The relative influence of available resources during the residency match: a national survey of canadian medical students.
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ABSTRACT:
SUBMITTER: Blissett S
PROVIDER: S-EPMC3244315 | biostudies-other | 2011 Dec
REPOSITORIES: biostudies-other
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Project description:BackgroundDespite explicit policies and reporting mechanisms in academia designed to prevent harassment and ensure respectful environments, sexual harassment persists. We report on a national survey of Canadian medical students' experiences of sexual harassment perpetrated by faculty, patients and peers, their responses to harassment, and their suggestions for improving the learning environment.MethodsWith ethics approval from all 17 Canadian universities with medical schools, an invitation to participate in an anonymous, electronic survey was included in three Canadian Federation of Medical Students' newsletters (2016). Narrative information about sexual harassment during medical training, perpetrators, ways of coping, sources of support, formal and informal reporting/discussion, and suggestions for change was sought. Three authors then conducted a qualitative analysis and identified emergent themes.FindingsWhen asked to estimate the number of occurrences of SH experienced during medical school, 188 students reported 807 incidents perpetrated by peers, patients, and, to a lesser extent, faculty. Perpetrators were almost always men and 98% of victims were women. What emerged was a picture of social, educational, and individual conditions under which sexual harassment becomes normalised by faculty, peers and victims. Students often tried to ignore harassment despite finding it confusing, upsetting, and embarrassing. They offered strategies for schools to raise awareness, support students, and prevent or mitigate harms going forward.InterpretationSexual harassment is a part of the Canadian medical education environment where most who reported harassment are subject to the dual vulnerabilities of being learners and women. Although survey respondents recognised the systemic nature of the problem, as individuals they often described shame and self-blame when victimised, came up with solutions that implied they were the problem, and often reported thinking silence was less risky than confrontation or official reporting. Many participants believed in the transformative power of education - of themselves and faculty - as a means of improving the medical environment whilst we await social change.
| S-EPMC6537541 | biostudies-literature
Project description:BackgroundHeadache 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.MethodsOnline 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.ResultsA 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.ConclusionOur 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.
| S-EPMC10433594 | biostudies-literature
Project description:BackgroundThe Association of American Medical Colleges described 13 Core Entrustable Professional Activities (EPAs) that graduating students should be prepared to perform under indirect supervision on day one of residency. Surgery program directors recently recommended entrustability in these Core EPAs for incoming surgery interns. We sought to determine if graduating students intending to enter surgery agreed they had the skills to perform these Core EPAs.Study designUsing de-identified, individual-level data collected from and about 2019 Association of American Medical Colleges Graduation Questionnaire respondents, latent profile analysis was used to group respondents based on their self-assessed Core EPAs skills' response patterns. Associations between intended specialty, among other variables, and latent profile analysis group were assessed using independent sample t -tests and chi-square tests and multivariable logistic regression methods.ResultsAmong 12,308 Graduation Questionnaire respondents, latent profile analysis identified 2 respondent groups: 7,863 (63.9%) in a high skill acquisition agreement (SAA) group and 4,445 (36.1%) in a moderate SAA group. Specialty was associated with SAA group membership (p < 0.001), with general surgery, orthopaedic surgery, and emergency medicine respondents (among others) overrepresented in the high SAA group. In the multivariable logistic regression models, each of anesthesiology, ophthalmology, pediatrics, psychiatry, and radiology (vs general surgery) specialty intention was associated with a lower odds of high SAA group membership.ConclusionGraduating students' self-assessed Core EPAs skills were higher for those intending general surgery than for those intending some other specialties. Our findings can inform collaborative efforts to ensure graduates' acquisition of the skills expected of them at the start of residency.
| S-EPMC9653107 | biostudies-literature
Project description:BackgroundPostgraduate medical education is undergoing a paradigm shift in many universities worldwide, transitioning from a time-based model to competency-based medical education (cbme). Residency programs might have to alter clinical rotations, educational curricula, assessment methods, and faculty involvement in preparation for cbme, a process not yet characterized in the literature.MethodsWe surveyed Canadian medical oncology program directors on planned or newly implemented residency program changes in preparation for cbme.ResultsPrior to implementing cbme, all program directors changed at least 1 clinical rotation, most commonly making hematology/oncology (74%) entirely outpatient and eliminating radiation oncology (64%). Introductory rotations were altered to focus on common tumour sites, and later rotations were changed to increase learner autonomy. Most program directors planned to enhance resident learning with electronic teaching modules (79%), new training experiences (71%), and academic half-day changes (50%). Most program directors (64%) planned to change assessment methods to be entirely based on entrustable professional activities. All programs had developed a competence committee to review learner progress, and most (86%) had integrated academic coaches.ConclusionsTransitioning to cbme led to major structural and curricular changes within medical oncology training programs. Identifying these commonly implemented changes could help other programs transition to cbme.
| S-EPMC7755432 | biostudies-literature
Project description:BackgroundMedical cannabis (MC) is used by Canadian Veterans to manage a wide range of health issues. However, there is little information comparing the reasons for MC use and its perceived effectiveness between Veterans and non-Veterans.ObjectsWe compared MC use among a convenience sample of Canadian Veterans and with non-Veteran controls, including demographics, reasons and patterns of use, and perceived effectiveness.MethodsBetween November and December 2021, Canadian Veterans using cannabis were invited to participate in a survey using a national press release, social media, and announcements on online platform dedicated to promoting health among Canadian Veterans and non-Veterans during the pandemic (www.MissionVav.com). The survey was also mentioned in a monthly newsletter from Veteran Affairs Canada. Self-reported effectiveness was evaluated using a 0 to 10 visual analogue scale (0 being not all effective, 10 being the most effective).ResultsThe survey was completed by 157 people, including 108 (69%) males and 49 (31%) females. The mean age was 57 years (range 19 to 84). Among responders, 90 (63%) identified as Veterans. The most common reasons for MC use among Veterans included: insomnia (80%), anxiety (73%), and depression (52%). Veterans reported medical conditions such as chronic pain (88%) and arthritis (51%). Compared with non-Veterans, Veterans were significantly more likely to be male (83% vs. 49%), have a higher BMI (35.2 vs. 30.9), to report problems with sleep, anxiety, depression, and PTSD, and to use cannabis in edible form (51% vs. 22%). Self-reported mean effectiveness scores for MC were highest for PTSD (8.4), insomnia (8.2), anxiety (8.1), depression (8.0), and chronic pain (7.6).ConclusionsWe found important differences in user characteristics and cannabis use patterns between Canadian Veterans and non-Veterans. Further controlled studies are required to validate these findings, but these data suggest that orally administered cannabis products may be worth further study.
| S-EPMC10619467 | biostudies-literature
Project description:ObjectivesThe Coronavirus disease 2019 (COVID-19) pandemic disrupted medical student education, particularly in New York City (NYC). We aimed to assess the impact of the COVID-19 pandemic on medical students' residency choices.MethodsThe authors conducted a cross-sectional survey of medical students in all years of study at four NYC medical schools (Columbia, Cornell, NYU, and SUNY Downstate). The survey was fielded from 19 Aug 2020 to 21 Sep 2020. Survey questions included items assessing COVID-19 impact on residency choices, personal impact of COVID-19, residency/specialty choices, and factors influencing these choices.ResultsA total of 2310 students received the survey, with 547 (23.7%) providing partial responses and 212 (9.2%) providing valid responses for our primary analysis. 59.0% of participants thought that COVID-19 influenced their choice of residency/specialty, with 0.9% saying the influence was to a great extent, 22.2% to some extent, and 35.8% very little. On multivariable analysis, factors that were independently associated with COVID-19 impacting residency choice included low debt ($1 to $99,999: adjOR 2.23, 95%CI 1.02-5.03) compared with no debt and Other race/ethnicity (adjOR 0.26, 95%CI 0.10-0.63) compared with White race/ethnicity. On secondary analysis of all participants answering survey items for logistic regression regardless of survey completion, direct personal impact of COVID-19 was significantly associated with COVID-19 impacting specialty choice (adjOR 1.90, 95%CI 1.04-3.52). Moreover, 24 students (11.6%) reported a change in their top residency choice from before to during/after COVID-19, citing concerns about frontline work, work-life balance, and risk of harm.ConclusionsOur study found that 3 in 5 (59.0%) participants felt that COVID-19 impacted their residency choice, with 11.6% of respondents explicitly changing their top specialty choice. Investigating the impact of the pandemic on medical student residency considerations is crucial to understand how medical career outlooks may change in the future.
| S-EPMC8494369 | biostudies-literature
Project description:BackgroundChronic kidney disease (CKD) clinics across Canada provide tailored care for patients with CKD with an aim to slow progression and prevent complications. These clinics provide CKD self-management resources; however, there is limited information about what resources are being used by clinics. We undertook a survey of CKD clinics across Canada to identify self-management resources for adults aged 18 years and over with CKD categories 1 to 5 and not requiring dialysis or transplant.ObjectiveTo identify and collate self-management resources (eg, strategies, tools, educational materials) used by CKD clinics across Canada for adults with CKD (categories 1 to 5, not requiring kidney replacement therapy).DesignSelf-administered, semistructured electronic survey.Setting participantsCanadian CKD clinics with previously identified contact information.Methods and measurementsWe contacted 57 CKD English-speaking clinics and invited them to complete an online survey. The survey was available from October 2016 to January 2017 and consisted of 17 questions regarding the use and attributes of self-management resources including topic, delivery format, provider, target population, where the intervention was provided, and resource languages.ResultsForty-four clinics (77%) completed the survey. The most common topic was modality education provided in print format, by nurses. The most frequently used resource was the Kidney Foundation of Canada (KFOC) Living With Kidney Disease manual. We also identified that the majority of resources were available in English, targeting both patients and caregivers in the outpatient setting.LimitationsOur survey included Canadian adult CKD clinics, which may not be generalizability to other settings, such as care of people with CKD in primary care.ConclusionsAdult CKD clinics across Canada provide some similar resources, but also provide many different self-management resources. Even though some of the same resources were used by multiple clinics, the way they were provided them (ie, provider, location, delivery format) varied by the individual clinics. Knowledge of self-management resources currently provided in CKD clinics, along with synthesis of the literature and patient preferred self-management strategies, will inform the design and development of a novel self-management intervention that is patient-centric and adheres to the principles of self-management.
| S-EPMC5967152 | biostudies-literature
Project description:Studies have shown that there is a deficiency in focused oncology teaching during medical school in Canada. This study aimed to develop oncology education goals and objectives for medical students through consensus of oncology educators from across Canada.In 2014 we created a comprehensive list of oncology education objectives using existing resources. Experts in oncology education and undergraduate medical education from all 17 Canadian medical schools were invited to participate in a 3-round modified Delphi process. In round 1, the participants scored the objectives on a 9-point Likert scale according to the degree to which they agreed an objective should be taught to medical students. Objectives with a mean score of 7.0 or greater were retained, those with a mean score of 1.0-3.9 were excluded, and those with a mean score of 4.0-6.9 were discussed at a round 2 Web meeting. In round 3, the participants voted on inclusion and exclusion of the round 2 objectives.Thirty-four (92%) of the 37 invited oncology educators, representing 14 medical schools, participated in the study. They included oncologists, family physicians, members of undergraduate medical education curriculum committees and a psychologist. Of the 214 objectives reviewed in round 1, 146 received a mean score of 7.0 or greater, and 68 were scored 4.0-6.9; no objective received a mean score below 4.0. Nine new objectives were suggested. The main themes of participants' comments were to minimize the number of objectives and to aim objectives at the knowledge level required for family physicians. In round 2, the participants were able to combine 28 of the objectives with other existing objectives. In round 3, 7 of the 49 objectives received consensus of at least 75% for inclusion. The final Canadian Oncology Goals and Objectives for Medical Students contained 10 goals and 153 objectives.Through a systematic process, we created a comprehensive, consensus-based set of oncology goals and objectives to facilitate the design of undergraduate medical education curricula and improve oncology education for medical students.
| S-EPMC5047803 | biostudies-other
Project description:BackgroundMedical training programs candidate's interview is an integral part of the residency matching process. During the coronavirus disease 2019 (COVID-19) pandemic, conducting these interviews was challenging due to infection prevention restrains (social distancing, namely) and travel restrictions. E-interviews were implemented by the Saudi Commission for Healthcare Specialties (SCFHS) since the matching cycle of March 2020 to hold the interviews in a safer virtual environment while maintaining the same matching quality and standards.AimThis study was conducted to assess the medical training residency program applicants' satisfaction, stress, and other perspectives for the (SCFHS) March 2020 Matching-cycle conducted through an urgently implemented E-interviews process.MethodA cross-sectional, nationwide survey (Additional file 1) was sent to 4153 residency-nominated applicants to the (SCFHS) March 2020 cycle.ResultsAmong the 510 candidates who responded, 62.2% applied for medical specialties, 20.2% applied for surgical specialties, and 17.6% applied for critical care and emergency specialties. Most respondents (61.2%) never had previous experience with web-based video conferences. Most respondents (80.2%) used the Zoom application to conduct the current E-interviews, whereas only 15.9% used the FaceTime application. 63.3% of the respondents preferred E-interviews over in-person interviews, and 60.6% rated their experience as very good or excellent. 75.7% of the respondents agreed that all their residency program queries were adequately addressed during the E-interviews. At the same time, 52.2% of them agreed that E-interviews allowed them to represent themselves accurately. 28.2% felt no stress at all with their E-interviews experience, while 41.2% felt little stressed and only 8.2% felt highly stressed. The factors that were independently and inversely associated with applicants' level of stress with E-interviews experience were their ability to represent themselves during the interviews (p = 0.001), cost-savings (p < 0.001), their overall rating of the E-interviews quality (p = 0.007) and the speed of the internet connection (p < 0.006).ConclusionVideoconferencing was implemented on an urgent basis during the COVID-19 pandemic in the medical residency application process in Saudi Arabia. It was perceived as an adequate and promising tool to replace in-person interviews in the future. Applicants' satisfaction was mainly driven by good organization, cost-saving, and their ability to present themselves. Future studies to enhance this experience are warranted.
| S-EPMC8405253 | biostudies-literature
Project description:BackgroundMedical students perceive neurology to be a difficult subject, a phenomenon described as "neurophobia". Studies investigating student attitudes towards neurology have so far been limited by small sample sizes as a consequence of being conducted within a single medical school or region. We aimed to conduct the first national survey of the perception of neurology among UK medical students.MethodsA 24 question online survey was designed and distributed in the form of a web-link to all UK medical schools. Responses were collected for 10 weeks with reminders sent at 3 and 6 weeks. A prize-draw of £300 was offered upon completion of the survey.Results2877 medical students from 25 of 31 medical schools responded. Students found neurology to be significantly more difficult than other specialties and were least comfortable drawing up a neurological differential diagnosis compared to other specialties (p < 0.0001 for neurology vs. each of the other specialties). Neuroanatomy was regarded as the most important factor contributing to neurology being perceived as difficult.ConclusionsThe findings of the first national survey addressing this issue are consistent with previous research. The perception of neurology remains unchanged, in contrast to the rapidly changing demands of neurological care in an ageing population. Neurological examination and formulating a differential diagnosis are important skills in any medical specialty, and combatting "neurophobia" in medical students is therefore essential.
| S-EPMC4295337 | biostudies-literature