Search

Objective: The study explored knowledge, attitude, and practices of Canadian Medical Education Directions for Specialists (CanMEDS) "'Leader" role in faculty psychiatrists in a university setting., Methods: This is a qualitative study using a thematic analysis approach. Participants were identified by purposive, convenience, and snowball sampling. Telephone interviews were conducted to explore participants' perceptions of leadership. Qualitative analysis was carried out using a constant comparative analysis approach to identify themes across the interview data. Data was transcribed and coded into themes and categories to form an analysis of physicians' knowledge, attitude, and practices of the CanMEDS "Leader" role., Results: Twenty-eight faculty psychiatrists participated in the study. The following themes and subthemes emerged from analysis: (a) characteristics of leadership and lack of clarity regarding CanMEDS "Leader" role (subthemes: differences between manager and leader, lack of specificity and practicality, relevance to practice) and (b) the meaning of leadership (subthemes: "positional leadership" and "everyday leadership," physician as team leader, developing leadership skills, getting beyond "occupational adolescence")., Conclusion: Participants perceived CanMEDS "Leader" role description as a high-level vision, which needs practice-oriented guidance. Participants conceptualized the dual nature of physician leadership at an individual level and at an organizational level. Leadership training is important both in residency as well as lifelong learning.

Objective: Co-production involves service providers and service users collaborating to design and deliver services together and is gaining attention as a means to improve provision of care. Aiming to extend this model to an educational context, the authors assembled a diverse group to develop co-produced education for psychiatry residents and medical students at the University of Toronto over several years. The authors describe the dynamics involved in co-producing psychiatric education as experienced in their work., Methods: A collaborative autobiographical case study approach provides a snapshot of the collective experiences of working to write a manuscript about paying service users for their contributions to co-produced education. Data were collected from two in-person meetings, personal communications, emails, and online comments to capture the fullest possible range of perspectives from the group about payment., Results: The juxtaposition of the vision for an inclusive process against the budgetary constraints that the authors faced led them to reflect deeply on the many meanings of paying service user educators for their contributions to academic initiatives. These reflections revealed that payment had implications at personal, organizational, and social levels., Conclusion: Paying mental health service user educators for their contributions is an ethical imperative for the authors. However, unless payment is accompanied by other forms of demonstrating respect, it aligns with organizational structures and practices, and it is connected to a larger goal of achieving social justice, the role of service users as legitimate knowers and educators and ultimately their impact on learners will be limited.

Objective: With 40 to 65% of mental health patients being cared for by family members, nearly 500,000 Canadians are serving as caregivers. Yet family members are often excluded from daily clinical interactions and the development of mental health continuing medical education (CME). This qualitative study aimed to understand how best to involve families in mental health CME and how to advance their meaningful and equitable engagement in such initiatives., Methods: Semi-structured interviews were conducted with two samples: mental health care providers (n = 8) and family members of individuals diagnosed with a co-occurring addiction and mental health problems (n = 12) to explore barriers, facilitators, and strategies for family engagement., Results: Several themes related to the perception of expertise emerged from the interviews, including the tension between the validity of knowledge based on education/credentials and knowledge based on lived experience, as well as expressions of "voice." Participants also identified barriers to, and ethical considerations related to, family engagement, including stigma and confidentiality, and recommended strategies and supports to meaningfully include the family perspective within mental health CME., Conclusions: Aligning with the movement to improve collaboration between mental health professionals and service users requires developing relationships with family members. Identifying strategies to involve families in the development of CME is crucial to initiating and maintaining family engagement.

Objective: The authors describe a novel course that pairs service users as advisors to senior psychiatry residents with the goals of improving the residents' understanding of recovery, reducing negative stereotypes about people in recovery, and empowering the service users who participated., Methods: Service users who had experience working as peer support workers and/or system advocates were selected for a broad and deep understanding of recovery and an ability to engage learners in constructive dialogue. They met monthly with resident advisees over a period of 6 months. They were supported with monthly group supervision meetings and were paid an honorarium. Quantitative evaluations and qualitative feedback from the first two cohorts of the course, comprising 34 pairs, are reported here., Results: The first cohort of residents responded with a wide range of global ratings and reactions. In response to their suggestions, changes were made to the structure of the course to create opportunities for small group learning and reflective writing and to protect time for residents to participate. The second cohort of residents and both cohorts of service users gave acceptably high global ratings. Residents in the second cohort described gaining a number of benefits from the course, including an enhanced understanding of the lived experience of recovery and a greater sense of shared humanity with service users. Advisors described an appreciation for being part of something that has the potential for changing the practice of psychiatry and enhancing the lives of their peers., Conclusions: Positioning service users as advisors to psychiatry residents holds promise as a powerful way of reducing distance between future psychiatrists and service users and facilitating system reform toward person-centered recovery-oriented care.

Objective: The authors sought to evaluate a formal mentorship program for second-year psychiatry residents at the University of Toronto after the program's first year of implementation., Methods: Ten mentees and ten faculty mentors were interviewed by fellow second-year residents and an independent researcher, respectively, about their experiences in the program. Interview data were thematically coded and analyzed using a grounded theory approach., Results: Three major themes were identified. First, participants emphasized the importance of a natural, flexible, and engaging matching process for mentors and mentees. Many experienced the random assignment approach to matching and the mandatory nature of the program as barriers to developing a meaningful relationship with their mentors. Second, participants expressed a preference for geographic proximity between mentor and mentee workplaces and for meetings to take place in informal settings in order to improve the quality and quantity of their interactions. Lastly, participants felt that clear directions and expectations about the program's goals should be communicated, and that a forum for information sharing among mentors was needed., Conclusions: Overall, the majority of participants believed that the program facilitated growth and development and provided positive opportunities for both mentors and mentees. While challenges were present in the program, participants provided tangible recommendations to improve the process.