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A guest post from Dr. Kelly Caverzagie

 

Kelly Caverzagie

Dr. Kelly Caverzagie

When people ask why I attend ICRE every year, the answer is simple.  ICRE tackles the “big” topics in medical education.  The problems that confront us as a global community.  At ICRE, I am able to learn from friends and colleagues worldwide who are working on these issues and I learn new ways to address these problems at my own institution. 

By comparison, most conferences that I attend dedicate significant energy to update attendees about the latest regulatory changes or clinical updates about a disease or condition.  While they certainly have their place in education, these conferences don’t help me to advance my thinking or explore new solutions.  ICRE helps me to do the things that I want to do, as opposed to the things that I need to do.

At ICRE, the conference themes are fresh, timely and important. The conference pushes the envelope and helps the worldwide community actively advance a collective agenda as opposed to listen passively so that we can “check all of the boxes.”  In short, ICRE, with its diverse perspectives and viewpoints demands that attendees engage.

Recent conference themes have included the implementation of competency-based medical education, improving the clinical learning environment and our current meeting which focuses on promoting diversity and inclusivity in residency education and beyond.  Each is a frequent topic of discussion at the University of Nebraska Medical Center and I suspect the same can be said at your program or institution as well.

What makes ICRE so unique is its international flavor where attendees come from across the globe to contribute to the conversation.  In fact, the last five years have seen an average of 33 countries represented, a number that is certainly expected to continue to grow.  I’ve spoken with many of these attendees and they are very happy that they have chosen to attend.  They commend how ICRE provides an opportunity to think, engage, network with kindred spirits and most importantly, take steps to solving the “big” problems of medical education.

I strongly encourage you to attend ICRE 2019.   See you in Ottawa!

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2018-10-18-ICRE-033The Postgraduate Medical Education (PGME) learning environment is a complex concept with many facets to consider in its critical exploration. Most interestingly, what differentiates this learning environment from others is the dually present, both synergistic and antagonistic relationship of the working and learning environments. Increased strains on healthcare systems, ever-increasing bodies of knowledge and procedural skills, and greater emphasis upon patient safety, bring the need to optimize the PGME learning environment to the forefront.

Despite being such a rich and complex topic for discussion, the PGME learning environment has been slow to emerge in the medical education academic literature – in particular, there is lack of evidence on how we may improve our learning environments to optimize outcomes for learners, teachers and, most importantly, patients.

The ICRE 2018 conference took a focused and critical look at the PGME learning environment through a variety of lenses and forums. In the two days prior to ICRE proper, the Royal College hosted an international consensus conference on the learning environment. The goals included to more clearly:

  • define and explore the learning environment;
  • capture some practical tips for optimizing the learning environment based on available evidence and informal consensus;
  • identify specific gaps in the current body of literature.

We were thrilled to host a group of MedEd enthusiasts from a variety of backgrounds and countries including ‘on-the-ground’ medical educators, local and national medical education leaders, postgraduate deans and training college representatives.

Prior to the meeting, a group of medical education experts, through a review of literature and informal consensus, developed the ‘avenue framework’ to approach the complex construct of the learning environment in postgraduate medical education (Fig. 1). The consensus conference program was then structured upon this framework as participants worked through large and small group sessions where theory and practical experiences were shared and discussed.

Consensus Conference

Figure 1: The Avenues Framework to approach the learning environment (Nordquist et al. 2019).

Ultimately, we had very fruitful and inspiring discussions that served as springboards for new ideas and research avenues. A set of consensus papers, including an editorial and a commentary piece, were developed based upon the work leading up to the conference and in-conference discussions, and published in a special edition of Medical Teacher this spring. These papers capture the themes of the discussions from the conference – and we hope they will provoke deeper thought and understanding into this important aspect of training that we are only just beginning to grasp. We also hope that the Avenues Framework provides a platform for future exploration and research. Links to each of the articles are included below for your review. We hope you enjoy the read!

2018_ICRE_ChiefResident_Hall_PhotoBy Dr. Jena Hall

on behalf of the consensus conference executive organizing committee

Dr. Jena Hall MD, MEd

Returning ICRE Chief Resident 2019

PGY3 OBGYN, Queen’s University

Published online:

Introductory Editorial: The clinical learning environment

The education avenue of the clinical learning environment: A pragmatic approach

Inclusion in the clinical learning environment: Building the conditions for diverse human flourishing

Learning and professional acculturation through work: Examining the clinical learning environment through the sociocultural lens

Psychology and learning: The role of the clinical learning environment

Examining the clinical learning environment through the architectural avenue

Communication, learning and assessment: Exploring the dimensions of the digital learning environment

Commentary by Dr. Larry Gruppen: Context and complexity in the clinical learning environment

Reference (Fig 1):

Jonas Nordquist, Jena Hall, Kelly Caverzagie, Linda Snell, Ming-Ka Chan, Brent Thoma, Saleem Razack & Ingrid Philibert (2019) The clinical learning environment, Medical Teacher, DOI: 10.1080/0142159X. 2019.1566601

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Perspective from two Resident Survival Stories  Panelists

Resident Survival Stories

From left to right: Drs. Justin Jek-Kahn Koh, Elizabeth Hendren, Damon Dagnone and Adelle Roberta Atkinson.

The current learning environment for residents can be stressful, even if you are able bodied and experience no significant hardship.

On top of that, we know that virtually all physicians will experience significant life stressors during training or in their early career, and about 15-30% of residents will go through this in any given year (Hu, 2012)1.

The impact of illness and personal crisis can have profound effects on physician well-being, burn out and eventual practice patterns. This may in part explain why by the end of residency training, residents experience higher levels of psychological distress than the overall population. Even though so many residents experience personal crisis in some shape or another during residency (whether through personal health issues, mental health or through grief and loss), we rarely talk about it. This is what Resident Survival Stories is all about. It is the start of a conversation, an opportunity to acknowledge what so many will experience, done through the use of narrative.

As people who have done it, we know that applying to the Resident Survival Stories panel can be a lesson in vulnerability. It is not just the disclosure of your personal narrative that makes you feel this way, but also the thought that your experience may not be enough. However, with vulnerability comes courage and strength. The process of reflecting on the darker moments you have experienced in your medical career is inherently thought provoking and rewarding.

Your story will be a catalyst for cultural change. Program directors and administrators are in the room and you can share what has helped and hindered your journey. The lessons you have learnt in overcoming adversity can help others avoid the same mistakes that you did.
Survival should not be the main goal of residency. But we know that it is a necessary step towards thriving.

Click here to submit your survival story. The deadline is May 20, 2019.

1. Hu, Y.-Y. Physicians’ Needs in Coping With Emotional Stressors. Arch Surg 147, 212–6 (2012).

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New Video Contest

#IAmResidencyEducation : A WorldWide Celebration of Diversity in Residency Education

Video contest banner _ engAre you a resident/trainee, medical educator or healthcare professional? Don’t miss this unique chance to attend the 2020 International Conference on Residency Education (ICRE), in Vancouver, Canada.

ICRE is the world’s largest conference devoted exclusively to advancing residency education. Each year, ICRE brings together more than 1,500 clinical educators and physicians from around the world to share ideas, challenges, innovations, and advance training.

To highlight this year’s theme, Diversity in Residency Education: Training in a World of Differences, ICRE has launched a video contest to celebrate diversity in residency education in all its forms.

Eligibility
To be eligible, you are required to submit a short video (15 seconds or less) of yourself in which you:

  • state your name, your profession and the name of your country in English or French;
  • end your video with the contest’s hashtag: “I Am Residency Education” in a language of your choice.

Submission
To submit your video, include the contest’s hashtags: #IAmResidencyEducation and #ICRE2019 in your post and share it on your social media account (Twitter or Instagram).

If you don’t have a social media account, click here to upload your video.

Prize value
The winner will earn one (1) complimentary registration to ICRE 2020. The conference will be held September 24-26 in Vancouver, Canada.

This contest is open till August 23, 2019.

Download the complete set of contest rules and guidelines here.

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Resident Survival Stories

Life and residency can, at times, be a real struggle

Here is Dr. Simon Fleming’s Resident Survival Story

2017-icre-friday-027

Dr. Simon Fleming

I don’t know about you, but I quite like my job. I like fixing people, I like talking (a lot), I like working with tools and my hands (yes, I am an orthopaedic resident/trainee), I like training and teaching, and generally I like the world of healthcare.

However, there are also bits of my job that I don’t like. From the mundane such as, chasing assessments and filling out forms, to the traumatic and awful things that keep you awake at night, or pop into your brain while you’re randomly watching a film.

 

Sometimes, it’s nothing to do with the job itself. It’s just that the job is, in and of itself, traumatic. Death, loss, grieving, difficult decisions and mistakes (not just the making of mistakes, which I do a lot of, but the consequences and having to admit them and, and, and…). On top of the job, life happens: friends argue, relationship struggles, personal health deteriorates, loved ones get sick or die and, sometimes, the universe just decides to chuck it all at you at once.

And yet, we are still here. We cope, we show grit and we keep putting one foot in front of the other. I know why I am still here. How I coped. Who I had to thank and who I will never be able to thank enough (won’t stop me from trying though). Sure, most of the time, I personally store my trauma memories ‘neatly’, away in boxes, so they don’t “pop out”. But I also recognise that sometimes, both for me and for others, it’s important to share. To show that I was vulnerable, or hurting or struggling and how I got through it. Sometimes, to show how I’m not quite through it yet.

Residents and attendings (we were all residents once) – there are still people out there, in our community, who feel helpless, incompetent, or controlled by their fear. If you have a story you want to share, in a safe and supportive environment, whether it’s to help yourself, to help others or just because you want to be heard, please, submit your story to icre@royalcollege.ca

Deadline for submissions is May 20, 2019.

Click here to access the submission site.


 

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Dr. Quinn CapersThe ICRE planning committee is pleased to announce Dr. Quinn Capers, as the ICRE 2019 closing plenary lecturer.

Dr. Quinn Capers, IV is an interventional cardiologist, medical educator, and Associate Dean for admissions in The Ohio State University College of Medicine.

His physician peers have voted him one of America’s “Best Doctors” annually from 2009 to 2017.

Serving as Associate Dean for Admissions in the College of Medicine since 2009, Dr. Capers has led the admissions team to achieve the following:

  • a 44% increase in total applications;
  • an increase in women matriculates such that women have outnumbered men in the last four entering classes;
  • an increase in the percentage of underrepresented minority (URM) students in the entering class from 13% to 26%;
  • and an increase in the average MCAT score of the entering class to the 94th percentile.

He has published several articles on interventional cardiology procedures, healthcare disparities, and diversity enhancement in medicine. His latest study is the first to document the presence and extent of unconscious racial bias in medical school admissions.

Dr. Capers graduated with honors from Howard University before obtaining his MD from The Ohio State University. He completed his residency in internal medicine and fellowships in vascular biology research, cardiovascular medicine, and interventional cardiology all at Emory University in Atlanta.

We look forward to having Dr. Capers close this year’s conference in Ottawa!

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Richardson_LisaThe ICRE planning committee is thrilled to announce Dr. Lisa Richardson, as the ICRE 2019 opening plenary lecturer.

Dr. Richardson is a clinician educator in the University of Toronto’s Division of General Internal Medicine, and practices at the University Health Network. Her academic interest lies in the integration of critical and Indigenous perspectives into medical education.

She holds the roles of Strategic Advisor in Indigenous Health for the University of Toronto’s Faculty of Medicine and is also the Indigenous Strategy Lead for Women’s College Hospital. She co-leads a new portfolio for the Department of Medicine called Person-Centered Care Education.

Dr. Richardson chairs several provincial and national committees to advance Indigenous medical education, and has been honoured with the Royal College of Physicians and Surgeons’ Thomas Dignan Award for Indigenous Health.

We look forward to having Dr. Richardson open this year’s conference in Ottawa!

Stay tuned for more conference programming announcements and details on Dr. Richardson’s lecture.

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