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Purpose: This study explores the lived experiences of women living with multiple sclerosis (MS) and identifies barriers to their optimal health and well-being. Methodology: Using van Manen's interpretative phenomenologic analysis, the researchers conducted semistructured interviews with 23 women diagnosed with MS in Southwestern Ontario, Canada. Data were analyzed using NVivo 12 software, and themes were validated through member checking. Results: The study revealed a key theme of "obstacles for women with MS" and subthemes related to barriers to physical, mental, and social well-being. Participants reported experiencing feelings of health despite their MS diagnosis but identified various constraints on their optimal health and well-being, including challenges with employment, financial support, and housing security. Conclusion: The findings highlight the need for healthcare professionals to advocate for equitable treatments, medication, and accessibility supports for women with MS, as well as for policies that address disability income support and affordable housing. Further research is recommended to explore power imbalances experienced by women with MS in precarious employment situations or living with episodic disabilities. [ABSTRACT FROM AUTHOR]

Research on the impostor phenomenon (IP) is rapidly growing in medical education due to its relationship with distress and burnout. How IP is theoretically conceptualized and analyzed has been inconsistent, however, which limits our understanding of results and how to act on them. We hypothesized that a person-centered analysis, in combination with a robust theoretical framework, would provide a more specific 'profile' of medical student IP and help to optimize supports for their well-being. We used exploratory factor analysis to assess the factor structure of the Clance Impostor Phenomenon Scale (CIPS) in medical students, followed by cluster analysis to identify distinct 'impostor' profiles, based on the identified factors. We then used self-determination theory's (SDT) framework of motivation to explore how students in each profile differed in their general causality orientation, autonomous motivation towards going to medical school, and psychological need satisfaction in the medical program – factors that SDT identifies as predictors of engagement, performance, and well-being. Factor analysis yielded three main IP factors – feeling like a fake, attributing success to luck, and discounting achievement – in line with Clance's original definition of IP. The cluster analysis then identified four distinct IP profiles based on individual differences in these factors, each varying in aspects of their self-determination. This study sheds light on the ways that medical students may experience IP, further reinforcing the notion that not all 'impostors' are created equal. Findings support the three-factor structure of the CIPS among medical students, and that most students will fall into one of four IP profiles. These profiles and their implications are discussed. [ABSTRACT FROM AUTHOR]

Students training for people-oriented careers, such as medicine and teaching, experience disproportionately high levels of burnout before entering the workforce. This is problematic because burnout is associated with negative outcomes such as unprofessionalism, low self-efficacy, and early career departure. The purpose of this research was to compare medical students' and pre-service teachers' achievement goals and examine the extent to which achievement goals contribute to or protect students from academic burnout. Using a cross-sectional survey design, we collected data from a total of 281 medical students and pre-service teachers enrolled at a Western Canadian university. To answer our research questions, we used descriptive data, correlational analyses, and multiple linear regression. Results suggest that both medical students and pre-service teachers score highest on mastery-approach achievement goals; although all goal types are endorsed similarly. Medical students reported higher burnout than pre-service teachers but across groups mastery-approach and performance-approach goals were negatively associated with burnout whereas performance-avoidance goals were positively associated with burnout. Limitations and directions for future research are discussed, as well as implications of these findings for researchers, educators, and students training for people-oriented professions.

The study examines the role that perceptions or impressions of learning environments and assessments play in students' performance on a large-scale standardized test. Hierarchical linear modeling (HLM) was used to test aspects of the Learning Errors and Formative Feedback model to determine how much variation in students' performance was explained by students' and school principals' perceptions of learning environments and assessments. Results from sequential HLM testing indicated that students' but not principals' perceptions explained a significant, although modest, amount of the total variation in students' test performance. These results suggest that when students perceive learning environments to be safe and valuable, and positive assessment activities to be taking place, they tend to perform better on standardized tests than when they perceive learning environments and assessment activities otherwise. These findings provide a rationale for investigating the variables that can help improve students' perceptions in order to enhance their test performance.

Theory: Impostor phenomenon (IP) refers to people's feelings of intellectual fraudulence and fear of being "discovered," despite contradicting evidence of success. Due to its association with burnout and distress, it is progressively being studied in medicine. While various explanations for IP have been discussed in the literature, the role of motivation has largely been neglected. Hypotheses: Using self-determination theory (SDT) as a lens, it was hypothesized that different general causality orientations (impersonal, control, autonomy), domain-specific types of motivation (autonomous vs. controlled) toward going to medical school, and levels of satisfaction of basic psychological needs (autonomy, competence, relatedness) in the medical program, would each predict severity of IP symptoms. Method: A total of 1,450 medical students from three Canadian institutions were invited to complete a survey containing the Clance Impostor Phenomenon Scale and scales derived from SDT's mini theories: basic psychological needs theory, causality orientations theory, and organismic integration theory. We explored the prevalence of IP among the students and used regression to capture variable relationships, accounting for gender effects. Results: Data from 277 (19.1%) students were assessed, 73% of whom reported moderate or worse IP symptoms. Having an impersonal general causality orientation, more controlled motivation toward going to medical school, and lower need satisfaction in the medical program, each related to increased IP severity. Together, these motivational factors accounted for 30.3%, 13.6%, and 21.8% of the variance in students' IP severity, respectively. Conclusions: Findings from this study suggest that students who are more self-determined (both in general and in medical school), and whose basic psychological needs are more supported in their medical program, will experience less frequent and severe IP symptoms. Preliminary explanations and implications of these findings are discussed within the medical education context. [ABSTRACT FROM AUTHOR]

Background/Objectives: As the elderly population and associated number of persons with dementia increase, so does the need for decision‐making capacity assessments (DMCAs). Many healthcare professionals (HCPs), however, do not feel prepared to conduct DMCAs. We have provided 4‐h DMCA workshops to HCPs since 2006 and offered physicians either a 3‐h or 2‐day DMCA workshop from 2013 to present. We evaluated the effectiveness of the workshops on self‐reported key concepts of capacity. Design Pre‐/post‐test design. Setting: DMCA workshops for physicians across Canada and HCPs within Alberta. Participants: Two hundred and eighty‐one physicians and 835 HCPs. Measurements Pre‐/post‐workshop ratings on level of comfort with and understanding of 15 core DMCA concepts using 4‐point Likert‐type items. Results: For the DMCA workshops among physicians, ten 3‐h workshops were held in 2014–2015 with 166 participants and seven 2‐day workshops, between 2014 and 2018, with 115 participants. With respect to the self‐report on core DMCA concepts, at least 62.7% (range: 62.7%–89.6%) of physician participants had higher post‐workshop ratings (sign test; p < 0.001) than pre‐workshop ratings for all core DMCA concepts. For the DMCA workshops among HCPs, 4‐h workshops were delivered to 835 HCP participants from 2008 to 2012. At least 49.6% of participants (range: 49.6%–78.9%) had increased post‐workshop ratings (sign test; p < 0.001) for all level of comfort items with and understanding of core DMCA concepts. Conclusion: There is a need for DMCA training for physicians and HCPs. The content and method of the workshops are effective at enhancing self‐reported level of comfort with and understanding of core DMCA concepts. [ABSTRACT FROM AUTHOR]

In Canada, family physicians may pursue extended training for added competence in areas such as Palliative Care or Emergency Medicine by applying to Enhanced Skills (ES) programmes. Despite the increasing popularity of ES programmes, there are no studies that examine trends in applications to ES programmes before and after the introduction of family medicine focused competency-based curricula at individual universities. Additionally, there is a scarcity of research examining factors common among applicants to ES programmes. We undertook a retrospective observational study using secondary data analysis of archived resident files from a large Canadian family medicine residency programme. The proportion of applicants to ES programmes decreased since implementation of a competency-based curriculum in the subject programme. Older, male, and Canadian medical graduates (CMGs) applied to ES programmes more often than their respective counterparts. Residents in a family medicine competency-based curriculum may be less inclined to extend their training by applying to ES programmes. This is remarkable considering that the Canadian residency programme is the shortest among high-income countries. Further studies are needed to investigate the role of competency-based medical education programmes in enabling shortening residency training around the world. [ABSTRACT FROM AUTHOR]

Background: Lack of compassion is claimed to result in poor and sometimes harmful nursing care. Developing strategies to encourage compassionate caring behaviours are important because there is evidence to suggest a connection between having a moral orientation such as compassion and resulting caring behaviour in practice. Objective: This study aimed to articulate a clearer understanding of compassionate caring via nurse educators' selection and use of published texts and film. Methodology: This study employed discourse analysis. Participants and research context: A total of 41 nurse educators working in universities in the United Kingdom (n = 3), Ireland (n = 1) and Canada (n = 1) completed questionnaires on the narratives that shaped their understanding of care and compassion. Findings: The desire to understand others and how to care compassionately characterised educators' choices. Most narratives were examples of kindness and compassion. A total of 17 emphasised the importance of connecting with others as a central component of compassionate caring, 10 identified the burden of caring, 24 identified themes of abandonment and of failure to see the suffering person and 15 narratives showed a discourse of only showing compassion to those 'deserving' often understood as the suffering person doing enough to help themselves. Discussion: These findings are mostly consistent with work in moral philosophy emphasising the particular or context and perception or vision as well as the necessity of emotions. The narratives themselves are used by nurse educators to help explicate examples of caring and compassion (or its lack). Conclusion: To feel cared about people need to feel 'visible' as though they matter. Nurses need to be alert to problems that may arise if their 'moral vision' is influenced by ideas of desert and how much the patient is doing to help himself or herself. [ABSTRACT FROM AUTHOR]

Introduction: Lifelong learning requires sustained motivation for learning. Employing a motivational theory framework, we investigated the relationships of psychological need satisfaction, clinical teaching involvement, and lifelong learning of physicians at different career stages and in various medical specialties. We also examined the associations of physician lifelong learning with stress, burnout, teaching enjoyment, and life satisfaction, all of which are essential for physician well-being and, ultimately, for the provision of quality patient care. Methods: This was a cross-sectional study. Using survey methodology, quantitative data were collected from 202 practicing physicians in Canada. The questionnaire contained validated scales of physician lifelong learning and psychological need satisfaction, measures of clinical teaching (involvement and enjoyment), stress level, burnout frequency, and life satisfaction. Analysis of covariance and correlational analysis were performed. Results: On average, participants reported moderate to moderately high levels of lifelong learning, psychological need satisfaction, teaching enjoyment, and life satisfaction. Irrespective of career stage and specialty, physicians' psychological need satisfaction and involvement in clinical teaching were significant in relation to lifelong learning. That is, physicians who experienced greater psychological need satisfaction at work and those who were involved in clinical teaching had, on average, higher lifelong learning scores. Physician lifelong learning had significant associations with life satisfaction and teaching enjoyment but not with stress level and burnout frequency. Discussion: Fulfilling physicians' basic psychological needs at work and supporting them in their teaching roles is likely to enhance physician lifelong learning and, ultimately, quality of patient care. [ABSTRACT FROM AUTHOR]

Objectives:Competency-based education places increasing emphasis on formative feedback to learners as part of the assessment process. We wished to determine if gender bias was present in the feedback shared with post-graduate medical trainees (residents) in a two-year family medicine residency program at a Canadian university. Methods:We performed secondary data analyses of documented feedback (FieldNotes) extracted from the Competency-Based Achievement System database. Between 2012 and 2016, 464 preceptors (188 female (F); 276 male (M)) wrote in total 7316 FieldNotes for 192 residents (104 F; 88 M), forming four gender dyads. Descriptive statistics were used to examine trends in FieldNotes frequencies, competencies (Sentinel Habits; SH), progress levels (PL), and the use of adjectives (agentic/competency-based; communal/warmth-based) by preceptors in the FieldNotes. Results:Male and female preceptors wrote on average 7 and 14 FieldNotes, respectively. Female residents received on average more feedback comments from female preceptors (7 notes) than from male preceptors (4 notes). The M–M and M–F resident-preceptor dyads had, respectively, the least and the most ‘Stop, Important correction’ FieldNotes in both the PGY1 and PGY2 groups. Although preceptors used agentic adjectives more frequently than communal adjectives overall, the F–M resident-preceptor dyad contained the highest proportion of communal adjectives and the lowest proportion of agentic adjectives. Conclusions:Residents would benefit from multiple opportunities for feedback from both male and female preceptors throughout their residency training. Faculty development to bring attention to potential gender bias may be useful to ensure equitable teaching and quality feedback for learners. [ABSTRACT FROM PUBLISHER]

The article reports on research which was conducted to investigate the perceptions that medical residents in Alberta, Canada had about their preparedness to practice in the field of geriatric medicine after participating in a care of the elderly diploma program at the University of Alberta. Researchers surveyed 39 residents. They found that 97% of respondents felt somewhat or very prepared and that most respondents were spending a majority of time in direct patient care.