Linda Snell

McGill University | McGill · Centre for Medical Education

Objective The educational experience in operating rooms (OR) plays a central role in the transformation of a trainee into a surgeon. As Canadian residency programs transition to competency-based medical education, and since most surgical competencies are attained in the OR, we investigated the perceptions of Canadian surgical residents about their...

Background Despite the use of ‘patient ownership’ as an embodiment of professionalism and increasing concerns over its loss among trainees, how its development in residents has been affected by duty hour regulations has not been well described. In this qualitative study, we aim to outline the key features of patient ownership in internal medicine,...

Background This study aims to compare medical students’ educational outcomes in performing knee arthrocentesis through searching and using YouTube videos versus traditional supervisor‐led sessions. Method Seventy‐one medical students were randomly assigned to three groups. Group A had a traditional supervisor‐led clinical session, where the superv...

Aim: This perspective is part of a series of articles that are outcomes of a consensus conference, that seek to offer a comprehensive examination of the clinical learning environment (CLE), using different academic disciplines and areas of focus termed “avenues.” The education dimensions of the CLE are discussed in detail in this perspective, along...

Learning in a clinical context is foundational in the training of health professionals; there is simply no alternative. The subject of the clinical learning environment (CLE) is at the forefront of discussions. In this introduction to a themed issue on the CLE, we present an expanded conceptual model that approaches the CLE through six different le...

This chapter discusses what instructional design (ID) is and differentiates it from curriculum development, why ID is important to medical educators, the education theories underpinning ID and leading to ID models. It also discusses the design considerations including the use of relevant teaching and learning strategies. In medicine, where professi...

en While local research environments significantly impact individuals’ abilities to engage in scholarly activities, we contend that health professions education scholars are increasingly mobilizing virtual spaces and resources to further their research endeavors.

Teaching about resilience is one of the biggest challenges in medical education. One of the problems of currently accepted definitions is that they attribute individualistic notions mainly originating in North American society, such as “endure ongoing hardship,” “thrive on challenges,” “be healthy,” and “be stronger.” In response to this situation,...

PURPOSE: Entrustable professional activities (EPAs) have become a cornerstone of assessment in competency-based medical education (CBME). Increasingly, EPAs are being adopted that do not conform to EPA standards. This study aimed to develop and validate a scoring rubric to evaluate EPAs for alignment with their purpose, and to identify substandard...

Competency-based medical education (CBME) is an approach to the design of educational systems or curricula that focuses on graduate abilities or competencies. It has been adopted in many jurisdictions, and in recent years an explosion of publications has examined its implementation and provided a critique of the approach. Assessment in a CBME conte...

For more than 60 years, competency-based education has been proposed as an approach to education in many disciplines. In medical education, interest in CBME has grown dramatically in the last decade. This editorial introduces a series of papers that resulted from summits held in 2013 and 2016 by the International CBME Collaborators, a scholarly net...

Objective: The current medical education system is steeped in tradition and has been shaped by many long-held beliefs and convictions about the essential components of training. The objective of this article is to propose initiatives to overcome biases against competency-based medical education (CBME) in the culture of medical education. Materials...

The paradigm shift brought about by the advent of competency-based medical education (CBME) can be characterized as an adaptive change. Currently, its development and implementation suffer from the lack of a lingua franca. A shared language is needed to support collaboration and dissemination across the world community of medical educators. The Int...

Competency-based medical education (CBME) is as important in continuing professional development (CPD) as at any other stage of a physician’s career. Principles of CBME have the potential to revolutionize CPD. Transitioning to CBME-based CPD will require a cultural change to gain commitment from physicians, their employers and institutions, CPD pro...

Competency-based medical education (CBME) is both an educational philosophy and an approach to educational design. CBME has already had a broad impact on medical schools, residency programs, and continuing professional development in health professions around the world. As the CBME movement evolves and CBME programs are implemented, a wide range of...

Although medical education has enjoyed many successes over the last century, there is a recognition that health care is too often unsafe and of poor quality. Errors in diagnosis and treatment, communication breakdowns, poor care coordination, inappropriate use of tests and procedures, and dysfunctional collaboration harm patients and families aroun...

Background: Role modelling is a fundamental method by which students learn from residents. To our knowledge, however, resident-as-teacher curricula have not explicitly addressed resident role modelling. The purpose of this project was to design, implement and evaluate an innovative programme to teach residents about role modelling. Methods: The...

Educators frequently learn together in cross cultural settings such as at international conferences. Cultural differences should influence how educational programs are designed and delivered to effectively support learning; cultural sensitivity and the competence to deal with such differences are important skills for health professions educators. T...

Teaching about resilience is one of the biggest challenges in medical education. One of the problems is that medical educators might still ascribe to the individualistic self-definition mainly promoted in the North American society. This definition includes characteristics such as “enduring ongoing hardship,” “thriving on challenges,” “being health...

Objective: Letters of recommendation (LOR) provide valuable information that help in selecting new residents. In this study, we aim to investigate the perceptions of surgical residency program directors (PDs) in Canada on the elements that can affect the strength and value of LOR. Design: Cross-sectional; survey. Setting: A national survey was...

Accreditation of medical residency programs has become globally important. Currently it is moving from the goal of attaining minimal standards to a model of continuous improvement. In some countries, the accreditation system engages peers (physicians) to survey residency programs. The surveyors are sometimes volunteers, usually engaged in multiple...

Background: Latin America has experienced a tremendous growth in a number of medical schools, and there are concerns about their quality of training in critical areas such as professionalism. Medical professionalism is a cultural construct. The aim of the study was to compare published definitions of medical professionalism from Latin American and...

Clinician Educators (CE) have numerous responsibilities in different professional domains, including clinical, education, research, and administration. Many CEs face tensions trying to manage these often competing professional responsibilities and achieve " work-work balance. " Rich discussions of techniques for work-work balance amongst CEs at a m...

High-fidelity simulation-based training, such as those aimed at teaching the management of medical crises, constitutes a highly complex learning task. To be effective, its design must be guided by sound learning principles. Cognitive load theory is a well-developed framework and has been extensively used in other settings to improve instructional d...

The International Competency-Based Medical Education (ICBME) Collaborators have been working since 2009 to promote understanding of competency-based medical education (CBME) and accelerate its uptake worldwide. This article presents a charter, supported by a literature-based rationale, which is meant to provide a shared mental model of CBME that wi...

The decision to trust a medical trainee with the critical responsibility to care for a patient is fundamental to clinical training. When carefully and deliberately made, such decisions can serve as significant stimuli for learning and also shape the assessment of trainees. Holding back entrustment decisions too much may hamper the trainee's develop...

Purpose: Although some evidence suggests that resident duty hours reforms can lead to shift-worker mentality and loss of patient ownership, other evidence links long hours and fatigue to poor work performance and loss of empathy, suggesting the restrictions could positively affect professionalism. The authors explored perceived impacts of a 16-hou...

Abstractcontext and objective: Training for specialist physicians in Brazil can take place in different ways. Closer liaison between institutions providing this training and assessment and health care services may improve qualifications. This article analyzes the impact of closer links and joint work by teams from the National Medical Residency Co...

Unlabelled: Myxoedema madness was first described as a consequence of severe hypothyroidism in 1949. Most cases were secondary to long-standing untreated primary hypothyroidism. We present the first reported case of iatrogenic myxoedema madness following radioactive iodine ablation for Graves' disease, with a second concurrent diagnosis of primary...

Recent calls to focus on identity formation in medicine propose that educators establish as a goal of medical education the support and guidance of students and residents as they develop their professional identity. Those entering medical school arrive with a personal identity formed since birth. As they proceed through the educational continuum, t...

Curriculum change, emphasizing competencies and the evolution of our understanding of competence, lies at the forefront of twenty-first century medical education. Teaching and assessing fundamental competencies to learners (e.g. leadership skills, health advocacy, professionalism) implies the incorporation of new content and emerging (and potential...

Improved pediatric crisis resource management (CRM) training is needed in emergency medicine residencies because of the variable nature of exposure to critically ill pediatric patients during training. We created a short, needs-based pediatric CRM simulation workshop with postactivity follow-up to determine retention of CRM knowledge. Our aims were...

Teaching medical professionalism is a fundamental component of medical education. The objective is to ensure that students understand the nature of professionalism and its obligations and internalize the value system of the medical profession. The recent emergence of interest in the medical literature on professional identity formation gives reason...

Successful emergency medicine (EM) education scholarship requires a systematic approach that includes searching the (grey) literature, mobilizing resources, adopting frameworks to focus the innovation, integrating a component of program evaluation, and disseminating the innovation via traditional and emerging avenues. This paper provides direction...

Background: Faculty development is often local and international experiences are usually limited to conferences and courses. In 2006, five schools across the globe decided to enhance international faculty experiences through an exciting new collaboration: the International Medical Educators Exchange (IMEX) initiative. Method: Twice a year, one o...

Emergency medicine (EM) is defined, in part, by clinical excellence across an immense breadth of content and the provision of exemplary bedside teaching to a wide variety of learners. The specialty is also well-suited to a number of emerging areas of education scholarship, particularly in relation to team-based learning, clinical reasoning, acute c...

As emergency medicine (EM) education evolves, a more advanced understanding of education scholarship is required. This article is the first in a series of three articles that reports the recommendations of the 2013 education scholarship consensus conference of the Academic Section of the Canadian Association of Emergency Physicians. Adopting the Ca...

As emergency medicine (EM) education evolves, a more advanced understanding of education scholarship is required. This article is the first in a series of three articles that reports the recommendations of the 2013 education scholarship consensus conference of the Academic Section of the Canadian Association of Emergency Physicians. Adopting the Ca...

Emergency medicine (EM) is defined, in part, by clinical excellence across an immense breadth of content and the provision of exemplary bedside teaching to a wide variety of learners. The specialty is also well-suited to a number of emerging areas of education scholarship, particularly in relation to team-based learning, clinical reasoning, acute c...

To determine a consensus definition of a clinician-educator and the related domains of competence. During September 2010 to January 2011, the authors conducted a two-phase mixed-methods national study in Canada using (1) focus groups of deans of medicine and directors of medical education centers to define the attributes, domains of competence, and...

Despite widespread implementation of policies to address mistreatment, high rates of mistreatment during clinical training are reported, prompting the question of whether "mistreatment" means more to students than delineated in official codes of conduct. Understanding "mistreatment" from students' perspective and as it relates to the learning envir...

Medical educators endeavour to foster patient-centred learning. Although studies of patient-educators report general increases in patient-centredness, no formal review of students' reflections on the role of patients in their education has yet been undertaken. Our research questions were: (i) What themes might be identified through a qualitative an...

Factors influencing specialty choice have been studied in an attempt to find incentives to enhance the workforce in certain specialties. The notion of "controllable lifestyle (CL) specialties," defined by work hours and income, is gaining in popularity. As a result, many reports advocate providing a 'lifestyle-friendly' work environment to attract...

Success in a task is not only related to skill, but it is also related to 'self-efficacy', or belief in one's capability to perform that task. No tool currently exists to measure self-efficacy in clinical decision-making in general paediatrics. To develop and provide validity evidence for the General Pediatrics-specific Self-Efficacy (GPedsSE) scal...

Previous research has shown that Dutch medical residents feel inadequate in certain management areas: 85% had a need for management training and reported preferences on the format of such training. Our objective was to explore if the perceived deficiencies and needs among Dutch residents were similar to those of their peers in other countries, and...

Short duty hours, imposed by the Accreditation Council of Graduate Medical Education (ACGME) regulations, have been claimed to be associated with loss of continuity of care among surgical patients, leading to a potentially increased risk of adverse surgical outcomes. This systematic review and meta-analysis assessed the strength of associations bet...

BACKGROUND⁄ Pain-related misbeliefs among health care professionals (HCPs) are common and contribute to ineffective postoperative pain assessment. While standardized patients (SPs) have been effectively used to improve HCPs' assessment skills, not all centres have SP programs. The present equivalence randomized controlled pilot trial examined the e...

Appendices. Appendices 1, 2 and 3.

Despite the high burden of musculoskeletal (MSK) diseases, few generalists are comfortable teaching MSK physical examination (PE) skills. Patient Partners® in Arthritis (PP®IA) is a standardized patient educator program that could potentially supplement current MSK PE teaching. This study aims to determine if differences exist in MSK PE skills betw...

Docere, the Latin root of the word doctor, means to teach, and teaching is an intrinsic part of being a physician. Most physicians routinely teach their students, residents, colleagues, and patients. Residents regularly contribute to the education of medical students and their fellow residents and may spend up to one-fourth of their time supervisin...

Musculoskeletal (MSK) complaints comprise 12-20% of primary healthcare; however, practicing physicians' MSK physical examination (PE) skills are weak. Further, there is a shortage of specialists able to effectively teach this subject. Previous evaluations of patient educators have yielded mixed results. The aim of this study is to document how teac...

Educators in surgical training programs are concerned that the Accreditation Council for Graduate Medical Education (ACGME) duty hours limitations may adversely affect surgical residents' education, especially their operative experience, so the authors aimed to evaluate the impact of duty hours reductions on surgical residency. The authors searched...

The increasing complexity of medical training often requires faculty members with educational expertise to address issues of curriculum design, instructional methods, assessment, program evaluation, faculty development, and educational scholarship, among others. In 2007, The Royal College of Physicians & Surgeons of Canada responded to this need by...

Although competency-based medical education (CBME) has attracted renewed interest in recent years among educators and policy-makers in the health care professions, there is little agreement on many aspects of this paradigm. We convened a unique partnership - the International CBME Collaborators - to examine conceptual issues and current debates in...

Changes in educational thinking and in medical program accreditation provide an opportunity to reconsider approaches to undergraduate medical education. Current developments in competency-based medical education (CBME), in particular, present both possibilities and challenges for undergraduate programs. CBME does not specify particular learning str...

Competency-based education in the health care professions has become a prominent approach to postgraduate training in Canada, the Netherlands, the United Kingdom, the United States, and many other countries. Competency frameworks devised at national and international levels have been well received, and in many cases mandated, by governing bodies. H...

Journal clubs are active at many universities and they involve many specialties and subspecialties. There is a surprising dearth of journal clubs which deal with articles related to the science of medical education. In an effort to expose medical educators to the outstanding benefits of medical education journal clubs we have devised a set of twelv...

The McGill University Faculty of Medicine undertook a pilot, simulation-based multiple mini-interview (MMI) for medical school applicant selection, which ran simultaneously with traditional unstructured interviews (all applicants underwent both processes). This paper examines major stakeholder (applicants and evaluators) opinions towards the MMI co...

An academic journal serves its purpose by being read and understood. International medical education journals that want to reach a wider readership must be accessible to a multitude of cultures and contexts. It is therefore important that authors and editors consider how their use of language will be interpreted by health care education colleagues...

Interactive lecturing involves an increased interchange between teachers, students and the lecture content.The use of interactive lectures can promote active learning, heighten attention and motivation, give feedback to the teacher and the student, and increase satisfaction for both.This article describes a number of interactive techniques that can...

Multiple-choice questions (MCQs), the predominant evaluation vehicle in North America, are a reliable and valid measure of knowledge but have many detractors. We use MCQs widely in evaluating undergraduate students in a junior Internal Medicine clerkship but find it difficult to maintain a suitable secure bank of questions. We therefore involved ou...

In a previous study, a group of non-clinician medical education experts identified 30 pedagogical principles, knowledge of which might enhance clinical teaching effectiveness. To assess expert teachers? perceptions of which basic pedagogical principles, if known and understood, would enhance their teaching effectiveness. We conducted an on-line Del...

Musculoskeletal (MSK) complaints have high prevalence in primary care practice (12%-20% of visits), yet many trainees and physicians identify themselves as weak in MSK physical examination (PE) skills. As recruitment to MSK specialties lags behind retirement rates, there is a shortage of physicians able to effectively teach this subject. We investi...

Although educational innovations in medical education are increasing in number, many educators do not submit their ideas for publication. The goal of this initiative was to assist faculty members write about their educational innovations. Twenty-four faculty members participated in this intervention, which consisted of a half-day workshop, three pe...

We reviewed the medical-education literature in order to explore the significance and importance of teaching medical students about education principles and teaching skills. To discuss reasons why formal initiatives aimed at improving teaching skills should be part of the training of all physicians, and how it could begin at the medical-student lev...

Colorectal cancer screening is underutilized, resulting in preventable morbidity and mortality. In the present study, age-related and other disparities associated with physicians' delivery of colorectal cancer screening recommendations were examined. The present cross-sectional study included 43 physicians and 618 of their patients, aged 50 to 80 y...

To determine thematic similarities and differences in the implementation of common-content communications skills training (CST) in medicine, surgery, paediatrics, and obstetrics and gynaecology residency programmes. Communications skills training based upon the Kalamazoo consensus statement of communication skills in the clinical encounter was impl...

Is learning enhanced when the continuing medical education (CME) intervention corresponds to the physician's preferred learning method? Eighty-eight primary care community-based physicians were involved in this study. Each physician attended one of three 2-day CME programs based on a needs assessment of community-based primary care physicians. Each...

Physician nonadherence to colorectal cancer (CRC) screening recommendations contributes to underuse of screening. To assess physicians' knowledge of CRC screening guidelines for average-risk individuals, perceived barriers to screening and practice behaviours. Between October 2004 and March 2005, staff physicians working in three university-affilia...

Survey – Canadian General Internal Medicine Training. Copy of survey instrument used.