Medicine and Health Sciences Commons^™

The Sum Of The Parts Detracts From The Intended Whole: Competencies And In-Training Assessments, Elaine Zibrowski, S. Singh, Mark Goldszmidt, Christopher Watling, Cynthia Kenyon, Valerie Schulz, Heather Maddocks, Lorelei Lingard

Lorelei Lingard

OBJECTIVES: Despite the fact that Canadian residency programmes are required to assess trainees' performance within the context of the CanMEDS Roles Framework, there has been no inquiry into the potential relationship between residents' perceptions of the framework and their in-training assessments (ITA). Using data collected during the study of ITA, we explored residents' perceptions of these competencies.

METHODS: From May 2006-07, a purposive sample of 20 resident doctors from internal medicine, paediatrics, and surgery were interviewed about their ITA experiences. Data collection and analysis proceeded in an iterative fashion consistent with grounded theory. In April 2008, a summary of recurrent …

'It's A Cultural Expectation...' The Pressure On Medical Trainees To Work Independently In Clinical Practice, Tara Kennedy, Glenn Regehr, G. Baker, Lorelei Lingard

Lorelei Lingard

CONTEXT: Medical trainees demonstrate a reluctance to ask for help unless they believe it is absolutely necessary, a situation which could impact on the safety of patients. This study aimed to develop a theoretical exploration of the pressure on medical trainees to be independent and to generate theory-based approaches to the implications for patient safety of this pressure towards independent working.

METHODS: In Phase 1, 88 teaching team members from internal and emergency medicine were observed during clinical activities (216 hours), and 65 participants completed brief interviews. In Phase 2, 36 in-depth interviews were conducted using video vignettes. Data collection …

Family Medicine Residency Characteristics Associated With Practice In A Health Professions Shortage Area, Warren J. Ferguson, Suzanne B. Cashman, Judith A. Savageau, Daniel H. Lasser

Judith A. Savageau

BACKGROUND AND OBJECTIVES: While some family medicine residency programs are designed to train residents in community health centers (CHCs) for future careers serving underserved populations, there are few outcome studies on such programs. Our residency program provides three options for ambulatory health center training, but otherwise residents participate in the same curriculum. We analyzed relationships between ambulatory training site and likelihood of practice in health professions shortage areas (HPSAs).

METHODS: We sent a mail survey to all graduates of one family medicine residency about practice locations, types, and populations; influences on practice choice; and sociodemographic characteristics.

RESULTS: Training in a …

Preserving Professional Credibility: Grounded Theory Study Of Medical Trainees' Requests For Clinical Support, Tara Kennedy, Glenn Regehr, G. Baker, Lorelei Lingard

Lorelei Lingard

OBJECTIVE: To develop a conceptual framework of the influences on medical trainees' decisions regarding requests for clinical support from a supervisor.

DESIGN: Phase 1: members of teaching teams in internal and emergency medicine were observed during regular clinical activities (216 hours) and subsequently completed brief interviews. Phase 2: 36 in depth interviews were conducted using videotaped vignettes to probe tacit influences on decisions to request support. Data collection and analysis used grounded theory methods.

SETTING: Three teaching hospitals in an urban setting in Canada.

PARTICIPANTS: 124 members of teaching teams on general internal medicine wards and in the emergency department, …