Engaging residents to choose wisely: Resident Doctors of Canada resource stewardship recommendations

Abstract

Background: Resident doctors are integral to healthcare delivery in Canada. Engaging residents in resource stewardship is important for professional development, but also as they are drivers of healthcare resource use. To date, no national resident-specific resource stewardship guideline has been developed. Resident Doctors of Canada (RDoC) in collaboration with Choosing Wisely Canada (CWC) sought to develop an evidence-informed, consensus-based list of five recommendations to promote resource stewardship. Methods: RDoC convened a taskforce with diverse geographic and specialty representation to develop candidate recommendations targeting resident resource stewardship behaviours using a consensus-based process, supported by a literature review. Residents across the country provided feedback on the candidate recommendations via an online questionnaire. The taskforce used this feedback to finalize the list.Results: The taskforce prepared 28 candidate recommendations for consideration. A detailed literature review and consensus process narrowed this list to 12 candidate recommendations for consultation. A total of 754 residents (754/10,068 residents = 7.5%) representing all provinces and levels of residency training reviewed and ranked the candidate recommendations. The highest-ranked recommendations comprised the final list.Conclusion: Resident doctors are willing and able to demonstrate leadership in advancing resource stewardship by the development of a national resident-specific list of Choosing Wisely Canada recommendations.

Going against the status quo in screening

“…Physicians, medical trainees, and patients potentially all have different understandings of key screening concepts, making appropriate and informed decision making challenging. 23,24 It is important to emphasize that screening guidelines are not rules, and that using them properly requires understanding the evidence behind them. Critical thinking skills are key to understanding how to communicate screening to patients (such as using infographics and decision aids) through a shared decision-making approach.…”

À l’encontre du statu quo en matière de dépistage

“…Les médecins, les étudiants en médecine et les patients comprennent tous différemment les concepts clés du dépistage, ce qui complique la prise de décisions appropriées et éclairées 23,24 . Il importe de réaffirmer que les lignes directrices relatives au dépistage ne sont pas des règles, et qu'il faut bien comprendre les données probantes qui les étayent pour les utiliser correctement.…”

Engaging medical trainees in resource stewardship through resident-led teaching sessions: A choosing wisely educational initiative

“…Medical trainees order more tests than practicing physicians. 1,2 This variation may stem from insecurity, inadequate understanding, or misguided expectations. 3 Residents are active on the frontlines of medical care and, as recent graduates, they are in a unique position as near-peer educators to medical students to address trainee-specific barriers to resource stewardship, while simultaneously building their own skills in this area.…”