Protocol for a scoping review study on learning plan use in undergraduate medical education.

BACKGROUND: The current paradigm of competency-based medical education and learner-centredness requires learners to take an active role in their training. However, deliberate and planned continual assessment and performance improvement is hindered by the fragmented nature of many medical training programs. Attempts to bridge this continuity gap between supervision and feedback through learner handover have been controversial. Learning plans are an alternate educational tool that helps trainees identify their learning needs and facilitate longitudinal assessment by providing supervisors with a roadmap of their goals. Informed by self-regulated learning theory, learning plans may be the answer to track trainees' progress along their learning trajectory. The purpose of this study is to summarise the literature regarding learning plan use specifically in undergraduate medical education and explore the student's role in all stages of learning plan development and implementation. METHODS: Following Arksey and O'Malley's framework, a scoping review will be conducted to explore the use of learning plans in undergraduate medical education. Literature searches will be conducted using multiple databases by a librarian with expertise in scoping reviews. Through an iterative process, inclusion and exclusion criteria will be developed and a data extraction form refined. Data will be analysed using quantitative and qualitative content analyses. DISCUSSION: By summarising the literature on learning plan use in undergraduate medical education, this study aims to better understand how to support self-regulated learning in undergraduate medical education. The results from this project will inform future scholarly work in competency-based medical education at the undergraduate level and have implications for improving feedback and supporting learners at all levels of competence. SCOPING REVIEW REGISTRATION: Open Science Framework osf.io/wvzbx.

Illness presenteeism among physicians and trainees: Study protocol of a scoping review.

BACKGROUND: Illness presenteeism (IP) is the phenomenon where individuals continue to work despite illness. While it has been a prevalent and longstanding issue in medicine, the recent onset of the COVID-19 pandemic and the growing movement to improve physician wellness brings renewed interest in this topic. However, there have been no comprehensive reviews on the state of literature of this topic. PURPOSE: The main aim of this scoping review is to explore what is known about presenteeism in physicians, residents, and medical students in order to map and summarize the literature, identify research gaps and inform future research. More specifically: How has illness presenteeism been defined, problematized or perceived? What methods and approaches have been used to study the phenomenon? Has the literature changed since the pandemic? METHOD: Using the Arksey and O'Malley framework several databases will be searched by an experienced librarian. Through an iterative process, inclusion and exclusion criteria will be developed and a data extraction form refined. Data will be analyzed using quantitative and qualitative content analyses. POTENTIAL IMPLICATIONS OF RESULTS: By summarizing the literature on IP, this study will provide a better understanding of the IP phenomena to inform future research and potentially have implications for physician wellness and public health.

Current use of simulation for EPA assessment in emergency medicine.

OBJECTIVE: Approximately five years ago, the Royal College emergency medicine programs in Canada implemented a competency-based paradigm and introduced the use of Entrustable Professional Activities (EPAs) for assessment of units of professional activity to assess trainees. Many competency-based medical education (CBME) based curricula, involve assessing for entrustment through observations of EPAs. While EPAs are frequently assessed in clinical settings, simulation is also used. This study aimed to characterize the use of simulation for EPA assessment. METHODS: A study interview guide was jointly developed by all study authors and followed best practices for survey development. A national interview was conducted with program directors or assistant program directors across all the Royal College emergency medicine programs across Canada. Interviews were conducted over Microsoft Teams, interviews were recorded and transcribed, using Microsoft Teams transcribing service. Sample transcripts were analyzed for theme development. Themes were then reviewed by co-authors to ensure they were representative of the participants' views. RESULTS: A 64.7% response rate was achieved. Simulation has been widely adopted by EM training programs. All interviewees demonstrated support for the use of simulation for EPA assessment for many reasons, however, PDs acknowledged limitations and thematic analysis revealed certain themes and tensions for using simulation for EPA assessment. Thematic analysis revealed six major themes: widespread support for the use of simulation for EPA assessment, concerns regarding the potential for EPA assessment to become a "tick- box" exercise, logistical barriers limiting the use of simulation for EPA assessment, varied perceptions about the authenticity of using simulation for EPA assessment, the potential for simulation for EPA assessment to compromise learner psychological safety, and suggestions for the optimization of use of simulation for EPA assessment. CONCLUSIONS: Our findings offer insight for other programs and specialties on how simulation for EPA assessment can best be utilized. Programs should use these findings when considering using simulation for EPA assessment.

RéSUMé: OBJECTIF: Il y a environ cinq ans, les programmes de médecine d'urgence du Collège royal au Canada ont mis en place un paradigme basé sur les compétences et ont introduit l'utilisation d'activités professionnelles confiables (APC) pour l'évaluation des unités d'activité professionnelle afin d'évaluer les stagiaires. De nombreux programmes d'enseignement médical basés sur les compétences (CBME) prévoient l'évaluation des compétences par l'observation des APC. Bien que les APC soient fréquemment évaluées en milieu clinique, la simulation est également utilisée. Cette étude visait à caractériser l'utilisation de la simulation pour l'évaluation de l'APC. MéTHODES: Un guide d'entretien d'étude a été élaboré conjointement par tous les auteurs de l'étude et a suivi les meilleures pratiques en matière d'élaboration d'enquêtes. Un entretien national a été réalisé avec les directeurs de programmes ou les directeurs adjoints de tous les programmes de médecine d'urgence du Collège royal au Canada. Les entretiens ont été menés sur Microsoft Teams, enregistrés et transcrits à l'aide du service de transcription de Microsoft Teams. Les transcriptions des échantillons ont été analysées pour développer des thèmes. Les thèmes ont ensuite été revus par les co-auteurs pour s'assurer qu'ils étaient représentatifs des points de vue des participants. RéSULTATS: Un taux de réponse de 64,7 % a été obtenu. La simulation a été largement adoptée par les programmes de formation en médecine d'urgence. Toutes les personnes interrogées se sont montrées favorables à l'utilisation de la simulation pour l'évaluation de l'APE pour de nombreuses raisons. Cependant, les DP ont reconnu des limites et l'analyse thématique a révélé certains thèmes et tensions liés à l'utilisation de la simulation pour l'évaluation de l'APC. L'analyse thématique a révélé six thèmes majeurs : un appui généralisé à l'utilisation de la simulation pour l'évaluation de l'APC, inquiétudes concernant la possibilité que l'évaluation de l'APC devienne un exercice de type « case à cocher ¼, des obstacles logistiques limitant l'utilisation de la simulation pour l'évaluation de l'APC, les perceptions variées quant à l'authenticité de l'utilisation de la simulation pour l'évaluation de l'APC, le potentiel de la simulation pour l'évaluation de l'APC de compromettre la sécurité psychologique des apprenants, et des suggestions pour l'optimisation de l'utilisation de la simulation pour l'évaluation de l'APC. CONCLUSIONS: Nos résultats offrent un aperçu à d'autres programmes et spécialités sur la meilleure façon d'utiliser la simulation pour l'évaluation de l'APC. Les programmes devraient utiliser ces résultats lorsqu'ils envisagent d'utiliser la simulation pour l'évaluation de l'APC.

Social Studies of Science and Technology: New ways to illuminate challenges in training for health information technologies utilisation.

CONTEXT: Electronic health records (EHRs) have transformed clinical practice. They are not simply replacements for paper records but integrated systems with the potential to improve patient safety and quality of care. Training physicians in the use of EHR is a highly complex intervention that occurs in a dynamic socio-technical health system. Training in this complex space is considered a wicked problem and would benefit from different analytic approaches to the traditional linear causal relationship analysis. Social Sciences theories see technological change in relation to complex social and institutional processes and provide a useful starting point. AIM: Our aim, therefore, is to introduce the medical education scholar to a selection of theoretical approaches from the Social Studies of Science and Technology (SSST) literatures, to inform educational efforts in training for EHR use. METHODS: We suggest a body of theories and frameworks that can expand the epistemological repertoire of medical education scholarship to respond to this wicked problem. Drawing from our work on EHR implementation, we discuss current limitations in framing training for EHRs use as a research problem in medical education. We then present a selection of alternative theories. RESULTS: Unified Theory of Acceptance and Use of Technology (UTAUT) explains the individual adoption of new technologies in the workplace and has four key constructs: performance/effort expectancy, social influence and facilitating conditions. Social Practice Theory (SPT), rather than focusing on individuals or institutions, starts with the activity or practice. The socio-technical model (STM) is a comprehensive theory that offers a multidimensional framework for studying the innovation and application of EHRs. Practical examples are provided. CONCLUSIONS: We argue that education for effective utilisation of EHRs requires moving beyond the epistemological monism often present in the field. New theoretical lenses can illuminate the complexity of research to identify the best practices for educating and training physicians.

Implicit versus explicit first impressions in performance-based assessment: will raters overcome their first impressions when learner performance changes?

First impressions can influence rater-based judgments but their contribution to rater bias is unclear. Research suggests raters can overcome first impressions in experimental exam contexts with explicit first impressions, but these findings may not generalize to a workplace context with implicit first impressions. The study had two aims. First, to assess if first impressions affect raters' judgments when workplace performance changes. Second, whether explicitly stating these impressions affects subsequent ratings compared to implicitly-formed first impressions. Physician raters viewed six videos where learner performance either changed (Strong to Weak or Weak to Strong) or remained consistent. Raters were assigned two groups. Group one (n = 23, Explicit) made a first impression global rating (FIGR), then scored learners using the Mini-CEX. Group two (n = 22, Implicit) scored learners at the end of the video solely with the Mini-CEX. For the Explicit group, in the Strong to Weak condition, the FIGR (M = 5.94) was higher than the Mini-CEX Global rating (GR) (M = 3.02, p < .001). In the Weak to Strong condition, the FIGR (M = 2.44) was lower than the Mini-CEX GR (M = 3.96 p < .001). There was no difference between the FIGR and the Mini-CEX GR in the consistent condition (M = 6.61, M = 6.65 respectively, p = .84). There were no statistically significant differences in any of the conditions when comparing both groups' Mini-CEX GR. Therefore, raters adjusted their judgments based on the learners' performances. Furthermore, raters who made their first impressions explicit showed similar rater bias to raters who followed a more naturalistic process.

Having a Bad Day Is Not an Option: Learner Perspectives on Learner Handover.

PURPOSE: Learner handover is the sharing of learner-related information between supervisors involved in their education. The practice allows learners to build upon previous assessments and can support the growth-oriented focus of competency-based medical education. However, learner handover also carries the risk of biasing future assessments and breaching learner confidentiality. Little is known about learner handover's educational impact, and what is known is largely informed by faculty and institutional perspectives. The purpose of this study was to explore learner handover from the learner perspective. METHOD: Constructivist grounded theory was used to explore learners' perspectives and beliefs around learner handover. Twenty-nine semistructured interviews were completed with medical students and residents from the University of Ottawa and University of California, San Francisco. Interviews took place between April and December 2020. Using the constant comparative approach, themes were identified through an iterative process. RESULTS: Learners were generally unaware of specific learner handover practices, although most recognized circumstances where both formal and informal handovers may occur. Learners appreciated the potential for learner handover to tailor education, guide entrustment and supervision decisions, and support patient safety, but worried about its potential to bias future assessments and breach confidentiality. Furthermore, learners were concerned that information-sharing may be more akin to gossip rather than focused on their educational needs and feared unfair scrutiny and irreversible long-term career consequences from one shared mediocre performance. Altogether, these concerns fueled an overwhelming pressure to perform. CONCLUSIONS: While learners recognized the rationale for learner handover, they feared the possible inadvertent short- and long-term impact on their training and future careers. Designing policies that support transparency and build awareness around learner handover may mitigate unintended consequences that can threaten learning and the learner-supervisor relationship, ensuring learner handover benefits the learner as intended.

Novel Performance Rating Instruments for Gynecological Procedures in Primary Care: A Pilot Study.

BACKGROUND AND OBJECTIVES: Improving training and confirming the acquisition of gynecological procedure skills for family physicians (FPs) is crucial for safe health care delivery. The objectives of this study were to (a) develop performance rating instruments for four gynecological procedures, and (b) pilot them to provide preliminary validity evidence using modern validity theory. METHODS: Sixteen academic FPs and gynecologists participated in a modified Delphi technique to develop procedure-specific checklists (PSCs) for four procedures: intrauterine device insertion, endometrial biopsy, punch biopsy of the vulva, and routine pessary care. We modified a previously validated global rating scale (GRS) for ambulatory settings. Using prerecorded videos, 19 academic FPs piloted instruments to rate one first-year and one second-year family medicine resident's performance. They were blinded to the level of training. We compared the mean scores for PSCs and GRS for each procedure using paired samples t tests and Cohen's d to estimate effect sizes. RESULTS: Consensus on items for the final PSCs was reached after two Delphi rounds. PSC and GRS scores were numerically higher for the second-year resident than the first-year resident for every procedure, with statistically significant differences for six of eight comparisons (P<.05). All comparisons demonstrated large effect sizes (Cohen's d>0.8). Both instruments received high scores for ease of use by raters. CONCLUSIONS: We developed novel performance rating instruments for four gynecological procedures and provided preliminary validity evidence for their use for formative feedback in a simulation setting. This pilot study suggests that these instruments may facilitate the training and documentation of family medicine trainees' skills in gynecological procedures.

Current state of headache training within Canadian Neurology Residency program: a national survey.

BACKGROUND: Headache disorders are the most common neurological disorders worldwide. Despite their widespread prevalence and importance, the topic of headache is inconsistently taught at both the undergraduate and postgraduate levels. The goal of this study is to establish a better picture of the current state of Headache Medicine (HM) training in Neurology postgraduate programs in Canada and describe the impact of the current pandemic on training in this domain. METHODS: Online surveys were sent to senior residents of adult Neurology programs in Canada. We also conducted telephone interviews with Neurology Program Directors. Descriptive statistics were analyzed, and thematic analysis was used to review free text. RESULTS: A total of 36 residents, and 3 Program Directors participated in the study. Most of the teaching in HM is done by headache specialists and general neurology faculty. Formal teaching is mainly given during academic half day. Most of the programs expose their residents to Onabotulinum toxin A injections and peripheral nerve blocks, but they don't offer much formal teaching regarding these procedures. Residents consider HM teaching important and they would like to have more. They don't feel comfortable performing interventional headache treatments, despite feeling this should be part of the skillset of a general neurologist. CONCLUSION: Our study is the first to establish the current state of headache teaching in post-graduate neurology programs as perceived by trainees and program directors in Canada. The current educational offerings leave residents feeling poorly prepared to manage headaches, including procedural interventions. There is a need to diversify the source of teaching, so the educational burden doesn't lie mostly upon Headache specialists who are already in short supply. Neurology Residency programs need to adapt their curriculum to face the current need in HM.

Educator's blueprint: A primer on consensus methods in medical education research.

Consensus methods such as the Delphi and nominal group techniques are increasingly utilized within medical education research. This educator's blueprint paper provides practical strategies regarding five key steps for ensuring best practices when using consensus methods. These strategies include deciding which consensus method is best, developing the initial questionnaire, identifying the participants, determining the number of rounds and consensus threshold, and describing and justifying any modifications. These strategies will help guide education researchers on their next study using consensus methods.

Synthesis and perspectives from the Ottawa 2022 conference on the assessment of competence.

INTRODUCTION: The Ottawa Conference on the Assessment of Competence in Medicine and the Healthcare Professions was first convened in 1985 in Ottawa. Since then, what has become known as the Ottawa conference has been held in various locations around the world every 2 years. It has become an important conference for the community of assessment - including researchers, educators, administrators and leaders - to share contemporary knowledge and develop international standards for assessment in medical and health professions education. METHODS: The Ottawa 2022 conference was held in Lyon, France, in conjunction with the AMEE 2022 conference. A diverse group of international assessment experts were invited to present a symposium at the AMEE conference to summarise key concepts from the Ottawa conference. This paper was developed from that symposium. RESULTS AND DISCUSSION: This paper summarises key themes and issues that emerged from the Ottawa 2022 conference. It highlights the importance of the consensus statements and discusses challenges for assessment such as issues of equity, diversity, and inclusion, shifts in emphasis to systems of assessment, implications of 'big data' and analytics, and challenges to ensure published research and practice are based on contemporary theories and concepts.

Protocol for an extended scoping review on the use of virtual nominal group technique in research.

INTRODUCTION: Consensus group methods such as the Nominal Group Technique (NGT) and Delphi method are commonly used in research to elicit and synthesize expert opinions when evidence is lacking. Traditionally, the NGT involves a face-to-face interaction. However, due to the COVID-19 pandemic, many in-person meetings have moved to online settings. It is unclear to what extent the NGT has been undertaken in virtual settings. The overarching aim of this scoping review is to explore the use of the virtual NGT in research. Our specific objectives are to answer the following questions: To what extent has the NGT been used virtually? What modifications were made to accommodate this online format? What advantages and disadvantages were noted by authors in comparison with the face-to-face mode of the technique? MATERIALS AND METHODS: This scoping review will follow the steps outlined by Arksey and O'Malley and the PRISMA-ScR guidelines. Several pilot searches were completed to refine inclusion and exclusion criteria. Media Synchronicity Theory will provide a conceptual framework to inform the research, including data extraction and summarizing results. As an additional extension to the literature review, online interviews with corresponding authors will be conducted to gather further information.

Musculoskeletal Point-of-Care Ultrasonography Training Among Canadian Postgraduate Rheumatology Programs.

OBJECTIVE: This study aimed to assess the current state of musculoskeletal point-of-care ultrasonography training among the rheumatology postgraduate programs in Canada and explored the interest in developing a national curriculum. METHOD: A Canadian survey was developed by academic rheumatologists including point-of-care ultrasonography experts and point-of-care ultrasonography non-users. Across Canada, all 15 adult and 3 pediatric rheumatology English and French postgraduate programs were surveyed via Survey Monkey with a standardized questionnaire. RESULTS: The completed response rates were 27% (24/89) for postgraduate year-4 and -5 rheumatology trainees and 61% (11/18) for program directors. Forty-two percent (10/24) of trainees had access to formal point-of-care ultrasonography training, and 67% (16/24) had some form of informal nonstructured exposure. Of all respondents, 87.5% (21/24) trainees and 82% (9/11) program directors agreed or strongly agreed that point-of-care ultrasonography is an important clinical tool in rheumatology. Eighty-nine percent (8/9) of program directors felt that point-of-care ultrasonography should be a formal part of rheumatology training. CONCLUSION: This national survey demonstrates that while musculoskeletal point-of-care ultrasonography is considered an important component of clinical practice, significant training barriers exist. The majority of both trainees and program directors felt that point-of-care ultrasonography should be a formal part of training and would be interested in a national standardized point-of-care ultrasonography curriculum in Canada.

Training physicians and residents for the use of Electronic Health Records-A comparative case study between two hospitals.

BACKGROUND/PURPOSE: Despite widespread use of Electronic Health Records (EHR), the promise of benefits has not been clearly realised due, in part, to inadequate physician training. Training for EHR use is a highly complex intervention that occurs in a dynamic socio-technical health system. The purpose of this study was to describe and critically assess the interplay between educational activities and organisational factors that influenced EHR training and implementation across two different hospitals. METHODS: Based in a socio-technical framework, a comparative qualitative case study was undertaken as well suited to real-world processes. Semi-structured interviews were completed (n = 43), representing administrative leaders, staff physicians, residents and EHR trainers from two Canadian academic hospitals. Thematic analysis was employed for analysis. RESULTS: Similar findings were noted at both hospitals despite different implementation strategies. Despite mandatory training, physicians described limited transferability of training to the workplace. Factors contributing to this included standardised vendor modules (lacking specificity for their clinical context); variable EHR trainer expertise; limited post-launch training; and insufficient preparation for changes to workflow. They described learning while caring for patients and using workarounds. Strong emotional responses were described, including anger, frustration, anxiety and fear of harming patients. CONCLUSIONS: Training physicians for effective EHR utilisation requires organisational culture transformation as EHRs impacts all aspects of clinical workflows. Analytic thinking to consider workflows, ongoing post-launch training and the recognition of the interdependency of multiple factors are critical to preparing physicians to provide effective clinical care, and potentially reducing burnout. A list of key considerations is provided for educational leaders.

A Curriculum Ignored? The Usage of Unofficial Commercial and Peer Learning Resources in Undergraduate Medical Education at a Canadian Medical School.

Medical students often seek educational resources outside of the formal curriculum to support their education. Commercial and student-developed educational resources are readily available, and may supplement or even replace aspects of the formal curriculum. Since this has the potential to impact what students learn and ultimately impact patient care, gaining a better understanding of the prevalence and patterns of use of these resources is of great interest. The purpose of this study, therefore, is to explore the use of non-traditional resources in undergraduate medical education. We surveyed University of Ottawa medical students to determine the usage, rationale, and perceived benefits and drawbacks of these educational resources. The response rate was 57/342 (17%). Of 57 respondents (first year = 21, second year = 34, MD/PhD = 2), 98.2% report using non-traditional resources, with Upper Year Notes, Student Developed Anki decks (a spaced repetition flashcard tool), and Student Developed Question Banks being most common. Although 75% of students reported using official lecture slides and practice tests, they reported spending more of their time (63%) using third-party resources compared to official curriculum offerings. Reported advantages of non-traditional resources listed were faster, more efficient, and easier to understand/search. Disadvantages were difficulty aligning unofficial resources with local exams, determining the level of detail required, and cost. These results suggest a need to examine curriculum design and delivery and further investigate the role of non-traditional resources developed by medical students and the role of medical students as peer educators. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-023-01899-5.

Factors affecting patient satisfaction with outpatient rheumatology phone visits during the COVID-19 pandemic.

The aim was to evaluate patient satisfaction with virtual care, and identify factors associated with level of satisfaction. Surveys were mailed to all patients who had a phone visit at The Ottawa Hospital Rheumatology division. Patients' satisfaction with various aspects of the phone visits was assessed on a 5-point scale and analyzed according to demographic variables using chi-square and regression analyses. Of 2423 surveys mailed, we received 742 responses (31%). Eighty-nine percent of patients were satisfied overall with the phone visit. Statistically significant less satisfaction was seen in patients who spoke to a resident compared to their rheumatologist (p < 0.001), were not called on time (p < 0.001), had difficulty using a telephone (p < 0.001), needed assistance of a second person (p < 0.01), or had new consultations (versus routine follow-up, p = 0.01), the former 3 factors being significant in a multivariate regression analysis. Rheumatology patients expressed a high level of satisfaction with virtual care; however, areas of improvement were identified. Patients' satisfaction will be important to inform future decisions regarding the sustainability of virtual care. Further research is required to understand the impacts of virtual care on patients' Key Points • Patients in rheumatology practice were satisfied with phone visits and preferred this method to in-person visits during the pandemic. • Speaking directly to the rheumatologist, being phoned on time, and the capability of using the telephone were the major determinants of high patient satisfaction. • Based on the identified factors, further improvement of the quality of and satisfaction with phone visits can be pursued given that virtual care may continue longer, beyond the pandemic.

eConsult Specialist Quality of Response (eSQUARE): A novel tool to measure specialist correspondence via electronic consultation.

High-quality correspondence between healthcare providers is critical for effective patient care. We developed an assessment tool to measure the quality of specialist correspondence to primary care providers (PCPs) via electronic consultation (eConsult), where specialists provide advice without specialist-patient interactions. We incorporated fourteen previously described features of high-quality eConsult correspondence into an assessment tool named the eConsult Specialist Quality of Response (eSQUARE). Six PCPs and two specialists applied the 10-item eSQUARE tool to 30 eConsults of varying quality as informed by PCP survey data. Content, response process, and internal structure validity evidence was gathered. Psychometric properties were calculated using descriptive statistics and generalizability analyses. Mean total score for low-quality eConsults (M = 24 ± 5.6) was significantly lower than moderate-quality eConsults (M = 38 ± 4.7; p<0.001) which was significantly lower than high-quality eConsults (M = 46 ± 3.0; p = 0.002). Reliability measures were high, including generalizability coefficient (0.96), inter-item (≥0.55) and item-total correlations (≥0.68). A decision study demonstrated that a single rater was adequate to achieve a reliability measure of ≥0.70. This study demonstrates initial validity evidence including multiple reliability measures for the eSQUARE. A single rater is adequate to achieve reliability measures for formative feedback. Future studies can apply the eSQUARE when planning educational initiatives aiming to improve specialist-to-PCP correspondence via eConsult.

The impact of local health professions education grants: is it worth the investment?

BACKGROUND: Local grants programs are important since funding for medical education research is limited. Understanding which factors predict successful outcomes is highly relevant to administrators. The purpose of this project was to identify factors that contribute to the publication of local medical education grants in a Canadian context. METHODS: Surveys were distributed to previous Department of Innovation in Medical Education (DIME) and Department of Medicine (DOM) grant recipients (n = 115) to gather information pertaining to PI demographics and research outcomes. A backward logistic regression was used to determine the effects several variables on publication success. RESULTS: The overall publication rate was 64/115 (56%). Due to missing data, 91 grants were included in the logistic regression. Variables associated with a higher rate of publication; cross departmental compared to single department OR = 2.82 (p = 0.04), being presented OR = 3.30 (p = 0.01), and multiple grant acquisition OR = 3.85 (p = 0.005). CONCLUSION: Although preliminary, our data suggest that increasing research publications from local grants may be facilitated by pooling funds across departments, making research presentations mandatory, and allowing successful researchers to re-apply.

OBJECTIF: Les programmes de subventions locales sont importants car le financement de la recherche en éducation médicale est limité. Il est très important pour les administrateurs de comprendre quels sont les facteurs de réussite. Le but de ce projet était d'identifier les facteurs qui, dans le contexte canadien, contribuent à la publication d'articles à l'aide de subventions locales pour l'éducation médicale. MÉTHODES: Un sondage a été réalisé auprès des anciens récipidendaires de subventions du Department of Innovation in Medical Education (DIME) et du Department of Medicine (DOM) (n=115) afin de recueillir des informations relatives à la démographie des chercheurs principaux et aux résultats de la recherche. Une régression logistique descendante a été utilisée pour déterminer les effets de plusieurs variables sur le succès des publications. RÉSULTATS: Le taux de publication global était de 64/115 (56 %). En raison de données manquantes, 91 subventions ont été incluses dans la régression logistique. Variables associées à un taux de publication plus élevé; OR inter-départements comparé à un seul département = 2,82 (p = 0,04), soumis OR = 3,30 (p = 0,01) et OR l''obtention de plusieurs subventions = 3,85 (p = 0,005). CONCLUSION: Bien que préliminaires, nos données suggèrent que la publication de recherches à l'aide de subventions locales pourrait être facilitée en regroupant les fonds des divers départements, en rendant la présentation de recherches obligatoire et en permettant aux chercheurs dont l'article a été retenu de faire une nouvelle soumission.

Real-World Patient Experience of Long-Term Hybrid Closed-Loop Insulin Pump Use.

OBJECTIVES: Understanding of patient experiences and adaptations to hybrid closed-loop (HCL) pumps beyond the confines of short-term clinical trials is needed to inform best practices surrounding this emerging technology. We investigated long-term, real-world patient experiences with HCL technology. METHODS: In semistructured interviews, 21 adults with type 1 diabetes at a single Canadian tertiary diabetes centre discussed their transition to use of Medtronic MiniMed 670G auto-mode. Interviews were audio-recorded, transcribed and analyzed iteratively to identify emerging themes. RESULTS: Participants' mean age was 50±13 years, 12 of the 21 participants were female, baseline glycated hemoglobin (A1C) was 7.9±1.0% and auto-mode duration was 9.3±4.6 months. Three had discontinued auto-mode. Most participants praised auto-mode for reducing hypoglycemia, stabilizing glucose overnight and improving A1C, while also reporting frustration with frequency of alarms and user input, sensor quality and inadequate response to hyperglycemia. Participants with the highest baseline A1Cs (8.8% to 9.8%) tended to report immense satisfaction and trust in auto-mode, meeting their primary expectations of improved glycemic control. In contrast, participants with controlled diabetes (A1C <7.5%) had hoped to offload active management but experienced significant cognitive and emotional labour associated with relinquishing control during suboptimal auto-mode performance. Participants were commonly aware of workarounds to "trick" the pump, and almost all participants with A1C <7.5% tried at least 1 workaround. CONCLUSIONS: In the real-world setting, patients' goals and satisfaction with auto-mode appeared to vary considerably with their baseline diabetes control. Patients with the most suboptimal glycemic control described the greatest benefits and easiest adaptation process, challenging commonly held assumptions for patient selection for pump therapy.