UA Open Access Publishing Fund / Background: The transition from medical student to first-year intern can be challenging. The stress of increased responsibilities, the gap between performance expectations and varying levels of clinical skills, and the need to adapt to a new institutional space and culture can make this transition overwhelming. Orientation programs intend to help new residents prepare for their new training environment. Objective: To ease our interns’ transition, we piloted a novel clinical primer course. We believe this course will provide an introduction to basic clinical knowledge and procedures, without affecting time allotted for mandatory orientation activities, and will help the interns feel better prepared for their clinical duties. Methods: First-year Emergency Medicine residents were invited to participate in this primer course, called the Introductory Clinician Development Series (or “intern boot camp”), providing optional lecture and procedural skills instruction prior to their participation in the mandatory orientation curriculum and assumption of clinical responsibilities. Participating residents completed postcourse surveys asking for feedback on the experience. Results: Survey responses indicated that the intern boot camp helped first-year residents feel more prepared for their clinical shifts in the Emergency Department. Conclusion: An optional clinical introductory series can allow for maintenance of mandatory orientation activities and clinical shifts while easing the transition from medical student to clinician.

UA Open Access Publishing Fund / Background: Medical residency can be a time of increased psychological stress and sleep disturbance. We examine the prospective associations between self-reported sleep quality and resident wellness across a single training year. Methods: Sixty-nine (N69) resident physicians completed the Brief Resident Wellness Profile (M17.66, standard deviation [SD] 3.45, range: 017) and the Pittsburgh Sleep Quality Index (M6.22, SD 2.86, range: 1225) at multiple occasions in a single training year. We examined the 1-month lagged effect of sleep disturbances on residents’ self-reported wellness. Results: Accounting for residents’ overall level of sleep disturbance across the entire study period, both the concurrent (within-person) within-occasion effect of sleep disturbance (B 0.20, standard error [SE]0.06, p0.003, 95% confidence interval [CI]: 0.33, 0.07) and the lagged within-person effect of resident sleep disturbance (B 0.15, SE0.07, p0.037, 95% CI: 0.29, 0.009) were significant predictors of decreased resident wellness. Increases in sleep disturbances are a leading indicatorof resident wellness, predicting decreased well-being 1 month later. Conclusions: Sleep quality exerts a significant effect on self-reported resident wellness. Periodic evaluation of sleep quality may alert program leadership and the residents themselves to impending decreases in psychological well-being.

Through the combined efforts of the American Pathology Foundation (APF), the American Society for Clinical Pathology (ASCP), and the Program Directors Section (PRODS) of the Association of Pathology Chairs (APC), a needs assessment was performed via a survey on the PRODS listserv, workshops at the APC/PRODS annual meetings in 2009 and 2010, and a Work Group of representatives of APF, ASCP, and PRODS. Residency program needs and resource constraints common to training pathology residents in practice and laboratory management were identified. In addition, a consensus curriculum for management training was created to serve as a resource for residency training program directors and others. The curriculum was converted into a "wiki" design tool for use by program directors, residents, and faculty.

The College of Family Physicians of Canada, responsible for accreditation of residency programs, prescribe ‘The Four Principles of Family Medicine’ and the 27 competencies derived from them, as the curricular framework for Canadian family medicine residencies. The literature reveals little about the development of the Four Principles of Family Medicine. This study was conducted to determine the degree to which each competency was considered relevant to clinical practice and learned by recent graduates of the University of Manitoba Family Medicine program. For the 27 competencies, the ratings of graduates were similar to those of family medicine experts as the competencies were generally viewed as moderately important and frequently used. Graduates reported being well prepared in most of the competencies. This supports the use of the Four Principles of Family Medicine as a curricular framework for family physician trainees in Canada.

The College of Family Physicians of Canada, responsible for accreditation of residency programs, prescribe ‘The Four Principles of Family Medicine’ and the 27 competencies derived from them, as the curricular framework for Canadian family medicine residencies. The literature reveals little about the development of the Four Principles of Family Medicine. This study was conducted to determine the degree to which each competency was considered relevant to clinical practice and learned by recent graduates of the University of Manitoba Family Medicine program. For the 27 competencies, the ratings of graduates were similar to those of family medicine experts as the competencies were generally viewed as moderately important and frequently used. Graduates reported being well prepared in most of the competencies. This supports the use of the Four Principles of Family Medicine as a curricular framework for family physician trainees in Canada.

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Securing and Excelling in a Pharmacy Residency is a practical guide and handbook for pharmacy students seeking a residency, residents currently enrolled in a program, and residency program leadership. This user-friendly text encourages high-quality pharmacy residency training, which elevates the individual, the profession, and ultimately patient care. Answering the need for residency training and improvement raised by the ASHP/ACCP joint 2020 initiative, Securing and Excelling in a Pharmacy Residency uniquely prepares students for the increasingly competitive pharmacy residency market. This one-of-a-kind resource is also helpful to guide individuals currently enrolled in a residency and their mentors. This valuable resource also addresses options after residency training, priceless guidance for both current residents and faculty advisers.

The launch of Competence by Design (CBD) in 2017 by the Royal College of Physicians and Surgeons of Canada (RCPSC) ushered in a new era of residency education in Canada. For CBD to succeed, faculty responsible for training residents must undergo faculty development to attain the relevant knowledge and skills required to fulfil their new duties. This thesis examines the faculty development resources available to faculty, and the approaches taken by program directors to facilitate faculty development. This research was guided by two research questions: (1) What faculty development resources (e.g., online modules, websites, slide decks) are currently available for faculty members in CBD programs across Canada? (2) How do program directors facilitate faculty development within their specific program? Phase 1 of this study involved a document review of all English-speaking medical schools in Canada with a post graduate CBD program. In phase 2, semi-structured interviews were conducted with program directors from the emergency medicine and psychiatry specialties. The document review found that Canadian universities hosted a range of informative websites, documents, newsletters, live sessions, and online modules to support faculty development efforts on a range of topics. During the interview phase, program directors identified live faculty development sessions, both in-person and online, were the most effective. They also expanded on their experience in the transition to CBD, some noting that their previous assessment models shared similarities with CBD, lessening the burden on faculty to change their teaching practice. Many expressed concerns over resource and time constraints on faculty development and the implementation of CBD as a whole.

Competency-based medical education (CBME) is a paradigm of assessing resident performance through well-defined tasks, objectives and milestones. A large number of data points are generated during a five-year period as a resident accomplishes the assigned tasks. However, no tool support exists to process this data for early identification of a resident-at-risk failing to achieve future milestones. In this thesis, the implementation of CBME at McMaster's Royal College Emergency Medicine residency program was studied and the development of a machine learning algorithm (MLA) to identify patterns in resident performance was reported. The adaptivity of multiple MLAs to build a tool support for monitoring residents' progress and flagging those who are in most need of assistance in the context of emergency medicine education was evaluated. / Thesis / Master of Science (MSc)

Despite a mandated 1-month rotation in developmental-behavioral pediatrics (DBP), pediatric residents report inadequate training in behavioral health care. As a first step in much needed curriculum development in this area, this study sought to assess learner experiences regarding the management of behavioral health problems during residency. Four focus groups were conducted for residents in years 1-3 of training in 2 residency programs in a northeastern state. Transcripts were analyzed and coded by researchers through qualitative classical content analysis. The exploratory analysis revealed 9 key themes: time requirements, rapport building, resources and referrals for behavioral health, psychiatric medications, diagnosis vs. treatment, working with families, the importance of behavioral health, fears of working with a pediatric population, and training issues. These qualitative data further identify gaps in the behavioral health training of pediatric residents and may inform future innovations in training curricula.