Scholarly activity as a selection criterion in the Canadian Residency Matching Service (CaRMS): A review of published criteria by internal medicine, family medicine, and pediatrics programs.

BACKGROUND: Undergraduate medical students seek as much information as possible as to how residency programs select candidates. The Canadian Residency Matching Service (CaRMS) website is one of their primary sources of information. Students may be more competitive in the match if they know whether scholarly activity is used in the selection process by their preferred programs, as described on the CaRMS website. METHODS: For all 17 Canadian faculties of medicine, 2019 R1 entry internal medicine, family medicine and pediatrics program descriptions were reviewed on the CaRMS website looking for keywords related to scholarly activity. RESULTS: Forty-one percent of family medicine, 65% of internal medicine and 71% of pediatric programs explicitly stated having interest in applicants with scholarly experience. In Western Canada, 80% of internal medicine and 60% of pediatrics programs included scholarly activity in their CaRMS description of criteria considered in ranking applications. Similarly, in Ontario, 66% of internal medicine and 83% of pediatrics programs mentioned scholarly activity as a valuable quality. In Quebec 100% of family medicine and 50% of pediatrics programs include scholarly activity in their descriptions. Pediatrics and family medicine programs (100%) in Atlantic Canada mentioned scholarly activities but neither of the two Atlantic Canada internal medicine programs mentioned scholarly activities. CONCLUSION: Undergraduate medical students can use this project to prioritize extracurricular activities and scholarly work to be competitive for application to family medicine, internal medicine and pediatrics residency programs.

CONTEXTE: Les étudiants de premier cycle en médecine cherchent autant de renseignements que possible sur la manière dont les programmes de résidence sélectionnent les candidats. Le site Web du Service canadien de jumelage des résidents (CaRMS) représente l'une de leur principale source de renseignements. Les étudiants peuvent être plus compétitifs dans le jumelage s'ils savent comment les activités d'érudition sont utilisées dans le processus de sélection par leurs programmes préférés, comme il est décrit sur le site Web de CaRMS. MÉTHODES: Pour l'ensemble des 17 facultés de médecine canadiennes, les descriptions des programmes d'entrée R1 de 2019 en médecine interne, en médecine familiale et en pédiatrie ont été examinées sur le site Web du CaRMS pour la recherche de mots clés liés aux activités d'érudition. RÉSULTATS: 41 % des programmes de médecine familiale, 65 % de ceux en médecine interne et 71 % de ceux en pédiatrie énonçaient explicitement avoir un intérêt pour les candidats avec une expérience en érudition. Dans l'Ouest canadien, 80 % des programmes en médecine interne et 60 % de ceux en pédiatrie comportaient une activité d'érudition dans leur description CaRMS des critères dont ils tenaient compte dans le classement des demandes. De même, en Ontario, 66 % des programmes en médecine interne et 83 % de ceux en pédiatrie mentionnaient que les activités d'érudition représentaient une qualité importante. Au Québec, 100 % des programmes en médecine familiale et 50 % de ceux en pédiatrie présentent une activité d'érudition dans leur description. Les programmes de pédiatrie et de médecine familiale (100 %) dans le Canada atlantique mentionnent les activités scientifiques, mais aucun des deux programmes de médecine interne du Canada atlantique ne mentionnait des activités scientifiques. CONCLUSION: Les étudiants de premier cycle en médecine peuvent utiliser le présent projet pour prioriser leurs activités extracurriculaires et le travail d'érudition pour être compétitifs lors de leurs applications dans des programmes de médecine familiale, de médecine interne et de pédiatrie.

A review of methods to assess the economic impact of distributed medical education (DME) in Canada.

BACKGROUND: Canadian distributed medical education (DME) increased substantially in the last decade, resulting in positive economic impacts to local communities. A reliable and simple method to estimate economic contributions is essential to provide managers with information on the extent of these impacts. This review paper fills a gap in the literature by answering the question: What are the most applicable quantitative methods to assess the economic impact of Canadian DME programs? METHODS: The literature is reviewed to identify economic assessment methods. These are evaluated and compared based on the benefits, challenges, data needs, outputs and potential for use in the DME context. RESULTS: We identified five economic impact methods used in similar contexts. Two of these methods have the potential for Canadian DME programs: the Canadian Input-Output (I-O) model and the Simplified American Council on Education (ACE) method. CONCLUSION: Choice of a method is contingent on the ability to measure the salient economic impacts, and provide an output that facilitates sustainable decision making. This paper thus fills a gap by identifying methods applicable to DME. These methods will assist stakeholders to calculate economic impacts, resulting in both the advancement and sustainability of these programs over short-and long-term time frames.

Assessing the Short-Term Global Health Experience: A Cross-Sectional Study of Demographics, Socioeconomic Factors, and Disease Prevalence.

Interest in short-term global health experiences to underserviced populations has grown rapidly in the last few decades. However, there remains very little research on what participants can expect to encounter. At the same time, it has been suggested that in order for physicians and workers to provide safe and effective care, volunteers should have a basic understanding of local culture, health systems, epidemiology, and socioeconomic needs of the community before arriving. Our objective was to add to the limited literature on what short-term global health trips can expect to encounter through a cross-sectional study of patient demographics, socioeconomic markers, and the prevalence of diseases encountered on a short-term medical service trip to Lima, Peru. Descriptive analysis was conducted on clinic data collected from patients living in Pamplona Alta and Pamplona Baja, Lima, Peru, in July 2015. We found that volunteers encountered mainly female patients (70.8%), and that there were significant socioeconomic barriers to care including poverty, poor housing, environmental exposures, and lack of continuity of health care. Analysis of the disease prevalence found a high proportion of acute and chronic musculoskeletal pain in the adult populations (18.8% and 11.4%, respectively), and a high presentation of upper respiratory tract infections (25.4%) and parasites (22.0%) in the pediatric group. These findings can be used by future short-term medical service trips to address potential gaps in care including the organization of weekend clinics to allow access to working men, and the use of patient education and nonpharmacological management of acute and chronic disease.

Staff perceptions of collaboration on a new interprofessional unit using the Assessment of Interprofessional Team Collaboration Scale (AITCS).

The aim of this study was to obtain baseline information on staff attitudes and perceptions of interprofessional collaboration on a newly formed interprofessional education unit. The Assessment of Interprofessional Team Collaboration Scale (AITCS) was administered to 54 interprofessional team members on a 30-bed medical interprofessional education (IPE) unit. We found that the team members respected each other but felt they needed more organisational support to further develop team skills. Additionally, team members noted that they did not have enough time for team reflection or to make changes to the team processes. The results obtained from this study will help to develop and refine educational strategies to assist the staff working on the IPE unit.

Presence with purpose: attitudes of people with developmental disability towards health care students.

CONTEXT: Early clinical encounters help medical and nursing students build professional competencies. However, there is a necessary emphasis on patient autonomy and appropriate consent. Although most individuals do not object to student involvement in clinical encounters, there are occasions when personal preference and health care education conflict. Many studies have evaluated patient attitudes towards students across a variety of specialties. OBJECTIVES: The purpose of this study was to identify the attitudes, comfort level and preferences of individuals with developmental disability (DD) towards the presence and involvement of medical and nursing students during clinical encounters. METHODS: Adults with DD across the Hamilton-Niagara region were invited to participate. Focus groups were moderated by two students with a health care facilitator and physician-educator. Participants were provided with focus group questions in advance and encouraged to bring communication aids or care providers. Data were analysed for emerging themes by two independent reviewers, who then compared results. RESULTS: Twenty-two individuals participated. A wide range of opinions were expressed. Some participants were positively disposed towards students and perceived better care and improved communication with the health care team. Others were indifferent to students in a clinical setting. The final group was opposed to the presence of health care students, expressing confusion over their role and purpose, uneasiness with deviation from the norm, and concerns about confidentiality. Informative introductions with confidentiality statements and the presence of a supervising clinician were seen as helpful. CONCLUSIONS: People with DD are affected by above-average health care needs. Their input into health care planning has been limited. Their opinions on health care learners varied considerably. Themes relating to attitudes, comfort and preferences about student involvement provide impetus for health care training practices that promote person-centred approaches and improvements to the quality of care received by people with DD.

Interprofessional Collaboration: The Experience of Nursing and Medical Students' Interprofessional Education.

In this hermeneutic phenomenological study, we examined the experience of interprofessional collaboration from the perspective of nursing and medical students. Seventeen medical and nursing students from two different universities participated in the study. We used guiding questions in face-to-face, conversational interviews to explore students' experience and expectations of interprofessional collaboration within learning situations. Three themes emerged from the data: the great divide, learning means content, and breaking the ice. The findings suggest that the experience of interprofessional collaboration within learning events is influenced by the natural clustering of shared interests among students. Furthermore, the carry-forward of impressions about physician-nurse relationships prior to the educational programs and during clinical placements dominate the formation of new relationships and acquisition of new knowledge about roles, which might have implications for future practice.

The effect of clinical teaching on patient satisfaction in rural and community settings.

INTRODUCTION: Few studies have examined the effect of clinical teaching on patient satisfaction in rural and community-based settings. We sought to examine whether patient satisfaction differed when patients were seen by a physician alone or by a physician and medical student in these settings. METHODS: We conducted a cross-sectional study in rural and community-based settings in southern Ontario (3 obstetrician-gynecologist offices and 4 family medicine clinics). Patients seen by a physician with or without a medical student present completed satisfaction and attitudes questionnaires about their experience. RESULTS: Patient satisfaction was high across both groups and did not differ when segregated by patient age, sex or employment status. Satisfaction scores were similar for patients seen by a physician with or without a student present. Satisfaction scores did not differ based on practice location. Patients' reasons for agreeing to be seen by a medical student included helping to teach students about medical concerns and helping to train future doctors. CONCLUSION: Patients in rural and community-based outpatient settings were satisfied with their care when a medical student was involved.

INTRODUCTION: Peu d'études ont analysé l'effet de l'enseignement clinique sur la satisfaction des patients en milieux rural et communautaire. Nous avons cherché à déterminer si la satisfaction des patients différait lorsqu'ils étaient accueillis par un médecin seul ou par un médecin et un étudiant en médecine dans ces contextes. MÉTHODES: Nous avons réalisé une étude transversale en milieux rural et communautaire du sud de l'Ontario (3 bureaux d'obstétriciens-gynécologues et 4 cliniques de médecine familiale). Les patients reçus par un médecin accompagné ou non d'un étu - diant en médecine ont rempli des questionnaires sur la satisfaction et les attitudes au sujet de leur expérience. RÉSULTATS: La satisfaction des patients était élevée dans les deux groupes et ne différait pas lorsqu'elle était distinguée selon l'âge et le sexe du patient ou le statut d'emploi. Les scores de satisfaction étaient semblables pour les patients reçus par un médecin accompagné ou non d'un étudiant. Les scores de satisfaction n'ont pas différé en fonction du lieu de pratique. Les raisons pour lesquelles les patients ont accepté d'être vus par un étudiant en médecine comprenaient le fait d'aider à donner aux étudiants de la formation au sujet de problèmes médicaux et d'aider à former de futurs médecins. CONCLUSION: Les patients reçus en clinique externe dans les milieux rural et communautaire étaient satisfaits des soins reçus lorsqu'un étudiant en médecine était présent.

Comparing academic performance of medical students in distributed learning sites: the McMaster experience.

BACKGROUND: In 2004, the Michael G. DeGroote School of Medicine at McMaster University in Hamilton, Ontario, developed the McMaster Community and Rural Education program (Mac-CARE), to coordinate core rotations for undergraduate and post-graduate medical learners in communities in Southern Ontario. AIMS: The purpose of this study is to compare the academic performance of medical clerks learning at distributed sites to students who remained in Hamilton using four measures of academic performance. METHODS: Progress test, OSCE, clerkship scores, and pre-clerkship tutorial-based evaluations were collected and Mac-CARE students were compared to non-Mac-CARE students on each performance measure using ANOVA. RESULTS: Outcomes are based on the first cohort to engage in Mac-CARE rotations. There were no statistically significant differences in academic performance between the 2 groups before the intervention rotation (pre-clerkship and clerkship evaluations, progress tests, or an inaugural OSCE). Mac-CARE students, however, scored higher on their post-clerkship OSCE than did non-Mac-CARE students. CONCLUSION: This study has shown that academic performance among students was at least comparable across all learning sites. To our knowledge, this is the first such study to be published within a Canadian context.