In 2012, the Department of Family Medicine at the University of Ottawa conducted a study to identify stakeholder’s perspectives of site visits and how they can be improved to support preceptors and provide the best learning experience for medical students and residents. Two data sources were utilized to address the research questions: interviews with stakeholders (both focus group and individual interviews) and online surveys with preceptors. The findings assert that establishing a process for site visits to maximize preceptor support and the quality of medical student and resident supervision is a complex process. Perceptions of quality site visits for all stakeholders were strongly linked to: 1) having clear expectations; 2) making site visits a priority and supplying the necessary support and resources; 3) supporting preceptors to be better teachers; 4) the quality and timeliness of preceptor feedback from residents and medical students; 5) involving the medical student and resident in the site visit process; and 6) an integration and collaboration among curriculum, faculty development and evaluation resources. As researchers continue to build site visit recipes based on theory and reflection of practical experiences, the resulting insights will enable all stakeholders in family medicine programs to make more informed decisions to positively impact the quality of the site visit experience, support preceptors in being better teachers and improve the quality of the supervision of residents and medical students. This study takes one step toward building a broad base of theoretical knowledge informed by practical experiences on site visits.

Background: In March 2020, the COVID-19 pandemic disrupted competency-based medical education in Family Medicine programs across Canada. Faculty and residents identified a need for clear, relevant, and specific competencies to frame teaching, learning, supervision and feedback during the pandemic. Methods: A rapid, iterative, educational quality improvement process was launched. Phase 1 involved experienced educators defining gaps in our program’s existing competency-database, reviewing emerging public health and regulatory guidelines, and drafting competencies. Phase 2 involved translation, member-checking, and anonymous feedback and editing of draft competencies by residents and other educational leaders. Phase 3 involved wider dissemination, collaborative editing and feedback from residents and faculty throughout the department. Results: A total of 44 physicians including residents and faculty from multiple contexts provided detailed feedback, review, and editing of an ultimate list of 33 competencies organized by CanMEDS-FM roles. Broad agreement was obtained that the competencies form reasonable learning outcomes during the COVID-19 pandemic. Conclusions: These competencies represent learning objectives reflecting the initial educational mindsets of a wide range of teachers and learners experiencing a global pandemic. The project illustrates a novel collaboration across educational portfolios as a rapid educational response to a public health crisis.

Contexte : La rétroaction écrite est primordiale dans l’enseignement aux résidents, mais les précepteurs ne sont pas toujours bien outillés pour offrir une rétroaction pertinente. Cette étude visait à évaluer l’efficacité de formations multiépisodiques et l’utilisation d’un guide critérié pour les rétroactions écrites des précepteurs en médecine familiale d’un centre hospitalier académique francophone. Méthode : Vingt-trois (23) précepteurs ont participé aux formations et ont utilisé le guide critérié pour les guider lors de l’évaluation écrite dans une fiche évaluative nommée « feuille de route ». Le contenu de ces feuilles de route a été analysé selon la complétion, le taux de rétroactions spécifiques et le taux de rétroactions par rôle CanMEDS-MF avant et après les formations sur une période de 3 mois.   Résultats : Selon l’analyse des feuilles de route (n=70 prétest ; n=138 posttest), une augmentation du pourcentage de complétion (50% vs 92%, z=2.97, p=0.0030) et de rétroactions spécifiques (59% vs 92%, z=2.47, p=0.0137) fut notée. Il n’y avait aucune augmentation significative quant aux rétroactions par rôle CanMEDS-MF.   Conclusions : L’élaboration de formations multiépisodiques et d’un guide critérié, créés selon le référentiel CanMEDS-MF, suggère une amélioration de rétroactions écrites complètes et spécifiques en éducation de la médecine familiale.

Background: Third-year enhanced skills programs, also known as family medicine (FM) PGY3 programs, have always been an area of debate. Their exponential growth does not stem from a strong body of academic evidence or public health needs assessment. This qualitative descriptive study explores the current perspectives of second-year FM residents at the University of Ottawa on extended training programs through semi-structured interviews. Results: Of the fifteen participants, eight were applying to PGY3 FM programs, six were not and one was unsure. Themes generated included: developing generalist niches within primary care, increasing confidence of FM graduates, allowing generalists to fill in healthcare gaps to meet community needs, meeting the pressures of workplace competition and employability requirements, and creating alternate paths to five-year specialties. 80% would extend their core FM training, with self-design and options of shorter time frames as preconditions. Conclusion: FM residents are interested in furthering their training, whether through extending core residency period or via enhanced skills programs. The demand for these programs will continue rising. Capitalizing on residents’ interests to catapult the profession forward and optimize the quality of healthcare should be the priority for licensing bodies and medical educators.