1. PREPARATIONS FOR FM EXTERNAL REVIEW MARCH 14 & 15, 2016 Bruce D. Martin MD MSc CCFP FCFP José François MD MMedEd CCFP FCFP MARCH 2, 2016 COLLEGE OF MEDICINE DEPT. FAMILY MEDICINE TOWNHALL

4. ACCREDITATION At its June 2014 meeting, the CFPC Accreditation decided: ‘Be it resolved that the Family Medicine program at the University of Manitoba be granted the status of accredited program with an external review to be conducted within 24 months (by June 2016).’ ‘Be it resolved that the Family Medicine Enhanced Skills program at the University of Manitoba be granted the status of accredited program with an external review to be conducted within 24 months (by June 2016).’

5. OUR CORE PROGRAM FM REVIEWERS Dr. Louise Nasmith UBC Dr. Douglass Dalton McGill

6. OUR ENHANCED SKILLS PROGRAMS REVIEWERS Dr. Geoff Hodgetts Queen’s Dr. Daniel Grushka Western

7. ACCREDITATION Standards Areas not fully compliant / for improvement: Governance & Program Leadership Administration & Resources Resident Selection Family Medicine residency curriculum & academic program Program evaluation Resident assessment Educational environment Faculty evaluation Faculty development Research

8. Governance & Program Leadership Committee structure reviewed and solidified Strategic Council with all-site and stream representation Strategic plan developed to guide FM: Smaller Executive Committee focused on department operational issues Strengthened WRHA Primary Care relations with new FM Associate Head, Winnipeg, Dr. Sheldon Permack Continued relations with rural/northern communities with Associate Head, Distributed Education, Dr. Don Klassen Postgrad committee with 4 sub-committees Postgrad Leads to support Postgrad Education Director and programming

11. Administration and Resources Significant turnover in staff since 2014 accreditation visit, with now stabilized staffing. Central department staff now centralized at Bannatyne campus Full time FM Administrative Director focusing only on university programming Space (CDS, KMC, Northern Connections) New funding model for distributed teaching sites Teaching expectations for alternately-funded Winnipeg physicians Continued work on full alternate funded model for NCMC physicians GFT forum working group reviewing GFT contracts and expectations Presently in review of job descriptions of Unit Directors and Education Directors

12. Resident Selection College of Medicine-wide targets of 70% of positions to go to Manitobans Based on work by Klassen et al, 2011 - retention of clinicians in Manitoba is significantly impacted by completion of both undergraduate and postgraduate training in Manitoba Improvements in resident selection process include use of z-scoring Post-CaRMS process regarding un-matched medical students clear: –oversight of process at level of College of Medicine Postgrad office –students must have applied to FM during first or second round of CaRMS and must be deemed appropriate by family medicine to be considered for post-CaRMS residency position

13. Curriculum FM Competency Framework based on CanMEDS 2015 framework, integrated with CanMEDS-FM items and Four Principles of FM FM Competency Framework guiding document for development of rotation objectives and academic curriculum QI curriculum standardized and being delivered across all streams Defined core topics for behavioral medicine curriculum identified and to be implemented by all Streams for 2016-2017. Core topics for academic curriculum (Academic Day, in-units etc…) in development and to be implemented by all Streams for 2016-2017.

14. Curricular Evaluation VENTIS to support scheduling and monitoring of curriculum Within VENTIS all educational events to have evaluations linked Postgrad Curriculum Review Committee responsible monitoring of academic and clinical curriculum New Program Performance Measurement Framework and Logic Model defines data collected for program evaluation

15. Resident Assessment Revised Field Notes Revised ITARs linked to goals and objectives for all Family Medicine and off-service rotations Approaches to resident progress monitoring in revision and to be implemented for 2016-2017 All tools (Field Notes, ITARs, Periodic Review of Progress) are designed to integrate the CFPC’s Six Dimensions of evaluation and CanMEDS roles. Implementation of VENTIS, a web-based, custom-designed PGME tool to centralize, manage, and support resident registration, scheduling, learner & faculty assessment, program evaluation, and reporting functions

16. Education Environment Surveillance tool - Resident end of rotation evaluations, including feedback on mistreatment in the learning environment Monitoring of educational environment by Associate Dean Student Affairs for Postgrad, Dr. Michael West Core PGME session - Learning Environment Wellness Website Speak Up Card: “Have you personally experienced or witnessed discrimination or other challenges in your Learning Environment. We Are Here To Help...’’

17. Faculty Evaluation All GFT have yearly performance appraisals Joint WRHA/U of M FM faculty performance appraisal process being rolled out across nil-salaried Winnipeg region with 3 core components: –reflection on performance; –performance conversation with designated physician leader; –personal learning plan VENTIS to facilitate collection and collating of feedback on teaching to faculty

18. Faculty Development Faculty development resources enhanced – Preceptor Toolkit, documentation of Competency Framework College of Medicine faculty development opportunities include: –Yearly faculty development day in September –DFM faculty development seminars –Problem-based faculty development modules from McMaster available to any site –Department of Medical Education faculty development activities: lunch hour sessions, HamLET –Funding to attend medical education conferences available to GFT through College of Medicine GFT fund

19. Growth in research grant funding: –2012 research grants totaled $299,000) –2015 research grants totaled $2.85 million Manitoba Primary Care Research Network (MaPCReN) is part of the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) Manitoba Primary and Integrated Health Care Innovation Network (MPN) is part of SPoR network. Approach to allocation of research time within the department being reviewed by a GFT working group Research resources in rural and bilingual streams: –1.0 EFT PhD in Brandon Satellite Program hired in 2015 –0.2 EFT faculty in Bilingual Stream hired in 2015 Research

20. Enhanced Skills Programs Associate Director Enhanced Skills Programs presently vacant and being filled by Postgraduate Director. Recruitment for position will occur after accreditation visit. Newly appointed Assistant Directors for ES Programs (Anesthesia, Sports and Exercise Medicine, Cancer Care) Strengthened ESP Subcommittee communication and relationship with PGME – Associate Dean, PGME and Postgraduate Program Leads newly added as members of Subcommittee Enhanced program assistant supports to Enhanced Skills Program Enhanced collaboration between departments of FM and Anesthesia to support FP-A program resulting in expansion of program

21. FINAL THOUGHTS Challenges:  Staff turnover  Getting agreement on things in a historically decentralized model  Short timelines  Implementation VENTIS curriculum management system  Financial climate  Competing clinical teaching needs – other healthcare learners Facilitating factors:  Engaged faculty dedicated to ensuring best education for resident  Support from Postgraduate Associate Dean and Dean  Recognition of strategic importance of family medicine

22. FM PROGRAM – CURRENT PRIORITIES Enhance FM resources to support PGME learners and teachers Complete roll out, implementation and adoption of VENTIS Implement new Competency Framework and map educational activities for each domain, how they relate to the 99 Priority Topics/ 65 Core Procedures Review construct of clinical curriculum and identify potential improvements (i.e. half-day backs, short clinical exposures during family medicine time etc…) Complete work on Resident Educational Support and Assessment framework (i.e. competency coaching)

23. FM PROGRAM – CURRENT PRIORITIES Collect data over time using new Performance Measurement Framework and Logic Model and evaluate success of initiatives Promote and develop research Continue focus on resident wellness/safety/learning environment Continue building strong, positive working relationships with training partners Continue focus on retention of Manitoba graduates and needs of our communities

24. Family Medicine, a provincial resource

25. FAMILY MEDICINE TOWNHALL EXTERNAL REVIEW PREPARATIONS QUESTIONS?