Ten ways to get a grip on resident co-production within medical education change.

The Royal College of Physicians and Surgeons of Canada (RCPSC) is transforming its national approach to postgraduate medical education by transitioning all specialty programs to competency based medical education (CBME) curriculums over a seven-year period. Queen's University, with special permission from the RCPSC, launched CBME curricula for all incoming residents across its 29 specialty programs in July 2017. Resident engagement, empowerment, and co-production through this transition has been instrumental in successful implementation of CBME at Queen's University. This article aims to use our own experience at Queen's in the context of current literature and rooted in change leadership theory, to provide a guide for educators, learners, and institutions on how to leverage the interest and enthusiasm of trainees in the transition to CBME in postgraduate training. The following ten tips provides a model for avoiding the "black ice" type pitfalls that can arise with learner involvement and ensure a smoother transition for other institutions moving forward with CBME implementation.

Le Collège royal des médecins et chirurgiens du Canada (CRMCC) s'emploie à transformer son approche nationale à la formation médicale postdoctorale en effectuant une transition, répartie sur une période de sept ans, de tous les programmes spécialisés vers des programmes de formation médicale axéesur les compétences (FMAC). En juillet 2017, l'Université Queen, avec une permission spéciale du CRMCC, a lancé des cursus de FMAC pour tous les nouveaux résidents de ses 29 programmes spécialisés. La participation, la capacité d'agiret la coproduction par lesrésidents pendant cette transition ont contribué à la mise en œuvre réussie de la FMAC à l'Université Queen. Le présent article vise à utiliser notre propre expérience à l'Université Queen dans le contexte de la littérature actuelle et est ancrésur la théorie du leadership en matière de changement, pour procurer un guide aux éducateurs, aux apprenants et aux établissements sur la manière de tirer parti de l'intérêt et de l'enthousiasme des apprenantsdans la transition vers la FMAC dans la formation postdoctorale. Les dix conseils suivants proposent un modèle pour éviter les écueils du type « glace noire ¼ qui peuvent survenir avec la participation de l'apprenant et s'assurer une transition plus harmonieuse pour les autres établissements qui vont de l'avant avec la mise en œuvre de la FMFC.

Where does resiliency fit into the residency training experience: a framework for understanding the relationship between wellness, burnout, and resiliency during residency training.

BACKGROUND: Medical literature reports high rates of burnout among medical professionals. The terms wellness and resilience are often used interchangeably in the solution focused discussions. By confusing the terminology, the distinct role of resilience within residency training may be ill-appreciated.The objective of this paper is to define wellness, burnout, and resiliency and detail a proposed framework to explain how these terms manifest within residency training. METHODS: MEDLINE and EMBASE searches were performed using the key words "resilience," "residency," "wellness," and "burnout." The search was limited to English language articles published between 2003-2017. RESULTS: The authors propose a framework based on the literature review. This work supports the implementation of resilience-based interventions that enable residents to engage with workplace adversity in a healthy way, acquire skills during the process and avoid resource depletion and, ultimately, burnout. CONCLUSION: This framework can be used by residency programs to promote educators and residents' understanding of the unique role of resilience within residency, and the importance of differentiating between wellness and resilience initiatives. Future research is required to study the utility of this framework.

A Canadian experience of integrating complementary therapy in a hospital palliative care unit.

BACKGROUND: The provision of complementary therapy in palliative care is rare in Canadian hospitals. An Ontario hospital's palliative care unit developed a complementary therapy pilot project within the interdisciplinary team to explore potential benefits. Massage, aromatherapy, Reiki, and Therapeutic Touch™ were provided in an integrated approach. This paper reports on the pilot project, the results of which may encourage its replication in other palliative care programs. OBJECTIVES: The intentions were (1) to increase patients'/families' experience of quality and satisfaction with end-of-life care and (2) to determine whether the therapies could enhance symptom management. RESULTS: Data analysis (n=31) showed a significant decrease in severity of pain, anxiety, low mood, restlessness, and discomfort (p<0.01, 95% confidence interval); significant increase in inner stillness/peace (p<0.01, 95% confidence interval); and convincing narratives on an increase in comfort. The evaluation by staff was positive and encouraged continuation of the program. CONCLUSIONS: An integrated complementary therapy program enhances regular symptom management, increases comfort, and is a valuable addition to interdisciplinary care.