Risa Freeman

University of Toronto, Toronto, Ontario, Canada

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Publications (3)10.38 Total impact

  • [show abstract] [hide abstract]
    ABSTRACT: This article describes and evaluates a unique site-visit process for community-based teaching sites. A continuous quality-improvement program was developed by the undergraduate program in the Department of Family and Community Medicine at the University of Toronto Faculty of Medicine to facilitate and document both self- and peer-assessment. A pilot program was launched in 2000, and, after some adjustments based on initial feedback, the program in its current form was implemented in 2002. This program provides individualized support mechanisms to address the faculty development needs and infrastructure requirements of community-based, mostly volunteer, teachers. It also trains participating reviewers to provide individualized faculty development at the point of teaching. During their training, reviewers receive a toolkit consisting of suggestions for initial contact with teachers, guidelines for peer assessments, previously completed previsit teacher surveys, reviewer checklists, postvisit feedback forms, sample thank-you letters, and a faculty development reference resource list. A two-year evaluation of the program demonstrated that faculty and reviewer participants perceived it to be comprehensive, consistent, informative, and an acceptable method of reviewing existing and prospective community-based teaching sites. This program should be transferable to other institutions that engage in community-based teaching.
    Academic Medicine 06/2007; 82(5):465-8. · 3.29 Impact Factor
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    ABSTRACT: Teaching medical students to spontaneously identify biopsychosocial issues (e.g. family violence) remains a challenge. We examined the extent to which using unannounced standardised patients (SPs) presenting in a clerk's clinical setting could assist with this teaching challenge. All clerks attended a family violence seminar in their family medicine rotation. Intervention students additionally saw an unannounced SP portraying 1 of 2 scenarios in their preceptor's office during the rotation, and received immediate feedback about their performance. An end of rotation objective structured clinical examination (OSCE) included an SP presentation similar to that seen by the intervention students. Clerks who received the intervention demonstrated increased questioning about family violence, from 0% (0 of 29 students) to 19% (5 of 26 students) in 1 OSCE scenario (P = 0.019), and from 40% (12 of 30 students) to 76% (19 of 25 students) in the other (P = 0.007). Seeing unannounced SPs had a dramatic effect on later student performance. This potentially powerful intervention could be applied to a range of clinical issues.
    Medical Education 10/2004; 38(9):969-73. · 3.55 Impact Factor
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    ABSTRACT: Referral and consultation letters ferry patients among providers, negotiating co-operative care. Our study examined how "relevance" is signalled and decoded in these letters, from the perspective of both experts and trainees in three clinical specialties. 104 letters were collected from 16 physicians representing family medicine, psychiatry and surgery. Interviews were conducted with 14 of these physicians and 13 residents from the three specialties. All documents and transcripts were analysed for emergent themes. Six rhetorical factors influenced expert physicians' decisions about what material is relevant: educational, professional, audience, system-institutional, medical-legal, and evaluative. Each specialty placed different emphasis on these factors. Trainees reported having no instruction regarding how to construct rhetorically relevant letters, and they demonstrated awareness of only three of the factors identified by experts--professional, audience and evaluative. Experts and trainees differed in their understanding and application of these three factors. This research demonstrates that six rhetorical factors influence relevance decisions in letter writing, and that experts address these factors in tacit, dynamic and discipline-specific ways. Trainees share with experts an appreciation of the rhetorical functions of referral and consultation letters, but lack a comprehensive understanding of the influential factors and do not receive instruction in them. These findings provide a framework for instruction in this domain to equip novices to meet the expectations of their professional audiences successfully.
    Medical Education 03/2004; 38(2):168-76. · 3.55 Impact Factor