Dans l'enseignement médical, le perfectionnement du corps professoral se fait souvent de façon ad... more Dans l'enseignement médical, le perfectionnement du corps professoral se fait souvent de façon ad hoc et non dans le cadre d'un programme structuré en fonction des besoins individuels définis sur la base de données. Dans cet article, les autrices, qui ont toutes une vaste expérience en matière de perfectionnement du corps professoral (PCP), présentent un cadre pour le perfectionnement fondé sur les compétences (PCPFC) visant à renforcer les effets du PCP. Les étapes et les principes de ce cadre reflètent les enseignements tirés de la formation médicale fondée sur les compétences (FMFC), dont l'objectif fondamental est de former les médecins de façon à ce qu'ils puissent répondre aux besoins de la société. De manière analogue, le cadre PCPFC viserait à mieux former le corps professoral pour qu'il puisse répondre aux besoins éducatifs. Les éléments centraux du cadre comprennent la définition des compétences pour chacun des rôles que les enseignants remplissent, la création de programmes de formation structurés et axés sur le développement de ces compétences et l'élaboration d'un programme d'évaluation ainsi qu'un processus pour soutenir de manière individualisée l'apprentissage et la croissance professionnelle des enseignants. Le cadre présente des idées sur les modalités des formations de PCPFC, sur l'environnement dans lequel elles interviennent, sur l'utilisation du coaching pour promouvoir la réflexion et la construction d'identité et sur la création de communautés d'apprentissage. Tout comme la FMFC, le cadre du PCPFC répond aux importants enjeux liés à la gestion du changement, y compris l'engagement des parties prenantes, l'amélioration continue de la qualité et la recherche. Les autrices proposent des exemples tirés de la littérature scientifique et passent en revue les défis et les points importants à considérer pour chaque étape.
The growing international adoption of competency-based medical education has created a desire for... more The growing international adoption of competency-based medical education has created a desire for descriptions of innovative assessment approaches that generate appropriate and sufficient information to allow for informed, defensible decisions about learner progress. In this article, the authors provide an overview of the development and implementation of the approach to programmatic assessment in postgraduate family medicine training programs in Canada, called Continuous Reflective Assessment for Training (CRAFT). CRAFT is a principles-guided, high-level approach to workplace-based assessment that was intentionally designed to be adaptable to local contexts, including size of program, resources available, and structural enablers and barriers. CRAFT has been implemented in all 17 Canadian family medicine residency programs, with each program taking advantage of the high-level nature of the CRAFT guidelines to create bespoke assessment processes and tools appropriate for their local ...
Introduction: To assess the effect of a training programme called 6for6 (the programme) on resear... more Introduction: To assess the effect of a training programme called 6for6 (the programme) on research competency and productivity amongst rural physicians. The programme develops the research skills of six rural physicians over six weekends. Physicians learn about various research methods and writing techniques through blended learning components. Methods: We conducted a quasi-experimental study, comparing research competency and productivity between intervention and non-equivalent control groups and over time through a repeated measures design. Generalized linear mixed model (GLMM), ANOVA, and Cochran Q tests were conducted. The intervention was provided to five groups of 6 rural physicians each between 2014 and 2019. Main outcome measures: self-assessed research competency (knowledge, attitudes and skills) and productivity (publications, grants and presentations of research-related work at conferences) were our primary and secondary outcomes, respectively. We measured the outcomes before, during and after the programme. Controls: Rural physicians who expressed interest in the programme and later enrolled. Results: This study shows that, amongst its thirty participants, overall research competency was significantly different between intervention and control groups (65.7% ± 37.6% and 58.6% ± 14.4%, P < 0.05 for GLMM). The percentage of participants who were productive before, during and after the programme was 26.7%, 16.7% and 50.0%, respectively. Overall, productivity rates were significantly different between intervention and control groups (rate difference was 72.2/100 person-years, P < 0.05 for GLMM). Conclusion: This study suggests that the programme improves research competency and productivity for rural physicians. Rural physicians who wish to improve their research competency would benefit from participating in similar programmes.
Background: While rural physicians are the ideal candidates to investigate health and healthcare ... more Background: While rural physicians are the ideal candidates to investigate health and healthcare issues in rural communities, they often lack the required skills, competencies, and resources. As a result, research skills development programs are crucial to help ensure communities receive the quality of care they deserve. Memorial University of Newfoundland created a research skills development program called 6for6 to empower and enable rural physicians to research solutions to community-specific health needs. 6for6 program delivery was exclusively in-person until 2019. However, with limitations introduced due to the COVID-19 pandemic, organizations around the globe needed to respond quickly. As we work to return to a post-pandemic environment, program administrators and educators worldwide are unsure whether to retain or remove the changes made to programs to adapt to the pandemic restrictions. Therefore, this work addresses the impact of the online delivery model in two areas: 1) attainment of competencies (specifically research skills, knowledge, and attitudes); and 2) participant experiences, defined as the ease of attendance, the capacity to interact with team members and peers, and challenges or barriers associated with navigating program resources. Methods: We compared the effect of an online delivery model pivoted to adapt pandemic restrictions with the original model (primarily face-to-face) on the acquisition of learning competencies and participant experience using a mixed-methods study. Various data collection methods, such as a pre-post program survey, post-program focus group, and structured observation, were utilized. Results: From 2014 to 2021, 35 physicians attended the program (30 face-to-face and five online). The Wilcoxon-signrank test did not show any significant differences in the participants' median change of research competency scores who attended face-to-face and online learning, respectively: knowledge (32.6, 26.8), attitudes (3.8, 3.5), and skills (32.4, 20.0). Flexibility and accessibility were key aspects of participants' experiences during the online model. Comparison with previous years demonstrated no significant challenges with the virtual delivery model, yet participants struggled with mentorship challenges and learning-life balance. Conclusions: Although presenting some unique challenges, the online model did not negatively affect learner competencies. Likewise, it provided opportunities for rural physicians to attend learning sessions and interact with experts and peers while remaining in their communities.
La traduction en français de cet article se trouve à www.cfp.ca dans la table des matières du num... more La traduction en français de cet article se trouve à www.cfp.ca dans la table des matières du numéro d'avril 2021 à la page e91.
Exclusivement sur le web Des médecins de famille adaptatifs L'attention accordée aux habiletés te... more Exclusivement sur le web Des médecins de famille adaptatifs L'attention accordée aux habiletés techniques est-elle une solution?
Rural physicians face many challenges with providing rural health care, which often leads to inno... more Rural physicians face many challenges with providing rural health care, which often leads to innovative solutions. Despite their creativity with overcoming barriers, there is a lack of support for rural health research-an area of health care where research makes great impacts on small communities. Rural research capacity building (RRCB) is essential to support rural physicians so that they can conduct relevant research, but RRCB programs are sparse. Thus, our team at Memorial University of Newfoundland, Canada, has created an RRCB ecosystem through the 6for6 and Rural360 programs, which outline a pathway for rural physicians to make meaningful contributions to their communities through research. This article describes the RRCB ecosystem and explains how the 6for6 and Rural360 programs address the need for RRCB. Designed to train six rural physicians over six sessions per year, 6for6 fosters learning of research practices through a conceptual framework that envelops complexity science, systems thinking, and anchored instruction. The use of this framework allows the learning to be grounded in issues that are locally relevant for each participant and follows guiding principles that enable many types of learning. Rural360 continues the pathway by providing an inhouse funding opportunity with an iterative review process that allows participants to continue developing their research skills and, ultimately, secure funding for their project. This anchored delivery model of RRCB programming is made possible through many support systems including staff, librarians, instructors, the university, and other stakeholders. It has successfully helped form communities of practice, promotes collaboration both between learners and with third parties, encourages self-organization with flexibility for learners outside of the in-house sessions, and ultimately drives social accountability in addressing local healthcare issues.
Occasion d'enseignement | Teaching Moment Exclusivement sur le web Exercer un leadership de votre... more Occasion d'enseignement | Teaching Moment Exclusivement sur le web Exercer un leadership de votre position d'éducateur Le rôle du leader pédagogique dans le Référentiel des activités pédagogiques fondamentales
Barriers like professional and geographical isolation prevent rural physicians, the most knowledg... more Barriers like professional and geographical isolation prevent rural physicians, the most knowledgeable and experienced players in rural medicine, from conducting research. The Discipline of Family Medicine has responded to these barriers with 6for 6, a tailored six session curriculum that provides Memorial-affiliated rural physicians with the expert training, support and mentorship to challenge their research barriers and embark on a research agenda. Here we will present barriers and enablers to developing a research education program for remote physicians, underscore key successes from a three-year curriculum pilot and highlight important lessons for anyone interested in pursuing a similar initiative. Methods: Needs assessment to identify skills and services needed by rural physicians to engage in research and curriculum development using the Kern 6-step curriculum development approach. Results: The 6for 6 curriculum has been piloted for 3 years and evaluated with pre-and post-program and preand post-session surveys measuring self-reported knowledge, attitudes and beliefs regarding research topics covered in the training sessions. Paired samples t-tests found significant improvements from pre-to post-test for knowledge (Mean difference = 3.375, p<.003) and attitudes (Mean difference = 0.5, p<.033). Participants report that 6for 6 is rurally relevant, supportive and has improved their research skills. Participants are producing tangible research scholarship, including grant proposals, journal articles and academic posters). Conclusion: 6for 6 is catalyzing a culture of research in rural areas of Canada, empowering rural physicians to develop rural solutions for rural problems. The program continues to evolve and improve as evaluation data is used to fine tune the curriculum.
People in Northern Newfoundland and Coastal Labrador (NNCL), Canada, face major challenges obtain... more People in Northern Newfoundland and Coastal Labrador (NNCL), Canada, face major challenges obtaining accessible and contextually-relevant healthcare. Rural360 is a socially accountable research incubator that provides funding for NNCL physicians to research solutions to these issues. NNCL graduates of the adjoined 6for6 research training program for rural physicians are invited to submit the research project they have conceptualised as part of that initiative as a letter of intent, and subsequently as a research proposal, to Rural360. These submissions are reviewed by relevant subject matter experts as part of the Rural360 adjudication process. This process is iterative and strives to guide and assist participants in refining their submission. The overarching objective of Rural360 is to collaborate with rural physicians to conduct, disseminate or otherwise catalyze unsupported community-based research in NNCL. In so doing, it is highly socially accountable, empowering participants to become change-makers who investigate contextually important health issues that emerge from NNCL communities.
Dans l'enseignement médical, le perfectionnement du corps professoral se fait souvent de façon ad... more Dans l'enseignement médical, le perfectionnement du corps professoral se fait souvent de façon ad hoc et non dans le cadre d'un programme structuré en fonction des besoins individuels définis sur la base de données. Dans cet article, les autrices, qui ont toutes une vaste expérience en matière de perfectionnement du corps professoral (PCP), présentent un cadre pour le perfectionnement fondé sur les compétences (PCPFC) visant à renforcer les effets du PCP. Les étapes et les principes de ce cadre reflètent les enseignements tirés de la formation médicale fondée sur les compétences (FMFC), dont l'objectif fondamental est de former les médecins de façon à ce qu'ils puissent répondre aux besoins de la société. De manière analogue, le cadre PCPFC viserait à mieux former le corps professoral pour qu'il puisse répondre aux besoins éducatifs. Les éléments centraux du cadre comprennent la définition des compétences pour chacun des rôles que les enseignants remplissent, la création de programmes de formation structurés et axés sur le développement de ces compétences et l'élaboration d'un programme d'évaluation ainsi qu'un processus pour soutenir de manière individualisée l'apprentissage et la croissance professionnelle des enseignants. Le cadre présente des idées sur les modalités des formations de PCPFC, sur l'environnement dans lequel elles interviennent, sur l'utilisation du coaching pour promouvoir la réflexion et la construction d'identité et sur la création de communautés d'apprentissage. Tout comme la FMFC, le cadre du PCPFC répond aux importants enjeux liés à la gestion du changement, y compris l'engagement des parties prenantes, l'amélioration continue de la qualité et la recherche. Les autrices proposent des exemples tirés de la littérature scientifique et passent en revue les défis et les points importants à considérer pour chaque étape.
The growing international adoption of competency-based medical education has created a desire for... more The growing international adoption of competency-based medical education has created a desire for descriptions of innovative assessment approaches that generate appropriate and sufficient information to allow for informed, defensible decisions about learner progress. In this article, the authors provide an overview of the development and implementation of the approach to programmatic assessment in postgraduate family medicine training programs in Canada, called Continuous Reflective Assessment for Training (CRAFT). CRAFT is a principles-guided, high-level approach to workplace-based assessment that was intentionally designed to be adaptable to local contexts, including size of program, resources available, and structural enablers and barriers. CRAFT has been implemented in all 17 Canadian family medicine residency programs, with each program taking advantage of the high-level nature of the CRAFT guidelines to create bespoke assessment processes and tools appropriate for their local ...
Introduction: To assess the effect of a training programme called 6for6 (the programme) on resear... more Introduction: To assess the effect of a training programme called 6for6 (the programme) on research competency and productivity amongst rural physicians. The programme develops the research skills of six rural physicians over six weekends. Physicians learn about various research methods and writing techniques through blended learning components. Methods: We conducted a quasi-experimental study, comparing research competency and productivity between intervention and non-equivalent control groups and over time through a repeated measures design. Generalized linear mixed model (GLMM), ANOVA, and Cochran Q tests were conducted. The intervention was provided to five groups of 6 rural physicians each between 2014 and 2019. Main outcome measures: self-assessed research competency (knowledge, attitudes and skills) and productivity (publications, grants and presentations of research-related work at conferences) were our primary and secondary outcomes, respectively. We measured the outcomes before, during and after the programme. Controls: Rural physicians who expressed interest in the programme and later enrolled. Results: This study shows that, amongst its thirty participants, overall research competency was significantly different between intervention and control groups (65.7% ± 37.6% and 58.6% ± 14.4%, P < 0.05 for GLMM). The percentage of participants who were productive before, during and after the programme was 26.7%, 16.7% and 50.0%, respectively. Overall, productivity rates were significantly different between intervention and control groups (rate difference was 72.2/100 person-years, P < 0.05 for GLMM). Conclusion: This study suggests that the programme improves research competency and productivity for rural physicians. Rural physicians who wish to improve their research competency would benefit from participating in similar programmes.
Background: While rural physicians are the ideal candidates to investigate health and healthcare ... more Background: While rural physicians are the ideal candidates to investigate health and healthcare issues in rural communities, they often lack the required skills, competencies, and resources. As a result, research skills development programs are crucial to help ensure communities receive the quality of care they deserve. Memorial University of Newfoundland created a research skills development program called 6for6 to empower and enable rural physicians to research solutions to community-specific health needs. 6for6 program delivery was exclusively in-person until 2019. However, with limitations introduced due to the COVID-19 pandemic, organizations around the globe needed to respond quickly. As we work to return to a post-pandemic environment, program administrators and educators worldwide are unsure whether to retain or remove the changes made to programs to adapt to the pandemic restrictions. Therefore, this work addresses the impact of the online delivery model in two areas: 1) attainment of competencies (specifically research skills, knowledge, and attitudes); and 2) participant experiences, defined as the ease of attendance, the capacity to interact with team members and peers, and challenges or barriers associated with navigating program resources. Methods: We compared the effect of an online delivery model pivoted to adapt pandemic restrictions with the original model (primarily face-to-face) on the acquisition of learning competencies and participant experience using a mixed-methods study. Various data collection methods, such as a pre-post program survey, post-program focus group, and structured observation, were utilized. Results: From 2014 to 2021, 35 physicians attended the program (30 face-to-face and five online). The Wilcoxon-signrank test did not show any significant differences in the participants' median change of research competency scores who attended face-to-face and online learning, respectively: knowledge (32.6, 26.8), attitudes (3.8, 3.5), and skills (32.4, 20.0). Flexibility and accessibility were key aspects of participants' experiences during the online model. Comparison with previous years demonstrated no significant challenges with the virtual delivery model, yet participants struggled with mentorship challenges and learning-life balance. Conclusions: Although presenting some unique challenges, the online model did not negatively affect learner competencies. Likewise, it provided opportunities for rural physicians to attend learning sessions and interact with experts and peers while remaining in their communities.
La traduction en français de cet article se trouve à www.cfp.ca dans la table des matières du num... more La traduction en français de cet article se trouve à www.cfp.ca dans la table des matières du numéro d'avril 2021 à la page e91.
Exclusivement sur le web Des médecins de famille adaptatifs L'attention accordée aux habiletés te... more Exclusivement sur le web Des médecins de famille adaptatifs L'attention accordée aux habiletés techniques est-elle une solution?
Rural physicians face many challenges with providing rural health care, which often leads to inno... more Rural physicians face many challenges with providing rural health care, which often leads to innovative solutions. Despite their creativity with overcoming barriers, there is a lack of support for rural health research-an area of health care where research makes great impacts on small communities. Rural research capacity building (RRCB) is essential to support rural physicians so that they can conduct relevant research, but RRCB programs are sparse. Thus, our team at Memorial University of Newfoundland, Canada, has created an RRCB ecosystem through the 6for6 and Rural360 programs, which outline a pathway for rural physicians to make meaningful contributions to their communities through research. This article describes the RRCB ecosystem and explains how the 6for6 and Rural360 programs address the need for RRCB. Designed to train six rural physicians over six sessions per year, 6for6 fosters learning of research practices through a conceptual framework that envelops complexity science, systems thinking, and anchored instruction. The use of this framework allows the learning to be grounded in issues that are locally relevant for each participant and follows guiding principles that enable many types of learning. Rural360 continues the pathway by providing an inhouse funding opportunity with an iterative review process that allows participants to continue developing their research skills and, ultimately, secure funding for their project. This anchored delivery model of RRCB programming is made possible through many support systems including staff, librarians, instructors, the university, and other stakeholders. It has successfully helped form communities of practice, promotes collaboration both between learners and with third parties, encourages self-organization with flexibility for learners outside of the in-house sessions, and ultimately drives social accountability in addressing local healthcare issues.
Occasion d'enseignement | Teaching Moment Exclusivement sur le web Exercer un leadership de votre... more Occasion d'enseignement | Teaching Moment Exclusivement sur le web Exercer un leadership de votre position d'éducateur Le rôle du leader pédagogique dans le Référentiel des activités pédagogiques fondamentales
Barriers like professional and geographical isolation prevent rural physicians, the most knowledg... more Barriers like professional and geographical isolation prevent rural physicians, the most knowledgeable and experienced players in rural medicine, from conducting research. The Discipline of Family Medicine has responded to these barriers with 6for 6, a tailored six session curriculum that provides Memorial-affiliated rural physicians with the expert training, support and mentorship to challenge their research barriers and embark on a research agenda. Here we will present barriers and enablers to developing a research education program for remote physicians, underscore key successes from a three-year curriculum pilot and highlight important lessons for anyone interested in pursuing a similar initiative. Methods: Needs assessment to identify skills and services needed by rural physicians to engage in research and curriculum development using the Kern 6-step curriculum development approach. Results: The 6for 6 curriculum has been piloted for 3 years and evaluated with pre-and post-program and preand post-session surveys measuring self-reported knowledge, attitudes and beliefs regarding research topics covered in the training sessions. Paired samples t-tests found significant improvements from pre-to post-test for knowledge (Mean difference = 3.375, p<.003) and attitudes (Mean difference = 0.5, p<.033). Participants report that 6for 6 is rurally relevant, supportive and has improved their research skills. Participants are producing tangible research scholarship, including grant proposals, journal articles and academic posters). Conclusion: 6for 6 is catalyzing a culture of research in rural areas of Canada, empowering rural physicians to develop rural solutions for rural problems. The program continues to evolve and improve as evaluation data is used to fine tune the curriculum.
People in Northern Newfoundland and Coastal Labrador (NNCL), Canada, face major challenges obtain... more People in Northern Newfoundland and Coastal Labrador (NNCL), Canada, face major challenges obtaining accessible and contextually-relevant healthcare. Rural360 is a socially accountable research incubator that provides funding for NNCL physicians to research solutions to these issues. NNCL graduates of the adjoined 6for6 research training program for rural physicians are invited to submit the research project they have conceptualised as part of that initiative as a letter of intent, and subsequently as a research proposal, to Rural360. These submissions are reviewed by relevant subject matter experts as part of the Rural360 adjudication process. This process is iterative and strives to guide and assist participants in refining their submission. The overarching objective of Rural360 is to collaborate with rural physicians to conduct, disseminate or otherwise catalyze unsupported community-based research in NNCL. In so doing, it is highly socially accountable, empowering participants to become change-makers who investigate contextually important health issues that emerge from NNCL communities.
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