Is there a role for a learner education handover as part of the Medical Council of Canada assessment and licensing process?
DOI:
https://doi.org/10.36834/cmej.73844Abstract
- The transition from undergraduate medical education (UGME) to postgraduate medical education (PGME) is a time of vulnerability for medical schools, postgraduate residency programs, and most importantly, trainees
- There is a disconnect between the UGME and PGME experience. Student information shared by UGME is primarily summative of knowledge and skills; PGME programs are unaware of specific learner accommodation requirements, tailored supervisory needs, or potential professionalism concerns identified during UGME
- This lack of integration between UGME and PGME increases potential risk to learners, postgrad programs and patients
- Better linkages and communication along the education continuum could optimize learning and reduce inefficiency and risk
- The Medical Council of Canada (MCC) has asked if there is a role for a learner handover (LH) within their licensing processes; however the intended purpose of an LH must first be determined
- A Canadian-based LH referred to as a Learner Education Handover (LEH) model including disclosure of student learning/disability accommodation needs, general health concerns, EDI/religious requirements, professionalism concerns, recommendations for special focus in residency of specific areas of medical knowledge/skill is described.
- Findings from beta and pilot testing support the value and feasibility of the LEH model
- Fundamental principles are outlined:
- LEH occurs post-residency match
- LEH should be forward facing; focused on ongoing or recurring learner issues and needs
- Learners must be included in the process
- Implementation would require participation by all Canadian medical schools and all learners
- Implementation challenges include:
- Ensuring learner safety following information disclosure
- Engaging UGME Deans
- Protection of information ensuring a ‘need-to-know’ status is maintained
- Incorporating the LEH into the licensing activity could enable the MCC to support a system that proactively responds to learner needs, optimizes physician performance and promotes safe, high quality patient care.
Metrics
References
Warm EJ, Englander R, Pereira A, Barach P. Improving learner handovers in medical education. Acad Med, 2017. 92(7): p. 927-931. https://doi.org/10.1097/acm.0000000000001457.
Mims LD, DeCastro AO, Kelly AG. Perspectives of family medicine clerkship directors regarding forward feeding: a CERA Study. Fam Med, 2017. 49(9): p. 699-705.
Pangaro L. "Forward feeding" about students' progress: more information will enable better policy. Acad Med, 2008. 83(9): p. 802-3. https://doi.org/10.1097/acm.0b013e318181d025.
Humphrey-Murto S, LeBlanc A, Touchie C, et al., The influence of prior performance information on ratings of current performance and implications for learner handover: a scoping review. Acad Med, 2019. 94(7): p. 1050-1057. https://doi.org/10.1097/acm.0000000000002731.
Sukhera J, Watling C. A framework for integrating implicit bias recognition into health professions education. Acad Med, 2018. 93(1): p. 35-40. HTTPS://DOI.ORG/10.1097/ACM.0000000000001819.
Espaillat A, Panna DK, Goede DL, Gurka MJ, Novak MA, Zaidi Z. An exploratory study on microaggressions in medical school: what are they and why should we care? Perspect Med Educ, 2019. 8(3): p. 143-151. https://doi.org/10.1007/s40037-019-0516-3.
Shaw T, Wood TJ, Touchie C, Pugh D, Humphrey-Murto SM. How biased are you? The effect of prior performance information on attending physician ratings and implications for learner handover. Adv Health Sci Educ Theory Pract, 2021. 26(1): p. 199-214. https://doi.org/10.1007/s10459-020-09979-6.
Sherbino J, Frank JR, Flynn L, Snell L. "Intrinsic roles" rather than "armour": renaming the "non-medical expert roles" of the CanMEDS framework to match their intent. Adv Health Sci Educ Theory Pract, 2011. 16(5): p. 695-7. https://doi.org/10.1007/s10459-011-9318-z.
Kassam A, Nickell L, Pethrick H, Mountjoy M, Topps M, Lorenzetti DL. Facilitating learner-centered transition to residency: a scoping review of programs aimed at intrinsic competencies. Teach Learn Med, 2021. 33(1): p. 10-20. https://doi.org/10.1080/10401334.2020.1789466.
Wancata LM, Morgan H, Sandhu G, Santen S, Hughes DT. Using the ACMGE milestones as a handover tool from medical school to surgery residency. J Surg Educ, 2017. 74(3): p. 519-529. https://doi.org/10.1016/j.jsurg.2016.10.016.
Sozener CB, Lypson ML, House JB, et al., Reporting achievement of medical student milestones to residency program directors: an educational handover. Acad Med, 2016. 91(5): p. 676-84. https://doi.org/10.1097/acm.0000000000000953.
Humphrey-Murto S, Lingard L, Varpio L, et al., Learner handover: who is it really for? Acad Med, 2021. 96(4): p. 592-598. https://doi.org/10.1097/acm.0000000000003842.
Kassam A, Nickell L, Bandiera G. The learner education handover – lessons learned from the beta-test. in Association of Medical Education of Europe (AMEE) Conference. 2019. Vienna, Austria.
Kassam A, Ruetalo M, Topps M, et al., Key stakeholder opinions for a national learner education handover. BMC Med Educ, 2019. 19(1): p. 150. https://doi.org/10.1186/s12909-019-1598-7.
Morgan HK, Mejicano GC, Skochelak S, et al., A responsible educational handover: improving communication to improve learning. Acad Med, 2020. 95(2): p. 194-199. https://doi.org/10.1097/acm.0000000000002915.
Kilminster S, Zukas M, Quinton N, Roberts T. Preparedness is not enough: understanding transitions as critically intensive learning periods. Med Educ, 2011. 45(10): p. 1006-15. https://doi.org/10.1111/j.1365-2923.2011.04048.x.
Hurst C, Kahan D, Ruetalo M, Edwards S. A year in transition: a qualitative study examining the trajectory of first year residents’ well-being. BMC medical education, 2013. 13(1): p. 1-9.
Busing N, Rosenfield J, Rungta K, et al., Smoothing the transition points in Canadian medical education. Acad Med, 2018. 93(5): p. 715-721. https://doi.org/10.1097/acm.0000000000002072.
Association of Faculties of Medicine of Canada (AFMC).
The future of medical education in Canada (FMEC): a collective vision for MD education. 2010.
Kulasegaram K, Hynes M, Bandiera G, Houston P. The current utility and future use of the medical student performance record: a survey of perceptions across Canada. Can Med Educ J, 2020. 11(3): p. e111-e115. https://doi.org/10.36834/cmej.69332.
Snell L, Frank JR, Sherbino J. CanMEDS 2015 physician competency framework. 2015: Royal College of Physicians & Surgeons of Canada.
Englander R, Carraccio C. From theory to practice: making entrustable professional activities come to life in the context of milestones. Acad Med, 2014. 89(10): p. 1321-3. https://doi.org/10.1097/acm.0000000000000324.
Tekian A, Ten Cate O, Holmboe E, Roberts T, Norcini J. Entrustment decisions: implications for curriculum development and assessment. Med Teach, 2020. 42(6): p. 698-704. https://doi.org/10.1080/0142159x.2020.1733506.
Ten Cate O, Competency-based postgraduate medical education: past, present and future. GMS J Med Educ, 2017. 34(5): p. doc69. https://doi.org/10.3205/zma001146.
Chen HC, van den Broek WE, ten Cate O. The case for use of entrustable professional activities in undergraduate medical education. Acad Med, 2015. 90(4): p. 431-6. https://doi.org/10.1097/acm.0000000000000586.
Veale P, Busche K, Touchie C, Coderre S, McLaughlin K. Choosing our own pathway to competency-based undergraduate medical education. Acad Med, 2019. 94(1): p. 25-30. https://doi.org/10.1097/acm.0000000000002410.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Leslie Nickell, Aliya Kassam, Glen Bandiera
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Submission of an original manuscript to the Canadian Medical Education Journal will be taken to mean that it represents original work not previously published, that it is not being considered elsewhere for publication. If accepted for publication, it will be published online and it will not be published elsewhere in the same form, for commercial purposes, in any language, without the consent of the publisher.
Authors who publish in the Canadian Medical Education Journal agree to release their articles under the Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 Canada Licence. This licence allows anyone to copy and distribute the article for non-commercial purposes provided that appropriate attribution is given. For details of the rights an author grants users of their work, please see the licence summary and the full licence.