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4. The revised Approved Instructional Resources score: An improved quality evaluation tool for online educational resources

Author

Grock, Andrew, Jordan, Jaime, Zaver, Fareen, Colmers-Gray, Isabelle N, Krishnan, Keeth, Chan, Teresa, Thoma, Brent, Alexander, Charlotte, Alkhalifah, Mohammed, Almehlisi, Abdulaziz S, Alqahtani, Saeed, Anderson, Scott, Anderson, Shelaina, Andrews, Colin, Andruko, Jocelyn, Antony, Nikytha, Aryal, Diptesh, Backus, Barbra, Baird, Jennifer, Baker, Andrew, Batty, Sarah, Baylis, Jared, Beaumont, Braeden, Belcher, Chris, Benavides, Brent, Benham, Michael, Botta, Julian, Berger Pelletier, Elyse, Bouchard, Nicholas, Brazil, Victoria, Brumfield, Emily, Bryson, Anthony, Bunchit, Wisarut, Butler, Kat, Buzikievich, Lindy, Calcara, David, Carey, Rob, Carrillo, Maria Rosa, Carroll, Stephen, Lyons, Casey, Cassidy, Louise, Challen, Kirsty, Chan, Kathryn, Chaplin, Tim, Chatham-Zvelebil, Natasha, Chen, Eric, Chen, Lucy, Chhabra, Sushant, Chin, Alvin, Chochi, Eric, Choudhri, Tina, Christensen, Jeremy, Connors, Kimberly, Coppersmith, Veronica, Cosgrove, Abby, Costello, Gregory, Cullison, Kevin, D'Alessandro, Andrew, Wit, Kerstin, Decock, Marie, Delbani, Rayan, Denq, William, Deutscher, Julianna, Devine, Brendan, Dorsett, Maia, Duda, Taylor, Dueweke, Justin, Dunphy, Teresa, Dyer, Sean, Eastley, Karthryn T, Edmonds, Marcia, Edwards, Ken, Ehrman, Robert, Elkhalidy, Youness, Fedor, Preston, Ficiur, Brian, Flynn, Caley, Fraser, Bill, Fu, Meagan, Fukakusa, James, Funk, Eric, Gaco, Damjan, Gawlik, Viktor, Ghaffarian, Kenn, Gharahbaghian, Laleh, Griffith, Andrew, Griffith, Phil, Gronowski, Tanner, Grossman, Cathy, Gucwa, Jaroslaw, Gupta, Pawan, Gustafson, Alexandra, Guy, Andrew, Haas, Mary, Haciski, Stanislaw, Hajdinjak, Emina, Hall, Andrew K, Hammock, Regina, Hansel, Jan, and Hart, Alexander

Subjects
Clinical Research, Generic health relevance, Good Health and Well Being
Abstract

BackgroundFree Open-Access Medical education (FOAM) use among residents continues to rise. However, it often lacks quality assurance processes and residents receive little guidance on quality assessment. The Academic Life in Emergency Medicine Approved Instructional Resources tool (AAT) was created for FOAM appraisal by and for expert educators and has demonstrated validity in this context. It has yet to be evaluated in other populations.ObjectivesWe assessed the AAT's usability in a diverse population of practicing emergency medicine (EM) physicians, residents, and medical students; solicited feedback; and developed a revised tool.MethodsAs part of the Medical Education Translational Resources: Impact and Quality (METRIQ) study, we recruited medical students, EM residents, and EM attendings to evaluate five FOAM posts with the AAT and provide quantitative and qualitative feedback via an online survey. Two independent analysts performed a qualitative thematic analysis with discrepancies resolved through discussion and negotiated consensus. This analysis informed development of an initial revised AAT, which was then further refined after pilot testing among the author group. The final tool was reassessed for reliability.ResultsOf 330 recruited international participants, 309 completed all ratings. The Best Evidence in Emergency Medicine (BEEM) score was the component most frequently reported as difficult to use. Several themes emerged from the qualitative analysis: for ease of use-understandable, logically structured, concise, and aligned with educational value. Limitations include deviation from questionnaire best practices, validity concerns, and challenges assessing evidence-based medicine. Themes supporting its use include evaluative utility and usability. The author group pilot tested the initial revised AAT, revealing a total score average measure intraclass correlation coefficient (ICC) of moderate reliability (ICC = 0.68, 95% confidence interval [CI] = 0 to 0.962). The final AAT's average measure ICC was 0.88 (95% CI = 0.77 to 0.95).ConclusionsWe developed the final revised AAT from usability feedback. The new score has significantly increased usability, but will need to be reassessed for reliability in a broad population.

Published
2021

6. Code Status Documentation Availability and Accuracy Among Emergency Patients with End-stage Disease

Author

Russell, Evan, Hall, Andrew K., McKaigney, Conor, Goldie, Craig, Harle, Ingrid, and Sivilotti, Marco L.A.

Subjects
emergency medicine, goals of care, code status, end-stage disease, palliative
Abstract

Introduction: Some patients with end-stage disease who may neither want nor benefit from aggressive resuscitation receive such treatment if they cannot communicate in an emergency. Timely access to patients’ current resuscitation wishes, or “code status,” should be a key metric of electronic health records (EHR). We sought to determine what percentage of a cohort of patients with end-stage disease who present to the emergency department (ED) have accessible, code status documents, and for those who do, how quickly can this documentation be retrieved.Methods: In this cross-sectional study of ED patients with end-stage disease (eg, palliative care, metastatic malignancy, home oxygen, dialysis) conducted during purposefully sampled random accrual times we performed a standardized, timed review of available health records, including accompanying transfer documents. We also interviewed consenting patients and substitute decision makers to compare available code status documents to their current wishes.Results: Code status documentation was unavailable within 15 minutes of ED arrival in most cases (54/85, or 63%). Retrieval time was under five minutes in the rest, especially when “one click deep” in the EHR. When interviewed, 20/32 (63%) expressed “do not resuscitate” wishes, 10 of whom had no supporting documentation. Patients from assisted-living (odds ratio [OR] 6.7; 95% confidence interval [CI], 1.7-26) and long-term care facilities (OR 13; 95% CI, 2.5-65) were more likely to have a documented code status available compared to those living in the community.Conclusion: The majority of patients with end-stage disease, including half of those who would not wish resuscitation from cardiorespiratory arrest, did not have code status documents readily available upon arrival to our tertiary care ED. Patients living in the community with advanced disease may be at higher risk for unwanted resuscitative efforts should they present to hospital in extremis. While easily retrievable code status documentation within the EHR shows promise, its accuracy and validity remain important considerations.

Published
2021

7. Competence By Design: a transformational national model of time-variable competency-based postgraduate medical education

Author

Frank, Jason R., primary, Karpinski, Jolanta, additional, Sherbino, Jonathan, additional, Snell, Linda S., additional, Atkinson, Adelle, additional, Oswald, Anna, additional, Hall, Andrew K., additional, Cooke, Lara, additional, Dojeiji, Susan, additional, Richardson, Denyse, additional, Cheung, Warren J., additional, Cavalcanti, Rodrigo B., additional, Dalseg, Timothy R., additional, Thoma, Brent, additional, Flynn, Leslie, additional, Gofton, Wade, additional, Dudek, Nancy, additional, Bhanji, Farhan, additional, Wong, Brian M.-F., additional, Razack, Saleem, additional, Anderson, Robert, additional, Dubois, Daniel, additional, Boucher, Andrée, additional, Gomes, Marcio M., additional, Taber, Sarah, additional, Gorman, Lisa J., additional, Fulford, Jane, additional, Naik, Viren, additional, Harris, Kenneth A., additional, St. Croix, Rhonda, additional, and Van Melle, Elaine, additional

Published
2024
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12. Society for Simulation in Healthcare Guidelines for Simulation Training

Author

Stefanidis, Dimitrios, primary, Cook, David, additional, Kalantar-Motamedi, Seyed-Mohammad, additional, Muret-Wagstaff, Sharon, additional, Calhoun, Aaron W., additional, Lauridsen, Kasper G., additional, Paige, John T., additional, Lockey, Andrew, additional, Donoghue, Aaron, additional, Hall, Andrew K., additional, Patocka, Catherine, additional, Palaganas, Janice, additional, Gross, Isabel T., additional, Kessler, David, additional, Vermylen, Julia, additional, Lin, Yiqun, additional, Aebersold, Michelle, additional, Chang, Todd P., additional, Duff, Jonathan, additional, Kolbe, Michaela, additional, Rutherford-Hemming, Tonya, additional, Decker, Sharon, additional, Collings, Amelia, additional, and Toseef Ansari, Mohammed, additional

Published
2024
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13. Evaluating Competence by Design as a Large System Change Initiative: Readiness, Fidelity, and Outcomes

Author

Hall, Andrew K., primary, Oswald, Anna, additional, Frank, Jason R., additional, Dalseg, Tim, additional, Cheung, Warren J., additional, Cooke, Lara, additional, Gorman, Lisa, additional, Brzezina, Stacey, additional, Selvaratnam, Sinthiya, additional, Wagner, Natalie, additional, Hamstra, Stanley J., additional, and Van Melle, Elaine, additional

Published
2024
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19. Lessons learned and new strategies for success: Evaluating the Implementation of Competency-Based Medical Education in Queen's Pediatrics.

Author

Acker, Amy, Leifso, Kirk, Crawford, Lindsay, Braund, Heather, Hawksby, Emily, Hall, Andrew K, McEwen, Laura, Dalgarno, Nancy, and Dagnone, Jeffrey Damon

Subjects
HOSPITAL medical staff, EVALUATION of human services programs, FOCUS groups, WORK, PEDIATRICS, COLLEGE teacher attitudes, TRANSITIONAL programs (Education), INTERVIEWING, EXPERIENCE, HUMAN services programs, OUTCOME-based education, MASTERS programs (Higher education), STUDENTS, EXPERIENTIAL learning, MEDICAL schools, DESCRIPTIVE statistics, RESEARCH funding, STUDENT attitudes, THEMATIC analysis, MEDICAL education, EDUCATIONAL outcomes, TEACHER development
Abstract

Objectives In 2017, Queen's University launched Competency-Based Medical Education (CBME) across 29 programs simultaneously. Two years post-implementation, we asked key stakeholders (faculty, residents, and program leaders) within the Pediatrics program for their perspectives on and experiences with CBME so far. Methods Program leadership explicitly described the intended outcomes of implementing CBME. Focus groups and interviews were conducted with all stakeholders to describe the enacted implementation. The intended versus enacted implementations were compared to provide insight into needed adaptations for program improvement. Results Overall, stakeholders saw value in the concept of CBME. Residents felt they received more specific feedback and monthly Competence Committee (CC) meetings and Academic Advisors were helpful. Conversely, all stakeholders noted the increased expectations had led to a feeling of assessment fatigue. Faculty noted that direct observation and not knowing a resident's previous performance information was challenging. Residents wanted to see faculty initiate assessments and improved transparency around progress and promotion decisions. Discussion The results provided insight into how well the intended outcomes had been achieved as well as areas for improvement. Proposed adaptations included a need for increased direct observation and exploration of faculty accessing residents' previous performance information. Education was provided on the performance expectations of residents and how progress and promotion decisions are made. As well, "flex blocks" were created to help residents customize their training experience to meet their learning needs. The results of this study can be used to inform and guide implementation and adaptations in other programs and institutions. [ABSTRACT FROM AUTHOR]

Published
2023
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24. Gender Differences in Emergency Medicine Attending Physician Comments to Residents: A Qualitative Analysis

Author

Mamtani, Mira, primary, Shofer, Frances, additional, Scott, Kevin, additional, Kaminstein, Dana, additional, Eriksen, Whitney, additional, Takacs, Michael, additional, Hall, Andrew K., additional, Weiss, Anna, additional, Walter, Lauren A., additional, Gallahue, Fiona, additional, Yarris, Lainie, additional, Abbuhl, Stephanie B., additional, and Aysola, Jaya, additional

Published
2022
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26. Emerging concepts in the CanMEDS physician competency framework

Author

Thoma, Brent, primary, Karwowska, Anna, additional, Samson, Louise, additional, Labine, Nicole, additional, Waters, Heather, additional, Giuliani, Meredith, additional, Chan, Teresa M, additional, Atkinson, Adelle, additional, Constantin, Evelyn, additional, Hall, Andrew K, additional, Gomez-Garibello, Carlos, additional, Fowler, Nancy, additional, Tourian, Leon, additional, Frank, Jason, additional, Anderson, Rob, additional, Snell, Linda, additional, and Van Melle, Elaine, additional

Published
2022
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30. Individual Gestalt Is Unreliable for the Evaluation of Quality in Medical Education Blogs: A METRIQ Study

Author

Thoma, Brent, Sebok-Syer, Stefanie S., Krishnan, Keeth, Siemens, Marshall, Trueger, Seth N., Colmers-Gray, Isabelle, Woods, Rob, Petrusa, Emil, Chan, Teresa, Alexander, Charlotte, Alkhalifah, Mohammed, Alqahtani, Saeed, Anderson, Scott, Anderson, Shelaina, Andrews, Colin, Andruko, Jocelyn, Ankel, Felix, Antony, Nikytha, Aryal, Diptesh, Backus, Barbra, Baird, Jennifer, Baker, Andrew, Batty, Sarah, Baylis, Jared, Beaumont, Braeden, Belcher, Chris, Benavides, Brent, Benham, Michael, Pelletier, Elyse Berger, Botta, Julian, Bouchard, Nicholas, Brazil, Victoria, Brumfield, Emily, Bryson, Anthony, Bunchit, Wisarut, Butler, Kat, Buzikievich, Lindy, Calcara, David, Carey, Rob, Carroll, Stephen, Lyons, Casey, Cassidy, Louise, Challen, Kirsty, Chaplin, Tim, Chatham-Zvelebil, Natasha, Chen, Eric, Chen, Lucy, Chhabra, Sushant, Chin, Alvin, Chochi, Eric, Choudhri, Tina, Christensen, Jeremy, Colmers-Gray, Isabelle, Connors, Kimberly, Coppersmith, Veronica, Cosgrove, Abby, Costello, Gregory, Cullison, Kevin, DʼAlessandro, Andrew, de Wit, Kerstin, Decock, Marie, Delbani, Rayan, Denq, William, Deutscher, Julianna, Devine, Brendan, Dorsett, Maia, Duda, Taylor, Dueweke, Justin, Dunphy, Teresa, Dyer, Sean, Eastley, Kathryn T., Edmonds, Marcia, Edwards, Ken, Ehrman, Robert, Elkhalidy, Youness, Fedor, Preston, Ficiur, Brian, Flynn, Caley, Fraser, Bill, Fu, Meagan, Fukakusa, James, Funk, Eric, Gaco, Damjan, Gawlik, Viktor, Ghaffarian, Kenn, Gharahbaghian, Laleh, Griffith, Phil, Griffith, Andrew, Grock, Andrew, Gronowski, Tanner, Grossman, Cathy, Gucwa, Jaroslaw, Gupta, Pawan, Gustafson, Alexandra, Guy, Andrew, Haas, Mary, Haciski, Stanislaw, Hajdinjak, Emina, Hall, Andrew K., Hammock, Regina, Hansel, Jan, Hart, Alexander, Hattin, Larissa, Herb, Brandon, Hilbert, SueLin, Hill, Jesse, Hill, Jeff, Ho, Amy, House, Emily, House, Nina, Huffman, James, Inboriboon, Charlie, Ireland, Alex, Jamal, Mohammed Ali, Jansen, Victor, Jarou, Zach, Jia, Vivian, Johnston, Levi, Kalnow, Drew, Kapur, Puneet, Kelly, Seth, Kelson, Kyle, Kent, William, Khakhkhar, Rishi, Khurana, Jaasmit, Kilp, Ashley, Knapp, Scott, Kohler, Sebastian, Kruhlak, Ivanna, Lalani, Nadim, Lam, Samantha, Lank, Patrick, Laurie, Zander, Lea, Kristina, Leber, Ernest, Lee, Ching-Hsing, Lenes, Haakon, Lenora, Nilantha, Leontowicz, Jesse, Lien, Kelly, Lin, Yingchun, Lin, Michelle, Little, Andrew, Liu, Ivy, Liu, Harry, Liu, Steve, Louka, Stephanie, Lovell, Elise, Lowe, David, Lubberdink, Ashley, Luc, Jessica, Ma, Sheng-Hsiang, MacLeod, Hugh, Mancuso, Nick, Maneshi, Anali, Carrillo, Dra. Maria Rosa, May, Jesse, Mayo, John, McDonnell, Mike, McLellan, Susan, McQuarrie, Carolyn, Nood, Julia, Mead, Therese, Meeuwisse, Cory, Meloy, Patrick, Menzies, Perry, Messman, Anne, Miazga, Stephen, Mills, Logan, Milne, Ken, Mix, Allan, Montag, Steve, Moore, Brendon, Morgenstern, Justin, Mott, Sarah, Mukherj, P., Mulla, Ali, Nandalal, Sheena, Nikel, Taylor, Nugent, Sean, Oakland, Morgan, Oberholzer, Werner, Otugo, Onyeka, Oyedokun, Taofiq Segun, Paddock, Mike, Pardhan, Alim, Patel, Kinjal, Paterson, Quinten, Patocka, Catherine, Patterson, Christine, Pearlman, James, Pelletier-Bui, Alexis, Phan, Marc, Poonja, Zafrina, Powell, Aubrey, Premkumar, Kamini, Prosen, Gregor, Puri, Vishal, Quaife, Tanis, Raffel, Ryan, Raja, Ali, Ramunno, Randi, Rang, Louise, Rannazzisi, Suzanne, Regan, Shauna, Ridderikhof, Milan, Rogers, Vanessa, Roh, Christine, Rosenberg, Keith, Roure, Marina, Rudinsky, Sherri, Rudner, Joshua, Saleh, Adeeb, Sanderson, Will, Scheirer, Owen, Schofield, Paul, Schunk, Paul, Schwarz, Evan, Shahrabadi, Parisa, Shappell, Eric, Sheffield, Julia, Sherbino, Jonathan, Singh, Manpreet, Singson, Hector C., Slessor, Dave, Smith, Sam, Sneath, Paula, Sobehart, Robert, Spearing, Kerry, Stempien, James, Sternard, Britni, Stratton, Tara, Stuart, Katherine, Stuntz, Bob, Susalla, Michael, Sweeney, Colleen, Swisher, Loice, Swoboda, Henry, Syed, Shahbaz, Taira, Taku, Tambe, Nikhil, Tang, Richard, Targonsky, Elisha, Taylor, Rachel, Taylor, Alan, Taylor, Todd, Ting, Paxton, Tiwald, Gerhard, Tran, Kelvin, Tran, Evelyn, Trickovic, Jason, Trinquero, Paul, Trueger, Seth, Tyagi, Aaron, Umana, Manrique, Vallance, Patrick, Van den Berg, Patricia, Vargas, Luis, Verbeek, Rene, Viggers, Sandra, Vlodaver, Zlata, Wagner, Matthew, Walji, Noorin, Walter, Joe, Wan, Miranda, Wang, Rachel, Wanner, Gregory, Warawa, Wyatt, Ward, Mike, Weekes, Jennifer, Weersink, Kristen, Weessies, Cara, Whalen-Browne, Anna, Whiteside, Brian, Willis, Matthew, Wilmer, Jonas, Wong, Nelson, Woodcroft, Mark, Woods, Rob, Yau, Lawrence, Yee, Jessica, Yeh, Calvin, Huang, Simon York Ming, Yurkiw, Katherine, Zaver, Fareen, and Zozula, Alexander

Published
2017
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36. Simulation in the Continuing Professional Development of Academic Emergency Physicians

Author

Forristal, Chantal, primary, Russell, Evan, additional, McColl, Tamara, additional, Petrosoniak, Andrew, additional, Thoma, Brent, additional, Caners, Kyla, additional, Mastoras, George, additional, Szulewski, Adam, additional, Chaplin, Timothy, additional, Huffman, James, additional, Woolfrey, Karen, additional, Dakin, Christa, additional, and Hall, Andrew K., additional

Published
2021
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39. Correspondence

Author

Ruberto, Aaron J., primary, Sivilotti, Marco L.A., additional, Hall, Andrew K., additional, and Crawford, Frances M., additional

Published
2021
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40. Capturing outcomes of competency-based medical education: The call and the challenge

Author

Van Melle, Elaine, Hall, Andrew K., Schumacher, Daniel J., Kinnear, Benjamin, Gruppen, Larry, Thoma, Brent, Caretta-Weyer, Holly, Cooke, Lara J., and Frank, Jason R.

Abstract

There is an urgent need to capture the outcomes of the ongoing global implementation of competency-based medical education (CBME). However, the measurement of downstream outcomes following educational innovations, such as CBME is fraught with challenges stemming from the complexities of medical training, the breadth and variability of inputs, and the difficulties attributing outcomes to specific educational elements. In this article, we present a logic model for CBME to conceptualize an impact pathway relating to CBME and facilitate outcomes evaluation. We further identify six strategies to mitigate the challenges of outcomes measurement: (1) clearly identify the outcome of interest, (2) distinguish between outputs and outcomes, (3) carefully consider attribution versus contribution, (4) connect outcomes to the fidelity and integrity of implementation, (5) pay attention to unanticipated outcomes, and (6) embrace methodological pluralism. Embracing these challenges, we argue that careful and thoughtful evaluation strategies will move us forward in answering the all-important question: Are the desired outcomes of CBME being achieved?

Published
2021
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41. Competency-based time-variable training internationally: Ensuring practical next steps in the wake of the COVID-19 pandemic

Author

Onderwijscentrum Onderwijs, Schumacher, Daniel J., Caretta-Weyer, Holly, Busari, Jamiu, Carraccio, Carol, Damodaran, Arvin, Gruppen, Larry D., Hall, Andrew K., Kinnear, Benjamin, Warm, Eric, Ten Cate, Olle, on behalf of the ICBME Collaborators, Onderwijscentrum Onderwijs, Schumacher, Daniel J., Caretta-Weyer, Holly, Busari, Jamiu, Carraccio, Carol, Damodaran, Arvin, Gruppen, Larry D., Hall, Andrew K., Kinnear, Benjamin, Warm, Eric, Ten Cate, Olle, and on behalf of the ICBME Collaborators

Published
2021

46. Evaluation of a National Competency-Based Assessment System in Emergency Medicine: A CanDREAM Study

Author

Thoma, Brent, primary, Hall, Andrew K., additional, Clark, Kevin, additional, Meshkat, Nazanin, additional, Cheung, Warren J., additional, Desaulniers, Pierre, additional, ffrench, Cheryl, additional, Meiwald, Allison, additional, Meyers, Christine, additional, Patocka, Catherine, additional, Beatty, Lorri, additional, and Chan, Teresa M., additional

Published
2020
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48. Development of a national, standardized simulation case template

Author

Baylis, Jared, primary, Heyd, Christopher, additional, Thoma, Brent, additional, Hall, Andrew K., additional, Chaplin, Timothy, additional, Petrosoniak, Andrew, additional, McColl, Tamara, additional, O'Brien, Michael, additional, Deshaies, Jean-François, additional, and Caners, Kyla, additional

Published
2020
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