Abstract The objective was to assess Professional, Health Advocate and Scholar CanMEDS competencies in anesthesia residents using a Generic Integrated Objective Structured Assessment Tool (GIOSAT) during simulated scenarios. Methods Twenty one anesthesia residents participated in managing two scenarios: “do not resuscitate” and “morphine overdose”. Four trained blinded raters analyzed video recordings using the GIOSAT. Internal structure was examined using generalizability analysis. Results Results of the g-study focused on PHAS and ME components alone, participants accounted for 20% of the scores variance (G-coefficient 0.66). A D-study indicated two raters and eleven or more scenarios would be required for a G-coefficient > 0.80. Conclusion This study demonstrates construct validity for assessing PHAS competencies for low stakes assessment. Results address the gap of assessment performance for PHAS competencies, describe methodology and produce recommendations for summative assessments using simulation.

Abstract The objective was to assess Professional, Health Advocate and Scholar CanMEDS competencies in anesthesia residents using a Generic Integrated Objective Structured Assessment Tool (GIOSAT) during simulated scenarios. Methods Twenty one anesthesia residents participated in managing two scenarios: “do not resuscitate” and “morphine overdose”. Four trained blinded raters analyzed video recordings using the GIOSAT. Internal structure was examined using generalizability analysis. Results Results of the g-study focused on PHAS and ME components alone, participants accounted for 20% of the scores variance (G-coefficient 0.66). A D-study indicated two raters and eleven or more scenarios would be required for a G-coefficient > 0.80. Conclusion This study demonstrates construct validity for assessing PHAS competencies for low stakes assessment. Results address the gap of assessment performance for PHAS competencies, describe methodology and produce recommendations for summative assessments using simulation.

Résumé : Le cadre de compétence CanMEDS définit les rôles attendus des médecins canadiens, mais fait l’objet de certaines critiques. Par exemple, la définition et l’adoption du rôle de promoteur de la santé semblent problématiques, entre autres en ce qui a trait à une dualité implicite entre des actions de type individuel et collectif. Cette étude visait à identifier les facteurs qui influencent l’intention d’adopter des comportements associés au rôle de promoteur de la santé et à en comparer les variables prédictives selon le type d’action. Une étude transversale descriptive a été réalisée utilisant un questionnaire web élaboré selon les principes de la Théorie du comportement planifié d’Ajzen. Le questionnaire a été envoyé par courriel en 2013 à tous les résidents en médecine de famille des universités francophones du Québec. Soixante-huit résidents (7%) ont complété le questionnaire. L’importance du rôle pour les participants et la pression sociale perçue étaient particulièrement significatives dans la prédiction de l’intention d’adopter des comportements associés au rôle de promoteur de la santé (variance expliquée de 26%, p<0.001; et 48%, p<0.001; respectivement). Les résidents participants avaient également une attitude plus positive envers les actions de type individuel (moyenne =72,8% vs 58,3%, p<.05), et percevaient plus de pression à adopter celles-ci (moyenne = 82.7% vs 74.3%, p<.05). Ils ressentaient moins de contrôle quant à l’adoption d’action de type collectif (moyenne = 79.8% vs 84.6%, p<.05). Étant donné que différents types d’action sont associés au rôle de promoteur de la santé, l’intention d’adopter ce rôle peut être influencée par différents facteurs. Une redéfinition éventuelle du rôle devrait prendre en compte cette dualité et les interventions pédagogiques devraient être modulées en conséquence. // Abstract : The CanMEDS framework defines the roles and competencies for all Canadian physicians. It is widely used but fraught with challenges, particularly concerning the understanding and adoption of the health advocate role, which includes both individual and collective type actions. This study aimed to identify the factors that influence the intention to adopt this role by family medicine residents and to compare their intention related to individual versus collective type actions. A cross sectional descriptive study was designed using a web questionnaire based on the theory of planned behaviour elaborated by Ajzen. The questionnaire was sent by email in 2013 to all family medicine residents from francophone programs in Quebec. Sixty-eight residents (7%) completed the questionnaire. The importance of the role for participants and social pressure were particularly influential factors regarding the intention to adopt behaviours associated with the health advocate role (26% variance explained p < 0.001 and 48% p < 0.001 respectively). Residents also had a more favourable attitude towards individual type actions (mean =72,8% vs 58,3%, p<.05), and perceived more pressure to adopt them (mean = 82.7% vs 74.3%, p<.05). They perceived less control towards collective-type actions (mean = 79.8% vs 84.6%, p<.05). Since different types of action are associated with the health advocate role, intention to adopt the role can be influenced by different factors. Future revisions of the role should take into account the implicit duality of the role focusing on both individual and collective type actions and pedagogical interventions should be tailored accordingly.

The purpose of this study was to examine the effectiveness of the Junior Master Wellness Volunteer (JMWV) program on select positive youth development (PYD) outcomes among program participants. These outcomes included Competence in health literacy, Connection, Contribution, Character, and Confidence. Research questions were (1) Does participation in the JMWV program improve participants’ Competency in health literacy? (2) Does participation in the JMWV program improve participants’ perceived ability to Connect with and Contribute to their community? (3) Does participation in the JMWV program improve participants' perceived Character or ability to engage in and understand their community? (4) Does participation in the JMWV program improve participants’ perceived self-efficacy (Confidence)? (5) Does participants’ delivery of the service component of the JMWV program relate to their perceived Connection, Contribution, Character, and Confidence? Secondary data from the Mississippi State University (MSU) Extension were analyzed to determine the JMWV program's effectiveness on PYD outcomes. Data included responses to matched pre-tests and post-tests (n = 93), matched pre-surveys and post-surveys (n = 108), and activity reports forms (n = 50). Paired t-tests were used to examine the differences in Competence as measured by the pre-test and post-test scores and changes in other PYD outcomes as measured by the pre-survey and post-survey. Analysis, including paired sample ttests, indicated that JMWV participants had a statistically significant improvement in all four of the PYD outcomes in this study. A correlation analysis also indicated a positive but weak relationship between the reported number of service hours completed as part of the JMWV program and perceived Connections and Contributions (r = -.340, p < .05), Character (r = -.340, p < .01), and Confidence (r = -.307, p < .05) after the program. JMWV participants improved in Competency, Connections and Contributions, Character, and Confidence. The number of hours spent engaged in community service marginally contributed to improvements to select PYD outcomes. This study adds to the evidence that the JMWV program results in PYD.