BackgroundTransformation of medical students to become medical professionals is a core competency required for physicians in the 21st century. Role modeling was traditionally the key method of transmitting this skill. Medical schools are developing medical curricula which are explicit in ensuring students develop the professional competency and understand the values and attributes of this role. The purpose of this study was to determine student perception of professionalism at the University of Ottawa and gain insights for improvement in promotion of professionalism in undergraduate medical education.MethodsSurvey on student perception of professionalism in general, the curriculum and learning environment at the University of Ottawa, and the perception of student behaviors, was developed by faculty and students and sent electronically to all University of Ottawa medical students. The survey included both quantitative items including an adapted Pritzker list and qualitative responses to eight open ended questions on professionalism at the Faculty of Medicine, University of Ottawa. All analyses were performed using SAS version 9.1 (SAS Institute Inc. Cary, NC, USA). Chi-square and Fischer’s exact test (for cell count less than 5) were used to derive p-values for categorical variables by level of student learning.ResultsThe response rate was 45.6% (255 of 559 students) for all four years of the curriculum. 63% of the responses were from students in years 1 and 2 (preclerkship). Students identified role modeling as the single most important aspect of professionalism. The strongest curricular recommendations included faculty-led case scenario sessions, enhancing interprofessional interactions and the creation of special awards to staff and students to “celebrate” professionalism. Current evaluation systems were considered least effective. The importance of role modeling and information on how to report lapses and breaches was highlighted in the answers to the open ended questions.ConclusionsStudents identify the need for strong positive role models in their learning environment, and for effective evaluation of the professionalism of students and teachers. Medical school leaders must facilitate development of these components within the MD education and faculty development programs as well as in clinical milieus where student learning occurs.

CQI can enhance educational program quality and outcomes, if the process is designed to collect relevant information and the results are used for program improvement.

OBJECTIVES To help reduce pressure on faculty staff, medical students have been used as raters in objective structured clinical examinations (OSCEs). There are few studies regarding their ability to complete checklists and global rating scales, and a paucity of data on their ability to provide feedback to junior colleagues. The objectives of this study were: (i) to compare expert faculty examiner (FE) and student-examiner (SE) assessment of students' (candidates') performances on a formative OSCE; (ii) to assess SE feedback provided to candidates, and (iii) to seek opinion regarding acceptability from all participants.METHODS Year 2 medical students (candidates, n = 66) participated in a nine-station formative OSCE. Year 4 students (n = 27) acted as SEs and teaching doctors (n = 27) served as FEs. In each station, SEs and FEs independently scored the candidates using checklists and global rating scales. The SEs provided feedback to candidates after each encounter. The FEs evaluated SEs on the feedback provided using a standardised rating scale (1 = strongly disagree, 5 = strongly agree) for several categories, according to whether the feedback was: balanced; specific; accurate; appropriate; professional, and similar to feedback the FE would have provided. All participants completed questionnaires exploring perceptions and acceptability.RESULTS There was a high correlation on the checklist items between raters on each station, ranging from 0.56 to 0.86. Correlations on the global rating for each station ranged from 0.23 to 0.78. Faculty examiners rated SE feedback highly, with mean scores ranging from 4.02 to 4.44 for all categories. There was a high degree of acceptability on the part of candidates and examiners.CONCLUSIONS Student-examiners appear to be a viable alternative to FEs in a formative OSCE in terms of their ability to both complete checklists and provide feedback.

The Future of Medical Education in Canada Postgraduate (FMEC PG) Project was launched in 2010 by a consortium of four organizations: the Association of Faculties of Medicine of Canada, the Collège des Médecins du Québec, the College of Family Physicians of Canada, and the Royal College of Physicians and Surgeons of Canada. The FMEC PG study set out to review the state of the Canadian postgraduate medical education (PGME) system and make recommendations for improvements and changes. The extensive process included literature reviews, commissioned papers, stakeholder interviews, international consultations, and dialogue with the public and learners. The resulting key findings and 10 recommendations, published in a report in 2012, represent the collective vision of the consortium partner organizations for PGME in Canada. Implementation of the recommendations began in 2013 and will continue beyond 2016.In this article, the authors describe the complex process of developing the recommendations, highlight several recommendations, consider implementation processes and issues, and share lessons learned to date. They reflect on the ways in which the transformation of a very complex and complicated PGME system has required many stakeholders to work together on multiple interventions simultaneously. Notwithstanding the challenges for the participating organizations, changes have been introduced and sustainability is being forged. Throughout this process, the consortium partners and other stakeholders have continued to address the social accountability role of all physicians with respect to the public they serve.