Connecting through education in the Faculty of Medicine & Dentistry University of Alberta ISSUE NO. 1
2019
Contents 4
Reaching out for deeper connection
8
Indigenous Health Initiatives Program a personal passion for new director
11 Dentistry, dental hygiene students give back
14 Medical Laboratory Science overhaul brings rich, experiential learning opportunities
17 Simulation training brings on the light-bulb moments
20 Academic Technologies office pursues educational innovation
24 Education Quality and Accreditation office moves into support role
28 Development and support key to attracting, retaining world-class faculty
32 Students take the lead in peer support
35 Caring for the whole student 39 Creative pursuits bring fresh perspective to medicine, healing
43 Associate dean positions MD program as national leader in research, social accountability
46 Residents, supervisors move toward competency-based medical education
49 Rural medical education: Boundless opportunities
52 Global Medical Summer Study
THE BRIDGE DIRECTOR, COMMUNICATIONS & MARKETING SALENA KITTERINGHAM
WRITER / COPY EDITOR / PROOFREADER SASHA ROEDER MAH
NATASIA DESIGNS NATASIA MARTIN
CONTRIBUTING WRITER KERI SWEETMAN
ISSUE NO. 1 – 2019
Message from Shirley Schipper Vice-Dean, Education I am truly grateful to be working within
and reflect the health needs of our
the Faculty of Medicine & Dentistry
communities. We need to ensure that
(FoMD) as a clinician educator.
our learning outcomes are maintained
I have the pleasure of working with
to the highest standards and continue
engaged students, incredible teachers,
to make us a world-class institution for
inspiring scientists and medical leaders.
health education. Our goal is to be a hub
Education is lifelong for most of us in
for innovative and creative minds that
the health professions. Our curiosity
share our faculty’s values of integrity,
and desire to develop to our fullest
inclusion and passion for knowledge.
potential improve the lives of those
Our vision for education focuses on:
around us and within the populations 1. Our learning environment.
that we serve.
We aim to ensure a humanistic The Faculty of Medicine & Dentistry at the University of Alberta stands as one of the premier health education
and supportive environment that enhances learning. 2. Our programs. We continue to
centres in Canada, attracting
build on interprofessional and
outstanding talents and forming
collaborative initiatives within
future leaders. Our undergraduate
and between FoMD programs.
programs include medicine, dentistry,
3. Our faculty. We must support,
dental hygiene, medical laboratory
engage and sustain our faculty
science and radiation therapy. We
within a culture of educational
offer numerous residency, graduate
scholarship and excellence. 4. Our communities. We engage
and postgraduate programs.
communities in reciprocal learning As Vice-Dean, Education, it is my role
opportunities with our pentagram
to ensure that our education programs
partners and through respectful
are innovative, flexible and adaptive,
collaboration.
SHIRLEY SCHIPPER, MD, CCFP, FCFP VICE-DEAN, EDUCATION FACULTY OF MEDICINE & DENTISTRY, UNIVERSITY OF ALBERTA
UNIVERSITY OF ALBERTA
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Reaching out for deeper connection BUILDING RELATIONSHIPS THE CORE OF SUPERIOR MEDICAL CARE
4
ISSUE NO. 1 – 2019
Jack Zhang was in his second year in
volunteers intend to return to
the MD program when the Faculty
make this an annual event, says
of Medicine & Dentistry hosted its
Helly Goez, co-ordinator of the
first ever LGBTQ “human library-
four-year physicianship course.
type experience” a half-day of
Goez collaborated with MD student
intimate conversation designed
Derek Fehr, ’19 MD, and community
to foster understanding of the
representatives to design the
unique challenges LGBTQ patients
sessions as part of six hours of new
experience in encounters with the
LGBTQ curriculum.
health-care system. “The experience was a valuable opportunity for me to
“I found it very rewarding to see
learn about vulnerability, humility,
participants’ currently held beliefs
sympathy and empathy,” he recalls.
and perceptions be challenged,”
“These are foundations to being a
says volunteer Lowell Acorda. “It’s
good physician, in my opinion, and
important that marginalized voices
can only be learned from candid
are represented and heeded … in
interactions in a safe environment.”
having more informed, and even affirming, health-care professionals,
About 160 MD students—the
we can improve the quality of health
readers—and 20 community
care provided to those within the
volunteers—the books—took
LGBTQ community as well as create
part in the session, the first of
confidence in our health-care system.”
its kind in Canada. Many of the
Helly Goez, Assistant Dean, Diversity Photo: Laughing Dog Photography
Artwork: Natasia Designs UNIVERSITY OF ALBERTA
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THE BRIDGE
Social engagement like this has been
faculty’s MD and Arts & Humanities
a movement in medical education
in Health & Medicine programs.
since 1995, when the World Health Organization urged medical schools to
Experiences like the PIE allow future
orient their education and research to
doctors to cultivate sensitivity to
meeting the needs of the communities
patients as human beings. Memorizing
they serve.
facts and studying textbooks are crucial aspects of becoming a
Explains Jill Konkin, Associate Dean,
competent physician, says Goez,
Community Engagement, “our
but “we are touching people in their
priorities are to be determined in
lowest moments in their lives, where
partnership with the community.”
there is so much insecurity and fear.”
And that means getting out from
Compassion must be a part of those
behind textbooks and into dialogue
interactions. “The relationships built
with the people being served.
in this program will help make more empathetic physicians,” Hillier says.
GETTING TO KNOW YOU Another part of the four-year physicianship course, the Patient
HEALING HISTORICAL WOUNDS
Immersion Experience (PIE)
The inaugural Indigenous Academic
pairs students over the span of
Day at the Alexis Nakoda Sioux Nation
two years with people living with
in 2016 was eye-opening for both
chronic illness. They go to doctor
medical residents and patients. “Prior
appointments together and spend
to this session many residents had
social time together as well, allowing
not been to a First Nations reserve,”
the students an in-depth look into the
says Cara Bablitz, ’07 Bsc, ’11 MD,
everyday battles these patients face.
who organized the event after working with the Indigenous Health Program
Tracey Hillier, Associate Dean, MD
to deliver primary care at the Alexis
program, says: “The idea is to come
Nakota Sioux Nation, about an hour
at this encounter from the lens of the
northwest of Edmonton. Her father,
patient. Students get to hear from the
a Métis physician, has been a source
patient about their lived experience
of inspiration for her work to reduce
with the health-care system and hear
health inequities.
from their families.” In 2018, more
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than 160 students took part in the
“The impact that our medical
program, a joint effort between the
schools can have in our Indigenous
FACULTY OF MEDICINE & DENTISTRY
ISSUE NO. 1 – 2019
communities in Alberta can be
and barriers Indigenous patients
enormous,” says Alika Lafontaine,
face in our health-care system. This
U of A lecturer and anesthesiologist,
knowledge was not presented to us
member of the board of governors for
with a spirit of condemnation, but
First Nations University of Canada
a spirit that welcomed partnership
and collaborative team leader for
and reconciliation, a true cultural
Indigenous Health Alliance.
immersion experience,” says Danika Leung, second-year resident and part
A second Indigenous Health
of the planning committee for the
Academic event took place at
Academic Day.
Poundmaker’s Lodge in August 2018, where elders shared meaningful
“A majority of the residents’
conversations with first- and second-
encounters with Indigenous peoples
year residents at the site of a former
prior to this day were in a medical
residential school. It was a powerful
setting, which could create a skewed
opportunity to learn from Indigenous
picture of who Indigenous people
community members about the
are,” says Bablitz, clinical lecturer in
culture, health issues and barriers to
the Department of Family Medicine.
health care they face.
“This day allows resident physicians to see the resilience and strength of our
“We were exposed to solemn topics
people at a site that is working towards
such as the history of Indigenous
Indigenous healing and wellness.”
peoples in Canada, and prejudice
The Patient Immersion program concludes with a creative art exhibit by the students, representing their insights and learning experience from the patient-mentor. Photo supplied
UNIVERSITY OF ALBERTA
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Tibetha Kemble, Director, Indigenous Health Initiatives Program Photo: Jordan Carson
Indigenous Health Initiatives Program a personal passion for new director When Maskwacis Elder Rick Lightning was a young boy in the Indian Residential School (IRS) system, the care he and his fellow students received from health professionals was rudimentary at best. Tibetha Kemble recalls Elder Lightning sharing with her the trauma he experienced and how it ultimately shaped his unease as a father, when sending his children for doctor checkups or dentist appointments.
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ISSUE NO. 1 – 2019
“Canada has a long and dark history
The ensuing 20 years have seen that
with Indigenous health that has
gap narrow marginally but, says
left a legacy of mistrust, anxiety
Kemble, “we’re not even halfway to
and fear of the health-care system
what that commission recommended,
among many Indigenous peoples.
which is the training of 10,000 new
Health professionals are a part of this
Indigenous physicians over 10 years.”
legacy,” says Kemble, Director of the Faculty of Medicine & Dentistry’s
To be part of the solution, Kemble
Indigenous Health Initiatives
and her team know they need to reach
Program (IHIP) since the fall of
prospective students early. Her office
2017. “Indigenous physicians play a
is working on a plan that focuses
crucial role in building back that trust
on engaging Indigenous junior high
and facilitating safe relationships.”
and elementary students to provide the kinds of exposure and valuable
Kemble—along with administrator
hands-on experiences that foster a
Kenton Boutillier, within
sense of place and belonging within
the Division of Community
the professions.
Engagement—remains committed to and focused on achieving the
The IHIP is also working to support
mandate of the IHIP program,
the faculty in building relationships
which is to recruit and support a
with treaty organizations, individual
growing body of future Indigenous
First Nations, First Nation Education
health professionals throughout
Authorities and other Indigenous
the faculty’s five undergraduate
representative organizations to
programs. Since its inception in
encourage community members
1988, the IHIP has focused on
to consider a future in the health
addressing the lack of First Nation,
professions. If we can spark an
Métis and Inuit students entering
interest in science, says Kemble, and
into and completing the medical
build awareness among Indigenous
doctor degree at the U of A. It has
youth about the journey into health
since broadened its scope to include
professions and beyond, students will
all of the health-profession streams.
be better situated to enter the faculty.
In 1996, the Royal Commission
The U of A recently eliminated a
on Aboriginal People found one
quota system that limited the number
Indigenous physician for every
of Indigenous students admitted
33,000 Indigenous people in Canada,
to its MD program through the
compared to one for every 515 people
IHIP process. Starting in fall 2019
in the non-Indigenous population.
and during the next admissions
UNIVERSITY OF ALBERTA
9
THE BRIDGE
application cycle, all Indigenous
To that end, following the release of
students who meet all eligibility
the Truth and Reconciliation’s final
requirements through IHIP will be
report and Calls to Action in early
offered a place in the medical school.
2016, an Indigenous Health Course
In addition, beginning in September
Working Group was established to
2019, and for each of the next four
design a new curriculum. Members
years, the MD program will award
from health sciences and community
four new full-tuition scholarships to
partners worked together on modules
entering Indigenous students.
that will teach health-science undergraduates and medical students
Recruiting Indigenous students is
about the history and legacy of
only part of Kemble’s mandate. IHIP
harmful colonial policy and the legacy
provides holistic, individualized
of Indian Residential Schools. These
supports for Indigenous students
legacies underpin the longstanding
currently in the faculty. “I’m really
health and social inequities
excited about creating a community,
experienced disproportionately by
because that’s fundamental to our
Indigenous people. The historic
Indigenous way of being,” she says.
collaboration—answering the Truth
This means establishing an advisory
and Reconciliation Commission’s
council of elders to offer teachings
call to action No. 24—resulted in
about culture and medicine, and
a 12-module course being piloted
creating a powerful mentorship
this academic year. “Our work on
network with Indigenous graduates
this together demonstrates a real
who are practising in the community.
commitment to partnership and to
It also means a robust calendar of
create a space for Indigenous health
cultural events to keep members of
here in the faculty,” says Kemble,
the Indigenous community within the
“and that’s meaningful.”
faculty connected to each other and to remind each other ‘you’re not alone’.
Kemble says the work she is doing is deeply personal for her. “As a
There are more signs of hope than
First Nations woman, through this
of struggle, stresses Kemble. Today,
program, I get to be a part of shifting
“there is a desire among non-
the system in whatever small way
Indigenous students, faculty and staff
that I can to improve the health,
to start to learn about Indigenous
well-being and social location of
people and work in partnership and
Indigenous people.”
collaboration to strengthen our connection to each other.”
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FACULTY OF MEDICINE & DENTISTRY
Photo: John Ulan
Dentistry, dental hygiene students give back COMMUNITY OUTREACH INSTILS SENSE OF SOCIAL RESPONSIBILITY
When Alexandra Sheppard, ’93 DH, was a dental hygiene student at the University of Alberta more than 20 years ago, the only external placement she did was at an Edmonton psychiatric institution and at the northern satellite clinics in High Level. Now, as Assistant Director of Dental Hygiene Clinical Education in the School of Dentistry, Sheppard supervises students who do placements in the inner city, long-term care facilities, a rehabilitation hospital and in northern Alberta. Some of the students even travel to Central America with dental missions. UNIVERSITY OF ALBERTA
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THE BRIDGE
Paul Major, Chair, School of Dentistry Photo: Jordan Carson
“We teach them basic dentistry
along with homeless people and those
and dental hygiene, but with that,
from lower-income groups.
we teach them how to be socially responsive,” says Paul Major, Chair
It can be an eye-opener for the
of the School of Dentistry. “If we
students, most of whom are in their
can instil this, then we’ve done a
early 20s and often from middle-
good job, and the only way this can
class backgrounds. Although they
happen is to immerse them in the
get an orientation prior to their first
community and provide meaningful
visit, Sheppard says the first rotation
experiences.”
can be daunting, especially when the clinic was in a dingy, cramped
Karen Ho, ’17 DH, says opportunities
room in the basement. Thanks
to work in the community are
to the school’s Dentistry for Life
what make the U of A program so
fundraising campaign, donor support
outstanding compared to others in
has enabled an expansion of the
the country.
Boyle McCauley Health Centre to a bigger, brighter location.
BOYLE MCCAULEY HEALTH CENTRE
“Once you see how much the service
Dental hygiene students treat patients
says dental hygiene graduate Ilona
at this inner-city centre twice a week
Kaliszuk. “People are so grateful for
as part of their curriculum, and as
the care.”
is needed, it’s a great experience,”
part of the new clinic expansion, dental students will join them there on regular rotations starting this academic year. They see Indigenous, new-immigrant and refugee patients,
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FACULTY OF MEDICINE & DENTISTRY
ISSUE NO. 1 – 2019
SHINE
SMILE PROGRAM
In addition to the weekday curriculum
Dental hygiene students volunteer
rotations, dental and dental hygiene
to go out into the community to give
students also volunteer their time at
presentations to schools, day-care
Boyle McCauley on Saturdays through a
centres, Stollery Children’s Hospital
program called SHINE (Student Health
patients and other organizations.
Initiatives for the Needs of Edmonton).
The visits are organized by students.
SHINE is organized by students, who find licensed dentists from the
Throughout the 2017–’18 school
community to attend as supervisors.
year, 31 presentations reached 440 children between the ages of 12
The energy of the young volunteers
months and 12 years.
makes visiting the SHINE clinic a positive experience for many patients. “I’ve always had bad experiences with
RURAL OUTREACH
dentists, but SHINE was different,” says
Dental and dental hygiene students
patient Monica Baker. “The students
all do a two-week rotation in northern
were friendly. They put me at ease.”
Alberta clinics in La Crete, High Level or McLennan, where they have the
GLENROSE REHABILITATION HOSPITAL AND LONG-TERM CARE FACILITIES
opportunity to do a wide range of dental work because many patients in those areas don’t have access to regular dental care.
As part of their curriculum, dental hygiene and dental students do regular rotations at the Glenrose, which
INTERNATIONAL MISSIONS
doubled the capacity of its dental
Dental and dental hygiene students
clinic in 2012. The dental clinic at the
volunteer to go on dental missions
Glenrose is outfitted with medical
with two not-for-profit Edmonton
lifts where patients who are elderly,
organizations, Dentistry for All and
medically compromised or have limited
Kindness in Action. Through these
mobility can be treated. Dental hygiene
organizations, between 10 and 25
students also do rotations in long-term-
students provide care in countries
care facilities, performing assessments
such as Guatemala and Nicaragua
and oral care and providing dental
each year. The students also hold an
hygiene education to the staff. Under
annual charity ball to raise money for
supervision by their instructors, they
the missions. They raised more than
learn to care for patients with dementia
$100,000 at the 2018 event.
and other medical conditions. UNIVERSITY OF ALBERTA
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Medical Laboratory Science overhaul brings rich, experiential learning opportunities HANDS-ON TRAINING CRUCIAL TO MASTER EMERGING TECHNOLOGIES, SAYS DIRECTOR
With big data, artificial intelligence and precision health making strides in medical research and practice, the University of Alberta’s Medical Laboratory Science program is in the midst of major changes to ensure the professionals coming out of its program are ready to hit the ground running. The four-year undergraduate degree, which celebrated its 60th anniversary in 2018, sees
Lisa Purdy, Assistant Dean,
an annual intake of 29 students seeking both
Graduate Student Affairs
certification as a medical laboratory technologist and the enhanced theoretical knowledge that comes with having earned a degree. It’s the only degree-
and Director, Division of Medical Laboratory Science Photo: Laughing Dog
granting program of its kind in Western Canada, and director Lisa Purdy wants to see it grow. Massive change is ahead in this field. “With the way technology is going, we need to be developing lab professionals who will be change agents, and who can help other health professionals manage the new technology,” she says.
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FACULTY OF MEDICINE & DENTISTRY
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To get ahead of the demand, Purdy is creating a new master’s degree in Medical Laboratory Science. In the process of working its way through university governance, the graduate program is so ahead of the curve, it will “create a professional that Alberta Health Services may not yet even have a job description for.” Launching a master’s program necessitated an overhaul of the undergraduate degree as well, a process Purdy welcomes as a chance to analyze and shift the desired program outcomes to better reflect current U of A focuses such as ethics and community outreach. An example of this is the recent elimination of the upper quota on the number of Indigenous students admitted to the Medical Laboratory Sciences program. “We need to be socially accountable as health professionals; we need to train our students to be more culturally aware”, says Purdy. The technical program’s focus has always been on making sure students are prepared to meet national certification criteria. Purdy says that won’t change, but the best health professionals of the future will also be intent on serving, giving back and engaging in the community. A professionalism course will be offered throughout the program’s three years, with opportunities to explore what being an ethical and engaged member of the community looks like. Purdy is also exploring a future option for a rural rotation to address underserved community needs. It’s in the final undergraduate year that the most sweeping curriculum changes appear, addressing the emerging technologies learners need to master. A series of one-credit courses—offered over three weeks online and one weekend
Nikki Yurkiw and Rachel McKellar, medical laboratory science graduates from the class of 2018 Photo: Melissa Fabrizio
UNIVERSITY OF ALBERTA
15
THE BRIDGE
hands-on in the lab—focus on advanced training in processes such as mass spectrometry and flow cytometry, neither of which are new technologies but are continually being called into action in new and different ways. “We have been teaching mass spec for years,” clarifies Purdy, “but most of it has been didactic. Now we want our students to get their hands on those instruments and become really proficient at using them, to address the growing need in clinical service.” Because the modules are mostly online, they’ll be accessible not only to students in the undergraduate program, but also—in partnership with the Faculty of Extension—to professionals looking to advance their career development. This shift to online learning and making learning more accessible to non-degree students is brand new for the program and a necessity to ensure practising technologists keep up their professional development. The proposed MSc in Laboratory Medicine & Pathology with Specialization in Medical Laboratory Science—which Purdy hopes to see launch in the fall of 2022—goes even further to ensure students enter their profession ready to embrace its fast pace of change. Purdy has proposed for the MSc four areas of specialization that reflect current and future needs: Bioinformatics & Molecular Diagnostics; Laboratory Leadership; Research & Development and Laboratory Utilization & Applied Statistics.
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FACULTY OF MEDICINE & DENTISTRY
Photo: Ed Ellis
Simulation training brings on the light-bulb moments RISK-FREE, HANDS-ON PRACTICE CRUCIAL TO MEDICAL EDUCATION
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Late one night in anesthesia resident
The first class of radiation
Kristin Radtke’s second year, she
therapists graduated
found herself responding to a complicated emergency call for a patient in respiratory distress. One glance told her that the situation—
in June 2017. From left: Sarah Sun, Ariel Letcher and Miranda Bowler Photo: Laughing Dog
an unco-operative patient in recovery from recent surgery, with some serious medical complications—would be far
Dentistry until the end of 2018, has
more complex than the straightforward
seen first-hand the power of crisis
cases she’d encountered in textbooks.
resource management training, where residents must simulate an operation
Recalling that day, Radtke credits her
while instructors add increasingly
simulation training in crisis resource
unpredictable and complicated
management (CRM) for helping her
factors. “We start with something
manage a dynamic and dangerous
relatively simple, then push people out
situation. “Simulation practice in
of their comfort zone,” he explains,
remaining calm and slowing down
“then do a facilitated debriefing,
the mind, situational awareness,
dissecting communication skills, crisis
using material and human resources,
management skills and leadership.”
communicating and decisiveness are the things that saved the day for
Simulation isn’t just about crisis
me,” she says.
training. Fairly early in medical school, students encounter basic task training
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Neil Gibson, Director of Simulation
with simulators for one-to-one
in the Faculty of Medicine &
procedures such as starting an IV or
FACULTY OF MEDICINE & DENTISTRY
ISSUE NO. 1 – 2019
What’s new? “We’re going through a generational shift with respect to technology and how we approach medical education,” Gibson says, “so it’s no longer just the early adopters. Academic faculty, no longer just clinical faculty, are beginning to realize it needs to be part of their academic careers.” To serve that need, Gibson is collaborating with Alberta Health Services to adapt existing AHS training modules into faculty development courses in simulation. His longterm plan involves working with IDEAS office Director Carol Hodgson to create a professional simulation certification for faculty and residents.
using an ultrasound machine. Every
linear accelerator, a procedure room
August before students head out for
and the audiovisual components
clinical placements, they take a two-
required to record students’ learning
week “link block” using simulation
so they can be given informative
to polish their basic-task skills.
feedback by instructors.
There’s also a move to involve more simulation in medical examination
“The students absolutely love it,” says
procedures, augmenting multiple
Susan Fawcett, Director, Radiation
choice, written and oral exams.
Therapy program. “It’s where everything comes together and where
APPLYING CLINICAL REASONING TO LEARNING SCENARIOS
their ‘aha’ moments begin to happen. This is where the rubber meets the road. The students take everything they have learned in their theoretical
The radiation therapy clinical
courses and put it all together in the
learning suite at the Cross Cancer
simulated environment.”
Institute boasts an OSCE-informed Photos: Ed Ellis
UNIVERSITY OF ALBERTA
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Academic Technologies office pursues educational innovation
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FACULTY OF MEDICINE & DENTISTRY
ISSUE NO. 1 – 2019
When Academic Technologies first launched about six years ago, its mandate was to create and implement a learning management system, an online way of organizing course material. That mandate has changed considerably, to reflect the needs and wishes of a tech-savvy and information-hungry world, both on campus and beyond. “Today, our job is to support all faculty and students within the Faculty of Medicine & Dentistry with respect to their teaching and learning, as it relates to technology,” says Lyn Sonnenberg, Director of Academic Technologies. “Our job is also to lead, in terms of innovation.” Students come into this program as ‘digital natives,’ says Sonnenberg, and they expect cutting-edge help and the flexibility that comes with access to technology, such as vodcasts and podcasts, and even—hopefully in a year’s time, she says—a tablet dissection table as an enhancement
“WE’RE LEADING THE CHARGE ACROSS THE UNIVERSITY OF ALBERTA IN OPEN EDUCATIONAL RESOURCE ADVOCACY.”
to human cadaver dissections. To address the shift toward technology-supported learning, Sonnenberg says her office is working to promote systemic changes. First, they’re identifying early-adopting faculty to train staff who may not be quick to independently embrace new technology, so more classes will offer options students expect. Second, while the university can certainly improve its own resources, the online world is already awash in valuable content for medical students. The trick, says Sonnenberg, is to make sure they know how to sift critically through biased and inaccurate information. “Currently, various programs are striving to develop critical thinking and analytical skills earlier in their programs.” And finally, with the increased volume of information students are expected to absorb, Sonnenberg stresses, it’s more important than ever for the
Lyn Sonnenberg, Director, Academic Technologies (second from right)and the team Photo: Jordan Carson UNIVERSITY OF ALBERTA
21
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Retain is a multidimensional educational tool—board game, card game and digital simulator—that trains practitioners in neonatal resuscitation.
administration to grant learners the freedom to pursue their education their way. “Traditionally we’ve said, ‘if you’re not physically present here, you’re not learning,’ and what we know about this generation of learners is that’s not how they want to learn.”
THE BUILDING BLOCKS The office of Academic Technologies spent much of the last year building an educational technologies framework, meant to define the competencies and reach of the team. Central to the framework are seven capabilities, says Sonnenberg—education, design, development, collaboration, leadership, administration and expertise. What began as a homegrown project has grown into a nationwide initiative to define best ed-tech practices in all post-secondary institutions across Canada. In partnership with the University of Ottawa, the office has been leading targeted focus groups and compiling responses to national surveys to formalize the framework for all participants and define a national community of practice around those seven pillars.
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ISSUE NO. 1 – 2019
OPENING BORDERS “We’re leading the charge across the University of Alberta in open educational resources (OER) advocacy,” says Sonnenberg. This practice puts research out in the open, usually online, legally accessible for free to everyone. Sonnenberg says today’s academics are warming up to this concept, a major shift from the traditional focus on protecting intellectual property. Within the faculty, the School of Dentistry has embraced open educational resources, with pilot projects also underway from Hematology, Medical Laboratory Science and Dental Hygiene. Sonnenberg imagines one day having an open-education medical school, “where anyone in the community could listen to or be part of different lectures.”
SERIOUS FUN The design team at Academic Technologies may have the most fun, collaborating with faculty and external contributors on gamification that facilitates training in the classroom and beyond. With the help and input of various faculty members, designer Patrick von Hauff has developed clinical problem-solving card sets in the areas of obesity management, general dentistry, emergency medicine and hematology. “Students need to cultivate a comfort with uncertainty and the flexibility to respond to change and adapt strategy,” he says, and these cards present complex clinical scenarios that encourage learners to think on their feet in a safe setting. The design team supplies professional resources, too. Thomas Jeffery is part of the team behind Retain, a multi-dimensional educational tool—board game, card game and digital simulator—that trains practitioners in neonatal resuscitation. Prompted by the needs of medical residents, Retain is now being used by students, nurses and other team members working in neonatal intensive care units. “You can use it on your own, in a group, on a break, in the middle of the night,” says Jeffery, highlighting yet another way Academic Technologies is revolutionizing and personalizing learning.
UNIVERSITY OF ALBERTA
23
Education Quality and Accreditation office moves into support role NEW ASSISTANT DEAN BUILDS TOOLS THAT EMPOWER FACULTY
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ISSUE NO. 1 – 2019
It has been four years since the
To foster EQI, Lai is focusing on two
University of Alberta’s MD program
streams: electronic infrastructure and
was recognized by the governing
tools that encourage active learning.
bodies of both Canadian and American medical schools with a highly
Much of the first stream involves the
successful accreditation. This year,
design of data dashboards. “I realized
the MD program has undergone both
we need a better system to collect and
an interim accreditation review and a
store all of our faculty’s accreditation
quality assurance unit review. Much of
information,” he says, “to retain our
the work done by faculty and students
vast amounts of business knowledge
to see that accreditation come to
and have a continuous quality
fruition is a credit to the office of
improvement process.” Responding to
Education Quality and Accreditation.
that need, and in collaboration with his team and the Department of Computer
With new assistant dean Hollis Lai at
Science, Lai custom-designed for the
the helm—and the next accreditation
MD program a software accreditation
process not due for four more years—
management system to hold all
the focus of the office is shifting
information previously kept in
somewhat. “Now is the time where we
unwieldy email chains and paper files.
can actually make the improvement strides and embed the accreditation
Programs other than MD are
process within each of the programs
beginning to express an interest in data
so that they can do the work that they
dashboards, which enable aggregation,
need to,” says Lai. He envisions a
review and communication of vast
move away from oversight and toward
quantities of information. “I’m
collaboration. “My passion is to make
passionate about cross-pollination,
an impact on educational quality
seeing the various tools that we’ve built
improvement (EQI), enabling and
benefit the entirety of the faculty and
empowering all programs to deliver a
streamline their workflow,” says Lai.
higher quality of education.” Dentistry is changing how they organize their clinic, and Lai has designed a dashboard to help them manage that. They piloted the system over the summer and will formally Hollis Lai, Assistant Dean,
implement its use this academic
Education Quality and
year. And a computerized platform
Accreditation Photo: Jordan Carson
for administering assessments is now being used not just by the MD UNIVERSITY OF ALBERTA
25
THE BRIDGE
program, but also by Dental Hygiene,
place makes it easier to give timely,
Dentistry and Pharmacy. It has also
relevant feedback to our students.”
been adopted with enthusiasm by Postgraduate Medical Education in
At the same time, Lai is working
its new competency-based medical
to encourage faculty development
education, which involves more
in active learning. This student-
frequent and meaningful assessments
centred method features two-way
of residents’ work.
communication and takes the instructor out from behind a podium and into more of a learning-coach role. It invites students into the
“I FEEL LIKE IMPLEMENTING ACTIVE LEARNING AND BLENDED LEARNING IS WHERE THE NEXT BIG SHIFT WILL BE FOR OUR FACULTY.”
education process in ways that passively listening to a lecture cannot. He worked with the office of Academic Technologies to design a card game that shares with instructors various active learning techniques and tools for lesson planning. Dentistry has taken the lead in trying the cards, he says, and he is now bringing a similar
Lai customizes his tools to the unique
tool to the MD program and beyond.
workflow of each program, but one
“We can design the best curriculum in
factor remains constant: The focus is
the world, but at the end of the day, if
always user-friendly, intuitive solutions
we are still lecturing for the full hour,
that anyone can use without a great
it is going to be difficult for students to
deal of training. As for how these tools
keep up,” he says.
benefit learners, says Lai, “with the shift toward customized learning, having all
“I feel like implementing active learning
of the information in one easy-to-use
and blended learning is where the next big shift will be for our faculty.”
26
FACULTY OF MEDICINE & DENTISTRY
ISSUE NO. 1 – 2019
Faculty Service Officers design and deliver valuable researchintensive undergraduate programming One of about 45 Faculty Service Officers (FSOs) in the Faculty of Medicine & Dentistry, Rachel Milner plays an integral academic role as a teacher in the Department of Biochemistry. The FSO agreement enables academics like her in the basic science departments such as biochemistry, pharmacology and physiology, or programs such as Radiation Therapy, to focus intensely on teaching, while other FSOs focus on research.
their senior-year research projects.
“The FSO agreement changes the traditional academic model that says you must focus on research and teaching in equal measure, recognizing that in certain fields such as medical research, it is almost impossible to focus adequately on both of those things at the same time,” Milner explains.
“This is the third year we have been offering it,” Milner says. “In my role as student adviser, I encourage students to take the certificate if you’re even thinking of doing grad school, but also if you want to pursue medical school or go out into the big wide world of industry.”
Initially hired in 2000 to redesign the senior undergraduate research laboratory skills course in the undergraduate biochemistry program, Milner’s ongoing mission is to align learning outcomes with program objectives and to prepare students for
“Biochemistry and the other basic medical sciences are so research intensive ... and I believe if you don’t do research, you haven’t really learned the discipline. You can learn a whole bunch of facts but to really be a biochemist, you have to do biochemical research,” says Milner. Recently, Milner was instrumental in the creation of the Certificate in Biomedical Research.
Milner says FSOs have been pivotally important in the quality of undergraduate programming in the medical sciences. “We work as a network and collaborate a lot on improving our education programs and research opportunities for students.”
UNIVERSITY OF ALBERTA
27
Development and support key to attracting, retaining world-class faculty SEVERAL OFFICES ENCOURAGE ACADEMIC GROWTH OPPORTUNITIES The University of Alberta’s Faculty of Medicine & Dentistry has a rich history of attracting world-class clinicians and academics. Once they’re here, what supports are in place to retain them and encourage their growth and development?
28
ISSUE NO. 1 – 2019
FACULTY DEVELOPMENT
Beyond polishing their skills,
The mandate for Mia Lang, Associate
says Lang, workshops are a great
Dean, Faculty Development, is to
opportunity for faculty to develop
“guide the individual faculty member to
relationships with peers and mentors.
optimize their professional skills, such
“I’d like to see us move away from our
as teaching, leadership and research
individual, siloed activities to more of
skills.” A new set of faculty evaluation
a community approach.”
committee standards come into effect July 1, 2019, to recognize, encourage and reward the changing contributions
IDEAS OFFICE
of faculty in cutting-edge areas such
The IDEAS office, launched in the
as education scholarship, showcasing
fall of 2017, is working to build a
research and development in health-
community of health-profession
professions education.
scholars to improve health professions education (HPE)
Lang’s office supports and facilitates
scholarship. The office does this by
a number of faculty-development
building relationships and providing
workshops every year. She’s encouraged
more supportive infrastructure and
by the popularity last year of a
personnel, says IDEAS Director and
graduate student supervisor seminar
J. Allan Gilbert Chair in Medical
on improving mentorship skills, and a
Education Research, Carol Hodgson.
three-part clinical reasoning workshop to help teachers assess how they
IDEAS aims to support all faculty and
respond to their students’ diverse
is particularly focused on members
needs. “We have to be very nimble
whose appointments have less than
about identifying different learner
40 per cent research. These faculty
needs and we need to think about why
often do not have the time or training
we ask the questions we ask,” Lang
to do all the scholarly work required
says. “Is it to help us assess them, or is
for merit increases or promotion.
it to help them learn?”
Support from the IDEAS team helps them develop HPE research through all its stages, from initial questions to final publications.
From left, Denise Campbell-Scherer, Associate Dean, Lifelong Learning
“Collaborations on presentations,
Carol Hodgson, Director, IDEAS office
publications and grants are the core of
Mia Lang, Associate Dean, Faculty
an office to support scholarship,” says
Development
Hodgson, “but the IDEAS team are also
Photo: Jordan Carson
very proud of their teaching through UNIVERSITY OF ALBERTA
29
THE BRIDGE
faculty and professional development,
existing knowledge. “Everything we
primarily through the Teaching
do is wasted if we can’t implement
Scholars Program. It is through this
it,” she explains. “Our office will
training that IDEAS hopes to build a
also help build capacity for quality
community of HPE scholars.”
improvement, which will play a key role in 21st-century continuous
LIFELONG LEARNING
professional development.”
The office of Lifelong Learning
The Physician Learning Program
fills a different niche, says Denise
(PLP) carries out projects with data
Campbell-Scherer, associate dean,
and human-centred design elements,
as the academic home for faculty
and can also pair practitioner teams
interested in implementation
with end users “to mobilize the tacit
science, or the application of
knowledge and lived experiences of
A closer look at Physician Learning Program The major programmatic grant (between Alberta Health and the Alberta Medical Association) in the office of Lifelong Learning is the Physician Learning Program (PLP). Working with physician leads, PLP designs and carries out projects that focus on gaps in clinical practice that exist despite strong evidence about what is appropriate. In addition to stand-alone projects, five pillars help organize projects. Here’s a snapshot of what’s happening: • Digestive health: Improving colonoscopies, in partnership with the Alberta Colorectal Cancer Screening program and the Digestive Health Strategic Clinical Network; • Antimicrobial stewardship: Partnering with AHS Antimicrobial Stewardship Committee, among others, to help physicians and teams better understand appropriate antibiotic use, in support of Choosing Wisely Canada; • Metabolic disease: Multiple projects tackling issues around obesity, diabetes and hypertension; • Patients Collaborating with Teams (PaCT): Primary Health Care Integration Network initiative designed to help primary care teams better support patients who require significant support to maintain their health; • Marginalized populations: Creating a searchable, online interactive map of the services and resources in Calgary and Edmonton that might benefit inner-city patients with high acute-care needs, in support of key partner Addiction Recovery and Community Health (ARCH).
30
FACULTY OF MEDICINE & DENTISTRY
ISSUE NO. 1 – 2019
families, patients, clinicians,” says
level planning and decision-making,
Campbell-Scherer. PLP projects create
to advocate for reduced burnout and
effective solutions to health-care needs.
better morale among faculty.
Campbell-Scherer’s team will grow
“Struggling faculty are often both a
in the coming months from the
symptom and a contributor to toxic
current seven to up to 15. “We’re
work and learning environments,”
also working to increase our reach
adds Lewis.
and impact of PLP projects through liaising with well-developed system stakeholder networks; this extends the scale and spread of the
EQUITY, DIVERSITY AND INCLUSION
innovations that are found through
Helly Goez, Assistant Dean,
our collective work.”
Diversity, says her office is well supported by the faculty’s formal
ADVOCACY & WELLBEING
diversity and equitable recruitment policies. She works hard to
The office formerly known as Learner
promote the understanding that all
Advocacy and Wellness has been
faculty experience different social
rebranded as the Office of Advocacy
intersectionalities, which bring the
& Wellbeing to enhance engagement
potential for stress and workplace
and wellness through the full Faculty
suffering. “We know that when people
of Medicine & Dentistry continuum:
are discriminated against because of
from undergraduate and postgraduate
their diversity it impacts their well-
learners to graduate students and
being and hinders their productivity.”
now also faculty members. “We all deserve to feel good when we The new office will have an assistant
come to work,” summarizes Goez.
dean for faculty wellness, says Melanie
“When we hire a person we open the
Lewis, Associate Dean, Advocacy
gate, but to keep them, we need to
& Wellbeing. She envisions the new
value their contribution and show it
assistant dean participating in high-
in a meaningful way.”
UNIVERSITY OF ALBERTA
31
Students take the lead in peer support CLUBS, WORKSHOPS HELP FUTURE MEDICAL PROFESSIONALS DEVELOP LEADERSHIP, COMPASSION
Photos: Jordan Carson
32
ISSUE NO. 1 – 2019
Students taking the University of Alberta’s Medical Laboratory Science degree went to their program director, Lisa Purdy, last year with an unusual suggestion: They wanted a self-defence course. Working evening shifts as part of their clinical training, some were worried about walking to public transit late at night. Purdy agreed to fund the self-defence course but challenged them to do more. Why not offer self-help workshops every month throughout the academic year? And so was born the Medical Laboratory Science program’s Student Wellness Nights, with a nutritionist talking about budget meal-planning, a study room with puppies, yoga, a talk from a financial adviser and, yes, a self-defence session. While it was funded by
Top photo: Carter Smith
the Medical Laboratory Sciences
Bottom photo: Paul Barber
program, all the planning and executing was done by the students. Fourth-year student Denise Alano is vice-president of wellness for the Medical Laboratory Students Association and will oversee the Wellness Nights this academic year. “In this program, the faculty already open their doors to students who may need help and support and they do a very good job at that,” says Alano. “But we also figured it’s very important for us as students to reinforce that we do support each other.” Purdy agrees that it’s vital for the students to take the lead in support groups. “We need to foster leadership within our trainees, because otherwise how are they going to practise that when they get out into the health-care environment?” UNIVERSITY OF ALBERTA
33
THE BRIDGE
Students in the Undergraduate Medical Doctor program have their own Mental Health Advocates team, which holds events and workshops throughout the academic year. One workshop last year dealt with talking about suicide. “We looked at it through the clinical lens about how to talk with a patient,” says Paul Barber, a second-year medical student and team leader, “but one of our subtle goals was to help facilitate that conversation between students as well.”
From left, Denise Alano and Gloria Kwon.
The team’s biggest project is the student-led Mental Health Week, whose capstone event is Mental Health Monologues, where students take to the stage of Dewey’s pub to share personal stories. The Monologues event, which has been running about four years at the U of A, has since been adopted on other campuses across Canada. While funding for the events comes mainly from the Medical Students Association, Barber says the Mental Health Advocates team gets incredible support from the Advocacy & Wellbeing office. “It’s vital that students take on these peer-support roles,” says Barber. “You are not always going to have a board or a faculty member to facilitate these conversations. So teaching students to do that themselves is incredibly empowering.” Melanie Lewis, Associate Dean of the Advocacy & Wellbeing office, agrees. “I think a lot of this stuff has to come from peers; it can’t be top-down. And our job in those cases is to support students in any way we can.” For many years, the medical students have also run a program called Coffee with Clerks, which matches incoming first-year medical students with third-year students who are beginning their clinical placements, known as clerkships. Carter Smith, a fourth-year student who was one of the organizers last year, says the matches give first-year students “a link, an ear, somebody who has been through it all, who can answer your questions and help with some of the anxiety.” Almost all first- and third-year students take part and the partnerships usually last two years.
34
FACULTY OF MEDICINE & DENTISTRY
Melanie Lewis, Associate Dean, Advocacy & Wellbeing Photo: Melissa Fabrizio
Caring for the whole student ADVOCACY & WELLBEING OFFICE IS HERE FOR ACADEMIC, MENTAL-HEALTH SUPPORT
35
THE BRIDGE
The core philosophy of the Alberta Medical Association is that asking for help is a sign of strength. But
WHY IS THIS OFFICE IMPORTANT IN A MEDICAL SCHOOL?
cultivating that willingness in physicians to be vulnerable and seek
There’s a stigma that persists in the
support begins in the Faculty of
medical profession around asking for
Medicine & Dentistry.
help or admitting one is suffering, says Lewis. “You feel like you’re less
It’s here that the faculty’s office of
than; you’re not as good as or as cool
Advocacy & Wellbeing serves a crucial
as or as well-adjusted as everyone
role, says Associate Dean Melanie
else; everybody’s coping better.” And
Lewis. “Our goal is to ensure that
sometimes, in the service of making
students meet their best academic
excellent physicians, student wellness
and personal potential, and that
ends up at the bottom of a long list of
we address any barriers that are
priorities. She says it’s important to
hampering them.”
build in students the habit of seeking help from the moment they enter
WHAT IS THE MANDATE OF A TYPICAL LEARNER ADVOCACY OFFICE? It is mandated through accreditation that all MD programs must have an office of student affairs, but only over
school, through clinical placements and residency and beyond.
HOW DOES THE OFFICE COLLABORATE WITH STUDENTS?
the past several years have such offices
The Office of Advocacy & Wellbeing’s
evolved to focus more on student
involvement in student wellness
well-being, both physical and mental.
initiatives begins during the annual
“We are unique in that we include
peer-support orientation week, when,
postgraduate and graduate learners
together with students, they plan
under one office,” says Lewis.
events that, as Lewis says, “introduce a supportive culture in which the students will have each other’s backs.” It’s not just her office that does the heavy lifting around student support: “The students have always been a major advocate at the table to get advocacy and wellness needs met in an official capacity.”
36
FACULTY OF MEDICINE & DENTISTRY
ISSUE NO. 1 – 2019
HOW FAR-REACHING IS THE SUPPORT OFFERED BY THE OFFICE OF ADVOCACY & WELLBEING?
decreased due to government funding and in 2017, 68 graduating medical students in Canada did not get a match.
The office supports students in myriad ways, from information about wellness and financial literacy embedded in the curriculum to individual psychological and career counselling services. “I want students to know that there are multiple doors here with multiple people students can trust that they can go to,” including a full-time
“I WANT STUDENTS TO KNOW THAT THERE ARE MULTIPLE DOORS HERE WITH MULTIPLE PEOPLE STUDENTS CAN TRUST THAT THEY CAN GO TO.”
psychologist and four assistant deans
— MELANIE LEWIS, ASSOCIATE DEAN,
who help with academic appeals,
ADVOCACY & WELLBEING
advice to deal with harassment or intimidation and conflict resolution, among other stressors. At the U of A’s medical school, “We are a confidential, safe space.
counselling to undergo the match
Students can come here knowing they
process is embedded as part of the
can unload whatever they need to,”
MD curriculum. “With less residency
says Lewis, “whether it’s addiction
positions available, many students
issues, or depression, or severe
have heightened concerns, especially
academic peril, and feel safe that this
for students pursuing specialties
information isn’t going to hurt their
where the demand substantially
academic reputation.”
outstrips the supply,” says Lewis. The MD program and the Advocacy
WHAT IS THE MOST PRESSING ISSUE FACING MEDICAL STUDENTS?
& Wellbeing office all work together to help students succeed and provide support for each stage of the process. Additional resources include resume
These days, Lewis sees a significant
reviews and practice interviews for
uptick in students seeking career
students with faculty and volunteer
counselling after having been
residents. They help unmatched
unmatched for the medical residency
students broaden their scope of
of their choice. Each year the number
potential specialties and connect
of residency positions available for
them with specialists to shadow.
Canadian medical graduates has UNIVERSITY OF ALBERTA
37
THE BRIDGE
“If they are still unmatched, we
have been very successful in the
create programs where they can
following match.”
stay as undergraduate students in the MD program and pursue special
“We have a commitment to our
training in research (MD STIR)
students,” says Lewis. “We are
or an MD/MBA program. Students
not going to leave them alone in
who have pursued that extra year
this journey.”
Soft skills for self-help “I think every aspect of our faculty should be promoting health and wellbeing,” says Pamela Brett-MacLean, Director, Arts & Humanities in Health & Medicine (AHHM) program, and a selection of electives from her program are doing just that. Newest among the offerings is Healer’s Art, held here for the first time last spring. The course was designed by Rachel Remen (University of San Francisco) and has since been embraced by medical schools across North America. Healer’s Art has proven to be a powerful experience for both facilitators and learners, says Brett-MacLean, a co-lead for the pilot course. • With only 20 students per session— five per facilitator for intimate group discussions—Healer’s Art provides a safe, non-judgmental space for personal growth and to help students understand the need for both self-care and deep empathy as they pursue their medical school journey. Topics in the seminar include grief and loss, compassion, stress prevention and what it means to truly embrace medicine as a calling.
38
• Over the course of eight hours, Introduction to Mindfulness teaches students techniques for stress management, focus and concentration. Students learn how practising mindfulness can improve their communication skills, openness to collaboration and ability to lead through example. • In Spirituality and Health, students learn about the significance of spiritual care for some patients, and are asked to delve into the role of spirituality in their own lives and how that will impact the care they provide.
FACULTY OF MEDICINE & DENTISTRY
Creative pursuits bring fresh perspective to medicine, healing
Pamela Brett-MacLean, Director, Arts & Humanities in Health & Medicine program Art from Under the Surface by Marilène Oliver in the McMullen Gallery at the University of Alberta Hospital Photo: Jordan Carson
39
THE BRIDGE
The Arts & Humanities in Health &
Today, AHHM’s reach extends to
Medicine (AHHM) program was born
students, faculty, practitioners and
in 2006, to encourage development of
the broader community.
skilled, reflexive and compassionate health professionals who can foster relationships between the arts,
STUDENT LIFE
humanities, social sciences and
“Using the arts, you engage many
medicine. AHHM is the second office
more aspects of the collective
of its kind in Canada. Says director
intelligence of the group,” says
Pamela Brett-MacLean: “I believe
Brett-MacLean. “It’s not just a
the importance of an office like mine
cognitive exercise; it makes difficult
is to bring a different disciplinary
discussions more human-centred
perspective, different ways of thinking
and engages the emotion.”
and knowing, to support questioning that can lead to new visions for
Students in the Faculty of Medicine
medicine. Arts and humanities are
& Dentistry are encouraged
always asking philosophical questions
to experience that ‘collective
about who we are, how to live, how
intelligence’ with an array of electives.
to be together, and it’s helpful to
Communicating Care: A Theatre-Based
create a formal space that recognizes
Approach offers an interactive and
and welcomes those who want to ask
impactful 12 hours practising presence
those questions.”
and mindful attention to patients
Through the elective Communicating Care: A Theatre-Based Approach, UAlberta med students use improvisational exercises and role-playing scenarios to check their assumptions and help them communicate better with patients. Photo: Ed Ellis
40
FACULTY OF MEDICINE & DENTISTRY
ISSUE NO. 1 – 2019
through experiential theatre exercises.
REAL-WORLD APPLICATIONS
The Art of Observation takes students to the Art Gallery of Alberta to cultivate
At the helm at AHS, Yiu has carried the
clear, unbiased visual observation,
values of AHHM into the community
a skill that is crucial to practising
with a unique storytelling program
medicine. Spirituality and Health
that brings complex diagnoses into the
pairs students with hospital chaplains,
realm of the deeply human. Patients
encouraging them to understand that
and loved ones are invited to share on
caring for spiritual needs is an integral
the AHS Youtube channel their stories
part of holistic health care.
of illness, treatment, recovery and death, putting a human face to what
Brett-MacLean is particularly proud of
can be complicated medical issues.
the three-week open-study electives
“We need to understand the personal
that draw students from other medical
situation to provide holistic care,”
schools across North America in their
stresses Yiu. “When we don’t have
third and fourth years.
the complete story and we only focus on the technology, therapeutics and
Along with enthusiastic participation
diagnostics, we lose the bigger picture.”
in curricular offerings, students in the faculty have followed the lead
Like storytelling, visual art can
of AHHM and created their own
be a powerful tool in humanizing
committee, which Brett-MacLean
medicine. School of Dentistry
expects will create a number of
associate professor Minn Yoon
initiatives, including the existing
wanted to support patients with
book club, which welcomes incoming
highly invasive head and neck
medical students.
cancers, beyond traditional medical treatment. Along with Brett-
Students also shared personal stories
MacLean and an interdisciplinary
about the importance of a humanistic
team of researchers, she paired local
approach to health care at an AHHM
artists with patients to create an
booth at the faculty’s second annual
exhibit that in early 2017 began its
Festival of Health last spring. The
life in an Edmonton art gallery and,
idea was born from a special public
most recently, spent the summer at
presentation by former interim dean
Chicago’s International Museum of
and AHHM co-director Verna Yiu
Surgical Science. Through painting,
(now CEO and President of Alberta
sketch, sculpture and video, FLUX:
Health Services) about the power of
Responding to Head and Neck Cancer
storytelling in health care.
offers an intimate portrait of the ways in which this illness can turn a UNIVERSITY OF ALBERTA
41
THE BRIDGE
life upside down. Collaborating with a visual artist to illustrate the effects of her illness was an unexpected gift for participant Kimberley Flowers, recovering from tongue cancer. “The art helped me understand experiences I felt that there simply aren’t words for,” she says. On Brett-MacLean’s wish list for the future is more-stable funding for programs like these. “It’s good for
Verna Yiu, President and CEO, Alberta
all of us,” she says, “for students, for
Health Services, is harnessing the power
patients, for the community.”
of storytelling to transform culture. Photo: Supplied
All the world’s a stage Twice a year, theatre director David Diamond visits the U of A from Vancouver to work with various programs within the faculty. He facilitates theatre-based group workshops around wellness, team functioning, moral distress— whatever topic is most pressing, says Brett-MacLean. Together with the Division of Community Engagement, the Indigenous Health Initiatives Program and numerous other community partners, AHHM also helps organize performances of Diamond’s Theatre for Living interactive play, šxʷʔam̓ət (home). Created and performed by a mixed Indigenous and non-Indigenous cast and production team, the play about reconciliation has been performed at the Boyle Street Community League and webcast on campus in the
42
Medical Sciences Building. This inclusive, open and highly creative approach to a complex and painful issue invites students— who need no artistic background to participate—to stretch beyond their comfort zone and think about their future role as medical professionals in advancing reconciliation. Responses from students have shown just how helpful it was to use the lens of theatre. Catherine Deschenes, MD ’21, says: “It helped me—and I think it helped quite a few audience members—to see more concrete ways to enable reconciliation.” Aulora Oleynick, MD ’20, agrees. ““šxʷʔam̓ət was a unique and powerful experience that not only allowed the audience to view issues surrounding reconciliation, but to deeply engage with the issues.”
FACULTY OF MEDICINE & DENTISTRY
Associate dean positions MD program as national leader in research, social accountability
Tracey Hillier, Associate Dean, MD program Photo: Melissa Fabrizio
43
THE BRIDGE
The MD program in the Faculty of Medicine & Dentistry has seen a major shift in the past several years, says associate dean Tracey Hillier, with both curriculum and instructional approaches changing to reflect the increasingly diverse needs of students and the community they will eventually serve. “While some schools focus mainly on research and others focus more on accountability to local populations, the University of Alberta is developing programs of excellence across multiple areas, developing student-led curricular change,” says Hillier. She is focusing the program’s drive to position itself as a nationwide leader on two fronts: social accountability and research. What makes the U of A the perfect place for both? “We’re leveraging the relationships that have come from our strong Division of Community Engagement,” for one, says Hillier, “and world-class researchers and facilities. We’re also able to be exceptionally adaptable in our ability to respond to changing health-care needs of the community because of our innovative faculty and our strong partnerships with students.”
SOCIAL ACCOUNTABILITY Hillier has prioritized making changes to the recruitment process to draw a more diverse population of medical students. “We need to look like the community we’re representing; we need to have people from a broad variety of backgrounds.” While the Division of Community Engagement is charged with recruiting from rural and Indigenous populations, the MD program also engages in outreach to city high schools. “But we now know that is too late,” says Hillier, “so we are now going out to junior highs, because toward the end of junior high is when most are making choices about their future.” The MD program has also reviewed its admissions processes to break down barriers to diversity. To help reduce bias, Assistant Dean of Diversity Helly Goez suggested an implicit association test for all admissions interviewers. This test can be tremendously effective, Goez says. “It gives scenarios to someone on a computer to show them their scores within biases such as gender and skin tone,” she explains. Implicit bias training was implemented last year for those involved with admissions selection, says Hillier, and the committee will continue to use the process.
44
FACULTY OF MEDICINE & DENTISTRY
ISSUE NO. 1 – 2019
It’s now mandatory that all MD students participate in some form of community service, says Hillier, a way for those students who come from a more privileged background to build an understanding of the challenges faced by disadvantaged populations. “We’re also piloting a new social-justice learning community for those who are exceptionally interested in serving marginalized populations,” says Hillier. Developed in collaboration with the Division of Community Engagement and interested students, this focused program will see enhancements to the core curriculum—which already contains elements of social accountability throughout all four years—and more opportunities to train in places and with mentors who serve vulnerable populations. Students will have an opportunity from the moment they begin their first year to declare an interest in joining this community.
SPOTLIGHT ON RESEARCH Regarding a revitalized focus on research, says Hillier, “we need physician scientists who are going to solve the health-care problems of the future, and we equally need to support excellence from that end of the spectrum.” Beginning this academic year, students interested in learning more about research and improving those skills can declare an interest and join a pilot of the new research learning community. The community, created in collaboration with students, will encompass people with graduate degrees, students in the MD program and those within the MD STIR (Special Training in Research) program. Facilitated by the MD office, they’ll share knowledge and nurture each other’s research interests, with the support of both external guest speakers and top-notch researchers within the faculty. Hillier is also hoping to encourage students to further pursue their interests in medical research through the MD/PhD program. Eventually the research learning community will become more structured. “We’re hoping for a series of seminars that rotates every two years,” says Hillier. But in its infancy, it will exist mainly as an informal gathering of MD students and faculty who share a passion for research.
UNIVERSITY OF ALBERTA
45
Residents, supervisors move toward competency-based medical education NEW APPROACH ‘JUST MAKES EDUCATIONAL SENSE,’ SAYS ASSOCIATE DEAN, POSTGRADUATE MEDICAL EDUCATION
ISSUE NO. 1 – 2019
Competency-based medical education
“Just because you put a person in
(CBME) began gaining traction as a
a situation for a certain amount of
preferred method of resident training
time, doesn’t mean they’re going
about eight years ago, when the College
to learn what they need to,” says
of Family Physicians of Canada made a
Kearney. “When you understand
gradual introduction of the methodology
how people learn, you say, ‘How
to family medicine residents nationwide.
could this not be better?’ It just
The University of Alberta’s Faculty of
makes educational sense. We’re
Medicine & Dentistry Postgraduate
not throwing time out the door,
Medical Education program is now part
but now ‘three months of pediatric
of the broader national shift to CBME,
anesthesia’ does not necessarily
and last year began with two programs:
mean you’re good to go. Some of you
Anesthesiology and Otolaryngology. Six
can finish in two months, some of
more have since been added.
you may need four.”
CBME is based on a better
You may imagine that the most
understanding of how people learn.
important difference between
“In the past, curricula have been
traditional time-based residency
written in the form of objectives, using
training and CBME involves a move
very traditional educational language,”
away from rigid time limits for the
says Ramona Kearney, Associate Dean,
completion of rotations. But that’s
Postgraduate Medical Education.
only a small piece of what’s changed, explains Kearney.
While the vast majority of residents have proceeded smoothly through
In the traditional approach to
their rotations under the traditional
resident training, a supervisor
model, about 15 per cent needed a
assumes that all graduates come with
bit of extra support to succeed, says
a common toolkit of abilities. “So as
Kearney. And those people were often
soon as they arrive, you’ll give them
slipping through cracks in the system.
a task, and they’ll go off and do it.”
“They were struggling, not passing their
The new approach critiques whether
rotations, with no one telling them
that’s a fair way to train for success.
exactly what they need to change” and suddenly being told, after four years of
“They’re not cookie-cutter people;
building bad habits, they weren’t going
they all have strengths and
to be successful. “That’s something we
weaknesses in different areas,” says
really wanted to change.”
Kearney. With CBME, residents are given the chance to first work
Artwork: Natasia Designs
through a task with their supervisor, UNIVERSITY OF ALBERTA
47
THE BRIDGE
who observes and gives constructive
Supervisors are being taught to teach
feedback before sending them out
and assess differently. They proceed
to work alone with patients. “In
through a series of training modules,
terms of psychological safety as a
developed in partnership with the
learner, you’re not being put into a
Faculty Development office. They
situation you’ve not been in before,
begin with a broad introduction to the
so you should have more confidence
concept of CBME and work through
in what you’re doing,” says Kearney.
more specific skill development such as how to educate using a coaching model. Another benefit of CBME is that
“WHEN YOU UNDERSTAND HOW PEOPLE LEARN, YOU SAY, ‘HOW COULD THIS NOT BE BETTER?’ ”
no one supervisor has to make a
— RAMONA KEARNEY
no end-of-rotation evaluation now,”
pass or fail decision on a resident’s performance, which can be challenging for the supervisor and threaten the teacher-learner relationship. “There’s says Kearney. Instead, assessments are collected from the app, submitted to a portfolio and shared at least four times
Frequent observations of daily
a year with a competence committee,
workplace events and situations—
who then meet with the resident’s
toward achieving revised outcomes
academic adviser to determine the
called entrustable professional
resident’s readiness to move on.
activities—continue throughout the
48
residency. Before CBME, a resident
Kearney has already seen powerful
might go through a two-month
evidence of the effectiveness of
rotation and receive feedback twice.
CBME. Last year, at the very first
And that feedback might have
four-month competence committee
either been friendly but unhelpful
meeting, it was clear that a resident
(“You’re fun to work with”) or
was struggling, she recalls. “That
negative but too general (“You need
would not have happened in the old
to read more”). Now, with the help
system, probably not until second
of an app, residents complete an
year. That was early detection as a
electronic self-assessment at the end
direct result of daily feedback, and
of every shift and share it with their
from that, they were able to make an
supervisor, who will input their own
educational plan for that resident.
feedback and assessment.
This is an amazing improvement.”
FACULTY OF MEDICINE & DENTISTRY
Rural medical education: Boundless opportunities LEAVING EDMONTON FOR TRAINING BROADENS HORIZONS FOR STUDENTS, RESIDENTS
Jill Konkin, Associate Dean, Division of Community Engagement Photo: Jordan Carson
On any weekday at the University
and towns in Alberta, in northern
of Alberta’s Faculty of Medicine &
Canada and in rural and urban
Dentistry, hundreds of students
centres across the globe. When
from more than 20 departments can
it comes to learning and clinical
be seen in the halls and classrooms
placements, the faculty encourages
of the Edmonton Clinical Health
its students to spread their wings.
Academy. It’s a busy place. “We want students to go out and learn But students from the faculty can
in different places because we want
also be found in large and small
them to go out and work in different
health settings in other cities
places,” says Jill Konkin, Associate
UNIVERSITY OF ALBERTA
49
THE BRIDGE
Rural Integrated Community Clerkship In 2017, the U of A’s Rural Integrated Community Clerkship marked a decade of immersing medical students into the daily routine of rural physicians. Rather than completing their core rotations in Edmonton, third-year medical students in the rural clerkship program spend 10 months living and learning in northern and central Alberta rural communities, where they are based in family medicine clinics under the mentorship of local physician preceptors and follow patients to all venues of care including the hospital inpatient ward, operating room, labour and delivery suite, patients’ homes, public health clinics and more. To date, about 190 participants have been placed in communities such as Camrose, Edson, Hinton, Ponoka, St. Paul, Sylvan Lake, Westlock and Whitecourt. Students who do the rural clerkship are more likely to choose careers as family doctors or generalists, often working in underserved communities, but also go into other competitive specialities. Andrew Halladay, MD ’13, completed the Rural Integrated Community Clerkship program and now practises as a family physician in Whitecourt and is a preceptor. “This is an excellent program,” he says. “I don’t think I would be as good a doctor today if I didn’t go through it.”
Dean, Division of Community Engagement. “If all we ever do is have them learn next to the Walter C. Mackenzie Health Sciences Centre … then that’s all they’ll know and that’s all they’ll feel is important.” For undergraduate medical students, the Rural Integrated Community Clerkship (ICC), a core clerkship opportunity, allows them to meet all the competencies of the third-year MD program in rural Alberta. There is also a second-year gastrointestinal course delivered outside of Edmonton and a mandatory thirdyear, one-month rural placement for those not in the ICC. About 25 to 30 medical students also do placements overseas each year in various countries. One of the faculty’s long-running international partnerships is with the Patan Academy of Health Sciences, based in Kathmandu, Nepal. “Patan is a school that is oriented toward graduating physicians who will serve the needs of their communities, particularly rural,” says Konkin. “We are learning from them as well.” Ramona Kearney, Associate Dean of Postgraduate Medical Education, says rural-based programs are one way her office connects medical residents to the community.
50
FACULTY OF MEDICINE & DENTISTRY
ISSUE NO. 1 – 2019
“We have two years of family
The idea is if that’s your home
medicine residency situated
base and that’s where you train,
either in the city or in three of our
we hope that will entice (residents)
smaller urban communities … . Fort
to start a practice in one of those
McMurray, Grande Prairie and Red
smaller areas.”
Deer are the three home bases for 40 of our residents in family medicine.
Radiation therapy: Unleashing Alberta’s next generation of cancer care The U of A’s Radiation Therapy program launched in September 2014. The degree includes classes on the U of A campus, a five-week clinical introduction and an eight-month clinical placement at the Cross Cancer Institute and at the Tom Baker Cancer Centre in Calgary. Susan Fawcett, Director, Radiation Therapy program, says the Tom Baker partnership was mandated by the Alberta government when it chose U of A to offer the radiation therapy degree, with an expectation that it would be a provincial program. Eventually, some shorter placements will take place in smaller cancer centres in Lethbridge, Red Deer and Grande Prairie. Radiation therapy is specialized in terms of technology. “Each centre develops different expertise and may not treat all types of tumours,” says Kari Osmar, the U of A’s clinical faculty educator at the Tom Baker Cancer Centre. Students must develop the full scope of clinical and professional competencies to pass their national exams and meet the radiation therapy program outcomes. Students wouldn’t be able to accomplish that at only one centre, adds Fawcett. Radiation therapy graduate Kristi Ngo, ’18 BScRdThpy, was grateful for the mentoring at both the Cross and the Tom Baker centres. “It really opens your eyes as to how things can be done differently to accomplish the same goal. It helps you become a better radiation therapist because you’re not so rigid in your thinking.” Ngo and all her 2018 classmates have been hired by either the Tom Baker Centre or the Cross Cancer Institute. UNIVERSITY OF ALBERTA
51
Renny Khan, Director, International Programs Photo: Jordan Carson
Global Medical Summer Study FOUR-WEEK PROGRAM GIVES INTERNATIONAL STUDENTS A TASTE OF CANADA’S HEALTH SYSTEM
52
ISSUE NO. 1 – 2019
Every summer, a group of select
WHY A SUMMER SCHOOL?
medical students from top schools
To best serve those students
in China—and, more recently,
without taking away resources
Thailand—gathers at the University
from the MD program, Khan and
of Alberta for a crash course
Fedorak decided on a summer
in Canadian health care. The
school. “It works for the vacation
intensive four-week Global Medical
season in Asia, and it works because
Summer Program introduces some
our students are off school at that
of Asia’s best and brightest to
time,” says Khan, which means
what it’s like to study and practise
increased faculty availability and
medicine in Canada.
improved accessibility to oncampus housing. Every summer, the
This elite summer school was
program serves about 30 carefully
designed and implemented
selected students from the upper
three years ago by the Faculty of
echelons of the partner schools.
Medicine & Dentistry’s Director of International Programs, Renny Khan, together with late dean Richard Fedorak and a small advisory group.
WHAT DO THE FOUR WEEKS INCLUDE? Khan calls the program “medical school in a box.” The students get
WHERE DID THE IDEA FOR THE GLOBAL MEDICAL SUMMER PROGRAM COME FROM?
a taste of the Canadian system through lectures, discovery learning and small-group discussion sessions with U of A faculty, MD and PhD students. Perhaps most important,
“China is innovating its health-care
local physicians and advisers to the
system and looking at international
program—especially family doctors
models,” explains Khan. Several years
John Chiu and Fang Ba—recruit
ago, a handful of Chinese medical
colleagues in family medicine
schools—including Peking University
and a few other specialities to
(“the No. 1 ranked university in
open up their clinics for weeklong
China,” says Khan); Fudan; Zhejiang;
observation sessions.
China Medical University and Jilin University—reached out to the U of A, seeking a partnership that would show their best medical students Canada’s medical-education and health-care systems. UNIVERSITY OF ALBERTA
53
THE BRIDGE
HOW IS THIS DIFFERENT FROM COMPARABLE PROGRAMS AT OTHER SCHOOLS? Khan says this is a unique program in North America. “When we did the research before starting, we found other programs in places that offered general summer courses. What we could provide to our partners and students was a very strong, interesting, innovative and engaging academic experience with opportunity for observation sessions; nobody else is doing that.” In other summer schools, he continues, “the students are left on their own” to find housing and get to know the city. Here, the program coordinator helps connect the visiting students with housing and the group gets together outside of instruction time for shared meals and outings. “We really take care of these students.”
WHAT IS THE GOAL OF THE SUMMER SCHOOL? “We are aiming to influence future leadership in education, clinical
Young Physicians Training Program As a complement to the Global Summer Medical Program, the U of A is the international partner of choice in the Young Physicians Training Program. Over the next three to four years, one particular stream of the program in Family Medicine will bring six to eight young Chinese physicians and academic leaders from Zhejiang province to the Faculty of Medicine & Dentistry in six-month blocks for “trainthe-trainer” education. Once back home, these doctors will help to develop a curriculum and share what they’ve learned with an extended group of up to 200 general practitioners. This significant Chinese pilot project is intended to demonstrate to the government the crucial part family doctors could play in their health-care system.
HOW DOES THE PROGRAM BENEFIT U OF A STUDENTS AND FACULTY?
practice and research,” says Khan.
54
“These students are going to become
The summer school “builds our brand
physicians in the top health systems
among elite universities in China
in their countries, and we’re giving
and other countries and creates a
them a snapshot of how that works
lot of opportunities for us,” Khan
in Canada, and how we train for the
says. “They have a big vision and
system in Canada.”
as they’re rising, we want to be in FACULTY OF MEDICINE & DENTISTRY
ISSUE NO. 1 – 2019
that company.” The program also
somewhat rote learning, where the
generates revenue. “We charge a
teacher stands up and lectures and
tuition and we earmark a significant
the learning is passive. The whole
portion of that revenue for our
meaning of ‘teach’ is very different
medical students to go out on global
here,” says Khan. “It’s more
exchanges.” Most exciting to Khan
interactive—like a conversation—
is the reciprocity factor. Local
and they embrace that.” They also
students—MD and PhD students have
express surprise at how much
opportunities to teach and mentor
hands-on practice local medical
during the summer school—get to
students get compared to them.
learn about a very different approach
By far the difference most noted,
to health care. This has proven a
though, is the crucial role the family
particularly exciting side-benefit, says
doctor plays in Canadian health
Khan: “I want to prepare our future
care, a role that doesn’t exist in the
physicians for the globalized world.”
Chinese medical system.
“THESE STUDENTS ARE GOING TO BECOME PHYSICIANS IN THE TOP HEALTH SYSTEMS IN THEIR COUNTRIES, AND WE’RE GIVING THEM A SNAPSHOT OF HOW THAT WORKS IN CANADA, AND HOW WE TRAIN FOR THE SYSTEM IN CANADA.”
HOW WOULD YOU LIKE TO SEE THIS PROGRAM GROW? While the project was piloted in partnership with Chinese schools, Khan says, he sees enormous potential for growth. “If we’re going to call this a global summer school, it should encompass a breadth of countries and partners that we work with, so we have been expanding.” New to the program, for example, is a partnership with Thai school Thammasat University. “My vision is to have a broad representation of regions and expand the number of
WHAT FEEDBACK HAVE YOU RECEIVED FROM VISITING STUDENTS?
positions in the program.”
Visiting Chinese students are surprised by western instructional methods. “Teaching in China is still UNIVERSITY OF ALBERTA
55
OFFICE OF ADVANCEMENT
2J2.00 Walter C. Mackenzie Health Sciences Centre 8440 - 112 Street Edmonton, AB Canada T6G 2R7 UALBERTA.CA/MEDICINE E advadmin@ualberta.ca P 780-492-6621
Faculty of Medicine & Dentistry – University of Alberta @UAlberta_FoMD @UAlberta_FoMD