Medical education research in the Department of Family Medicine Shelley Ross Faculty Development Date: February 14, 2013

Today I will describe… Why we do medical education research Areas of interest Some interesting findings Future directions

Why do medical education research? Quality of education Evidence-based approach Quality assurance (evaluation) Theory development 3

Education quality Evaluate current practices Refine Evaluate Innovate

Evidence-based Approach Look at the literature Develop a philosophy Align with best practices

Quality assurance Implement innovations Evaluate Refine Report

Areas of research

CBAS Participatory action research Multiple components Publication (program description):Ross S, Poth C, Donoff M, Humphries P, Steiner I, Schipper S, Janke F, Nichols D. The Competency-Based Achievement System (CBAS): Using formative feedback to teach and assess competencies with Family Medicine residents. Canadian Family Physician. 2011;57:e323-e330.

Feedback What kind of feedback do residents get? Is there a gender difference among preceptors? Is there a difference based on years of experience? What are the categories of feedback given?

Implementation fidelity Does CBAS work in all contexts? How do we fix it if it is not working the way we expect? Publication: Ross S, Poth C, Donoff M, Papile C, Humphries P, Stasiuk S, Georgis R. Involving Users in the Refinement of the Competency-Based Achievement System (CBAS), an Innovative Approach to Competency- Based Assessment. Medical Teacher. 2012; 34:e413- e417.

Teaching the teachers Using existing written feedback, coaching is targeted to each preceptor’s strengths and weaknesses Publication: Nichols D, Kulaga A, Ross S. Coaching the coaches: Targeted faculty development for teaching. Medical Education (in press)

Applications beyond Family Medicine Practice ready assessments (to grant provisional licenses to foreign-trained physicians) South Sudan

Social Media Facebook Twitter Publication: Forgie S, Duff J, Ross S. Twelve Tips for using Twitter as a Learning Tool in Medical Education. Medical Teacher. 2013; 35; Online professionalism

Professionalism in digital age Publication: Ross S, Forgie S. Distracted doctoring: electronic multi-tasking impairs learning and patient care. CMAJ. 2012; 184: DOI: /cmaj

Cultural competency Sensitivity to other cultures Enhancing Cultural Diversity Awareness of Medical/Dentistry Students (Szafran O, Waugh E, Parent R, Khera S, Triscot J). Cultural competency training manual for health professionals (Waugh, Szafran, Crutcher)

Narrative reflective practice Reflect on personal feelings about doctor patient relationship (Cave & Tan)

Community-based Experience Do student experiences in community family medicine clinics change attitudes and beliefs about Family Medicine? (Tan & Ross)

Palliative Care Can palliative care and end of life care be effectively taught using virtual cases? (Tan & Ross) What are resident experiences in palliative care? (Tan)

Addictions New addictions curriculum: Is there a change in attitudes and beliefs after taking the new course? (Salvalaggio, Steblecki, Duerksen, Ross)

Motivation Multiple studies (Ross) Can we incorporate motivation theory into teaching and assessment? What are the motivational patterns of residents entering the program? Do those patterns change?

Problem-based learning How effective is problem-based learning? Does it improve comprehension? (Ross, Peterson, Amin) Does PBL translate to other cultures? (Steiner & Ross)

Rural Multiple projects (Konkin, Janke, Ross, others) What are effective methods to deliver educational programming for distributed sites? What is the impact of rural rotations? What influences choice to practice in rural settings?

Benchmark examination Multiple studies (Campbell-Scherer, Schipper, Duerksen, Ross) Are benchmark examinations useful to plan curriculum? Do residents find benchmark exams useful for planning their own learning? Are residents accurate self-assessors on benchmark examinations?

Faculty Development Needs assessment (Koppula, Janke, Ross) Innovate ways to deliver Faculty Development

Triple C Evaluation Member of pilot team – longitudinal program evaluation (Ross, Schipper)

Physician lifestyles How are physician lifestyles related to the counseling they give patients about healthy lifestyles? (Klein)

Graduate survey 5 year cohort surveys of our graduates (Crutcher R, Szafran O, Woloschuk W, Schipper S, Wycliffe-Jones K, Ross S, Palacios M, Dickinson J, Myhre D). The main purpose of the study is to examine Alberta family medicine graduates’ educational experiences and practice patterns after completion of the family medicine residency program and to compare these findings to those of graduates from previous years.

Critical thinking skills To what degree do our residents think critically? (Ross, Schipper, Loeffler, Allen, Ross) Does critical thinking change over time in the residency program?

Global Health Education Initiatives Projects to assist other countries with primary care education in: Uganda Tanzania China Nepal

Women in medicine Book project (Waugh & Ross) Do women practice medicine differently? Are there different expectations of women than men ? Are there differences in the stresses faced by women when they choose a career in medicine?

Future Directions

CBAS Multiple studies using database of FieldNotes and progress reports Remediation project: Does CBAS help identify struggling learners earlier than previous methods? Long-term evaluation Comparison between our graduates and traditional program graduates

Teaching What is the most effective faculty development to improve teaching? How do we teach residents to be good teachers?

Motivation Use motivational theory to increase engagement in learning across all elements of residency program

Rural Rural curriculum evaluation

Questions?