Education Matters 2012 by FDpublications

Number 19

Spring 2012

Faculty Development & Educational Support

Education MATTERS Teaching Tips and More for Members of the UBC Faculty of Medicine

What to Do About the Disengaged Clinical Trainee

Benefits of a Clinical Faculty Appointment

Five Faculty Members from across BC Share Teaching Experiences

Teaching Tips from Students and a Standardized Patient

30–31

22–23

26–28

Editors’ Words

Dear Faculty Colleagues: We have recently joined the small team of faculty members spread across the four sites, most of us clinicians, who dedicate a portion of our work lives to faculty development within the Faculty of Medicine. What’s faculty development? It’s anything that helps faculty members succeed in their teaching roles. Our current priorities are to increase awareness among faculty members that faculty development is a resource available to all, and to help faculty members feel more engaged with the school and inspired about their teaching. Thus, as the new editors, we initiated some changes to this, the print periodical of the Faculty Development Office, hoping it would help us start to achieve our goals. We struck a committee of faculty members who represent various jurisdictions within the Faculty to help determine relevant content and format for you as faculty. The committee prioritized several areas: teaching tips; new teaching technologies/approaches; and perspectives and ideas of faculty, students, and others we interact with in the teaching environment. We also summarized each of the five undergraduate and master’s programs within the Faculty. We anticipate faculty who teach certain components of particular program(s) will benefit from an improved sense of where their students are in their developmental trajectories. We look forward to your feedback on this edition. With the wide and impressive variety of teaching that occurs in the Faculty of Medicine at UBC, we realize an individual reader may not relate to every article, but we hope that there is something here for everyone. For future editions we want to include even more contributions to better represent the full spectrum of our faculty. Please flip to the back page and consider how you can contribute. Enjoy the read, Linlea Armstrong and Heather Buckley

Education Matters Committee members: Left to right in the photo: Beth Watt, Jason Ford, Issy Laher, Yan Huang, Heather Buckley, Joseph Lam, Michael Lee, Linlea Armstrong. Not photographed: Richéal Carroll, Lesley Bainbridge, Carol-Ann Courneya, Kiran Veerapen, Becky Hartley, Howard Yan (Photo: Richéal Carroll)

Apple images on cover and back pages conceptualized by editors and created by Richéal Carroll Photos provided by contributors or as indicated Production: UBC IT Creative Services

Contents Improving Our Teaching

The UBC Programs

Tips for Teachers 2012

Clinical Preceptor Pearls: The Learning Cycle

Three Ways to Teach Non-verbal Communication Skills in the Clinic

Effective Use of the Audience Response System (ARS)

Simulation in Health Care Education

Case Study of a Disengaged Clinical Trainee

An Introduction to Assessment

Assessment of Your Teaching by Students and Others

The Teaching Community

Dawn Dewitt and Her Vision for Programs within the Faculty

“Program Milestones”: Quick References to Determine What Your Student Should Already Know and Where Your Student is Heading

Success in Interprofessional Education: An MD Course Invites Students in Other Programs to Learn Together

An OT and a Family Doctor Reflect on CompetencyBased Clinical Education Evaluation Tools

Views from Other Sides Students Speak to Us

“Five by Five”: Five Faculty Members from Across the Province Share Their Teaching Experiences

The Evaluation Studies Unit Finds that “The Learning Environment” Predicts Student Satisfaction and Performance at UBC

Advantages of a Clinical Faculty Appointment: Academic Services and Resources

A Day in the Life of a Standardized Patient: An Actor Offers her Insights

Advantages of a Clinical Faculty Appointment: Personal Benefits

Share Your Thoughts and Feedback

back page

Tips for Teachers 2012

Joseph Lam (Moderator) The Tips for Teachers section is a place where teachers and learners can share his/her teaching tips. Submissions can be sent to education.matters@ubc.ca

Adam Lund, MD “When taking a history on a trauma patient, apply the ‘Spielberg Principle’ – the famous movie director! Get enough history that you can write the screenplay, hire stuntmen, arrange props and costumes, and recreate the scene. If you can fully visualize what happened, you can predict most injuries based on understanding how energy was transferred to the body. Props include the tools, sports equipment, and automobiles involved. There’s a big difference between a collision in a 2010 Civic and a 1972 Oldsmobile. Costumes include protective equipment, safety goggles, etc. Applying the ‘Spielberg Principle’ ensures you really understand what happened to your patient.” 4

Tamara Shenkier, MD “At the end of a clinic or at any other clinical learning opportunity the preceptor picks a specific clinical interaction (e.g. discussing the side effects of steroids before starting prednisone) and writes it down. Beneath a brief description of the clinical problem, the preceptor draws two adjacent columns and asks the resident what they think went well (Plus) and what they think is a gap that needs work (Delta). This is written down briefly. Then the preceptor elaborates or adds to the resident’s self-assessment. The learner leaves with a specific new learning point to explore (e.g. remember to mention chronic steroid effects and look up evidence-based preventative measures to reduce bone loss; check for understanding as you talk to patients). The page is dated, signed, and given to the resident to add to his/her portfolio.”

the audience will have a tough time digesting everything and you will be hard pressed to get through it all. The most memorable presentations are ones that engage the audience and leave them with a few key messages.”

Darlene Redenbach, PT PhD “In most of our programs, students work very hard and it is important they be acknowledged for that, even when the result isn’t sterling. I find that it helps to remember that for every statement about what can be improved, there are glass half-full and glass half-empty forms of feedback. A simple example, in feedback about a presentation, is instead of ‘I could not follow because you spoke too quickly’, you could say, ‘I could follow better if you spoke a little more slowly.’ I make a practice of checking my feedback for statements that can be changed and let students know that you are in their corner. Not only is it easier for the student Vivian Leung, MSI II “I personally find it really helpful when lecturers to accept, but it also describes the desirable behaviour and implies that the student can do include multiple-choice questions within the it. I am not sure this is very novel, but it works lecture to check my understanding before and I like it much better when I get that kind of moving on to a new topic. Even just a minute feedback.” or two to discuss it with a neighbour is really beneficial.” Stan Bardal, BSc(Pharm), MBA, PhD “I believe that perhaps above all else, a good Jonathan Yang, MSI I teacher needs to be creative, and they must “I often see instructors show a slide and then be able to recall what it was like to learn comment, ‘This slide has a lot of information the concept they are teaching for the first – but you don’t need to know any of it.’ In my opinion, this slide has no place in a presentation time. They must be able to make the concept and can be replaced with a simple reference for relevant for the student, relating it to their everyday lives, and ensuring that it has students to read on their own time.” significance to their future careers.” Aaron Knox, MD PGY-2 “For large group lectures it works well to adhere Joseph M. Lam, MD, is a Clinical Assistant Professor to the three step business presentation format. in the Department of Pediatrics and associate Step 1: Tell your audience what you’re going to member of the Department of Dermatology and Skin Sciences at the University of British Columbia. He tell them. Step 2: Tell them. Step 3: Tell them practices pediatric dermatology in Vancouver. He is what you told them. A good rule of thumb is one of the three winners of the 2012 Clinical Faculty to limit yourself to one slide of material per Award for Excellence in Clinical Teaching. minute of allocated time. More than that and

Clinical Preceptor Pearls: The Learning Cycle Leslie Sadownik

The following model helps to outline the different stages adults move through as they gain mastery in a clinical skill. Novices usually begin learning a skill by observing an “expert” perform the skill. Naturally, an expert performs the skill with little effort. The novice learner may not appreciate the complexity of the skill because it “looks so easy.” At some point, the learner may even think, “What’s the big deal? If they just gave me a chance I could perform that skill.” At this point the learner does not know what they do not know. The learner is unconsciously incompetent.

to reach the stage of conscious competence faster than if they are left on their own. At this stage, the learner is able to perform the skill—but is consciously focusing on the skill. The learner may be “talking themselves” through the skill—for example, reviewing the procedure beforehand, visualizing what they will do, or rehearsing the steps. Or they may be using frameworks to remind themselves how to approach a clinical problem. perform the skill. Teachers often resort to demonstrating: “Don’t do it like that, do it like this…”

UNCONSCIOUS COMPETENCE

MASTERY

(Photo: Richéal Carroll)

How do adults learn in a clinical setting?

CHANGE

4 Now, let’s say you involve the learner. Perhaps I ask the learner to “Set up what THE UNCONSCIOUS you need to perform a Pap smear, choose CONSCIOUS 3 LEARNING 1 COMPETENCE INCOMPETENCE CYCLE the appropriate equipment, and position the patient;” the learner suddenly becomes 2 LEARNING AWARENESS aware of what they do not know. Likely the learner was not paying attention to the preparatory steps needed to perform CONSCIOUS the skill. The learner begins to reflect on FEEDBACK INCOMPETENCE INVOLVEMENT what he/she needs to know, “Do I use the spatula or brush? Why are there different types of speculums?” The learner realizes, “I For example, using mnemonics to guide their need to know more in order to perform this history taking or differential diagnosis. Learners skill.” If the awareness occurs in a supportive at this stage make excellent teachers as they learning environment the learner will feel are very aware of “what you need to know” to motivated to address his/her learning needs. perform the skill. In a busy setting, consider involving novice Eventually, with enough experience, the learners in specific tasks associated with a learner stops thinking about the skill—it patient encounter (history taking or parts of becomes second nature. The learner is now the clinical exam) rather than handing over the unconsciously competent—a state we want entire patient encounter – “why don’t you go all independent physicians to reach! Over time see this patient....” the physician may “forget” the theoretical Practice, practice, practice. Observation of principles and steps behind each procedure – the learner by a teacher with timely and they just “do it.” At this point, it may be difficult appropriate feedback will help the learner for the expert to explain to a learner how to

This model outlines some important principles of adult education. Adult learners need to be actively involved in their learning in order for them to develop learning needs. These needs will then motivate the adult to obtain the necessary knowledge and skills to become competent. Adults need to make mistakes so that they become consciously incompetent. In order for them to be receptive to constructive feedback, these mistakes need to take place in a supportive environment. Otherwise, learners are likely to avoid a situation in which they feel incompetent and no further learning will occur. Learners left on their own may not advance their skill level. As teachers we need to observe learners, even consciously competent learners, and provide feedback. Everyone deserves feedback. Leslie Sadownik is an Assistant Professor in the UBC Department of Obstetrics and Gynaecology. She also works within the Office for Educational Support and Faculty Development as a Faculty Development Project Leader.

Three Ways to Teach Non-verbal Communication Skills in the Clinic Cicely Bryce

Communication skills are a major focus of instruction in the pre-clerkship years in the Faculty of Medicine at UBC. One skill that is particularly difficult to teach in a lecture is how to interpret emotional information that is not verbalized. In a busy clinic even very junior students can practice focusing on what a patient’s body language and facial expressions are saying rather than just listening to the content of the patient’s speech. Depending on the level of the learner, you can try one of the following exercises with the learner: 1.

Have the student identify a non-verbal communication (usually a behaviour or emotion). In this activity the student is advised that after the interview you will discuss together “what else” the patient was saying.

Have the student turn a non-verbal communication into a verbal one. In this activity the student is to verbalize and address an observed emotion or behaviour you have observed, e.g. “I see that you are getting restless and wonder if you have some thoughts about what I am saying.” Later discuss what the student noticed.

Have the student explicitly act on a non-verbal cue. In this activity the student identifies and explores the patient’s cues, to the extent that they can directly impact management, e.g. modifying a treatment protocol that had initially caused unspoken anxiety.

Acquiring good communication skills takes practice and benefits from explicit attention. To demonstrate effective communication skills we have to be good observers of our own interactions, be able to self-regulate (change the direction of our actions), and self-reflect (think about what we could do differently). Demonstrating both effective personal skills and communication strategies has the best chance of turning good students into excellent doctors.

Cicely Bryce is a medical oncologist by training with an interest in communication skills, patient-centred care, the patient experience of serious illness and inter-professional dialogue. She is currently the Course Director for Clinical Skills Year 2 VFMP.

Effective Use of the Audience Response System (ARS) Roger Wong and Linlea Armstrong • Reduce the amount of content that’s The ARS uses wireless hardware and covered during the lecture. The number of presentation software to facilitate slides will need to be decreased to allow communication within a lecture. The lecturer for interactivity to occur in a less stressful poses questions to the class, and poll responses manner while being supportive of the can be displayed for the lecturer or for the students’ learning needs. whole class to see. When we recently introduced ARS into our course, a number of lecturers simply inserted a handful of questions within their historicallyused slide sets, but otherwise delivered their lecture as they always had. This approach generally did not make the most of the ARS. Linlea Armstrong, as course director, interviewed Roger Wong about his approach, as Roger was identified by the students as the most effective lecturer using the ARS. His responses during the interview distill to the following advice: • Increase the interactivity of learners so that they feel actively engaged and able to participate. This is particularly important because peoples’ attention span can drop quickly in a purely didactic lecture. Thus, though the objectives are decided ahead of time, the finer points of these and delivery details should be modified based on the students’ responses.

asking a question because it’s not just about getting people clicking from different campuses—you need to get people talking! We need to remember to involve all campuses and avoid focusing mainly on our own campus in terms of the facilitated discussion.

• Gather the data from the previous year. Use it as a needs assessment to make adjustments to the lecture. • Commit to posting all the materials following the lecture on Medicol. This allows people to sit and relax and to try to absorb the lecture rather than frantically writing. • Use the ARS not only to arrive at what is right or wrong but also to get the students to think about why they got it right or wrong. For instance, if there is a challenging topic, pause and explore the reasons why students may have selected the incorrect response. Try and explain to the students the clinical deductive reasoning they need to use to help them arrive at the right response. • Have a good educational reason for each question asked using the ARS. Do not ask questions just for the sake of using the system.

• Strategically position the questions to gauge the learning needs of the audience over the • Ideally ask questions with varying degrees course of the learning session. If there is a of difficulty. Alert the students when there sense that a significant number of students is a more difficult question so they don’t were unable to obtain the correct responses, feel bad if they don’t get it. Let them know look at the responses and try to explore this how we think about arriving at the right and adjust/adapt teaching accordingly. answer. • Use cases. This is helpful as it gives some • Engage the different sites when degree of simulation to students to eliciting responses if using the ARS for a participate in the decision making and geographically-distributed session. Start clinical reasoning in the case. from the different distributed sites when

Roger Wong is a Clinical Professor in the Division of Geriatric Medicine, Department of Medicine, UBC, and is the Interim Assistant Dean of Postgraduate Medical Education, Faculty of Medicine, UBC.

Simulation in Health Care Education: What’s the Buzz About?

(Photo: Sandra Jarvis-Selinger)

Karen Joughin

There has been a buzz in recent years about the use of simulation in health care education, and how great it is. At the same time, there is confusion about what simulation is, exactly, and how we should or shouldn’t be using it. The following answers to some “Frequently Asked Questions” will hopefully explain in part what the buzz is about! What is simulation? Simulation is a learning or assessment activity in which learners/ practitioners perform tasks relevant to their work (or future work) in an environment created to look or feel real, and/or with people or materials that mimic those found in a real world setting. Simulations vary in complexity and level of realism. Examples from our own education programs in the Faculty of Medicine include learners practicing skills with special anatomical models or real tissues, interacting with actors playing the roles of clients/patients/ health care workers in specific scenarios, and responding to crisis situations using complex computerized mannequins in mocked-up health care settings. There are inconsistencies in labelling particular types of activities as simulation activities in the literature and in education practice, which can be confusing. Nonetheless, the key feature of simulation is the opportunity to practice or be assessed performing work-related tasks outside of the workplace. What are the benefits of simulation? In health care education specifically, simulation allows students to acquire and practice skills without disrupting real world health care delivery or endangering patient well-being. Trainees benefit because they can learn in a safe environment, seeing and dealing with the consequences of their actions without harm being done. Patients benefit directly from the higher levels of expertise. The system benefits because students are more efficient and effective when they later perform tasks in real health care environments. Benefits are similar when experienced health professionals use simulations to 8

maintain, re-acquire, or upgrade skills. Patient safety has been pivotal in the development of simulation methods in health care training and continuing professional development. Research has confirmed that what health care providers think they will do and what they actually do when placed in a situation may not be the same! Practicing in a realistic but simulated context facilitates the transfer of skills to performance later in the real context. (References are available on request). How is simulation being used in our programs now? Recent surveys have revealed that there is a great deal of simulation being used in Faculty of Medicine education programs currently, and there is a strong desire to use it more in the future. For learning or assessing communication skills including data gathering, counselling, and difficult discussions, “Standardized Patients/Clients” with roles played by trained actors are used in the genetic counselling program, occupational therapy, physical therapy, medical undergraduate, and medical postgraduate (residency) programs. For practicing clinical assessment and reasoning, virtual patient cases are used, in addition to other training methods. Virtual patient cases are online interactive case scenarios requiring learners to see, hear, and process information, make decisions and see outcomes based on decisions made. Virtual patient cases are also being used for inter-professional teamwork development. Invasive examination training and procedural skills training are aided by task-training models in most of our programs, an approach particularly prominent in the midwifery program. The medical undergraduate, postgraduate and continuing professional development programs are the heaviest faculty users of the

computerized mannequins, used in practicing crisis management and inter-professional teamwork in crisis situations. We have a number of faculty members with significant expertise in using simulation in health care education and assessment. Since 2003, many programs have been able to take advantage of the Centre of Excellence for Simulation, Education and Innovation (CESEI), a highly specialized simulation centre situated at the Vancouver General Hospital in Vancouver. CESEI was collaboratively built with assistance from UBC, Vancouver Coastal Health, industry partners and the VGH and UBC hospital foundations. The high-tech facilities and skilled staff support the use of simulation in Faculty of Medicine programs, nursing education programs, health authority training and professional development programs, and numerous other health care delivery service programs, e.g. paramedics. Shared-use high-tech simulation centres have been recently developed for Nanaimo, Prince George, and Kelowna as well. How could our programs use simulation strategically—most bang for the buck? As you can imagine, simulation can be time-consuming, labourintensive, and expensive. These constraints are balanced with the significant educational benefits of these activities. We may wish to be as strategic as possible in using simulation in our programs. One good approach is to start with the education goals i.e. skills we want learners to have or practitioners to demonstrate, and then consider what different learning or assessment methods offer. Simulations are often used to apply knowledge or practice skills previously acquired through other means, a way to consolidate and practice in context. A simulation can, however, also be used to immerse learners in new situations so that they understand the challenges and what they need to learn (useful in areas in which learners have trouble conceptualizing tasks at the outset). A simple role-play, with faculty playing the role of a patient or team member, can be incredibly powerful. A well selected and thought-out scenario, whether provided simply or in a complex environment with paid actors and high-tech tools, is central to the activity’s effectiveness for learning or assessment. For procedural skills, the realism or fidelity of the simulation need only be as high as the learner needs for their learning goals. For instance, to learn how to insert stitches in skin, a piece of foam and instruments may be all that is required if the learner is just learning how to hold or manoeuvre instruments. Using pig’s tissue will help when the learner needs to appreciate stitch insertion relative to layers of skin and subcutaneous tissue, the feel of different layers and thicknesses

public is keenly interested in “ The seeing more simulation training and

assessment in our programs, and many of our accreditation bodies are incorporating the use of simulation into program accreditation requirements.

”

of skin, or modifying distances between stitches when skin is different thicknesses. In order to allow a learner to integrate and practice performing the procedure in its entirety, a hybrid simulation set-up might be most suitable. In such a case an actor would play the role of a patient so that the learner addresses the patient’s needs (explaining the plan to the patient, telling him/her what is going on, or responding to challenging situations), while a synthetic skin model attached to the actor’s body part would be used in performing the manual aspects of the procedure. The optimal approach overall, then, is to determine what is specifically needed for the desired learning goal. Where are we headed in using simulation in our programs? The public is keenly interested in seeing more simulation training and assessment in our programs, and many of our accreditation bodies are incorporating the use of simulation into program accreditation requirements. The evidence of educational benefits is growing in the literature and faculty are receptive in wanting our learners to be the best they can be. These strong drivers, particularly the will of our faculty and learners, will undoubtedly lead to an increase in the use of simulation over the next few years. The increased use will be accompanied by needs for dedicated resources and faculty development, so that our faculty are well-equipped and confident in using these techniques. The Faculty of Medicine is currently developing strategies for supporting the use of simulation in its education programs. At the same time, the Faculty is working with partners to augment and coordinate simulation opportunities for learners and experienced health professionals across the province. Exciting times are ahead! That’s what the buzz is about. Karen Joughin is a plastic surgeon with a master’s degree in medical education and a PhD in surgical patient safety. She recently served as Interim Associate Dean, Undergrad Medical Education. 9

Case Study of a Disengaged Clinical Trainee

concerns about the learner’s performance.

Beth Watt and Leslie Sadownik

Review clinical performance at the mid point: Are the learner’s expectations being met? Are your expectations being met? This conversation should mirror your original conversation. “Remember at the start of the rotation I said that we expect you to arrive on the ward at 7:00 am? It has come to my attention that you were late on the following dates.” This is your opportunity to review your expectations, inform the learner he is not meeting these expectations, perhaps explore why the student is not meeting the expectations and then make a plan on how the student’s behaviour can improve. The plan is the most important part of the conversation, offering concrete strategies and guidance for the learner to improve his performance.

You are the clinical preceptor of a student on his first day of a rotation. You have previously outlined the expectations of the service including call. He is not on the floor yet at 8:20 am, and by 8:30 am you have to get on with rounds by yourself. He is late again the next day. After working with him, you feel he has a reasonable background of knowledge, but has problems putting things together and interpreting. Later in the week, you enquire about the student – no one has seen him on the ward or in clinic. You phone him to see if everything is okay. He says he has had a bad migraine for the last two days. You remind him to let someone know if he is going to be off. After your weekend off, you go onto the ward to again see how the student is doing. You have difficulty finding him, and you notice the call schedule is switched. The student has taken himself off future call with you. You talk to some of your colleagues on the service. Many have not met the student, and others give lukewarm feedback.

discuss what the goals and/or expectations are for the clinical rotation, (“What are you hoping to get out of your clinical experience?”) and what your goals/expectations are as the primary preceptor. It may be helpful to frame learning goals in terms of knowledge, skills, and attitudes. Try and be specific about clinical role and responsibilities (job description). Performance will be assessed based on observed behaviours. Be SMART about the target behaviours you expect – Specific, Measurable, Achievable, Realistic/Relevant and Timed behaviours. For example, “It is your responsibility to arrive on the ward at 7:00 am, see your assigned patients, write a brief note in the patient’s chart, and be prepared to present the patient during rounds. Rounds will start at 7:30 am.” Remember expectations about performance (e.g. start time, what to wear, how to write a chart note) likely differ across clinical contexts and therefore should be made explicit as soon as possible.

Review the written evaluation with the student to reinforce this conversation. Any concerns you have need to be documented on this mid-point form.

Ask for help: If your expectations and the student’s expectations do not match, it is worthwhile to discuss the situation with your program administrator. You should have the contact name and information for the program administrator (e.g. in the MDUP, this would be the clerkship site director). Also, if you are You try to talk to the student, but staff informs Reinforce the discussion by providing a written unable to have a constructive discussion with he has been off the last two days with the flu. job description and a schedule of activities the learner about his performance and the You finally catch up to him the next day, and (call, ward, clinic). Include the contact names need to change his behaviour, it is worthwhile ask if everything is okay. He says he’s fine. The and information for whom to inform if he is sick discussing this with the administrator. Your student does not ask you for a reference letter. and/or needs to make changes to the schedule. administrator needs to know if you have serious In his assessment, you review with him issues Gather specific feedback about the learner in a concerns about a learner’s performance. of professionalism and other concerns. He systematic fashion: For example, record specific Hearing about it at end of the rotation is too becomes very angry and storms out yelling “You examples of his performance on a prescription late! are just like all the others.” You call the school pad and keep these notes on your desk. Use but are not clear at first to whom you should an end-of-shift assessment to be filled in by Beth Watt has a full service family practice. She outline your concerns. supervising preceptors in clinics or while on call. teaches medical students and residents in classroom, This sheet can be immediately faxed to the site Recommendations office, and hospital settings. preceptor. Encourage your colleagues to send Orient the learner: At the start of the rotation, you an email and/or give you a call if they have it is helpful to sit down with the learner and 10

An OT and a Family Doctor Reflect on CompetencyBased Clinical Education Evaluation Tools Donna Drynan, OT; Beth Watt, MD Aspects adapted from: Holmes, J., (2010) Professional competence is the habitual and judicious use of communication, knowledge, technical skills, clinical reasoning, emotions, values, and reflection in daily practice for the benefit of the individual and community being served (Epstein & Epstein 2002).

student to entry practitioner. At UBC, the Master of Occupational Therapy program has used this competency-based evaluation tool for the past nine years. The tool was found to accurately measure and capture student acquisition of knowledge, skill, behaviour, and values in each of the seven competency domains, resulting in students who are either ready to enter the profession or catch those that require remedial experiences.

Evaluation of student competencies in the practice setting is, therefore, crucial to ensuring that graduating students have developed the professional competencies to enter professional practice. Many different tools are used to The pneumonic “RIME” is another helpful tool for assessing the level of learners at the beginning evaluate students during clinical placements of a rotation, as well as for midpoint and end-of-rotation evaluations. The tool describes various around the world. levels of learner abilities as they develop a competency. It ties in to the concepts found in the learning cycle model (see page 5). This intuitive tool was developed by internist Dr. Louis Pangaro. One among these is the Competency Based Fieldwork Evaluation for Occupational R = Reporter • able to accurately and reliably gather clinical information Therapists (CBFE-OT) (Bossers et al., 2002, • able to distinguish important from unimportant information and focus on 2007), an instrument designed to evaluate central issues (~end of 3rd or 4th year MDUP) occupational therapy students’ performance I = Interpreter • able to identify and prioritize problems during their fieldwork placements on seven • able to develop a differential diagnosis (~end of 4th year MDUP) practice competencies. During each placement, M = Manager • able to develop and defend a diagnostic and therapeutic plan for each of the following seven practice competencies are the patient’s central problems evaluated: • able to utilize their growing clinical judgement when action needs to be • Practice Knowledge; taken (~4th year MDUP, early residency) • Clinical Reasoning; E = Educator • have mastered the fundamental skills above • Facilitating Change with a Practice Process; • have the insight to define important questions to research further, seek out • Professional Interactions; evidence behind clinical practice, and share in educating the rest of the team • Communication; (~mid and late residency) • Professional Development; and • Performance Management. For each competency, students’ progress is evaluated using an eight-point competency rating scale, representing the student’s development along a continuum from entry

As Dawn DeWitt notes on page 14, preceptors frustrated with using summative tools for formative feedback are likely to welcome the RIME framework into their tool set. Donna Drynan is a Senior Instructor and Academic Fieldwork Coordinator in the Department of Occupational Science and Occupational Therapy, Faculty of Medicine and the Director of Interprofessional Practice Education in the Division of Interprofessional Education and Practice at the College of Health Disciplines, UBC. 11

An Introduction to Assessment Andrea Busse, Jennifer Fletcher, Andrea Jones, George Pachev, and Vesna Pavlovic Blueprinting: Ensures the coordination of assessment with program goals and learning experiences by matching the questions or observation units to the objectives. The blueprint:

Assessment, regardless of format, is a process that involves three interrelated but still distinct steps: • collection of information, • synthesis, interpretation, drawing conclusions from the collected information, and • decision making.

Blueprints Standard Setting

Items

The pillars are built upon a foundation of strong, clear learning objectives for the course/rotation.

student behavior, conditions of performance, and performance criteria

Objectives

Good Items: There are a variety of methods to assess student learning. Each method must: 1. 2. 3.

lists all of the objectives; shows all questions and/or observation units organized by objective; and ensures you have covered the objectives in a relevant way.

Standard Setting: A process by which we assign meaning to the numerical outcome of a written exam or clinical evaluation form. The process:

Objectives: Clear and unambiguous description of your educational expectations for students, including 1. 2. 3.

1. 2. 3.

relate directly to the objectives; test the application of important concepts; and be appropriate for the level of cognitive skill (recognition, recall, understanding, application, analyzing, evaluating, creating).

1. 2.

is based on the judgements of content experts, who are also familiar with the expected level of competence of the examinees; and identifies the score that indicates an examinee has reached the desired level of competency.

Andrea Busse, Jennifer Fletcher, Andrea Jones, and Vesna Pavlovic are the Assessment Managers for years 1 to 4, respectively, in the Educational Assessment Unit (EAU) of the Dean’s Office, Faculty of Medicine, UBC. George Pachev is the Head of the Unit.

The Educational Assessment Unit (EAU) and Faculty Development work together to periodically run exam writing and development workshops. All faculty are encouraged to use this resource. For a more in depth discussion of Best Practice for Assessment of Clinical Performance written from the point of view of a practicing occupational therapist (Dr. Megan Dalton), please visit our website www.facdev.med.ubc.ca → Teaching resources → Assessment & Feedback.

Assessment of Your Teaching by Students and Others Linlea Armstrong

To teach session after session without information upon which to base improvements, would be like practicing medicine without ever getting follow-up data on treated patients. For those who have never received an assessment of their teaching, the idea of being assessed may seem intimidating, perhaps even irritating, given the contexts in which the majority of faculty teach. Most of us teach without or with only limited administrative support and direct compensation. However, a high quality, sensitively-designed teacher assessment process can be a teacher’s best friend. The purpose of this article is to help faculty understand this, as well as provide an update on where things are with respect to assessment of teaching within the MDUP. Being assessed and receiving feedback helps reach one’s full potential. If you’re skeptical, consider whether an athlete would ever become a pro without a keenly observant and communicative coach. Some courses and clerkships in the MDUP have recognized the value of assessment of teaching and developed processes. Yet the data that these home-grown systems have collected is heterogeneous in terms of format, content, quality, accessibility, and application. Further, there are some departments where no assessment occurs. The Improving Teaching Through Assessment Initiative is in the process of designing and piloting a system for the MDUP that builds upon many of the concepts, tools, systems, and resources already in small scale use. It aims to ensure that efforts are more efficiently, effectively, and widely distributed.

A lot of attention is being paid to ensuring the questions asked are the relevant ones, reflective of what the FOM values in our teachers. As well, ensuring the process is fully transparent and that the data is treated sensitively are also priorities. The approach recognizes that for the majority of teachers contributing to the program, assessment needs are purely formative*. For these faculty, the focus is on communicating qualitative assessments. The approach is also responsive to the needs of the full time equivalent faculty at the various sites who also need quantitative data for their career advancement. The educational leader (in most cases the course or clerkship director) of any faculty member to be assessed is central to the process. The educational leader initiates and plans the assessment, reviews, and contextualizes the data, generates the report that goes to the teacher, and has the opportunity to highlight relevant faculty development opportunities. The process is also designed to inform department heads and regional associate deans of the teaching contributions of faculty members. This process will lead to better recognition and valuing of teaching in the MDUP, which to date has often been insufficiently celebrated.

*Formative assessments guide a performer, but do not impact the performer’s status or role. Formative assessments identify practices to reinforce, and point to where changes are needed. Summative assessments document and appraise teaching contributions, so that educational leaders can make recruitment, retention, and promotion decisions. This supports continuous improvement of teaching in the program overall.

Linlea Armstrong is a clinician with a portion of her time dedicated to Faculty Development. She has been working with George Pachev (Educational Assessment Unit) and Linda Peterson (Evaluations Studies Unit), with contributions from many faculty members, on the Improving Teaching Through Assessment Initiative. This will lay the groundwork for a comprehensive and unified approach for assessment of teaching within the MDUP that has potential for widespread adoption by other components of the FOM. See archived newsletters about the initiative on the Faculty Development website.

As we plan toward more widespread implementation within the MDUP, input from faculty members, whether or not they were involved with the pilots, will be invaluable. Please email tassessment@exchange.ubc.ca. 13

Dawn DeWitt and Her Vision for Programs within the Faculty Interview with Dawn DeWitt, Regional Associate Dean, Vancouver Fraser; Associate Dean Undergraduate Medical Education and Internist by Linlea Armstrong on February 16, 2012

Welcome to UBC. You were enthusiastically awaited. Please could you briefly describe your background? My father was a rural surgeon who trained in Vermont. When I was six we moved to Wisconsin, and the main thing I remember about living in Vermont was that my father was Maria von Trapp’s doctor. Maria von Trapp ran a home for unwed mothers there, and she broke her arm and my father fixed it. My dad caught TB from a patient and died when I was young. I decided that medicine had killed him and that I didn’t want to go to medical school. After exploring zoology, I got into Harvard Medical School during the pilot of the “New Pathway” and was lotteried into the pilot, which really changed my life. It was a new take on the McMaster’s Problem-Based Learning Curriculum in a very small group, just 38 of us. So we really struggled with the PBL thing. When I finished medical school the bowtie east coast culture wasn’t quite right for me, so I went out to Seattle and fell in love with the educational culture. There is such a strong commitment to educating students and residents as opposed to Harvard where people were really committed but often to research, and students were kind of in the way. I did my residency at the University of Washington and stayed on as the first woman chief resident at UW Medical Center. I decided I really had a passion for this rural medicine thing and being an advocate for underserved populations. I was lucky enough that some people were willing to take a risk on me (even though I almost applied for a personality transplant during residency. “It’s on back order. It’s coming. It’s coming”). I also loved teaching and medical education so I started working in the WWAMI Program (the only large-scale, publicly funded regional medical education program in the USA). What experiences at WWAMI will most influence the directions you set here? At that time ambulatory clerkships in medicine were new, so I set up 14

one of those with a lot of mentorship. I also got to really revitalize the WWAMI regional rotations. We ended up developing an interactive website for distributed students. I also developed a longitudinal evaluation form (for preceptors to use). The preceptors said, “we’re supposed to fill in the end of clerkship form every month and we’re supposed to show that the students are improving…” I thought, “What you really need is a progress report and a discharge summary.” We set up the ‘progress report’ using the RIME (recorder, interpreter, manager, educator) framework to show how the students were progressing. From your eventual role as director of WWAMI, you went to Australia. How did that lead you here? When I came here to interview, I looked at the curriculum here. We had just finished changing the curriculum at the Melbourne Medical School and I got to help with the change from a six-year MBBS program to a four-year MD. Since I was the Clinical Dean for Rural Health (three core rural sites), we had to adapt the metro curriculum for rural and work around the rural clinical teacher shortage. Luckily, we built several simulation labs and found an expert teacher, so we developed some fun simulation curriculum. My group created a really innovative, supportive student program and most of the elements were incorporated into the new Melbourne MD, which was really exciting. What do you think of the current MDUP program and the current renewal processes? My first impression was that UBC has a pretty traditional curriculum. You don’t do a lot of simulation with the students, it’s all rotationalbased, it’s all lecture based and I thought, “well there’s a lot to be done here.” So then I came back and people had done a wonderful job with the planning and processing of curriculum renewal and I thought, “Wow – these guys are amazing!”

Please describe your vision for the MD Undergrad Program. As David Hirsh from Harvard said, “The curriculum has to matter to the student, and [importantly] the student has to matter to the curriculum.” Most medical schools deliver a curriculum and the students, who of course are expected to participate, don’t actually matter that much to what we do. We lecture at them, we run some labs, we test them. For example, one of my favourite things is to take students to a multi headed scope to look at blood films, e.g. of leukemia. If it’s not their patient it’s just another display of nicely coloured objects. So the difference is we somehow need to have the students matter to the curriculum. The way to do that really is to say you guys need some connection; you need continuity with the teachers, with each other, and with patients. Somehow we’ve lost that continuity and need to bring it back as a central tenet of spiralled learning. Ironically the rural sites (distributed sites) with smaller student numbers have that. The regional Associate Deans know all the students and the students know them. The vision I think is about “how to” and I think the academic learning communities could provide the continuity so that teachers can deliberately help students progress their skills. The other thing, and people are probably going to shoot me for this, is that I’m not actually sure that tertiary hospitals are the best places for students to be learning. I think it’s much better for students to have generalistic experiences and for us to be telling them, “It’s wonderful if you get to see rare surgeries and diseases, but it’s not core curriculum. If you become a hand surgeon you will need to go back and really learn the detailed anatomy of the hand, but right now we’re going to focus on your core skills like physical diagnosis, history-taking, communicating to colleagues about patients, and active clinical problem solving.” One of the most fun parts of PBL for me was actually being able to say to the student. “We have a question here—how are we going to solve it right now?“ So, if we have a 15 minute meeting with a patient how are we going to answer this question in real time so that we don’t spend five hours every night answering patient’s questions and then getting back to them or requiring them to come back for another visit? So, I want to look at that as an explicit part of the curriculum, problem solving, because that’s what you do as doctors. Half the time you manage information, you solve little mysteries and learning how to do that is a skill. You can’t teach them everything but we can teach them how to figure things out, maybe not at Nobel Prize level, but you have to have aspirations. What is the coolest thing you can think of that we should incorporate into the programs across the Faculty?

People are already doing lots of creative work. Whether it’s a seminar around a movie or a painting or web-based virtual patients, we should be pulling those great ideas out of the woodwork and then standardizing them and weaving them throughout the curriculum. Course, clerkship, block, and week leaders are wondering about how much will actually change in the next three years. Can you address this with respect to their content and their roles? We have a very strong medical school program already. The accreditation mandate for a “centrally driven curriculum” will probably help us deliver a more cohesive program to the students. I do believe that we should have a blueprint for both curriculum and assessment. By doing this, I think we can eliminate enough unintentional repetition to allow time for deeper learning and deliberate reinforcement of topics. I think we need to thread themes (apply to every case) such as pathology (anatomical, histological, and lab), pharmacology and evidence-based practice through every PBL and clerkship. Other themes, e.g. ethics, genetics, and professionalism, need to be highlighted in some percentage of PBLs and cases throughout the four years. We need to look at a coordinated stream of academic half-days (or even two) throughout the clinical years. These should have standard cases, seminars, etc. that deliberately allow students to revisit or explore underlying basic science issues when they are seeing patients in clinical settings. Finally, please describe how this change will be managed. Managing change is really important. Everyone should read Kotter’s “My Iceberg is Melting.” The main thing I want everyone to understand is that I think the new roles and opportunities (Academic Learning Community Leaders/Coaches/Mentors), potential for Cluster and Theme Directors, and other new needed threads (simulation in medical education—how, when, who, what) will outweigh the losses of any current positions. For many people, change may be disconcerting, but stagnating isn’t so much fun either. As a Harvard professor I know told me recently, “Be the substrate, not the catalyst, because the catalyst gets used up.” For all of us at UBC, I hope we will end up as new entities (substrates) while retaining some resemblance to our old (substrate) selves. I guess that might make Cliff Fabian and Dave Snadden the catalysts. I’m sure not going to volunteer after that advice, but it seems my fate to have your backs. I think that there will be much more fun to be had as Curriculum Renewal rolls out.

Program Milestones Use these quick references to determine what your student should already know and where your student is heading. The following six pages summarize the programs within the Faculty of Medicine to provide a gauge for teachers on student development. Edited by Angela Ford

Audiology Program by Sharon Adelman Student background: Students must have a bachelor’s degree with biology, math, and psychology foundation, including credits in physics, developmental psychology, introduction to linguistics, sensation and perception, neuroanatomy, and research methods. As well, students have an interest in human communication, and at least one observation in a clinical audiology setting.

Y ear

Term 1: Sept-Dec

Term 2: Jan-Apr

Term 3: May-Aug

An introduction to the theoretical concepts of hearing science: • Anatomy and physiology of the auditory system • Acoustics and psychoacoustics • Speech perception • Language development across the lifespan • Communication disorders • Audiology as a clinical field

A study of advanced concepts in hearing science, including: • Amplification • Aural rehabilitation • Diagnostic audiology • Electrophysiology

Major practicum: students are placed in community clinics throughout BC and Canada full-time for the 13-week term.

Students have brief exposure to fieldwork, including a half-day observation at a clinic, participation in kindergarten hearing screenings, and a 1 week practicum.

Year

On an ongoing basis, students learn about working with First Nations populations. Students participate in lab and community-based hearing assessments, and attend a full-day hearing screening/education program. Students receive an orientation to clinical placements and working in teams.

The first term of Year 2 covers advanced concepts Students partake in 2 major practica in community clinics throughout BC and Canada, for a total of 13 in hearing science: weeks. • Advanced anatomy and physiology of the auditory system • Diagnostic audiology • Advanced amplification • Issues in professional practice • Hearing conservation • Pediatric audiology • Hearing and aging • Cochlear implants

Students partake in community visits for practical experience in First Nations health provision.

Speech and Language Pathology Program by Lisa Avery Student background: New students hold a bachelor’s degree with psychology and linguistics foundation, with credits in speech sciences, phonology, language acquisition, psycholinguistics or cognitive psychology, neurolinguistics, neuroanatomy, and research methods. Students have an interest in human communication, and at least one observation in a clinical SLP setting.

Year

Term 1: Sept-Dec

Term 2: Jan-Apr

Term 3: May-Aug

An introduction to the theoretical concepts of hearing science, audiology, language development, and speech pathology, including: • Language development across the lifespan • Phonological development, assessment, and intervention • Developmental language disorders

An advanced study of the science of speech and hearing, including: • Disorders of speech production, acquired language, swallowing • Case studies in phonological intervention

Major practicum: students are placed in community clinics throughout BC and Canada full-time for the 11-week term.

Students have brief exposure to fieldwork, including kindergarten hearing screenings and a 1 week practicum.

Year

The first term of Year 2 contains both theoretical and practical learning. In the classroom, students study: • Language disorders in the school years • Perceptual, cognitive, and social affective issues in communication • Issues in professional practice This term’s practicum is 2 days per week for 11 weeks in a local community clinic.

Students partake in community visits for practical experience in First Nations health provision.

On an ongoing basis, students learn about working with First Nations populations. Students receive an orientation to clinical placements and working in teams.

Advanced studies that include:

March-May:

June-July:

• Acquired disorders of language, speech, swallowing • Discourse analysis

An 8-week major practicum in community clinics throughout BC and Canada.

Advanced studies that include: • Augmentative and alternative communication systems • Fluency disorders

Occupational Therapy Program by Michael Lee Student background: Successful applicants have a recognized baccalaureate degree in any field, as well as three credits in the following pre-requisite courses: Human Anatomy, Social Sciences, Behavioural Sciences. New students have also completed a minimum of 70 hours of volunteer or work experience with individuals with disabilities.

Year

Term 1: Sept-Dec

Term 2: Jan-Apr

Term 3: May-July

An introduction to theoretical concepts and basic clinical skills, including: • core concepts in occupational therapy, including conceptual models of occupation, health, illness, disease, and activity • range of motion and manual muscle strength testing • interview skills, clinical communication, health records and charting • occupational performance assessment tools • the design and use of assistive technologies and techniques

Students begin more in-depth study into clinical reasoning and application. Together with research paradigms and method, students also participate in four skill-based modules: • Biomechanical intervention • Psychosocial intervention • Neuro-rehabilitation • Multi-system issues – seating and positioning, splinting and casting

Students learn the structure and function of the human nervous system. Term 3 includes 7 weeks of Level 2 fieldwork from May to June. Level 2 fieldwork focuses on further knowledge application and skills acquisition.

Term 2 includes 5 weeks of Level 1 fieldwork from January to early February.

Interprofessional learning happens throughout Throughout the two-year curriculum, small group the curriculum, through mandatory core learning case-based tutorials help to integrate content activities and elective interprofessional learning from all courses, addressing issues for clients of opportunities. different ages, abilities, and circumstances. Cases cover a wide range of clinical context, and their complexity is gradated to foster independent learning.

Year

Throughout Year 2, students attend theory and practice workshops on specific areas of practice. Topics include: advanced psychosocial intervention, assistive technology, autism, driver rehabilitation, assessment and management of eating, drinking and swallowing difficulties, ergonomics, gerontology, hand therapy, leisure, life care planning, and vocational rehabilitation. Students also complete a limited-scope research project or program evaluation and study about societal and environmental influences on practice. Year 2 includes a block of Level 2 fieldwork for 7 weeks, as well as two Level 3 fieldwork blocks, each 6 weeks long. Level 3 fieldwork focuses on knowledge and skills consolidation, preparing to enter professional practice.

Physical Therapy Program by Alison Greig Student background: Students entering the Physical Therapy Program have completed courses in the basic sciences as well as human physiology and anatomy.

Year

Term 1: Sept-Dec

Term 2: Jan-Apr

Term 3: Apr-Aug

The first term establishes a foundation of theoretical knowledge, including: • Human gross anatomy • Disease mechanisms, including the immune system, infectious diseases, musculoskeletal system • Mechanisms of posture, movement, and exercise

Students build on their foundation of scientific knowledge in Term 2. Coursework covers: • Basic research methods • Structure and function of the nervous system • Disease mechanisms, including hematologic, cardiovascular, respiratory, CNS, and sensory organs • Motor development, aging, energy, and respiration

Students begin their clinical fieldwork in 2 placements (1 and 2), each lasting 5 weeks.

Students also learn basic clinical skills and decision making: • Interview, communication, confidentiality, universal precautions • Therapeutic touch, draping and positioning, walking aids, wheelchair and seating • Joint and muscle assessment and prescribing a basic exercise program

Year

Year 2 builds on theoretical knowledge, while further developing clinical skills. In the first term, students learn: • Disease mechanisms, including the GI system, reproductive, genetic disorders, the skin, endocrine, and neoplasia • Clinical skills and cases covering the spectrum of ages and abilities; focus on neurological, musculoskeletal, pediatric areas and electrotherapeutic agents Students complete a 5-week clinical placement (3).

Students study case-based integration with cases that cover hip and leg fractures, cystic fibrosis, and shoulder dislocation. Students learn theory and skills around teaching and learning, ethics and research projects.

Students continue to build their clinical and decision-making skills, including: • Functional activity analysis • Exercise prescription • Basic PT interventions • Common acute and chronic conditions: focus on musculoskeletal and cardiorespiratory areas Jan-Mar: Students complete a 5-week (4) clinical fieldwork placement. Case-based integration continues with a post-stroke case.

Apr-July:

July-Sept:

Students learn advanced clinical skills and decision-making in manual therapy, rheumatology, and complex conditions to prepare them for professional practice.

Students complete their final 5-week clinical fieldwork placements (5 and 6). Case-based integration concludes with a hand injury and SCI. Students present their research projects. 19

Medical Doctor Program by Jason Ford Student background: Some new medical students have an extensive background in the health sciences (e.g. RNs, PhDs) while others have a background in the arts or other non-health-science fields.

Year

1 Year

2 Year

3 Year

Term 1: Sept-Dec

Term 2: Jan-May

Year 1 begins with basic biomedical sciences and basic communication. The major course is Principles of Human Biology (PRIN). They are also beginning their exposure to human anatomy and histology.

Foundations of Medicine (FMED) coursework focuses on the basic physiology and pathophysiology of four systems: infectious disease and immunity, cardiovascular, pulmonary, and renal.

The FMED course now addresses four new systems: gastrointestinal, blood, musculoskeletal (i.e. orthopedics and rheumatology), and endocrine.

The FMED course concludes with: neurologic and psychiatric, reproductive (including OBGYN), and pediatric and nutritional systems.

Exposure continues to anatomy, histology, and pathology. Clinical skills training focuses on bone and joint, pelvic and breast, and ophthalmologic examinations.

Anatomy (including neuroanatomy), histology, and pathology conclude this term. Clinical skills sessions focus on breast and pelvic, neuropsychiatric, and pediatric histories and physicals.

There is ongoing exposure to anatomy, histology, and pathology. Clinical skills training focuses on introductory history and physical exam skills such as vitals, head and neck, chest and abdomen.

Year 3 begins with a one-week orientation to the clinical clerkship, which includes sessions on radiology, clinical order writing, suturing, and blood gas procedures. Communication skills and fluids/electrolytes are also addressed. After this orientation, the year is divided into clinical rotations which may be taken in any sequence: • dermatology (1) • anesthesiology (2) • psychiatry (6) • internal medicine • elective (2) • orthopedics (2) • obstetrics and (8 weeks) • ophthalmology (1) gynecology (6) • general surgery (8) • emergency medicine (4) • pediatrics (8) This year is entirely elective-based. Electives are usually 4 weeks, but may be 2 weeks. Students must take at least one elective in a “medical” specialty, one in a “surgical/procedural” specialty, and one in a “primary care” setting. Students often use electives from September to November to audition for the residency program they want. Residency program choices must be submitted to CaRMS (the Canadian Resident Matching Service) by late November. Students often hope to get reference letters from clinical preceptors in their autumn rotations to support their residency applications. In January and February, students take a small and large-group course called PMP (Preparation for Medical Practice), covering a variety of topics including communication skills, palliative care, pharmacology, radiology, transfusion medicine, etc. Students also use this period to travel across Canada for residency interviews. The remainder of the year consists of clinical electives. Students in academic difficulty may be assigned to remediation electives in the spring.

Midwifery Educational Program by Elaine Carty Student background: Successful applicants to the Midwifery Program have completed pre-requisite courses in human anatomy and physiology and university English. The majority of applicants have an undergraduate degree, although a degree is not required.

Year

1 Year

Term 1: Sept-Dec

Term 2: Jan-Apr

Year 1 contains pre-clinical foundational courses. Students learn the basics of midwifery theory and practice, which introduces knowledge and skills in prenatal care, labour and birth, postpartum care and newborn care. Coursework includes women’s health issues, birth and its meaning, and applied health sciences (chemistry, microbiology, immunology).

Introduction to theory and practice continues. Term 2 coursework also includes: • Counseling for maternity care providers • Lactation consultation • Pharmacology • Critical appraisal and research methods

In the core coursework of Year 2, students learn about care during normal pregnancy, labour, birth and puerperium, as well as assessment and management skills during the intrapartum period. The practicum is 10 weeks and clinical issues are discussed using a PBL approach.

Students continue the second term of Midwifery Theory for Primary Care using PBL audio and videoconference to consider clinical problems. Students in the clinical component of Term 2 are placed in locations around the province, and may also pursue an elective of their choice.

To prepare for clinical work, students learn about ethics and undergo a classroom and lab-based clinical skill intensive.

Year

Year 3 focuses on the recognition and management of variations of normal and findings outside normal.

In Term 2, students begin their senior research project, then choose one of two options:

Following a 1-week intensive, students participate in 10-week clinical placements in locations around the province.

Interprofessional Placement, in which students are assigned to health practitioners such as obstetricians, family physicians, nurses, and lactation consultants.

2. Global Maternal Infant Health and Global Clinical Placement, which consists of a placement outside of North America. (The global placement usually takes place over the summer months).

Year

Fourth year, Term 1, begins with a one-week intensive, followed by a clinical placement which focuses on advanced concepts in primary care. Clinical problems are discussed using PBL via videoconference.

In the Term 2 clerkship, students assume a primary care role in their clinical placements. Theoretical aspects involve regular case reviews with a tutor.

Five by Five

refers to an old radio communication term meaning “loud and clear.” It is the title for a new regular feature which uses five questions to highlight five UBC Faculty of Medicine educators and their teaching experiences and perspectives. Heather Buckley (Editor)

QUESTION 1 Please describe your role in teaching in the Faculty of Medicine. Q uestion 2 What 3 words best describe your course/program/ area?

Abeed Jamal

Alison Greig

The first is as a clinical teacher in the division of Nephrology primarily at St. Paul’s Hospital and the second is as my role as the Year 4 Clerkship Director for the Department of Medicine.

I have a leadership role in the management, coordination, and delivery of the Master of Physical Therapy (MPT) Program, which gives me the opportunity to be involved in many aspects of physical therapy education. I also teach clinical skills in an occupational science and occupational therapy course.

Longitudinal Dynamic Comprehensive

Moving Health Forward

Q uestion 3 How has your course/program/ area evolved over the past one-two years?

Over the past few years we have seen growth in our training program with respect to the number of international students and trainees we have working directly with us. The teaching methodology has also become much less didactic and more discussion/case based. The access to the most recent articles and information is more abundant today than ever before and the teaching now seems to focus more on the assimilation of information.

The department has made a major move into a fantastic new lecture, lab, and office space in the Friedman Building. With this move brought an expansion from 40 students to 80 students per cohort, and this expansion has had noticeable implications for teaching and learning. We have had to train instructors, modify our schedule, and revise sessions to best support the larger numbers of students.

Q uestion 4 Please describe a memorable teaching mishap.

We have all been faced unknowingly with the medical student with a PhD in immunology as we start to try and describe the immunologic basis of a disease, only to realize that the medical student could teach us the subject. I suppose this situation may well lead to embarrassment but I see no reason why we as teachers can’t continue to learn and I try to use these moments to learn myself. I think also the nature of most of our clinical teaching lends for this type of twoway learning.

I’ve had plenty of teaching mishaps, but I usually find that students are forgiving of many of these “hiccups.”

Q uestion 5 What is one thing you have learned in the past year that has changed or influenced your approach to teaching?

Humility. Apologies if this sounds corny. I have over the last few years seen parents age and have lost a couple of elder family members – parents’ siblings in particular. As a result of this I have spent more time on the side of the bed that I am not accustomed to being on – the patient’s side. This has made me realize that the role I play in a patient’s situation needs to be a multi-faceted accounting for medical, social, and often even financial stressors. If I can impart some of this understanding to students and create more compassionate physicians moving forward, then I think I may have succeeded.

I attended a UBC workshop on student evaluation of teaching. A very accomplished teacher spoke about collecting student feedback mid-way through a course. I decided to trial this approach. Based on the feedback, I made some adjustments to the remaining classes, including adding a mock exam and changing the structure of a review session. The formal student feedback (CoursEval) indicated very positive comments regarding this approach.

One recent mishap was a very busy lecture / lab session teaching students about the use of ambulation aids. It was already a rushed session, with groups of students on crutches and canes in stairways, halls, and labs all over the building – this session is notoriously a “gong show.” I suddenly realized that it was almost 4:00 pm and quickly rounded up all 80 students and five teaching assistants back at the main lab for a very rushed “debrief.” When I dismissed the class, I noticed many surprised faces and students were slow to pack up and leave. Some time after, one student kindly approached me and told me that the class was actually scheduled until 4:30 pm that day.

Heather Buckley is a family physician who has been involved in teaching a wide variety of medical undergraduate courses. She has been the VFMP Faculty Development Coordinator for the MD Undergraduate Program since January 2012.

Ryan Bystrom

Nancy Van Laeken

Jim Salzman

I am currently practicing in West Kelowna at a clinic with five other family physicians, and this is my first year of teaching. I have taken on two roles: teaching first year medical students in the clinical setting and teaching residents by being a preceptor.

I am a plastic surgeon who is a member of the UBC Division of Plastic Surgery. I have been involved with the Faculty of Medicine at UBC since I started practice in 1989. Since that time, I have had exposure to students at all levels of training to include preceptorships for first year medical students as well as training of all levels of residents not only in the plastic surgery program but in the various surgical programs that rotate through plastic surgery.

I am the course director for first-year clinical skills. I am also a tutor in first and second-year clinical skills courses. In addition, I tutor a third year communication skills session as well as sessions in the fourth year Preparing for Medical Practice course. In past years, I have tutored both years (one and two) of the Doctor, Patient and Society course as well as several Problem Based Learning blocks.

Clinical Work Mentoring Practical Teaching

Hand Clinic Breast Oncology Reconstructive Microsurgery

Communication Practice Understanding

So far so good. My family practice is large. West Kelowna has been an area of population growth. The students who work with me get to see a diverse group of patients including geriatric and emergent care. We never know who might walk in the door and that keeps the days interesting and full of learning opportunities.

We now have standardized teaching templates to ensure that all students are exposed to the same information regardless of the consultant that is assigned that day. Another change in the past few years is increased exposure to the numbers of students we teach, both at the graduate and undergraduate level.

Technology has enhanced some of our course presentations such as a virtual respiratory patient module that the students access on-line. We have incorporated aspects of communication skills from a culturally-sensitive perspective including the use of translators in the setting of a doctor-patient interview

My most memorable teaching mishap occurred in the context of communicating remotely with a student. It was becoming easy to keep track of each other during busy times by interacting via texting. During one of these brief interactions, it became clear that the student believed he was texting his girlfriend, not his preceptor. I tried to set things straight as quickly as possible but enough was exchanged for some substantial embarrassment to ensue. Of course the mortified student profusely apologized and weâ&#x20AC;&#x2122;ve had a few good laughs over the mix-up.

With respect to memorable teaching mishaps, I suppose my greatest embarrassment is when I am delayed by clinical activity for a formalized teaching session leaving the students waiting.

In years past, we had both dental students and medical students in communication skills but it was supposed to be separate (i.e. dental students interviewing dental patients and medical students interviewing medical patients). One of the medical students went to the patient waiting area and chose a dental patient by mistake for her interview. She could not figure out why the patient was confused by her medically-focused questions and the dental patient couldnâ&#x20AC;&#x2122;t understand why she was asking about his medical history and not his dental history.

This is all still new for me. My approach to teaching is evolving as I spend time with my students. What I have learned is that the process we undertake to educate our students works. All that time we spent as students rotating through different aspects of medicine, while we didnâ&#x20AC;&#x2122;t necessarily understand at the time, prepares us to speak the language, develop clinical competence, and treat our patients.

Often during a busy day, there is inadequate time to take a pause and adequately explain or go over a surgical technique with a resident. One of the residents commented that the cases in the OR are often so quickly completed that there is inadequate time to absorb the anatomy or the technique. That has allowed me to reflect on what I do, and, when possible, I will slow the process down to ensure that the residents and students have an opportunity to absorb what is being presented as well as ask questions.

Patients have stories to share and we have to provide a comfortable setting that allows them to do this.

descriptions of collaboration from the students were rich and very positive.

The second pilot involved two standardized patient (SP) encounters at the end of the PMP course. The two cases involved an elderly orthopaedic patient with a fractured hip and a young aboriginal woman presenting with a Lesley Bainbridge breech baby close to the end of her pregnancy. We invited students from physical therapy, Interprofessional education (IPE) has been occupational therapy, nursing, speech language defined as “occasions when two or more pathology, audiology, midwifery, and genetic professions learn with, from and about each counselling to join the medical students in other to improve collaboration and quality of these encounters. Unfortunately, some of the care” (CAIPE, 2002). professions were unable to participate due to scheduling conflicts but many students did Despite slow uptake of IPE over the past 50 participate. The tutors were provided with years, today it is one of the most common ways to include all students in the debriefing buzz words in health professional education. following the encounter. The exchange of ideas Navigating busy curricula to embed IPE is and information was lively in each group, and challenging. One place that it has gained the interactions among the students was very important traction is in the fourth year PMP positive, constructive, and respectful. Next year (Preparing for Medical Practice) course. we hope to include more students from other This spring we introduced two new pilot projects professions and to allow non-medical students to PMP focusing on IPE. In the first pilot, we to interact with the SP, possibly to enable the brought medical and pharmacy students orthopedic encounter to take place as a team together to work on a medication reconciliation encounter, and to enhance the interprofessional project. Medical students were assigned the discussions in the debrief. task as part of their PMP project and pharmacy students volunteered to participate for this first trial. There were two equally important foci for this pilot: the actual medical reconciliation learning and the interprofessional learning. Medical and pharmacy students were assigned to groups of four on average with two pharmacy students and two medical students. They were to meet as a group to discuss blinded medication histories of patients in a variety of settings. They then wrote a short report that described their observations of the medication issues and potential solutions AND they described the roles of the physician and the pharmacist with their respective contributions, skills, and knowledge along with a description of collaboration between the two professions. The 24

Lesley Bainbridge (BSRPT, MEd, PhD) is Director of Interprofessional Education in the Faculty of Medicine as well as Associate Principal in the College of Health Disciplines and is immersed in many aspects of interprofessional education and collaborative practice at UBC. Her home department is physical therapy and she worked as a clinician, manager and administrator in the health sector before moving to UBC where she has served as an administrator, educator, and researcher.

(Photo: Richéal Carroll)

Success in Interprofessional Education: An MD Course Invites Students in Other Programs to Learn Together

The Evaluation Studies Unit Finds That “The Learning Environment” Predicts Student Satisfaction and Performance at UBC Anne Worthington, Shayna Rusticus, Derek Wilson, Karen Joughin

Background: The learning environment (LE) is the “milieu in which the explicit curriculum is taught.” The present study was driven by faculty interest in exploring the LE at the UBC MDUP campuses following program expansion. Method: A modified version of the Medical School Learning Environment Survey (MSLES) was used. Items were added to increase the reliability. Factor analysis identified eight subscales such as flexibility, student interaction, supportiveness, organization, and emotional climate. The survey, including an item on overall satisfaction, was administered to Year 1, 2, and 3 medical undergraduate students (311 responded). Regression analyses were conducted to determine whether aspects of the LE could predict (1) overall satisfaction and (2) academic performance (GPA). Findings: Students reported high levels of satisfaction with their current year of study. Aspects of the LE predicted 46% of overall student satisfaction (very large effect), and 9% of student performance (medium effect). Aspects were unique for each year of study.

Predictors of Student Satisfaction Y1: Organized and coherent program Y2: Meaningful and relevant learning activities Y3: Confidence, self-value, and achievement

Predictors of Student Performance Y1: Broad curriculum (e.g. social context of medicine; psychological dynamics of being ill) Y3: Students support one another/ share problems

Results for individual MSLES items highlighted areas of strengths and weaknesses as follows. Strengths

Weaknesses

• Students get to know each another and spend time assisting one another (Y1 & Y2)

• Some inflexibility of curricular/ administrative policies

• Faculty and staff are supportive, enthusiastic, genuinely interested in helping students, and provide meaningful learning experiences

• Inability to shape the program to meet individual needs and learning pace

• Curriculum is organized with clearlyoutlined objectives, sufficient time for assignments, and systematic progression of classes from week to week • Curricular content assists students to become competent physicians • Connections are clear between basic science and patient care (Y1 & Y3)

• Increasing anxiety/decreasing sense of self-value (Y3) • Minimal time for friends, family, recreation, and community service (Y3, IMP, NMP) • Occasional emphasis on trivial details • Connections are less clear between the basic sciences and clinical applications (Y2)

Contact: anne.worthington@ubc.ca

Conclusions: The study of the LE identifies “bigger picture” strengths and weaknesses not currently being captured through regular course evaluations. Aspects of the learning environment are relevant predictors of student satisfaction and performance.

Anne Worthington has been an evaluation specialist

Shayna Rusticus is ESU’s statistical analyst. She has

Derek Wilson is the Associate Director of the

with ESU for the past three years. Her primary areas of work have included the Year 4 Program and Technology-Enabled Learning Initiatives.

a PhD in measurement, evaluation and research methodology and has been working with the Faculty of Medicine for four years.

Evaluation Studies Unit (ESU) in the UBC Faculty of Medicine. He has been a professional program evaluator for 25 years and is responsible for evaluating strategic initiatives, such as undergraduate curriculum renewal and accreditation. 25

Students Speak to Us The idea for this article came about over dinner with our mentor, Dr. Beth Watt. Dr. Watt invited us to develop an article to offer students’ insights into optimal learning in the academic lecture and clinical settings. We systematically surveyed all years of the MDUP, and subsequently selected the most dedicated and diverse representation of students available to us. Those who have contributed to this piece come from all four years of MDUP and an array of backgrounds, including training in B.Ed and certified teaching, in academic PhD, and in MD/PhD programs. Student involvement from other programs within the Faculty of Medicine was also solicited, and several MOT students submitted responses. We hope the ideas below will stimulate serious discussions among both academic and clinical instructors, and ultimately effect change in our learning. Sincerely, Rebecca Hartley and Howard Yan (MD, class of 2014)

Tips for the Lecturer Isabel Chen and Jesse Ory (MD, class of 2015) 1. It is helpful to start off with some basic context to orient everyone on the topic of your lecture and how it relates to clinical medicine. That way, when acronyms and formulae or more complicated material is introduced, we can keep up. The breadth and depth of lecture material varies within each week and block, so it would certainly improve cohesion and overall flow if we can all begin the lecture from the same starting point. 2.

Less is more. Lecture slides are beautiful when they are short and concise. Do not be afraid to maximize visuals and images, minimize text, and fill in all the details

with your own knowledge and clinical anecdotes. Since we are usually provided with printed lecture handouts beforehand, it would be greatly appreciated to make a lecture more of a lively and personalized session rather than a repetition of what we have in our booklets. Less text on slides will certainly encourage us to be more attentive in class, and relevant clinical scenarios help to solidify and contextualize concepts. 3. Give clinical examples of why your material is important. When you present new information without any context, the acronyms, tables and graphs feel like a foreign language. It is always more effective if, after your lecture on TV, FRC, Pa02, ERV, IRV, Pat, and R, that you give us a clinical case where you used those numbers to help treat the patient. Thank you again for your time. We hope that these tips might inform your next presentation! Tips for Small Group Facilitators and Tutors Charlie Zhang, Jackson Chu and Sesath Hewapathirane (MD, class of 2014) Small group learning environments, typically comprising two to eight students and a teacher, are being increasingly implemented within the Faculty of Medicine. Expert-led small groups can be especially conducive for learning when they are dynamic and allow students to freely communicate, i.e. when the tutor does not fall into the common trap of treating the session more like a didactic lecture rigid and predefined. As well, tutors may not be aware of the scope and level of detail of material students have previously been exposed to in their curriculum, and may overlook the fact that students come from diverse backgrounds (educational, occupational, social, etc.). Our recommendation is that at the outset of each session, instructors consider taking the time to ask the students what level of exposure

they have to the topics to be covered, and what the students hope to gain from the session. Tutors should also consider the level of proficiency that the students are expected to have at their specific level of training. Taken together, instructors can then be prepared to modify instruction to optimize learning for the particular group. We also encourage instructors to ask for feedback on the session and their instructional style during and at the end of each session. Finally, we really notice when tutors take the time to read the ‘Tutor Guide’ prior to the session, and have familiarized themselves with the material to be covered and the key learning objectives. This helps us feel confident that all student groups will receive the same core information. Tips for Clinical Preceptors Andy Chen (MD, class of 2013) and Ranita Manocha (MD, class of 2012) One of the more frequent problems we have encountered is that of the passive preceptor— that is, a resident or staff physician who does not actively engage students. We have often been delegated to the “fly on the wall” role, and feel that leaving the setting would have little effect on the outcome of patient care, or our own learning! Patient cases provide prime teaching opportunities, and students appreciate an initial preamble on the presenting condition followed by a flow of question-andanswer exchanges to supplement our learning. Questioning students brings up another oftencountered problem, the feared game of, “Guess what I’m thinking?” Acknowledging to a student beforehand that a question is a “Guess what I’m thinking?” situation and that an exact answer is not expected also goes a long way to turn down the heat! Being an effective preceptor is clearly a real skill. The best place to start is to ask your students for their input in planning their learning agenda.

Another helpful teaching approach was to allow me to take the lead for three hours with a client alternating with him doing the same. This way I knew that it was my responsibility to not only lead the assessment but report on the clients as well. He would encourage me to prioritize clients in the morning and choose which hours I felt most comfortable leading and observing. Holly Parsons (MOT, class of 2013) My first placement area was in acute inpatient mental health at VGH, so I will give some of my key ‘take away messages’: Dear fieldwork preceptor, • Push your practicum student by offering challenges. I had suggested to my preceptor that I co-facilitate a few groups by the end of placement, and she said, “Why not lead them?” Though uncomfortable at first, students really want to be challenged while on placement. • Encourage us to jump in. Along the same lines as the previous point, but specifically when working directly with clients, encourage us to jump in...over and over and over, as much as possible! We have spent months in the classroom and are eager to see just how all this theory stuff works in practice. • Allow mistakes. The key to learning is making mistakes—allow us to make

mistakes (obviously nothing that would harm a client) and take ownership of a mistake. For example, while on placement I gave a client a pass when he was not to be off the ward. My preceptor supported me in correcting the situation i.e. talking with the care nurses. She did so in such a way that I not only learned a great deal about communication with a team, but also was not embarrassed to be honest about the situation. Sylvie Rousseau (MOT, class of 2013) Some things I appreciated about my preceptor at my first placement were: • Her willingness to explain background information to me (like funding or hospital policy history) that was not taught in school but was affecting our interactions with clients. If there was no time in the moment she would discuss it at lunchtime when we had time to chat. • Her allowing me to take time to prepare myself before taking the lead on an interaction with a client (at least when it was my first time), and while she encouraged me to take the leap and give it a try, she assured me that she would also be there to jump in if needed. • Her ensuring that our mutual expectations were agreed upon early in the placement (which I found extremely helpful) so it was clear what we each expected of each other and what we were willing and able to provide for the other person.

often unsure of what skills and purposes are expected, thus much of our experience is hindered initially in trying to learn how hospital systems work and where things are located. Recognition of this early in rotations, and in all orientations offered, is always appreciated. As well, during clerkship we start to see patients with symptoms as opposed to diagnosed conditions, and this is a big transition. Therefore, perhaps teaching some first- and second-year sessions from an approachesbased point of view (i.e. giving students an approach to chest pain during cardiology block) would be very helpful. By the time fourth year arrives, we finally feel somewhat competent as clinical clerks, and possess a basic knowledge and experience level that allows us to begin to take more initiative in patient care, and thus expect an increase in the opportunities to do so. It is really appreciated when clinical educators (staff and residents) recognize our skill and experience, and help nurture it as opposed to less active roles such as retracting in the operating room and observing clinical assessments. Many students experience high stress related to career planning, and any offers of mentoring in this regard, formal or informal, from any faculty member will most certainly be greatly appreciated.

Wants and needs of third and fourth-year medical students:

(Photo: Richéal Carroll)

Bethany Brown (MOT, class of 2013) My placement was on an acute medical ward in Burnaby. One of the amazing things was to see such a diverse range of clients. One of the awesome things my preceptor did was ask me to complete an ADL assessment while he watched (he was always there to help or assist). After, he’d give me three to five pointers on how I could improve and then allowed me to immediately take on the next ADL assessment with a new client to implement my learning. This really helped to solidify my skills.

Andy Chen (MD, class of 2013) and Ranita Manocha (MD, class of 2012) Heading into the third year of medical school, students are 27

A Day in the Life of a Standardized Patient: An Actor Offers Her Insights Dawn Milman

As an actor I have had the opportunity to live in a lot of different shoes. Some of the most interesting shoes I have lived in are that of a standardized patient (SP). Who would have thought that educational facilities would hire and train actors to act as a real patient in order to simulate a set of symptoms or problems? Fantastic!

struggle through the learning opportunity. Other facilitators will let Student A discuss the situation until the time has run out and they have to leave the room. You feel a little ripped off, as you had a backstory to tell and a few prompts you could have delivered in order to support Student A along. No time for regret– the next group of students is arriving.

Let’s get specific. You are in a clinic room lying supine on a clinic bed, staring at the ceiling. You are waiting to be told that you have an illness that may shorten or, worst-case scenario, end your life. You have had three trainings to learn your backstory, prepare for the news, and how best to react to multiple scenarios. Still you are nervous. The stakes are high and you want the students to have a believable and sincere experience.

Things begin very similarly to the first interview, but then a “time out” is called and this time the facilitator decides no discussion is needed. Instead, “Let’s switch things up. Student B, you take over.” This is difficult for you because it means replaying the beginning of the scenario with no rapport or momentum. Once again you begin to cry and once again a “time out” is called. This time Student C is asked to take over. No rapport has been built and once again you are going over the same opening sequence. The session ends and though you made it a little further along, you still haven’t had the opportunity to deliver your backstory.

The first group of eight students walk in with their facilitator and the scenario begins, “Hello Mrs ____________ my name is Student A. I am a ___ year medical student. Is it okay if I talk to you before the doctor comes in?” You say your opening line. Some rapport is built and things seem to be going well… but then, “I didn’t know she was really going to cry. What should I do?” The “time out” is an excellent opportunity for the facilitator to give Student A a little guidance as to where to go. Ideally the discussion is succinct so all momentum isn’t lost and Student A can continue without too much awkwardness. But things aren’t always ideal. At times Student A would like to spend as much of his or her remaining time in discussion in order to avoid getting back to the role play. Experienced facilitators usually see through this and encourage Student A to 28

There is a knock at the door. You think, “Who could that be? I thought I had a few minutes before the next scenario is about to start?” Just then one of the facilitators pops his head in the room. “Before I bring my next group of students in I wanted to have a quick word. I like what you are doing but I want to tweak a couple of things.” This is a good time to talk about what the word standardized means in “standardized patient.” SPs are trained on actual cases and it is vital that we portray the role consistently to each student we meet in order for them to have a consistent experience. Feedback, therefore, cannot be

Patients] are “ [Standardized trained on actual cases and it is vital that we portray the role consistently to each student we meet in order for them to have a consistent experience.

”

incorporated by and should not be given to an SP directly during a session. SPs are actors and actors need rehearsals. The trainings are like the rehearsal process with the scenarios as the script. It wouldn’t be fair to ask an actor to change her character on the third night of her show’s run after all the work she put in during rehearsal; similarly, it wouldn’t make sense to ask an SP to change her portrayal in between sessions. From your clinic bed you say, “It is nice to meet someone who is so dedicated to the students’ learning process but my trainer has asked me to stick to the script. I am sure the session leaders would be happy to hear your comments at the end of the session. They are always looking for ways to improve and keep things fresh.” Your last session is like a dream. The student is empathetic and doesn’t panic when you cry. When a “time out” is called she takes the facilitator’s suggestions with a calm resolve. Things wrap up and you feel hopeful about the bad news and your future. As the facilitator is leaving the room she turns around and whispers, “Thank you. You made a difference to these students today.” She gives you a thumbs up and leaves the room.

• Be aware of time limits: consider maximizing the time in roleplaying and saving discussion time for later. • Steer clear of the “tag team” to avoid necessary but uncomfortable learning: consider offering a few suggestions to encourage one student to move forward. • Allow SPs to focus on their trained role: consider providing feedback to session developers after the session rather than giving SPs feedback directly. That’s the best way for feedback to be channelled to the SP trainers for subsequent sessions.

Dawn Milman is a professionally-trained actor, writer, and director. She has split the last 14 years between theatre, television, and SP gigs. She has worked as an SP trainer since 2008 and knows a thing or two about aches, pains, and diplomacy.

ADVANTAGES OF A CLINICAL FACULTY APPOINTMENT: ACADEMIC SERVICES AND RESOURCES Office of Clinical Faculty Affairs, Faculty of Medicine, UBC 2775 Laurel Street, 11th Floor, Vancouver, BC, V5Z 1M9 Tel: 604-875-4111 ext. 68647 Email: ocfa.med@ubc.ca Website: www.med.ubc.ca/faculty_staff/clinical_faculty

ACADEMIC SERVICES AND RESOURCES Faculty Development www.facdev.med.ubc.ca

The Office of Faculty Development supports faculty in their teaching roles and faculty with career interests in education: • Provides conferences, workshops, resources (free of charge) • Holds the annual Med Ed Day Conference for teaching faculty • Offers the A, B, C, D, and E workshops which address aspects of clinical teaching • Provides the “Teaching Skills for Community-Based Preceptors Handbook” to community-based preceptors • Holds the videoconferenced Faculty Development journal clubs approximately four times a year • Supports individual faculty members further their educational and leadership skills with the Faculty Development Initiative Grants Program

Centre for Health Education Scholarship (CHES) www.ches.med.ubc.ca

The Centre for Health Education Scholarship (CHES) is committed to enhancing health education scholarship by building capacity across the Faculty of Medicine through collaboration, team-building, mentorship of new faculty, successful funding applications, and other activities. Linked strongly to undergraduate and postgraduate activities, the Centre serves as a resource to help support best practice in terms of the delivery of the Faculty’s educational programs including assessment. Departmental links provide a resource for departmentally based members who require support and advice. CHES is also responsible for developing access to certificate and graduate programs in educational scholarship.

UBC Continuing Professional Development (UBC CPD) (This is an MD-focused resource) www.ubccpd.ca

Bringing together a unique combination of educational expertise, innovation, research, and the use of technology, UBC CPD, a division of the Faculty of Medicine, is a leader in providing accredited high quality unbiased educational programming to support the identified Continuing Medical Education (CME) and CPD needs of physicians.

eHealth Strategy Office www.ehealth.med.ubc.ca

The mission of the Faculty of Medicine eHealth Strategy Office is purpose-driven eHealth: to explore how modern information and communication technologies (e.g. cell phone, iPads, Internet, etc.) can enable, enhance, and fulfill the academic mission of education, research, knowledge translation, and community engagement in the context of health care. The eHealth Strategy Office has regular third Thursday of the month learning events, called eHealth Investigative Partnership Program (eHIPP) Rounds. They are held online via Adobe Connect http://ehealth.med.ubc.ca/education/ehipp/ for upcoming topics and to join a session. Each event consists of 40 minutes of presentation followed by 20 minutes of questions, and most are recorded for future viewing.

Centre for Teaching, Learning and Technology (CTLT) www.ctlt.ubc.ca

The Centre for Teaching, Learning and Technology takes a leadership role in addressing professional development needs for current and future practitioners in higher education and advances understanding of how technology can enhance UBC’s ability to create and maintain an outstanding learning environment. CTLT offers a variety of programs to the UBC community, including an ongoing development program for faculty members at different stages in their careers. The program is meant to support you in your teaching and learning endeavours and to provide information on current research on teaching and learning theories and methods.

ADVANTAGES OF A CLINICAL FACULTY APPOINTMENT: PERSONAL BENEFITS

PERSONAL BENEFITS UBC Card www.ubccard.ubc.ca Campus Wide Login (CWL) www.it.ubc.ca/cwl/homelink. shtml UBC Library www.library.ubc.ca Travel Discounts www.travel.ubc.ca Reciprocal Parking Agreements www.hr.ubc.ca/faculty-staffresources/perks/ UBC Conferences & Accommodation www.ubcconferences.com/ accommodations/ www.//okanagan. ubcconferences.com/ William A. Webber Medical Student & Alumni Centre (MSAC) www.med.ubc.ca/alum/ medresidency/ msac/Rental_ of_the_MSAC_Centre.htm E-Mail Account UBC Bookstore Discounts www.bookstore.ubc.ca/cpu/ index.html Apple www.apple.ca Retail Goods and Services Office Plaque Business Cards Vancouver Attractions www.hr.ubc.ca/faculty-staffresources/perks/ Day Care www.kidsandcompany.ca Communication

The UBC card is UBC’s official identification document. It can be used for UBC library services, UBC Bookstore and campus partners’ e-Money purchases, Food Services’ dining convenience and discounts, reduced or free admission to various UBC attractions and facilities. CWL is UBC’s single sign-on authentication system designed to give you access to UBC’s online applications using the same username and password. Initial access will include the Faculty and Staff Self-Services web portal and the Library. Clinical Faculty members have full access to all materials and services. These include remote access to medical journals, access to library research workshops, online guides and tutorials on a variety of topics, and assistance from the staff and reference librarians. For individuals who do not wish to register for a CWL, a library card will be provided. Government, University and Corporate rates are available for Canadian hotels and vehicle rentals, including ZipCar, Park N’ Fly, and YVR short-term and long-term parking. UBC has reciprocal parking agreements with SFU and UVic. UBC Faculty and staff who have current parking permits may park in faculty/staff lots at these institutions, and SFU and UVic faculty and staff with current parking permits may park in faculty/staff lots at UBC. Various types of accommodation are available on the UBC Point Grey Campus and UBC Okanagan Campus. For UBC Point Grey information and reservations, call 604-822-1000, or toll free 888-822-1030 and request the campus rate. For UBC Okanagan information and reservations, call 1-250-807-8050, or toll free 1-888-318-8666 and request the campus rate. MSAC, located on the corner of 12th Avenue and Heather Street near Vancouver General Hospital, is a social and recreational facility for UBC medical students, residents, alumni, faculty, and departments. Clinical Faculty may rent the two halls for meetings and receptions. Please see the website for rates and other rental information. Departments and schools will coordinate. Please contact the department/school administrator. With a UBC Card, you are eligible for discounts on computers. Visit the Academic Store online for discounts on hardware and software. Many companies offer government and educational discounts. Ask, and have your UBC Card with you. Office Plaques help recognize your contribution to teaching the next generation of health professionals. Please e-mail ocfa.med@ubc.ca to request delivery. Business Cards with the UBC logo indicating your appointment and rank can be ordered through your department/school for a nominal charge. Free admission to the UBC Museum of Anthropology, and reduced admission to the UBC Botanical Garden, Frederic Wood Theatre, TELUS Studio Theatre, other attractions and numerous fitness and recreation programs. UBC has a membership with Kids & Co., a Canadian child care company, which allows UBC faculty access to Kids & Co. child care spaces. You will receive a copy of the monthly Faculty of Medicine electronic bulletin, ‘The Link’, which provides updates about the Faculty Executive meeting minutes, award deadlines, and upcoming events. 31

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Send us your feedback on this edition Submit a letter to the editors Submit a teaching tip Submit an article

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2. Visit Faculty Development online www.facdev.med.ubc.ca 3. Register for the Faculty Development listserv by emailing fac.dev@ubc.ca

ld te! o H da 10 , the y, May3 th

da 201 i r F

4. Come to Vancouver for Med Ed Day, May 10th, 2013 An annual conference that focuses on celebrating and improving teaching in the UBC Faculty of Medicine. • Share experiences, challenges, and tips with other faculty. • Attend presentations, workshops, and a lecture lunch honouring Dr. William Webber. • All who teach in the UBC Faculty of Medicine are encouraged to attend!

Free online registration at www.facdev.med.ubc.ca Return undeliverable Canadian addresses to: Office of Faculty Development, Diamond Health Care Centre – 11th Floor 2775 Laurel Street, Vancouver, BC Canada V5Z 1M9