Is there a role for a learner education handover as part of the Medical Council of Canada assessment and licensing process?

Authors

  • Leslie Nickell University of Toronto
  • Aliya Kassam University of Calgary
  • Glen Bandiera University of Toronto

DOI:

https://doi.org/10.36834/cmej.73844

Abstract

  • 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.

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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.

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Published

2022-03-16

How to Cite

1.
Nickell L, Kassam A, Bandiera G. Is there a role for a learner education handover as part of the Medical Council of Canada assessment and licensing process?. Can. Med. Ed. J [Internet]. 2022 Mar. 16 [cited 2024 Nov. 18];13(4):15-22. Available from: https://journalhosting.ucalgary.ca/index.php/cmej/article/view/73844

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Commissioned Scientific Reports