaching & Learning - Postgraduate

P6 - 01-59487

Patient Emancipation? Patient Teacher Programs in

Medical Education

Farah Friesen University of Toronto, Stella Ng University of Toronto, Jory

Simpson University of Toronto, Emilia Kangasjarvi University of Toronto

Background/Purpose: "Patient as Teacher" (PAT)

educational initiatives aim to bring the human experience

more prominently into the medical education process by

integrating patients and their stories into teaching. Yet

despite decades of PAT programs and related research,

incongruent perspectives on patients' involvement and

motivations can still complicate PAT efforts. The

underlying reasons for patient engagement from the

perspectives of all PAT stakeholders - particularly patients

- requires further scrutiny to ensure meaningful, non-

tokenistic PAT programs and avoid potential coercion.

Methods: A new Patient as Teachers program was

launched in 2018 for undergraduate University of Toronto

MD students doing their surgical clerkship. Using a

phenomenographic approach, we conducted 21 semi-

structures interviews with patient teachers, students and

facilitators who participated in this program to investigate

the qualitatively various ways the program (the

phenomenon) was experienced.

Results: Analysis identified different phenomenographical

categories of description and how these categories were

structurally related. One category may explain why

patients participate in medical educational programs:

retroactive emancipation. The program offered a way for

patients' to counterbalance the dehumanizing care

experience parts, give voice and drive for a change in how

healthcare engages with patients

Conclusions: As patient engagement in medical education

increases, we should consider how to make patient

involvement more inclusive and authentic. By

conceptualizing PAT programs as potential early stage

emancipation movements we may better support

educational program development that involves patients

in a more humanistic and ethically sound manner to

promote true patient-centered healthcare.

P6 - 02-60826

Building a New Social Contract in Canadian Medical

Practice through Competence by Design

Fernanda Claudio McGill, Peter Nugus McGill

Background/Purpose: We examine the emerging social

contract between doctors and society in the context of

Competence by Design (CBD). Three seminal events define

medical specialty training: the union of barber-surgeons

and apothecaries in the 19th century (Porter, 2002); the

Flexner Report (1910); and, competency-based education

nowadays. Each event produced specific medical

professional identities and associated social contracts

based on understandings of population needs and rights.

CBD promises to create scientifically informed and socially

responsive doctors. CBD entails a new professionalism

and a new social contract, but how is this reproduced in

specialty training, which occurs in a dialogic relationship

between clinical practice and social accountability?

Methods: We conducted a comprehensive literature

search of competency-based medical education

approaches, Competence-by-Design, and the sociological

literature on social reproduction and education.

Results: We examined CBD through the vantage point of

social reproduction theory providing tools to understand

the roles of both education and practice in the re-making

of professional worlds. Education is one key locus of social

reproduction (Bourdieu, 1972; Freire, 1970), yet this is

mediated by structural constraints in various forms

(Collins, 2009), including contexts of practice.

Conclusions: We found that, beyond the parameters of

scientific medicine, CBD creates a medical professional

identity entangled with contemporary social and

contextual factors, including pandemic conditions, thus

creating a new social contract.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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P6 - 03-59933-Teaching together: The impact of a faculty-

resident co-teaching experience on resident teaching

skills.

Andrea Sandstrom Dalhousie University, Mandy Esliger Dalhousie

University, Cheryl Murphy Dalhousie University, Mark Bosma Dalhousie

University

Background/Purpose: A core feature of resident training

is development of the role as teacher. To support this

development our psychiatry department implemented an

opportunity for residents to co-teach Med 2 clinical skills

with a faculty member. The goal of this study was to

explore resident and faculty perceptions of the impact of

this co-teaching experience on resident teaching skills.

Methods: Faculty and residents at a single medical school

who co-taught the 2019/2020 clinical skills teaching

(n=12) were invited to participate in semi-structured

group interviews (one for faculty, one for residents) post

co-teaching experience. Transcripts were analyzed using

inductive thematic analysis to identify themes. Residents

also completed Likert scale self-assessment

questionnaires pre- and post- co-teaching to gauge self-

assessed impact of the experience on their teaching skills.

Results: Four faculty and three residents participated. Five

themes were identified: Role-as-Teacher, Enjoyment,

Perception of Feedback, Structure of Experience, and

Teacher Identity. Participants indicated the experience

fostered development of teacher identity, skill, and a

perceived sense of confidence via role modelling and

mentoring. Participants suggested more opportunities for

observed teaching, improved feedback, and

standardization of the co-teaching experience would be

beneficial. Quantitative analysis of questionnaires showed

improved perception of teaching skills although this

increase was non-significant (t(2)= -0.8542, p= 0.4830).

Conclusions: Our findings suggest the co-teaching

experience enhances resident teaching skills. Further

enhancement may be realized by incorporating suggested

improvements. Future studies should examine the co-

teaching experience in a larger sample and feasibility of

application more broadly.

P6 - 04-60814

Evaluating the Child and Adolescent Psychiatry sub-

specialty program using a rapid-cycle approach

Jennifer Dare Queen’s University, Heather Braund Queen’s University,

Jenniferr Turnnidge Queen’s University, Sarosh Khalid-Khan Queen’s

University, Nancy Dalgarno Queen’s University

Background/Purpose: Queen's University launched

Competency-Based Medical Education (CBME) in July

2017. Due to the relatively small size of the Child and

Adolescent program, the ability to iteratively respond to

programmatic needs has been limited, primarily due to

the lack of data. The purpose of this study is to evaluate

the transition to CBME for the Child and Adolescent

Psychiatry program at Queen's University.

Methods: The first cycle of this rapid evaluation was

completed in November 2019. Residents, faculty, program

leaders, allied health professionals, educational

consultant (n=12) participated in a focus group or

interview to understand experiences following CBME

implementation and to identify areas for improvement. All

data were analyzed thematically.

Results: Residents appreciated receiving timely feedback,

identifying areas for improvement, and acknowledging

efforts of program leaders. Program leaders identified the

small and relatively new program as a challenge, often

resulting in faculty serving multiple roles. Time

commitment was identified as a concern across

participants. Findings suggest ongoing refinement of

assessment tools based on their feedback is appreciated

and the competence committee is moving closer to

implementing as intended. Areas of support included the

educational consultant, CBME lead, and learning from

faculty and residents who had experience with CBME.

Areas for refinement included interpretation and

alignment of the entrustment scale and clarification of

CBME expectations.

Conclusions: The findings have identified what is working

well following the transition to CBME and areas for

program improvement. Despite the focus being on one

program, the findings can inform the implementation of

other CBME programs.

P6 - 05-60795

Evaluating the effectiveness of an airway mastery

curriculum

Fil Gilic Queen’s University, Heather Braund Queen’s University

Background/Purpose: An airway mastery curriculum was

developed to provide residents with the opportunity to

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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learn emergency airway management skills and was

designed using a combination of Cognitive Load Theory

(CLT), 4 Component Instructional Design (4CID), and a

mastery approach. This course spanned across 1 year and

included monthly modules, deliberate practice, and

mental rehearsal. This program evaluation aimed to

evaluate the effectiveness of the curriculum in preparing

residents for emergency airway management in practice.

Methods: All 10 residents participated in a focus group (n

= 7) or semi-structured interviews (n = 3) within 10 days of

course completion to describe their experiences with the

course and identify recommendations. Participants will be

interviewed again once they have worked independently

for six months. Data were analyzed thematically.

Results: All participants reported increased confidence in

airway management following course completion. Four

themes emerged: facilitators, challenges,

recommendations, and transfer to practice. Facilitators

included the course homework, schematic

representations, and repetition. The challenges related to

real-life practice and buy-in from non-course participants.

Participants suggested standardization across instructors,

additional practice outside of the course, and pediatric

scenarios. Participants discussed an increased ability to

prioritize and more planning before intubating resulting

from the course. Multiple participants discussed how their

skills became automatized allowing them to focus on

other areas of care.

Conclusions: Findings emphasized the practicality of the

course and identified areas for improvement. It is

encouraging that all participants felt that the course was

worthwhile and that it had improved their confidence in

airway management.

P6 - 06-60942

Project-Managing the Poetry of Medicine: Structure and

Meaning in an Accreditation and Quality Improvement

Unit

Patricia Wade McGill, Fernanda Claudio McGill

Background/Purpose: Competence-Based Medical

Education (CBME) poses new challenges for educational

quality improvement and, ultimately, accreditation of

residency programs. Medical education is multifaceted,

complex, and includes intangibles relating to professional

identity and delivery of high-quality responsive care that

serves patient needs and satisfies health system

structures. While CBME appears straightforward and self-

explanatory, the model is challenged by context of

implementation (system) social reproduction of medicine

(meaning).

Summary of innovation: The Office of Accreditation and

Education Quality Improvement (OAEQI) adopted a team-

based approach to support medical training in the context

of diverse populations, the Quebec health system,

medical education best-practice, and national

accreditation standards. OAEQI functions through a

tripartite service model that aligns curriculum,

assessment and evaluation delivered through the lens of

quality improvement and accountability in its various

institutional and social dimensions. Our strength is our

team. We are bilingual and demographically varied

working collaboratively and deriving our expertise from

psychology, medical anthropology, nursing, political

science, education, medicine, and others. Our structure is

enabling and humanistic in terms of work practice and

deliverables. We illustrate this approach with a case study

of a residency program.

Conclusions: Our multidisciplinary approach enables

identification of complex educational needs, barriers, and

opportunities. We design response models to address

residency programs needs accounting for strengths and

constraints, measures of outcomes and impacts, and

feedback.

P6 - 07-60938

Learner suggestions on improving residency education

Loni Desanghere University of Saskatchewan, Tanya Robertson-Frey

University of Saskatchewan, Anurag Saxena University of Saskatchewan

Background/Purpose: The postgraduate Medical

Education (PGME) office routinely gathers information

about resident's experiences, strengths and suggested

improvements as part of ongoing program evaluation. The

purpose of this project was to review learner suggestions

on improving residency education within our institution.

Methods: Exiting residents were asked to fill out an on-

line reflective survey about their experiences and

satisfaction about their training. Responses from 322

residents who completed their residency training in the

2014-2015, 2016-2017, 2017-2018, 2018-2019 and 2019-

2020 academic years were complied. Qualitative

responses from the question "how could your residency

program be improved?" was imported into NVIVO 12.

Emergent themes were generated as they appeared in the

data, larger thematic areas were broken down into sub-

themes if they were multi-faceted.

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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Results: Three overarching themes emerged: Resident

learning, organizational, and resident wellness, each with

various sub-themes. The majority of suggestions (74%)

revolved around resident learning. The main sub-themes

were suggestions on educational experiences (e.g., more

procedures), the delivery of education (e.g., improved and

focused teaching), and supervision and support. Other

areas included exam support, transition to practice and

scheduling. Organizational improvements (13% of

comments) mainly revolved around resources (e.g.,

physical, financial, technical, human resources) and

organizational communication. Finally, 10% of all

comments were focused on resident wellness (e.g.,

improving wellness initiatives and addressing

professionalism and harassment issues).

Conclusions: These results have helped in identifying key

factors that influence the overall residency experience.

Focusing organizational improvements on these factors

will help improve the ability of PGME to deliver high

quality resident training.

Teaching & Learning

P7 - 01-60824

Rethinking Certainty - how to teach 'evidence based'

patient care when there is no evidence?

Mairi Scott Centre for Medical Education, School of Medicine, University

of Dundee

Background/Purpose: The Covid-19 pandemic has

fundamentally upended our reliance on Evidence Based

Medicine (EBM) based on Randomised Controlled Trials

(RCT's) leaving clinicians to adjust to practicing medicine

when there is no evidence. Also, the necessary switch to

creating evidence through 'fast-tracking' research into

therapeutic improvisation based on anecdotes is

profoundly upsetting to practitioners who have been able

to rely on EBM as the foundation of clinical decision

making. This issue has been described as a 'Bayesian

fatigue' (Rosenquist ( 2020); 'a stress-induced dysphoria

experienced' caused when 'knowledge acquired over

decades…becomes less important than information being

gathered from disparate sources in real-time'. Yet whilst

'Trust me I'm an expert' is a valuable therapeutic tool how

do clinicians use it effectively when the foundation of that

expertise has been shaken to its core? This presentation

will explore how we can enable our students to develop

the skills to cope with this 'Bayesian dysphoria' when

practicing in a more complicated clinical environment

than we could ever have imagined

Summary of innovation: The established way to review

cases is in Clinical Case conferences. To address Bayesian

fatigue students must be able to review clinical cases using

critical reflection and analysis based on expressing the

'hunches' and 'best guesses' that are part of clinical

decision making. Teaching these critical reflection skills is

now a key part of the Masters in Medical Education at

Dundee so our student educators can embed this into all

clinical teaching

Conclusions: The Covid-19 pandemic has shown that

reliance on EBM is a false premise and as educators we

must enable students to critically reflect and express the

underlying reasons for their 'best guess' clinical decisions

P7 - 02-60932

Improv Bot - a web-based AI chatbot to improve

communication skills

Claudia Krebs University of British Columbia , Patrick Pennefather

University of British Columbia , Austin Kvaale University of British

Columbia , Sean Jeon University of British Columbia , Ye Lan Centre for

Digital Media, Rainie Han , Zhichun Li Centre for Digital Media, Elmira

Azizi Centre for Digital Media, Vi Mehra Centre for Digital Media, Liam

Fisher Centre for Digital Media, Parastou Hedari Centre for Digital

Media, Jacqueline Ashby University of British Columbia , Brenna Lynn

University of British Columbia , Joseph Anthony University of British

Columbia Aleteia Greenwood University of British Columbia , Adrian

Yee University of British Columbia , Cheryl Holmes University of British

Columbia

Background/Purpose: ImprovBot.ca is a web application

co-constructed by graduate students at the Centre for

Digital Media and the Faculty of Medicine in Vancouver.

The A.I. bot continues ongoing iterative development at

the UBC Faculty of Medicine's HIVE. Effective

communication relies on both listening skills and positive

responses. The need to have multiple opportunities to

practice communication skills is a challenge that programs

in the areas of health and life sciences constantly attempt

to improve. Learners benefit from increased training of

their professional communication abilities, yet often the

time devoted to practice is scarce and there may be

barriers to experimenting in front of peers. By the time

learners undertake clinical practice they may be under

prepared and have to fend for themselves working with

broad and often prescribed text book guidelines.

Summary of innovation: For this reason, an artificial

speaking agent, a chatbot was designed that afforded

learners persistent and regular opportunities to practice a

growing vocabulary of communication skills. Learners are

challenged to respond to chatbot prompts spontaneously

through a series of games to improve their listening skills

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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and respond to offers with a "Yes, and" mindset. The Yes

And, Repeat After Me, and a third Free Talk mode allow

users to interact with our A.I. chatbot through recordable

conversations that can be saved, sent, and replayed by

peers or teachers. Additional scenarios are focused on

clinical communication skills as they relate to critical care

and family practice.

Conclusions: The ImprovBot is a scalable innovation that

is currently undergoing further development to improve

machine learning algorithms and expand the repertoire of

activities in order to enrichen the learner experience and

provide multiple opportunities to exercise their

communication skills.

P7 - 03-59634

Développement du rôle d'éducateur des étudiants en

médecine dans un programme fondé sur une approche

par compétence.

Nathalie Bettez Université de Sherbrooke, Évelyne Cambron-Goulet

Université de Sherbrooke, Ann Graillon Université de Sherbrooke,

Ghislaine Houde Université de Sherbrooke, Frédéric Bernier Université

de Sherbrooke, Marie-Josee Leblanc Université de Sherbrooke, Cécile

Trochet Université de Sherbrooke, Marie-Josée leblanc Université de

Sherbrooke, Paul Chiasson Université de Sherbrooke, Louis Gagnon

Université de Sherbrooke, Sylvie Mathieu Université de Sherbrooke,

Sylvie Houde Université de Sherbrooke

Background/Purpose: Le rôle d'éducateur fait partie

intégrante de la pratique médicale dès le début de la

résidence. Il se traduit par des activités de supervision, de

présentations ou autres types d'activités de formation

auprès des collègues et autres intervenants. Ce rôle

intègre plusieurs compétences CanMeds, notamment la

communication, la collaboration, l'érudition, et

l'expertise. L'apprentissage de cette compétence est

souvent implicite ou informel dans les curriculum pré-

doctoraux. Dans le cadre de la refonte du programme de

médecine, nous avons construit des activités

pédagogiques intégrées et longitudinales soutenant le

développement du rôle d'éducateur.

Summary of innovation: Les activités pédagogiques sont

déployées tout au long des quatre années du programme

et préparent les étudiants à agir dans ces trois principaux

contextes en lien avec leur rôle d'éducateur: 1. Le partage

des connaissances en petits groupes, 2. La présentation

efficace en milieu clinique, 3. L'apprentissage et la

supervision en milieu clinique. Chacune de ces activités

visent l'acquisition de connaissances, leur intégration

dans des activités pratiques en situation réelles et le

développement de la pratique réflexive. Les acquisitions

sont supportées par des méthodes pédagogiques

interactives centrées sur l'apprenant. L'évaluation est

fondée sur des examens écrits et sur l'observation directe.

Conclusions: Le développement du rôle d'éducateur s'est

concrétisé dans des activités pédagogiques dédiées

rendant explicites les apprentissages sous-jacents. La

pertinence de ces activités pour la pratique future est

soulignée par les professeurs impliqués. L'intégration des

compétences de collaboration et de communication est

particulièrement appréciée des étudiants.

P7 - 04-60035

Development of interprofessional health education

programs in two academic family medicine practices:

Moving towards the Patients Medical Home

Amanda Tzenov Memorial – University of Newfoundland, Nicholas

Fairbridge Memorial – University of Newfoundland, Karen Hurtubise

Memorial – University of Newfoundland, Michelle Levy Memorial –

University of Newfoundland, Patricia Moores Memorial – University of

Newfoundland, Carmel O'Keefe Dalhousie University, Daphne Pereira

Dalhousie University, Lynn Shaw Dalhousie University, Katherine

Stringer Dalhousie University, Joanna Zed Dalhousie University

Background/Purpose: Models of collaborative team-

based care, such as the patient's medical home, are the

vision for primary care in Canada. Yet, opportunities for

the development of interprofessional competencies

necessary for the implementation of these models can

only be found in acute care settings. Two family medicine

clinics, one in St. John's and the other in Halifax, have

created pilot projects to integrate students from a variety

of health disciplines into such primary care models.

Summary of innovation: Novel interprofessional

opportunities were developed through Memorial

University and Dalhousie University. Learners from

pharmacy, nursing, medicine, social work, occupational

therapy and physiotherapy participated in a Memorial

University Family Medicine Clinic between July 2018 and

January 2020. Learners from occupational therapy and

physiotherapy participated in two Dalhousie family

medicine clinics from July - September 2020. Students

engaged with learners in other health disciplines in

primary care, fostering role clarification, team

functioning, collaborative leadership and team conflict

skills.

Conclusions: When surveyed, students revealed that the

team approach provides a supportive and collaborative

learning environment. Feedback revealed faculty and

learners gained knowledge, skills and understanding of

scope of practice of OT and PT health professionals.

Patients appreciated the efficiency of access to allied

CANADIAN MEDICAL EDUCATION JOURNAL 2021, 12(2)

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health professionals in and through the clinic. These

provincial initiatives provide a foundation for

interprofessional learning and innovation in care delivery

within family medicine. Partnerships across academic

health education programs, medical schools and primary

care clinics have the capacity to advance sustainable

clinical learning opportunities, improve patient care

outcomes, and authenticate the delivery of collaborative

interprofessional care.

P7 - 06-60890

Identifying Correlations in National Match Results

Mike Paget University of Calgary, Chris Naugler University of Calgary

Background/Purpose: One of the most public outcomes

for a MD program is the number of unmatched students

each year. We wanted to explore if the percentage of

students matching to the same institution they graduated

from had a relationship with the unmatched percentage.

Additionally, to explore if the percentage of graduates

with Family Medicine as a first choice had a strong

relationship with lower unmatched rates.

Methods: Data was gathered from the CaRMS website R1

first round data 2015 to 2019 (n=85).

(https://www.carms.ca/data-reports/r1-data-reports/)

and analyzed with SPSS 25. Aggregating Table 42 allows us

to report on national match percentages for students who

stay in the same institution.

Results: There is a suggested relationship between Family

Medicine as a first choice discipline (%) and unmatched

students by school of graduation (%) (Pearson Correlation

of -.339) . There was no relationship between percentage

of students staying in the same institution and percentage

of unmatched students (Pearson Correlation of .128)

There was a strong negative correlation between the of

percentage students staying at the same institution and

the percentage matching to their top rank discipline

(Pearson Correlation of -.503).

Conclusions: Although there is only a small proportion of

CaRMS data available for schools to understand their

graduating classes match result, there is some evidence

that indicates a high local match rate is not a definitive

solution for a match with a high first choice discipline

result. It would be enlightening if CaRMS would release

the rank order of schools of residency by school of

graduation.

P7 - 07-60940

Rural Longitudinal Integrated Clerkship: An answer to

increasing numbers of graduates choosing family

medicine & rural practice locations

Jill Konkin University of Alberta, Daniel Lemoine University of Alberta,

Darren Nichols University of Alberta

Background/Purpose: Canada's rural populations are

dramatically underserved by family physicians and family

medicine practices, and traditional medical education

practices appear to exasperate this problem by funneling

the majority of graduates into urban specialty practice.

Rural longitudinal integrated clerkships may be one way

of improving this situation. To determine the outcomes of

the ICC in regards to current practice locations and final

career choice as compared to the Rotation Based

Clerkship (RBC). The Rural Integrated Community

Clerkship (ICC) is a core year-long 3rd year clerkship with

students based in a community family practice learning

the core disciplines of medicine in an integrated fashion

following patients through the multiple venues for care in

their rural community.

Methods: Using the U of A graduation lists from 2009-

2016 and public medical profession databases, current

practice locations and final career choice for all graduates

were compiled.

Results: The total number of graduates is 1135 (1003 RBC

and 132 ICC). Current practice location is as follows: RBC =

87% in urban and 13% in rural communities; ICC = 55% in

urban and 45% in rural communities. Career choices of

these graduates are: RBC: 41% in Family Medicine and

59% in various specialties; ICC: 73% in Family Medicine

and 27% in various specialties. Urban origin ICC students

are 4x more likely to be in rural family medical practice

than urban origin students who did the RBC. Rural origin

ICC students are 2.4x more likely to be in rural family

medicine practice than those who did RBC.

Conclusions: Rural longitudinal integrated clerkships are

an important initiative through which socially accountable

medical schools can better serve their rural communities.