scholarly journals LO40: Describing CCFP(EM) programs in Canada: a national survey of program directors

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S20-S21 ◽  
Author(s):  
A. Nath ◽  
K. Yadav ◽  
J. J. Perry

Introduction: Enhanced skills training in emergency medicine (EM) for family physicians (CCFP(EM)) has existed since the 1970s. Accreditation standards define what every program must and should have, yet little is known on what is currently done across Canada. Our objectives were to: 1) describe major components of CCFP(EM) programs; and 2) determine how programs incorporate these components into their curriculum. Methods: A rigorous development process included expert content development and in-person pilot testing using Royal College Emergency Medicine Program Directors. An electronic survey questionnaire comprised of 63 questions was administered to all 17 CCFP(EM) program directors using a modified Dillman technique. Non-responders were sent a reminder email every 2 weeks over a 6-week period and an in-person reminder was given to non-responders at a face to face meeting 4 weeks after the initial survey was sent in June 2016. Results: All 17/17 (100%) program directors responded. There was considerable variation in administrative structure and financial support for each program. All programs provided ultrasound courses for basic skills (trauma, abdominal aortic aneurysm, intrauterine pregnancy). Variation exists for offering independent ultrasound certification (77%), advanced scanning (18%) and protected academic time for scanning (53%). All programs utilize high fidelity simulation. Some programs use in situ simulation (18%) and hold a simulation boot camp (41%). Most centres required an academic project, most commonly a quality assurance project (53%) and/or a critical appraisal of the literature (59%). Publication or national conference presentations were required by 12% of programs. Competency based assessments use simulation (88%) and direct observations (53%). Only 24% of programs have a transition to practice curriculum. All programs maintain strong connections to family medicine. Conclusion: This study demonstrates diverse structures of CCFP(EM) programs across Canada. Programs are similar regarding the provision of ultrasound, simulation and protected teaching time. Variation exists in administrative structure and financial resources of each program, academic project requirements, and how programs perform competency based assessments.

CJEM ◽  
2018 ◽  
Vol 21 (2) ◽  
pp. 274-282
Author(s):  
Avik Nath ◽  
Krishan Yadav ◽  
Jeffrey J. Perry

AbstractObjectivesEnhanced skills training in emergency medicine through the Canadian College of Family Physicians, CCFP(EM), has existed since the 1980s. Accreditation standards define what every program “must” and “should” have, yet little is known on what is currently done across Canada. Our objectives were to 1) describe major components of CCFP(EM) programs and 2) determine how curricular components are taught.MethodsAfter a rigorous development process (expert content development, cognitive reviews, and pilot testing), a survey questionnaire was administered to all 17 CCFP(EM) program directors using a modified Dillman technique.ResultsAll (17/17) program directors responded. Programs are similar in core clinical rotations conducted and provide ultrasound courses for basic skills (trauma, abdominal aortic aneurysm, intrauterine pregnancy). Variation exists for offering independent ultrasound certification (77%), advanced scanning (18%), and protected time for scanning (53%). All programs utilize high fidelity simulation. Some programs use in situ simulation (18%) and carry out a simulation boot camp (41%). Most centres require an academic project, which is a quality assurance project (53%) and/or a critical appraisal of the literature (59%). Publication or national conference presentations are required by 12% of programs. Competency-based curricula include simulation for rare procedures (88%), direct observations (65%), and a “transition to practice” curriculum (24%). All programs maintain strong connections to family medicine.ConclusionThis study demonstrates the diverse structures of CCFP(EM) programs across Canada. Programs have similar clinical rotations, ultrasound, and simulation requirements. Variation exists in administrative structure and financial resources of programs, academic project requirements, and programs’ competency-based curricula.


2019 ◽  
Vol 21 (1) ◽  
pp. 160-162
Author(s):  
Randy Sorge ◽  
Simiao Li-Sauerwine ◽  
Jorge Fernandez ◽  
Gene Hern

Introduction: It is unclear how emergency medicine (EM) programs educate core faculty about the use of milestones in competency-based evaluations. We conducted a national survey to profile how programs educate core faculty regarding their use and to assess core faculty’s understanding of the milestones. Methods: Our survey tool was distributed over six months in 2017 via the Council of Emergency Medicine Residency Directors (CORD) listserv. Responses, which were de-identified, were solicited from program directors (PDs), assistant/associate program directors (APDs), and core faculty. A single response from a program was considered sufficient. Results: Our survey had a 69.7% response rate (n=140/201). 62.9% of programs reported educating core faculty about the EM Milestones via the distribution of physical or electronic media. Although 82.6% of respondents indicated that it was important for core faculty to understand how the EM Milestones are used in competency-based evaluations, respondents estimated that 48.6% of core faculty possess “fair or poor” understanding of the milestones. Furthermore, only 50.7% of respondents felt that the EM Milestones were a valuable tool. Conclusion: These data suggest there is sub-optimal understanding of the EM Milestones among core faculty and disagreement as to whether the milestones are a valuable tool.


CJEM ◽  
2013 ◽  
Vol 15 (04) ◽  
pp. 241-248 ◽  
Author(s):  
Andrew Petrosoniak ◽  
Jodi Herold ◽  
Karen Woolfrey

ABSTRACTObjective:This study sought to establish the current state of procedural skills training in Canadian Royal College emergency medicine (EM) residencies.Methods:A national Web-based survey was administered to residents and program directors of all 13 Canadian-accredited Royal College EM residency programs. Programdirectors rated the importance and experience required for competence of 45 EM procedural skills. EM residents reported their experience and comfort in performing the same procedural skills.Results:Thirteen program directors and 86 residents responded to the survey (response rate of 100% and 37%, respectively). Thirty-two (70%) procedures were considered important by > 70% of program directors, including all resuscitation and lifesaving airway procedures. Four procedures deemed important by program directors, including cricothyroidotomy, pericardiocentesis, posterior nasal pack for epistaxis, and paraphimosis reduction, had never been performed by the majority of senior residents. Program director opinion was used to categorize each procedure based on performance frequency to achieve competence. Overall, procedural experience correlated positively with comfort levels as indicated by residents.Conclusions:We established an updated needs assessment of procedural skills training for Canadian Royal College EM residency programs. This included program director opinion of important procedures and the performance frequency needed to achieve competence. However, we identified several important procedures that were never performed by most senior residents despite program director opinion regarding the experience needed for competence. Further study is required to better define objective measures for resident competence in procedural skills.


CJEM ◽  
2015 ◽  
Vol 17 (2) ◽  
pp. 101-106 ◽  
Author(s):  
Eve Purdy ◽  
Brent Thoma ◽  
Joseph Bednarczyk ◽  
David Migneault ◽  
Jonathan Sherbino

AbstractIntroductionOnline educational resources (OERs) are increasingly available for emergency medicine (EM) education. This study describes and compares the use of free OERs by the Royal College of Physicians and Surgeons of Canada (RCPSC) EM residents and program directors (PDs) and investigates the relationship between the use of OERs and peer-reviewed literature.MethodsA bilingual, online survey was distributed to RCPSC-EM residents and PDs using a modified Dillman method. The chi-square test and Fisher’s exact test were used to compare the responses of residents and PDs.ResultsThe survey was completed by 214/350 (61%) residents and 11/14 (79%) PDs. Free OERs were used by residents most frequently for general EM education (99.5%), procedural skills training (96%), and learning to interpret diagnostic tests (92%). OER modalities used most frequently included wikis (95%), file-sharing websites (95%), e-textbooks (94%), and podcasts (91%). Residents used wikis, podcasts, vodcasts, and file-sharing websites significantly more frequently than PDs. Relative to PDs, residents found entertainment value to be more important for choosing OERs (p<0.01). Some residents (23%) did not feel that literature references were important, whereas all PDs did. Both groups reported that OERs increased the amount of peer-reviewed literature (75% and 60%, respectively) that they read.ConclusionsEM residents make extensive use of OERs and differ from their PDs in the importance that they place on their entertainment value and incorporation of peer-reviewed references. OERs may increase the use of peer-reviewed literature in both groups. Given the prevalence of OER use for core educational goals among RCPSC-EM trainees, future efforts to facilitate critical appraisal and appropriate resource selection are warranted.


CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S29
Author(s):  
A. Wang ◽  
K. Van Aarsen ◽  
A. Meiwald ◽  
J. Yan

Introduction: With a shift towards competency-based medical education, it is crucial to not only emphasize learner abilities such as clinical skills but also leadership in the conduct of research. Though the Royal College of Physicians and Surgeons of Canada's (RCPSC) training objectives for Emergency Medicine (EM) residents state that the specialist physician be able to describe the principles of research, the research methodology curriculum across EM training programs in Canada is likely variable. The primary goal of this study was to describe the variability of research methodology teaching among RCPSC-EM residency programs. Methods: An electronic survey was distributed to English-speaking RCPSC-EM program directors (PDs) and EM residents. The survey investigated residents' and PDs’ thoughts on the adequacy of their local curriculum and asked them to quantify their research methodology teaching. The primary outcome was the frequency and content of current research methodology and research ethics teaching as well as a description of scholarly project requirements of EM residency programs across Canada. The data was presented with simple descriptive statistics. Results: 79 EM residents and 7 PDs responded (response rate 22.3% and 58.3%, respectively). All 7 PDs indicate having a research methodology curriculum while 71.6% of residents are aware of this curriculum. Only 57.1% of PDs report having formal assessments. Most programs (71.4%) teach via small groups while 28.6% of programs use large group sessions. Residents identify teaching as led by research staff (68.9%), staff physicians (60%), and EM researchers (57.8%), while only 17.8% use outside educators. Students noted various modalities of curriculum feedback such as online surveys, weekly forms, and verbal feedback. Regarding the strength of the curricula, 85.7% of PDs believed their curriculum prepares residents for board exams, while only 62.2% of residents felt similarly. When asked about using a standard web-based curriculum module if available, 60.5% of residents responded in favour. Conclusion: This study demonstrates that EM residency programs across Canada vary with respect to research methodology curriculum and discrepancies exist between residents’ and program directors’ perceptions of the curriculum. Given the lack of a standardized research methodology curriculum for these residency programs, there is an opportunity for curriculum development to improve training in research methodology.


2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Sally Byford ◽  
Sarah Janssens ◽  
Rachel Cook

Abstract Background Transvaginal ultrasound (TVUS) training opportunities are limited due to its intimate nature; however, TVUS is an important component of early pregnancy assessment. Simulation can bridge this learning gap. Aim To describe and measure the effect of a transvaginal ultrasound simulation programme for obstetric registrars. Materials and methods The transvaginal ultrasound simulation training (TRUSST) curriculum consisted of supported practice using virtual reality transvaginal simulators (ScanTrainer, Medaphor) and communication skills training to assist obstetric registrars in obtaining required competencies to accurately and holistically care for women with early pregnancy complications. Trainee experience of live transvaginal scanning was evaluated with a questionnaire. Programme evaluation was by pre-post self-reported confidence level and objective pre-post training assessment using Objective Structured Assessment of Ultrasound Skills (OSAUS) and modified Royal Australian and New Zealand College of Obstetrics and Gynaecology assessment scores. Quantitative data was compared using paired t tests. Results Fifteen obstetric registrars completed the programme. Numbers of performed live transvaginal ultrasound by trainees were low. Participants reported an increase in confidence level in performing a TVUS following training: mean pre score 1.6/5, mean post score 3/5. Objective assessments improved significantly across both OSAUS and RANZCOG scores following training; mean improvement scores 7.6 points (95% CI 6.2–8.9, p < 0.05) and 32.5 (95% CI 26.4–38.6, p < 0.05) respectively. It was noted that scores for a systematic approach and documentation were most improved: 1.9 (95% CI 1.4–2.5, p < 0.05) and 2.1 (95% CI 1.5–2.7, p < 0.05) respectively. Conclusion The implementation of a simulation-based training curriculum resulted in improved confidence and ability in TVUS scanning, especially with regard to a systematic approach and documentation.


CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S76-S76
Author(s):  
R. Schonnop ◽  
B. Stauffer ◽  
A. Gauri ◽  
D. Ha

Introduction: Procedural skills are a key component of an emergency physician's practice. The Edmonton Zone is a health region that comprises twelve tertiary, urban community and rural community emergency departments (EDs) and represents over three hundred emergency physicians. This study describes the current attitudes toward procedural skill competency, current procedural skill practices, and the role for educational skills training sessions among emergency medicine physicians within a geographical health region. Methods: Multicenter descriptive cross-sectional survey of all emergency medicine physicians working at 12 emergency departments within the Edmonton Zone in 2019 (n = 274). The survey underwent several phases of systematic review; including item generation and reduction, pilot testing, and clinical sensibility testing. Survey items addressed current procedural skill performance frequency, perceived importance and confidence, current methods to maintain competence, barriers and facilitating factors to participation in a curriculum, preferred teaching methods, and desired frequency of practice for each procedural skill. Results: Survey response rate was 53.6%. Variability in frequency of performed procedures was apparent across the type of hospital sites. For majority of skills, there was a significantly positive correlation between the frequency at which a skill was performed and the perceived confidence performing said skill. There was inconsistency and no significant correlation with perceived importance, perceived confidence, or frequency performing a given skill and the desired frequency of training for that skill. Course availability (76.2%) and time (72.8%) are the most common identified barriers to participation in procedural skills training. Conclusion: This study summarized the current emergency department procedural skill practices and attitudes toward procedural skill competency and an educational curriculum among emergency medicine physicians in Edmonton. This represents a step towards targeted continuing professional development in the growing realm of competency-based medical education.


2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Gabrielle A. Jacquet ◽  
Jamil D. Bayram ◽  
William B. Ewen ◽  
Bhakti Hansoti ◽  
Steven Andescavage ◽  
...  

Background. There are currently 34 International Emergency Medicine (IEM) fellowship programs. Applicants and programs are increasing in number and diversity. Without a standardized application, applicants have a difficulty approaching programs in an informed and an organized method; a streamlined application system is necessary.Objectives. To measure fellows’ knowledge of their programs’ curricula prior to starting fellowship and to determine what percent of fellows and program directors would support a universal application system.Methods. A focus group of program directors, recent, and current fellows convened to determine the most important features of an IEM fellowship application process. A survey was administered electronically to a convenience sample of 78 participants from 34 programs. Respondents included fellowship directors, fellows, and recent graduates.Results. Most fellows (70%) did not know their program’s curriculum prior to starting fellowship. The majority of program directors and fellows support a uniform application service (81% and 67%, resp.) and deadline (85% for both). A minority of program directors (35%) and fellows (30%) support a formal match.Conclusions. Program directors and fellows support a uniform application service and deadline, but not a formalized match. Forums for disseminating IEM fellowship information and for administering a uniform application service and deadline are currently in development to improve the process.


2012 ◽  
Vol 4 (4) ◽  
pp. 425-433 ◽  
Author(s):  
Mohammad U. Malik ◽  
David A. Diaz Voss Varela ◽  
Charles M. Stewart ◽  
Kulsoom Laeeq ◽  
Gayane Yenokyan ◽  
...  

Abstract Introduction The Accreditation Council for Graduate Medical Education (ACGME) introduced the Outcome Project in July 2001 to improve the quality of resident education through competency-based learning. The purpose of this systematic review is to determine and explore the perceptions of program directors regarding challenges to implementing the ACGME Outcome Project. Methods We used the PubMed and Web of Science databases and bibliographies for English-language articles published between January 1, 2001, and February 17, 2012. Studies were included if they described program directors' opinions on (1) barriers encountered when attempting to implement ACGME competency-based education, and (2) assessment methods that each residency program was using to implement competency-based education. Articles meeting the inclusion criteria were screened by 2 researchers. The grading criterion was created by the authors and used to assess the quality of each study. Results The survey-based data reported the opinions of 1076 program directors. Barriers that were encountered include: (1) lack of time; (2) lack of faculty support; (3) resistance of residents to the Outcome Project; (4) insufficient funding; (5) perceived low priority for the Outcome Project; (6) inadequate salary incentive; and (7) inadequate knowledge of the competencies. Of the 6 competencies, those pertaining to patient care and medical knowledge received the most responses from program directors and were given highest priority. Conclusions The reviewed literature revealed that time and financial constraints were the most important barriers encountered when implementing the ACGME Outcome Project.


MedEdPORTAL ◽  
2010 ◽  
Vol 6 (1) ◽  
Author(s):  
Leo Kobayashi ◽  
Marc Shapiro ◽  
Arun Nagdev ◽  
Frantz Gibbs

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