Canadian Medical Education Journal
https://journalhosting.ucalgary.ca/index.php/cmej
<p>Welcome to the Canadian Medical Education Journal (CMEJ) that publishes scientific and scholarly work in medical education.</p>Canadian Medical Education Journalen-USCanadian Medical Education Journal1923-1202<p>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 If accepted for publication, it will be published online and it will not be published elsewhere in the same form, for commercial purposes, in any language, without the consent of the publisher.<br /><br />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 <a title="Creative Commons license summary" href="https://creativecommons.org/licenses/by-nc-nd/4.0/" target="_blank" rel="noopener"><span style="color: #aa0000;">licence summary</span></a> and the <a title="Creative Commons full license" href="https://creativecommons.org/licenses/by-nc-nd/4.0/" target="_blank" rel="noopener"><span style="color: #aa0000;">full licence</span></a>.</p>Five ways to get a grip on teaching advocacy in medical education: the health humanities as a novel approach
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/75274
<p><span style="font-weight: 400;">The advocate role is recognized as an intrinsic medical competency. Despite recent attention to pedagogical approaches, it is a role that remains poorly understood and difficult to teach. At the same time there is a growing body of evidence showing the necessity of incorporating humanities-based education into medical curricula. Here, we present five ways to use the humanities as a tool for teaching the advocate role including: decentring the physician as expert, fostering provider engagement, allowing for flexibility, making the humanities mandatory and normalizing narrative tools in education and practice.</span></p>Arundhati DharaSarah Fraser
Copyright (c) 2023 Arundhati Dhara, Sarah Fraser
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2024-02-062024-02-06151757710.36834/cmej.75274Exploring the experiences of Canadian medical students with a background in the arts and humanities
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/77005
<p><strong>Background: </strong>Arts and Humanities (A/H) training is a powerful strategy to help medical students develop key competencies which align with the CanMEDS roles that Canadian physicians are expected to embody. Students with backgrounds in A/H may enter medical school with the skills and dispositions that A/H training provides. This paper explores the varied experiences of medical students with prior A/H backgrounds, with an emphasis on how they navigate relationships with their student cohorts and participate in undergraduate medical training environments.</p> <p><strong>Methods:</strong> Descriptive qualitative research methodology was used to conduct and analyze semi-structured interviews exploring the perspectives of Canadian medical students with either a A/H degree or training in A/H (<em>n = </em>13). Domains such as identity, integration of interests, and challenges in maintaining A/H interests during medical training were explored.</p> <p><strong>Results:</strong> Participants described their A/H identity as intertwined with their identity as medical trainees and described their sense of interconnection between the disciplines. Challenges included imposter syndrome and difficulties in relating with peers from science backgrounds. Participants described returning to their A/H interests as a tool for wellness amidst medical training.</p> <p><strong>Conclusions:</strong> Medical students with a background in A/H training describe this background as offering both affordances and challenges for their sense of identity, belonging, and wellness. These students offer an untapped resource: they come with dispositions of value to medicine, and they perceive a positive, hidden A/H curriculum that supports their maintenance of these dispositions during training. Understanding more about these hidden treasures could help foster the development of well-rounded and humanistic physicians in the entire medical class.</p>Khadija AhmedArjun PatelLorelei Lingard
Copyright (c) 2023 Khadija Ahmed, Arjun Patel, Lorelei Lingard
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2023-10-052023-10-0515161410.36834/cmej.77005The hidden curriculum across medical disciplines: an examination of scope, impact, and context
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/75207
<p><strong>Background: </strong>While research suggests that manifestations of the hidden curriculum (HC) phenomenon have the potential to reinforce or undermine the values of an institution, very few studies have comprehensively measured its scope, impact, and the varied clinical teaching and learning contexts within which they occur. We explored the HC and examined the validity of newly developed constructs and determined the influence of context on the HC.</p> <p><strong>Methods: </strong>We surveyed medical students (<em>n</em> =182), residents (<em>n </em>=148), and faculty (<em>n</em> = 140) from all disciplines at our institution between 2019 and 2020. Based on prior research and expertise, we measured participants’ experience with the HC including perceptions of respect and disrespect for different medical disciplines, settings in which the HC is experienced, impact of the HC, personal actions, efficacy, and their institutional perceptions. We examined the factor structure, reliability, and validity of the HC constructs using exploratory factor analysis Cronbach’s alpha, regression analysis and Pearson’s correlations.</p> <p><strong>Results</strong>: Expert judges (physician faculty and medical learners) confirmed the content validity of the items used and the analysis revealed new HC constructs reflecting <em>negative expressions, positive impacts and expressions, negative impacts, personal actions, </em>and<em> positive institutional perceptions of the HC</em>. Evidence for criterion validity was found for <em>the negative impacts</em> and the <em>personal actions</em> constructs and were significantly associated with the stage of respondents’ career and gender. Support for convergent validity was obtained for HC constructs that were significantly correlated with certain contexts within which the HC occurs.</p> <p><strong>Conclusion</strong>: More unique dimensions and contexts of the HC exist than have been previously documented. The findings demonstrate that specific clinical contexts can be targeted to improve negative expressions and impacts of the HC.</p>Karen SchultzNicholas CofieHeather BraundMala JonejaShayna WatsonJohn DroverLaura MacMillan-JonesNancy Dalgarno
Copyright (c) 2023 Karen Schultz, Nicholas Cofie, Heather Braund, Mala Joneja, Shayna Watson, John Drover, Laura MacMillan-Jones, Nancy Dalgarno
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2023-06-212023-06-21151152510.36834/cmej.75207The CanMEDS Competency Framework in laboratory medicine: a phenomenographic study exploring how professional roles are applied outside the clinical environment
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/77140
<p><strong>Background: </strong>The CanMEDS Competency Framework is an internationally recognized model used to outline the proficiencies of a physician. It has predominantly been studied in clinical environments but not all medical specialties take part in direct patient contact. In laboratory medicine, the role of the physician is to promote and enhance patient diagnostics by managing and overseeing the functions of a diagnostic laboratory.</p> <p><strong>Methods:</strong> This phenomenographic study explores the lived experiences of biochemistry, microbiology, and pathology residency program directors to better understand how they utilize the CanMEDS competencies. Eight laboratory medicine program directors from across Canada were individually interviewed using a semi-structured interview, and the data was analysed using inductive thematic analysis.</p> <p><strong>Results:</strong> The findings show that the current framework is disconnected from the unique context of laboratory medicine with some competencies appearing unrelatable using the current standardized definitions and expectations. Nevertheless, participants considered the framework to be an appropriate blueprint of the competencies necessary for their professional environment, but to make it accessible more autonomy is required to adapt the framework to their needs.</p> <p><strong>Conclusion:</strong> Newer renditions of the CanMEDS Competency Framework should better consider the realities of non-clinical disciplines.</p>Chloe BogatyJanneke Frambach
Copyright (c) 2023 Chloe Bogaty, Janneke Frambach
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2023-12-112023-12-11151263610.36834/cmej.77140Medical escape games: experimenting with a new teaching method
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/77290
<p><strong>Implication Statement</strong></p> <p>With escape games gaining in popularity, we decided to adapt the concept of an existing medical escape game to the needs of our family medicine residents, by simulating clinical situations and creating puzzles with medical content. This activity was a fun way to integrate theoretical learning while developing a number of CanMEDS roles. Overall, the residents were very satisfied with the topics chosen and the interactive aspect of the experience. This escape game requires few resources, is adaptable to different environments and can be adjusted according to students' needs.</p>Pauline LaroucheKevin SweeneyJudith Lajeunesse
Copyright (c) 2023 Pauline Larouche, Kevin Sweeney, Judith Lajeunesse
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2023-09-122023-09-12151787910.36834/cmej.77290A practical model of faculty development in medical education: make it accessible, versatile, and easy to use!
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/77076
<p><strong>Implication Statement</strong></p> <p>Faculty development programs should provide transformative resources and prioritize the unique needs of faculty. However, if faculty members face difficulty in accessing these programs, the potential impact of the valuable resources may be limited. To alleviate this issue, we designed a faculty development program that is available to anyone at any time and in any configuration. By allowing faculty to choose from a diverse range of medical education topics, they may promptly apply crucial concepts in their teaching and education leadership roles. This program allows faculty members to engage in personalized professional development, enhance their teaching practices, and foster professional growth. Also, program coordinators and administrators can seamlessly integrate our resources into their existing faculty development program. These resources can serve as self-study materials, supplements for existing programs, or a stand-alone curriculum with high accessibility, versatility, and ease of use.</p>Henry MoonMarcel D'Eon
Copyright (c) 2023 Henry Moon, Marcel D'Eon
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2023-09-252023-09-25151808210.36834/cmej.77076A multilingual sexual and reproductive health animation: a novel educational tool for newcomer patients
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/77475
<p><strong>Implication Statement</strong></p> <p>Newcomer populations face many barriers accessing healthcare, including language barriers. Language-concordant care has been shown to enhance equity and optimize health outcomes for underserved populations. This paper describes a sexual and reproductive health (SRH) animation for newcomer populations. The animation was created collaboratively by the Department of Obstetrics and Gynaecology Global Health Unit, the Halifax Newcomer Health Clinic, and student volunteers. Integrating this animation into other healthcare settings may help improve inclusion, trust, and patient-centred care for newcomer patients. Institutions may also consider creating further SRH animations based on the needs of the patients they serve.</p>Aditi SivakumarKarla WillowsSepideh BehroozanJocelyn Stairs
Copyright (c) 2023 Aditi Sivakumar, Karla Willows, Sepideh Behroozan, Jocelyn Stairs
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2023-12-272023-12-27151838510.36834/cmej.77475Perspectives on a virtual student-led research conference in ophthalmology
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/77019
<p><strong>Implication Statement</strong></p> <p>We share our experience of organizing a one-day virtual educational event, the first Canadian national student ophthalmology conference, in response to the need for ophthalmology career exploration. The conference included mentorship with residents, research presentations, keynote speakers, and more. Following the event, students expressed some improvement in accessing ophthalmology mentorship and research opportunities, along with a modest enhancement in their understanding of the specialty. We provide insights into the organizational framework and quality improvement results, aiming to assist students in adapting similar events for various specialities.</p>Daiana R PurAndrew SamuelAmirthan SothivannanStuti M TanyaAnne X Nguyen
Copyright (c) 2023 Daiana R Pur, Andrew Samuel, Amirthan Sothivannan, Stuti M Tanya, Anne X Nguyen
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2023-10-022023-10-02151868810.36834/cmej.77019Responses to “On the advantages and disadvantages of virtual continuing medical education: a scoping review”
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/77943
Filipe Prazeres
Copyright (c) 2023 Filipe Prazeres
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2024-01-182024-01-18151999910.36834/cmej.77943A few comments on “let food be thy knowledge gap: the lack of nutrition education in medical curricula”
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/78784
Adam Neufeld
Copyright (c) 2023 Adam Neufeld
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2024-01-252024-01-2515110010110.36834/cmej.78784The impact of the medical school admissions interview: a systematic review
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/76138
<p><strong>Background: </strong>Interviews are considered an important part of the medical school admissions process but have been critiqued based on bias and reliability concerns since the 1950s. To determine the impact of the interview, this systematic review investigated the characteristics and outcomes of medical students admitted with and without interviews.</p> <p><strong>Methods: </strong>We searched four literature databases from inception through August 2022; all studies comparing medical students admitted with and without interviews were included. We excluded studies from outside the medical school setting and non-research reports. We reviewed interview type, study design, quality, and outcomes.</p> <p><strong>Results: </strong>Eight studies from five institutions across five countries were included. Six reported no demographic differences between students admitted with and without interviews; one found that more men were admitted without than with semi-structured interviews, and both cohorts had similar academic and clinical performance. Structured interviews admitted students who scored higher on clinical exams and social competence and lower on academic exams. Cohorts admitted with and without structured interviews had similar mental health issues by their final year of medical school.</p> <p><strong>Discussion: </strong>This review suggests that students admitted with and without unstructured and semi-structured interviews were similar demographically, academically, and clinically. Moreover, structured interviews selected more socially competent students who performed better clinically but worse academically. Further research is needed to determine the impact of the selection interview in medical school admissions.</p>John C LinChristopher ShinPaul B Greenberg
Copyright (c) 2023 John C Lin, Christopher Shin, Paul B Greenberg
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2024-01-042024-01-04151687410.36834/cmej.76138Apple Vision Pro and the advancement of medical education with extended reality
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/77634
Ethan WaisbergJoshua OngMouayad MasalkhiNasif ZamanPrithul SarkerAndrew G LeeAlireza Tavakkoli
Copyright (c) 2023 Ethan Waisberg, Joshua Ong, Mouayad Masalkhi, Nasif Zaman, Prithul Sarker, Andrew G Lee, Alireza Tavakkoli
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2023-08-222023-08-22151899010.36834/cmej.77634The utility of the MD extension program in Canadian medical education
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/77791
Sunil RupareliaDavid-Dan NguyenAnne X Nguyen
Copyright (c) 2023 Sunil Ruparelia, David-Dan Nguyen, Anne X Nguyen
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2023-12-192023-12-19151919210.36834/cmej.77791COVID-19 lessons learned: public health research should be integrated into medical school curricula
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/77594
Ponn P MahayosnandSamiha AhmedDiana Mora BermejoZM Sabra
Copyright (c) 2023 Ponn P Mahayosnand, Samiha Ahmed, Diana Mora Bermejo, ZM Sabra
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2024-02-162024-02-16151939410.36834/cmej.77594Dismantling discrimination through education
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/77999
Khaled Moustafa
Copyright (c) 2023 Khaled Moustafa
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2023-12-082023-12-08151959810.36834/cmej.77999Medical students’ perceptions on preparedness and care delivery for patients with autism or intellectual disability
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/76338
<p><strong>Introduction</strong>: To provide competent care to patients with autism spectrum disorder (ASD) or intellectual developmental disorder (IDD), healthcare professionals must recognize the needs of neurodivergent populations and adapt their clinical approach. We assessed the perceived preparedness of medical students to adapt care delivery for patients with ASD/IDD, as well as their perceptions on neurodiversity education.</p> <p><strong>Methods</strong>: We conducted a sequential explanatory mixed-methods study on undergraduate medical students at McGill University during the academic year 2020-2021. We administered an online survey, followed by semi-structured interviews. We analyzed data using descriptive statistics and thematic analysis. We integrated findings at the interpretation level.</p> <p><strong>Results</strong>: We included two-hundred-ten survey responses (~29% of class), and 12 interviews. Few students felt prepared to adjust care for patients with ASD/IDD despite most indicating doing so was important. Ninety-seven percent desired more training regarding care accommodation for neurodivergent patients. Thematic analysis unveiled the perception of current insufficient education, and the value of experiential learning.</p> <p><strong>Discussion/Conclusions</strong>: This study highlights low perceived preparedness of medical students to accommodate care for neurodivergent patients, and a desire for more instruction. Incorporating interactive training in medical school curricula regarding modifying care delivery for neurodivergent individuals may improve the perceived preparedness of medical trainees to work with these patients and care quality.</p>E BitektineMA HintermayerA ChenA KoC Rodriguez
Copyright (c) 2023 E Bitektine, MA Hintermayer, A Chen, A Ko, C Rodriguez
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2024-01-182024-01-18151374710.36834/cmej.76338A survey of undergraduate medical students’ knowledge and attitudes about gender bias: the Newfoundland and Labrador perspective
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/75919
<p><strong>Background: </strong>Female physicians and patients experience gender bias in healthcare. The purpose of this research is to explore medical students’ gender bias toward physicians and patients and whether their bias varies by gender.</p> <p><strong>Methods:</strong> We surveyed medical students at Memorial University between November 2020 and April 2021. We recruited participants through Facebook, email, and e-posters. We collected demographic information, including gender and class year. We used the Nijmegen Gender Awareness in Medicine Scale to measure gender sensitivity, gender role ideology toward patients, and gender role ideology toward doctors. We analyzed the data using averages and t-tests.</p> <p><strong>Results:</strong> Mean gender sensitivity scores were 4/5 indicating high gender sensitivity. Gender role ideology toward doctors mean scores were 2/5 indicating that students did not hold strong stereotypical views toward doctors. Although male students scored higher than female students (p<.05), mean scores for gender role ideology toward patients were low for both male and female students (x̄<2), indicating low stereotyping toward patients.</p> <p><strong>Conclusions: </strong>We found that students held largely non-biased ideologies surrounding gender in medicine and that female students were even less biased than male students for gender role ideology toward patients.</p>Erika MaxwellGillian SheppardYanqing Yi
Copyright (c) 2023 Erika Maxwell, Gillian Sheppard, Yanqing Yi
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2024-01-302024-01-30151485510.36834/cmej.75919Extending social accountability mandates to biomedical research in Canadian faculties of medicine
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/75425
<p><strong>Background: </strong>Social accountability (SA), as defined by Boelen and Heck, is the obligation of medical schools to address the needs of communities through education, research and service activities. While SA is embedded within health profession education frameworks in medicine, they are rarely taught within graduate-level (MSc/PhD) education.</p> <p><strong>Methods:</strong> As these programs train future medical researchers, we invited first-year graduate students enrolled in a mandatory professionalism class at our institution (<em>n</em> = 111) to complete a survey on their perceptions of the importance of SA in their research, training, and future careers.</p> <p><strong>Results: </strong>Over 80% (<em>n</em> = 87) of respondents agreed that SA is relevant and felt committed to integrating it into their future research activities, only a limited number of students felt confident and/or supported in their abilities to integrate SA into their research.</p> <p><strong>Conclusions:</strong> Specific SA training in graduate education is necessary for students to effectively incorporate elements of SA into their research, and as such support the SA mandates of their training institutions. We posit that awareness of SA principles formalizes the professional standards for biomedical researchers and is thus foundational for developing a professionalism curriculum in graduate education programs in medicine. We propose an expansion of the World Health Organization (WHO) <em>partnership pentagon</em> to include partners within the research ecosystem (funding partners, certification bodies) that collaborate with biomedical researchers to make research socially accountable.</p>Nadine Wiper-BergeronHolly L AdamKaylee EadyKatherine A MoreauChristopher RJ KennedyClaire E Kendall
Copyright (c) 2023 Nadine Wiper-Bergeron, Holly L Adam, Kaylee Eady, Katherine A Moreau, Christopher RJ Kennedy, Claire E Kendall
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2024-01-312024-01-31151566110.36834/cmej.75425Trends in ophthalmology applicants going unmatched in the Canadian Resident Matching Service
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/77287
<p><strong>Background: </strong>Applicants to ophthalmology have high rates of going unmatched during the CaRMS process, but how this compares to other competitive or surgical specialties remains unclear. Our research aims to examine this phenomenon by identifying trends and comparing match data with other specialties, to identify disparities that may inform the need for future interventions to improve the match process for applicants.</p> <p><strong>Methods</strong>: We used a cross-sectional analysis of data provided by CaRMS on the residency match from 2013 to 2022.</p> <p><strong>Results</strong>: We obtained data from 608 ophthalmology, 5,153 surgery, and 3,092 top five (most competitive) specialty first choice applicants from 2013-2022. Ophthalmology applicants were more likely to go unmatched (18.9% [120/608]) than applicants to the top five (11.9% [371/3,092]) and surgical (13.5% [702/5,153]) specialties (p<0.001) and were twice as likely to rank no alternate disciplines (31.8%, <em>p</em> < 0.001) over the study period. In the first iteration, when alternate disciplines were ranked, the match rate to alternate disciplines was highest for ophthalmology applicants (0.41, <em>p</em> < 0.001). The majority (57.8%) of unmatched ophthalmology applicants do not participate in the second iteration.</p> <p><strong>Conclusion</strong>: Compared to other competitive specialties, first choice ophthalmology applicants were more likely to go unmatched, rank no alternate disciplines, and choose not to participate in the second iteration. Ophthalmology applicant behaviours should be further studied to help explain these study findings.</p>Mostafa BondokMohamed S BondokChristine LawNawaaz NathooKarim F Damji
Copyright (c) 2023 Mostafa Bondok, Mohamed S Bondok, Christine Law, Nawaaz Nathoo, Karim F Damji
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2023-11-012023-11-01151626710.36834/cmej.77287The medical school curriculum is not designed for long-term retention: we should stop being alarmed when our learners forget
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/79004
Marcel F D'Eon
Copyright (c) 2024 Marcel F D'Eon
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2024-02-292024-02-291511510.36834/cmej.79004From curiosity to cure
https://journalhosting.ucalgary.ca/index.php/cmej/article/view/78189
Antonio Yaghy
Copyright (c) 2023 Antonio Yaghy
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2023-11-272023-11-2715110210310.36834/cmej.78189