ICRE Top Research Abstracts

Editor's Note: The following are the Top Research in Residency Education abstracts selected by Journal of Graduate Medical and Royal College Physicians Surgeons Canada for 2021 International Conference on (ICRE).Introduction: Faculty assessment burden is an anticipated effect competency-based medical education (CBME), but what workload residents? Additional faculty deemed necessary, because purpose CBME to provide a learner-centered that supports development competent physicians surgeons. However, good intentions can have unintended effects. We need understand from perspective residents.Methods: This study investigates how theory translates practice operative perioperative postgraduate training programs Canada. project employs constructivist grounded develop explanatory, contextual models social practice. Nineteen residents 5 institutions participated through semi-structured interviews averaging 1 hour length. Questions explored resident experience implementation. Themes “disconnect” concerning self-regulated learning formative feedback were identified initially; subsequent these disconnects occurring method theoretical sampling. Two members research team independently coded data discussed relationships between concepts with other reach analytic consensus results constant comparison.Results: was strikingly consistent residents. Rather than being informed self-directed their learning, described driven manage acquisition entrustable professional activities (EPAs) way made progression stressful opaque. While personalities, phase implementation, local cultures played role mediating stress, generated more external drivers such as EPA standards technology interfaces.Conclusions: Resident well-being at risk unanticipated managing progression. offers critical insight into this operates it be mitigated.M. Ott, R. Pack, S. Cristancho, M. Chin, J. VanKoughnettWestern University, London, ON, CanadaIntroduction: Workplace-based (WBA) key strategy. Concomitantly our program's launch Competence Design, we developed new WBA, Anesthesia Clinical Encounter Assessment (ACEA), assess readiness independence (ie, entrustability) competencies essential patient care. aimed examine validity evidence ACEA during anesthesiology training.Methods: comprises 8-item global rating scale (GRS), checklist, overall rating, case details. extracted University Toronto anesthesia July 2017 January 2020. Validity sources based unified validity, including internal structure, relations variables, consequences.Results: analyzed 8536 assessments 137 completed 341 assessors. From generalizability analysis, 10 observations (2 each assessors) sufficient achieve reliability threshold 0.70 in-training evaluations. A mean GRS score 3.65 out provided optimal sensitivity (94%) specificity (91%) determining competency ROC analysis. Test-retest high (ICC = 0.81) matched within 14 days other. Mean scores differed significantly level (P < .0001) correlated highly (0.91, P .001). consistency (a 0.96) excellent.Conclusions: provides supporting assessing competence performing care its use training.A. Kealey1, F. Alam1, L. Bahrey2, C. Matava3, G. McCreath3, Walsh31Sunnybrook Health Sciences Centre, Toronto, Canada; 2Toronto General Hospital, 3Hospital Sick Children, Entrustment, central construct operationalized (EPAs). foundational many systems, has yet clarify supervisors form judgments when same both workplace- simulation-based settings. explore features report influencing entrustment decisions across settings.Methods: conducted interview-based, theory–informed involving gastroenterology Calgary. Supervisors separate resident's endoscopic polypectomy relevant specialty-specific EPA) performance workplace interviewed after encounter they Transcribed interview iteratively using comparison generate themes.Results: Based 20 supervisors, found participants: (1) held multiple meanings entrustment, participants; (2) expressed variability justified decisions, related narrative, numerical scoring; (3) certain criteria making “comfortably” (eg, task authenticity, task-related variability, opportunity trainee response unexpected events); (4) perceived relative freedom simulation make due absence real patient.Conclusions: participants spoke about defined variety ways. That appeared lead judged These observed rater idiosyncrasies suggest residency cannot assume equivalence different Furthermore, likely needs attend needing comfortably decisions.T. Jeyalingam1, Walsh1, W. Tavares1, Mylopoulos1, K. Hodwitz1, Liu2, Heitman2, Brydges11University 2University Calgary, AB, CanadaEditor's Racial diversity vital promoting culturally physicians. To help diversify applicant pool, schools actively recruit applicants underrepresented minority (URM) application streams. URM students acts marginalization throughout training, unclear matriculants streams peers. uses online discussion forums North America non-URM applicants.Methods: total 840 posts 13 threads Premed101 (Canadian) Student Doctor Network (American) analyzed. Participants forum included undergraduate students, school, current groups. Inductive content analysis used data-driven coding scheme which several common themes identified.Results: Despite appreciation benefits diverse workforce, engaged heated surrounding America. Our prominent perceptions admitted lower quality, there broken admissions process fear change, influence socioeconomic status underappreciated schools.Conclusions: Online novel platform admission identifies barriers enticing factors programs. Ultimately, highlight misconceptions against actionable measures should taken reduce streams.H. Barootes1, A. Cong-anh Huynh1, Maracle1, Istl2, P. Wang3, Kirpalani31Western 2Johns Hopkins Baltimore, MD, USA; 3London Competency-based strives address societal focus outcomes observable inform competence. remains challenging continues largely physicians' inferred presentations rather direct observation workplace. Seeking patients' perspectives fundamental could influential addition workplace-based methods. patients assessors deserves additional attention practices contribute decisions. involvement psychometric tools assessment.Methods: Guided Arskey O'Malley's framework scoping reviews, searched 3 databases (MEDLINE, PubMed, Embase) prior November 2019, updated 2020 February 2021. authors assessed records eligibility empirical studies all designs examined residents.Results: 821 41 having met criteria. range specialties represented study. Patients primarily ambulatory (22 41, 53.7%) inpatient (13 31.7%) One-third component broader approach multisource [360°] engagement [14 34.1%]). Communication Tool most instrument (9 22.0%) collect feedback. generally ratings comments behaviors communication skills who focused expertise.Conclusions: review suggests feasible may offer unique insights not captured or providers. How confirm advance judgements attainment uncertain understudied.C. Gonsalves1, Gupta1, T. Horsley2, Khalife1, Y. Park3, Riddle4, Tekian41University Ottawa, 2Royal Canada, 3Harvard School, Boston, MA, 4University Illinois Chicago, IL, USAIntroduction: Arising impacts historic ongoing colonialism, Indigenous Peoples medicine, accentuated obstetrics gynecology (OB/GYN) surgical specialties. In effort decolonize substantive equality Alberta OB/GYN program Admissions Pathway (IAP). abstract describes IAP evaluation goals self-identified students.Methods: allied faculty, residents, community members, Elders created IAP. Self-identified Canadian school invited participate electronic survey. Analysis descriptive statistics thematic open-ended questions.Results: second year. Applicants apply usual manner indicate letter intent. panel parallel interviews. Thirty-six responded Eighty-one percent felt would choice program, 75% choose option applying program. All thought positive impact delivery patients.Conclusions: An must accompanied robust effective, community-driven initiatives education. will improve ultimate goal increasing representation improving access safe care.K. Black, Felske-Durksen, Flood, Hyakutake, Kemble, Manniapik, H. McKennitt, B. Schroeder, RichUniversity Alberta, Edmonton, Patient death inevitability training. Subsequent distress, decreased empathy, worse been reported among debriefing space reflection, promotes supportive culture, infrequently occurs. Early trainees often feel underprepared death. ascertain death, opportunities, coping strategies employed McMaster University.Methods: Trainees various medicine rotation participate. Semi-structured circumstances, emotional responses, support, mechanisms, preparedness regarding experience. Interviews transcribed identify emerging theory.Results: At time submission, 18 recruited. Three main categorized: 1–patient circumstances; 2–personal impact; 3–trainee support. Pronouncing communicating families, unexpected/unknown deaths challenges. Feelings guilt, helplessness, regret, grief followed events, amplified lack debriefs. Perceived power imbalances staff trainees, appearing unprofessional contributed consequences, difficulties sleeping, intrusive thoughts, distancing deaths. Respondents universally Some aware supports, although none accessed services. experiences congruent effects psychological trauma, consistently normalized trainees.Conclusions: traumatic learners perpetuate loss changes practice, residual environment, themselves. Further needed better prepare phenomenon culture operate.W. Ye1, Griffin1, I. Sverdlichenko2, D. Brandt Vegas11McMaster Hamilton, Social Pediatrics newest Program Alberta. Evaluation involves written reflective assignment identifying assets disparities influenced health child encountered rotation. published papers writing exist area pediatrics determinants (SDoH) individual's health. question is: During rotation, exploring SDoH led residents' awareness own practice?Methods: Grounded methodology analyze 35 reflections had submitted them preceptor addition, telephone further perceptions. verbatim analysis.Results: interviews, guided open, axial, selective coding, revealed themes: bias, experiences, systemic challenges, community, (5) frustration/hopelessness, (6) “everyone doing best,” (7) advocacy. Interview reinforced challenges advocacy also apparent exposures populations locations, increased knowledge specific resources, health.Conclusions: emerged importance enhancing SDoH. reflection assignments follow-up highlighted fostering typically traditional clinical environments value physician development.K. Connors1, Rashid1, Walton1, Chan2, Islam11University British Columbia, Vancouver, BC,