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This paper presents perspectives and controversies surrounding the use of milestones to assess competency in outcomes-based medical education. Global perspectives (Canada, Europe, and the United States) and developments supporting their rationales are discussed. In Canada, there is a significant movement away from conceptualizing competency based on time, and a move toward demonstration of specific competencies. The success of this movement may require complex (rather than reductionist) milestones that reflect students' progression through complexity and context and a method to narrate their journey. European countries (United Kingdom, France, and Germany) have stressed the complexity associated with time and milestones for medical students to truly achieve competence. To meet the changing demands of medicine, they view time as actually providing students with knowledge and exposure to achieve various milestones. In the United States, milestones are based on sampling throughout professional development to initiate lifelong learning. However, the use of milestones may not imply overall competence (reductionism). Milestones must be developed alongside outcomes-based curriculum with use of faculty and competency committees. The perspectives outlined in this paper underscore emerging challenges for implementing outcomes-based medical education and call for new conceptualizations of competence. [ABSTRACT FROM AUTHOR]

Background: The recognition of medical professionalism as a complex social construct makes context, geographical location and culture important considerations in any discussion of professional behaviour. Medical students, medical educators and practitioners are now much more on the move globally, exposing them to cultural and social attitudes, values and beliefs that may differ from their own traditional perceptions of professionalism. Aims and Methods: This paper uses the model of the intercultural development continuum and the concept of 'cultural fit' to discuss what might transpire when a student, teacher or doctor is faced with a new cultural environment. Using our own experiences as medical educators working abroad and supported by evidence in the literature, we have developed four anecdotal scenarios to highlight some of the challenges that different cultural contexts bring to our current (Western) understanding of professionalism. Results and Conclusions: The scenarios highlight some of the potentially different regional and/or cultural perspectives and nuances of professional behaviours, attitudes or values that many of us either take for granted or find difficult, depending on our training and socio-cultural upbringing. With this paper, we hope to start a long overdue conversation about global professionalism amongst medical educators, identify potential areas for research and highlight a need for medical schools to embrace a 'global' approach to how professionalism is embedded in their curricula. [ABSTRACT FROM AUTHOR]

Rationale: Public health and preventive medicine (PHPM) has been recognized internationally as a physician specialty, but national parallels and differences exist between training contexts. This paper reviews PHPM training and employment in Canada, France, Italy, Japan, the United Kingdom, and the USA. Methods: Information gathered from relevant accreditation bodies and literature searches was used to create descriptive profiles of national training demographics and structure and a narrative outlining trends and challenges facing the specialty. Results: Notable similarities and differences exist between national contexts. Key themes were differences in training strategies and practice scope, specialty stakeholders, certification structure, and funding. Recognition challenges faced the specialty across all six countries. Other challenges included unclear competencies and training strategies and a need for PHPM specialists to highlight their role in combating population health threats. Additional differences existed between comparator countries on the structure of training, funding sources for training programs, availability of training posts, and linkages with other physician specialties. Conclusion: Highlighting these themes is a first step to fostering training collaborations between PHPM specialist physicians to augment transnational action on global public health challenges and also supports PHPM physician educators with innovative solutions from abroad that might address domestic specialty challenges. [ABSTRACT FROM AUTHOR]

Purpose: Changing the current geographical maldistribution of the medical workforce is important for global health. Research regarding programs that train doctors for work with disadvantaged, rural populations is needed. This paper explores one approach of remote supervision of registrars in isolated rural practice. Researching how learning occurs without on-site supervision may also reveal other key elements of postgraduate education. Methods: Thematic analysis of in-depth interviews exploring 11 respondents’ experiences of learning via remote supervision. Results: Remote supervision created distinctive learning environments. Respondents’ attributes interacted with external supports to influence whether and how their learning was promoted or impeded. Registrars with clinical and/or life experience, who were insightful and motivated to direct their learning, turned the challenges of isolated practice into opportunities that accelerated their professional development. Discussion: Remote supervision was not necessarily problematic but instead provided rich learning for doctors training in and for the context where they were needed. Registrars learnt through clinical responsibility for defined populations and longitudinal, supportive supervisory relationships. Responsibility and continuity may be as important as supervisory proximity for experienced registrars. [ABSTRACT FROM PUBLISHER]

Background: Needs assessment should be the starting point for curriculum development. In medical education, expert opinion and consensus methods are commonly employed. Aim: This paper showcases a more practice-grounded needs assessment approach. Methods: A mixed-methods approach, incorporating a national survey, practice audit, and expert consensus, was developed and piloted in thrombosis medicine; Phase 1: National survey of practicing consultants, Phase 2: Practice audit of consult service at a large academic centre and Phase 3: Focus group and modified Delphi techniques vetting Phase 1 and 2 findings. Results: Phase 1 provided information on active curricula, training and practice patterns of consultants, and volume and variety of thrombosis consults. Phase 2's practice audit provided empirical data on the characteristics of thrombosis consults and their associated learning issues. Phase 3 generated consensus on a final curricular topic list and explored issues regarding curriculum delivery and accreditation. Conclusions: This approach offered a means of validating expert and consensus derived curricular content by incorporating a novel practice audit. By using this approach we were able to identify gaps in training programs and barriers to curriculum development. This approach to curriculum development can be applied to other postgraduate programs. [ABSTRACT FROM AUTHOR]

Background: Medical education has traditionally been compartmentalized into basic and clinical sciences, with the latter being viewed as the skillful application of the former. Over time, the relevance of basic sciences has become defined by their role in supporting clinical problem solving rather than being, of themselves, a defining knowledge base of physicians. Methods: As part of the national Future of Medical Education in Canada (FMEC MD) project, a comprehensive empirical environmental scan identified the timing and integration of basic sciences as a key pressing issue for medical education. Using the literature review, key informant interviews, stakeholder meetings, and subsequent consultation forums from the FMEC project, this paper details the empirical basis for focusing on the role of basic science, the evidentiary foundations for current practices, and the implications for medical education. Findings: Despite a dearth of definitive relevant studies, opinions about how best to integrate the sciences remain strong. Resource allocation, political power, educational philosophy, and the shift from a knowledge-based to a problem-solving profession all influence the debate. There was little disagreement that both sciences are important, that many traditional models emphasized deep understanding of limited basic science disciplines at the expense of other relevant content such as social sciences, or that teaching the sciences contemporaneously rather than sequentially has theoretical and practical merit. Innovations in integrated curriculum design have occurred internationally. Less clear are the appropriate balance of the sciences, the best integration model, and solutions to the political and practical challenges of integrated curricula. Discussion: New curricula tend to emphasize integration, development of more diverse physician competencies, and preparation of physicians to adapt to evolving technology and patients' expectations. Refocusing the basic/clinical dichotomy to a foundational/applied model may yield benefits in training widely competent future physicians. [ABSTRACT FROM AUTHOR]

The article presents news briefs regarding medical education and the Association for Medical Education In Europe (AMEE), including previews of events for the pending September 4-9, 2015 AMEE conference in Glasgow, Scotland, details regarding the AMEE Medical Education Fellowship Awards, and trivia questions and answers regarding medical education.

The article presents 2013 and 2014 news on medical education. The 16th Ottawa Conference/12th Canadian Conference on Medical Education will take place in Ottawa, Canada on April 25-29, 2014. The Association of Faculties of Medicine of Canada has launched a challenge to all medical students and residents to help develop a public health learning tool. The 2014 conference of the Association for Medical Education in Europe will be held in Milan, Italy on August 30-September 3.

This literature review describes the impact of health professional schools with a social accountability mandate by identifying characteristics of medical education found to impact positively on medical students, health workforce, and health outcomes of disadvantaged communities. A critical appraisal tool was used to identify the strengths and weaknesses of the published articles. Data are presented as a narrative synthesis due to the variety of methodologies in the studies, and characterized using a logic model. Health professional schools aiming to improve health outcomes for their disadvantaged local communities described collaborative partnerships with communities, equitable selection criteria, and community-engaged placements in underserved areas as positively impacting the learning and attitudes of students. Students of socially accountable schools were more likely to stay in rural areas and serve disadvantaged communities, and were often more skilled than students from more traditional schools to meet the needs of underserved communities. However, published literature on the impact of socially accountable health professional education on communities and health outcomes is limited, with only one study investigating health outcomes. The findings of this literature review guide schools on the inputs likely to maximize their socially accountability outputs and increase their impact on students, local health workforce and local communities. [ABSTRACT FROM PUBLISHER]

Objectives:Most medical schools using progress tests (PTs) provide feedback by utilizing a traffic-light system of green (satisfactory), yellow (borderline) and red (unsatisfactory) categories. There is little research assessing students’ perceptions or usage of this feedback. Therefore this study proposed to determine the effectiveness of formative PTs at informing and supporting student progress. Methods:A mixed methods study was performed, involving a retrospective analysis of a results database to establish the predictive validity of PT categories and 11 semi-structured interviews to explore students’ perceptions of PT feedback in a graduate entry medical programme. Results:Quantitative analysis revealed that students who always scored green performed better in their summative exams and graduated with a higher final degree than those who received a yellow or red category at least once. Qualitative analysis revealed that just over half of the interviewed students perceived the PT as having informed their progress. Most participants agreed that the current feedback is insufficient and doesn’t guide their on-going learning. Conclusion:While this study demonstrated that the PT is a useful predictive tool for informing student progress, in its current format it’s not fulfilling a truly formative role and supporting student progress sufficiently. [ABSTRACT FROM PUBLISHER]

Background: Medical schools are confronted with the challenge of teaching professionalism during medical training. The aim of this study was to examine medical students’ perceptions of using video clips as a beneficial teaching tool to learn professionalism and other aspects of physicianship. Methods: As part of the longitudinal Physician Apprenticeship course at McGill University, first year medical students viewed video clips from the television seriesER. The study used qualitative description and thematic analysis to interpret responses to questionnaires, which explored the educational merits of this exercise. Results: Completed questionnaires were submitted by 112 students from 21 small groups. A major theme concerned the students’ perceptions of the utility of video clips as a teaching tool, and consisted of comments organized into 10 categories: “authenticity and believability”, “thought provoking”, “skills and approaches”, “setting”, “medium”, “level of training”, “mentorship”, “experiential learning”, “effectiveness” and “relevance to practice”. Another major theme reflected the qualities of physicianship portrayed in video clips, and included seven categories: “patient-centeredness”, “communication”, “physician-patient relationship”, “professionalism”, “ethical behavior”, “interprofessional practice” and “mentorship”. Conclusions: This study demonstrated that students perceived the value of using video clips from a television series as a means of teaching professionalism and other aspects of physicianship. [ABSTRACT FROM PUBLISHER]

Several influential national/international bodies including The Bologna Accord, The Carnegie Foundation and The Future of Medical Education in Canada (FMEC) have called for increased coordination across the medical education continuum. FMEC recognizes accreditation as a 'powerful lever' and encourages the alignment of undergraduate and postgraduate standards. The Carnegie Foundation includes a similar call for the creation of a more coherent accreditation system. As a first step, using the Canadian context, we present a methodological approach that assesses the example of how well LCME/CACMS undergraduate accreditation standards align with the Royal College of Physician and Surgeons of Canada (RCPSC) postgraduate training standards. We analyzed how closely the 132 LCME/CACMS Medical School accreditation standards aligned with the 155 post-graduate standards from the RCPSC accreditation General Standards (A and B). This comparative evaluation demonstrates that the standards do not align closely. Gaps, redundancies and key differences are highlighted. These results are the first step in understanding how accreditation needs to be adapted and re-aligned across the education continuum to provide consistent and coordinated training and these methods could easily be applied to other contexts and jurisdictions. [ABSTRACT FROM AUTHOR]

The article presents news briefs, questions and answers, and other information related to the teaching of medicine as of July 1, 2014. Topics discussed include the future of educational research, the online streaming of the 2014 Association for Medical Education in Europe (AMEE) conference in Milan, Italy, and a question of whether or not medical students should be educated about sexual violence.

The article offers news briefs as of 2014. An International Association For Medical Education (AMEE) Office would be moving to a new location in Dundee, Scotland. The workshop entitled "Social Media Boot Camp" at the Canadian Conference on Medical Education (CCME) featuring panelists including Anne Marie Cunningham would be held on April 25, 2014. The use of flipped classrooms helped students to secure better grades at University of North Carolina, Asheville.

The article presents 2014 news on medical education. The Association for Medical Education in Europe (AMEE) has launched a web site which is located at www.amee.org. The 16th Ottawa Conference/12th Canadian Conference on Medical Education will take place in Ottawa, Canada on April 25-29.The 2014 AMEE Conference will be held in Milan, Italy on August 30-September 3.

The article presents 2013 and 2014 news on education. A Center for Innovative Research in Cyberlearning is being developed by the U.S. National Science Foundation and the research institute SRI International. The second International Conference on Faculty Development in the Health Professions will take place in Prague, Czech Republic on August 23-25, 2013. The 16th Ottawa Conference and the 12th Canadian Conference on Medical Education will be held in Ottawa, Canada on April 25-29, 2014.

The article presents 2013 news on medical teachers and education. James Pickering of the University of Leeds has developed a series of electronic learning screencasts that are concerned with anatomy. The website of St. Jude Cure4Kids received the Gold award for Best Overall Internet Site at the 2013 e-healthcare leadership awards in Las Vegas, Nevada. The Second International Conference on Faculty Development in the Health Professions will be held on August 23-25 in Prague, Czech Republic.

The article offers news briefs related to global medical education in as of January 2013. Topics discussed include the Association of Faculties of Medicine of Canada's (AFMC) challenge to develop virtual patients, 2.2 million pound funding from British Department of Health to the Royal College of Pediatrics and Child Health, and the University of Southampton's free course to train pediatric nurses.

Background: Dalhousie University's MD Programme faced a one-year timeline for renewal of its undergraduate curriculum. Aim: Key goals were renewed faculty engagement for ongoing quality improvement and increased collaboration across disciplines for an integrated curriculum, with the goal of preparing physicians for practice in the twenty-first century. Methods: We engaged approximately 600 faculty members, students, staff and stakeholders external to the faculty of medicine in a process described by Harris (1993) as 'deliberative curriculum inquiry'. Temporally overlapping and networked intraprofessional and interprofessional teams developed programme outcomes, completed environment scans of emerging content and best practices, and designed curricular units. Results: The resulting curriculum is the product of new collaborations among faculty and exemplifies distinct forms of integration. Innovations include content and cases shared by concurrent units, foundations courses at the beginning of each year and integrative experiences at the end, and an interprofessional community health mentors programme. Conclusion: The use of deliberative inquiry for pre-med curriculum renewal on a one-year time frame is feasible, in part through the use of technology. Ongoing structures for integration remain challenging. Although faculty collaboration fosters integration, a learner-centred lens must guide its design. [ABSTRACT FROM AUTHOR]

In this article, we outline an innovative and comprehensive approach to the development by consensus of curriculum content guidelines for a medical specialty. We initially delineated the content domain by triangulation of sources, validated a curriculum blueprint by both quantitative and qualitative methodology, and finally reached consensus on content by Delphi methodology. Development of curricular objectives is an important step in curriculum development. Content definition or 'blueprinting' refers to the systematic definition of content from a specified domain for the purpose of creating test items with validity evidence. Content definition can be achieved in a number of ways and we demonstrate how the concepts of content definition or validation can be transferred beyond assessment, to other steps in curriculum development and instructional design. Validity in Education refers to the multiple sources of evidence to support the use or interpretation of different aspects of a curriculum. In this approach, there are multiple sources of content-related validity evidence which, when accumulated, give credibility and strength to curriculum consensus guidelines. [ABSTRACT FROM AUTHOR]

Critical self-reflection, medical ethics and clinical skills are each important components of medical education but are seldom linked in curriculum development. We developed a curriculum that builds on the existing integration of ethics education into the clinical skills course to more explicitly link these three skills. The curriculum builds on the existing integration of clinical skills and ethics in first year medicine. It refines the integration through scheduling changes; adds case studies that emphasise the social, economic and political context of our province's patient population; and introduces reflection on the 'culture of medicine' as a way to have students articulate and understand their own values and moral decision making frameworks. This structured Clinical Skills course is a model for successfully integrating critical self-reflection, reflection on the political, economic and cultural contexts shaping health and healthcare, and moral decision making into clinical skills training. [ABSTRACT FROM AUTHOR]

Background: At times, preceptors struggle with aspects of resident education. Many are looking for more support and faculty development in this area. Aims: To address preceptors' needs for resources and provide a proactive framework for their teaching, the Academic Support Process (ASP) website was developed and evaluated. Preceptors' ( N == 35) experiences using the ASP website, as well as their perceptions of its usefulness in supporting resident education, were identified. Methods: The research comprised two phases: a self-directed workshop involving the creation of a web-based learning plan for a standardised scenario of a resident in difficulty followed by 3 months use of the ASP website with residents in their practice. Information on their experiences was solicited via surveys and focus group interviews. Results: Findings revealed the ASP website enabled preceptors to find words for their concerns around resident competency, gave them a proactive teaching framework, expanded their arsenal of teaching strategies, and supported a customised approach for all learners along the performance spectrum. However, there were a number of challenges encountered by the preceptors that affected site use and buy in. Conclusions: Results are promising. Next steps involve developing a clear strategy for adoption. [ABSTRACT FROM AUTHOR]

The article presents news and notes related to medical education. It states that the 2012 Ottawa Conference on the Assessment of Competence in Medicine and Healthcare Professions Education will be held in Kuala Lumpur, Malaysia on March 9-13, 2012. It says that a new software platform to promote learning collaboration and networking was unveiled by Indiana University-Purdue University. It presents questions and answers related to health professions education.

Focuses on the Royal College of Physicians & Surgeons of Canada's CanMEDS 2000 project, which is designed to ensure that post-graduate medical specialty training programs are responsive to societal needs. Impact of the project on medical education; Participation to the program; Effects on learning outcomes.

Attempts to clarify the mentoring experience of Canadian family medical practice faculty and teachers by examining several concepts in the mentoring process, dimensions of a professional relationship and adult development. Problem of assignment; Experience of mentorship; Concepts of importance to the mentorship experience.

Provides news briefs related to medical education. Integrated medical curriculum developed by Gold Standard Multimedia; Project of McGill University of Internal Medicine in Montreal, Canada using a computer program to generate call schedules for residents; Forum provided by the European Medical Students' Association for medical students to organize and participate in activities.