Teaching Tips & Tools - Introduction
Deficiencies can be identified in any CanMEDS roles. The most common are addressed here. A number of these issues can be viewed as inter-related across domains. Four primary domains that are most often flagged for remediation are:
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Medical Expert
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Communicator
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Professional
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Collaborator
Common areas of difficulty identified in learners:
MEDICAL EXPERT - Inadequate knowledge base - Application of Knowledge, Knowledge Translation, and/or Evidence-based Medicine - Procedural Skills - Clinical Skills (i.e. Patient Histories, Physical Exam) - Clinical reasoning skills, data synthesis, generation of a differential diagnosis - Clinical Decision-making - Management Plan - Cognitive Biases
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COMMUNICATION - Case Presentation Skills - Patient-centred Communication - Conciseness - Accuracy of information - Cultural Sensitivity/Competence - Written communications - Dictations - Non-verbal Communication Skills - Breaking difficult news and Empathy
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PROFESSIONAL - Recognizing Limitations, asking for help - Accountability, professional responsibility - Confidentiality & Consent - Adhering to policies, procedures, and expectations - Managing job-related stress and anxiety - Self-reflection and demonstrating insight |
COLLABORATOR - Inter- and Intra-professional interactions - Effective handovers, Organized Clinical Presentations - Conflict Resolution Skills - Seeking and accepting feedback - Demonstrating respect, respectful interactions
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Interventions and Modifications
There are modifications and interventions programs can consider when developing a remediation or probation plan. Possible modifications include:
ROTATION MODIFICATIONS:
- Protected Time for Remedial Activities
- Being excused from additional academic activities (e.g. journal clubs, half days, etc.)
- Being excused from specific mandatory program sessions
- Access to and organization of extra teaching & learning opportunities
- Predetermined specific preceptors
- Modified rotation to maximize exposure to specific clinical cases.
- Modified patient load, progressive responsibilities as per level of training
- Removal from call duties
SUPPORT OFFERED BY THE PROGRAM:
- Access to an impartial mentor (not involved with formal evaluation)
- Weekly meetings with the Program Director
SUPPORT OFFERED BY PGME:
- Funding support to pursue coaching as needed
- Funding support to pursue educational assessment as needed
- Sessions with Education and Learner Resource Specialist
MODFIED ASSESSMENT ACTIVITIES:
- Increased Frequency of Assessments and feedback
- Additional assessment types
- Modified assessments to target specific goals and objectives
- Regular follow-up by program director regarding the resident
- Assigned additional homework activities to the resident
- Practice written tests, OSCEs, observed clinical cases