Simulation as an educational tool to teach emergency medicine residents about unconscious bias.

Medical training embraces simulation-based education. One important topic that has recently been added to the simulation curriculum at the University of Toronto is unconscious bias. This educational innovation project evaluates a simulation that could be used as a novel instructional design strategy to teach unconscious bias. The simulation involved two resuscitation scenarios with a similar clinical trajectory. Each resuscitation was led by standardized physicians of different binary genders, followed by a debrief with highly trained facilitators. Tangible educational takeaways on team dynamic variation between different gendered team leaders were discussed following the simulation, highlighting its benefit to resident education on bias awareness and response. Limitations include inevitable unconscious bias in facilitators and unequal gender representation in the learner participants, which may impact simulation effectiveness. The findings support translating this simulation to other forms of bias education in future simulation development.

RéSUMé: La formation médicale englobe l'éducation basée sur la simulation. Un sujet important qui a récemment été ajouté au programme de simulation de l'Université de Toronto est celui des préjugés inconscients. Ce projet d'innovation éducative évalue une simulation qui pourrait être utilisée comme une nouvelle stratégie de conception pédagogique pour enseigner les préjugés inconscients. La simulation a impliqué deux scénarios de réanimation avec une trajectoire clinique similaire. Chaque réanimation a été menée par des médecins standardisés de sexe binaire différent, suivis d'un débriefing avec des facilitateurs hautement qualifiés. Après la simulation, on a discuté de points concrets à retenir sur la variation de la dynamique d'équipe entre les différents chefs d'équipe selon le sexe, en soulignant les avantages pour l'éducation des résidents sur la sensibilisation aux préjugés et la réponse. Les limites comprennent des préjugés inconscients inévitables chez les animateurs et une représentation inégale des sexes chez les apprenants participants, ce qui peut avoir une incidence sur l'efficacité de la simulation. Les résultats appuient la traduction de cette simulation à d'autres formes de formation sur les préjugés dans le développement futur de la simulation.

Factors affecting residency rank-listing: a Maxdiff survey of graduating Canadian medical students.

BACKGROUND: In Canada, graduating medical students consider many factors, including geographic, social, and academic, when ranking residency programs through the Canadian Residency Matching Service (CaRMS). The relative significance of these factors is poorly studied in Canada. It is also unknown how students differentiate between their top program choices. This survey study addresses the influence of various factors on applicant decision making. METHODS: Graduating medical students from all six Ontario medical schools were invited to participate in an online survey available for three weeks prior to the CaRMS match day in 2010. Max-Diff discrete choice scaling, multiple choice, and drop-list style questions were employed. The Max-Diff data was analyzed using a scaled simple count method. Data for how students distinguish between top programs was analyzed as percentages. Comparisons were made between male and female applicants as well as between family medicine and specialist applicants; statistical significance was determined by the Mann-Whitney test. RESULTS: In total, 339 of 819 (41.4%) eligible students responded. The variety of clinical experiences and resident morale were weighed heavily in choosing a residency program; whereas financial incentives and parental leave attitudes had low influence. Major reasons that applicants selected their first choice program over their second choice included the distance to relatives and desirability of the city. Both genders had similar priorities when selecting programs. Family medicine applicants rated the variety of clinical experiences more importantly; whereas specialty applicants emphasized academic factors more. CONCLUSIONS: Graduating medical students consider program characteristics such as the variety of clinical experiences and resident morale heavily in terms of overall priority. However, differentiation between their top two choice programs is often dependent on social/geographic factors. The results of this survey will contribute to a better understanding of the CaRMS decision making process for both junior medical students and residency program directors.

Rapid Cycle Deliberate Practice in Healthcare Simulation: a Scoping Review.

Rapid cycle deliberate practice (RCDP) is a type of simulation-based medical education (SBME) where learners cycle between deliberate practice and directed feedback until skill mastery is achieved before progressing to subsequent learning objectives. This scoping review examines and summarizes the literature on RCDP, compares RCDP to other modes of instruction, and identifies knowledge gaps for future research. Of the 1224 articles identified, 23 studies met inclusion criteria. The studies varied in design, RCDP technique implementation strategies, and outcome measures. RCDP is associated with positive outcomes in immediate learner performance. It is unclear if RCDP is superior to traditional simulation.