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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.

<p>Application of previously learned knowledge to new problems or contexts is a cognitive process known as transfer. Undergraduate medical education is optimized when learners are able to transfer basic science knowledge to clinical learning. A long history of transfer research suggests that spontaneous transfer of conceptual knowledge is not easy for learners, thus creating an educational challenge during undergraduate training. However, not all transfer tasks are equally difficult. When conceptual problems are presented in familiar contexts (e.g. similar surface details or semantic content in word problems), this <em>near </em>transfer is facilitated for learners. But when contextual familiarity does not exist, the problem is one of <em>far </em>transfer and becomes more difficult. Previous research suggests that using contextual information and focusing on conceptual teaching can improve transfer performance for novices.</p> <p>This thesis investigates how emphasizing contextual information versus conceptual information can impact transfer of principles of physics relevant to physiology (the concepts) to different organ systems (the contexts). Across three experimental studies, students were assigned to different learning and practice conditions where conceptual and contextual teaching were manipulated. The results showed 1) while emphasizing conceptual information can improve transfer, contextual alignment (near transfer) between learning and problem solving had the highest performance for all students. 2) Novices use contextual information as</p> <p>recognition cues for new problems but can be shifted to examine deep conceptual structure when provided with in-depth conceptual teaching as well as varying the number of contexts used to practice concepts. This shifts novices to equal success at near and far transfer. 3) Novices can revert to relying on contextual information if teaching interventions do not provide contextual variation and instead promote a close association between contextual details and conceptual information.</p> <p>This research suggests that shifting novices to examine conceptual problems at the deep structure level should be a key goal for teaching basic science for transfer. Novices default to using surface details to encode and retrieve conceptual information. While in some near transfer problems this can be an effective strategy, for far transfer it can lead to errors. Basic science teaching during undergraduate training must emphasize transferability of concepts by providing more relatable ways to understand conceptual information and showing the variation of a concept’s presentation.</p> / Doctor of Philosophy (PhD)

This thesis explores the role of formal bioethics instruction in preparing medical students to face ethical issues pertinent to diverse populations in clinical practice. The importance of bioethics education has been widely recognized and as a result, it is formally required in all medical schools. However, with little standardization on the actual logistics, ethics education in medical schools is extremely variable, producing students who are naïve and/or inconsistently capable of managing ethically complex situations. During medical school I pursued a Masters of Arts in Urban Bioethics (MAUB), which heavily focused on the social determinants of health and how they manifest in health care settings. I acquired new skills that gave me perspective and awareness into ethical issues that urban populations face, and during my clerkships I found I was better equipped and more comfortable navigating my patients’ non-medical complexities than my non-MAUB peers. Using three personal patient encounters as examples, I illustrate how a comprehensive urban bioethics education can positively impact patient care. Finally, I suggest improvements to medical schools’ bioethics curricula that will likely influence and mold each student’s thought processes to be more ethically-aware and culturally-sensitive. The goal of reforming bioethics education is to give students a set of real-world skills rather than a theoretical book of knowledge. Without a comprehensive and multifaceted approach to bioethics, students will likely lack the cultural sensitivity, awareness, and perspective necessary to treat a diverse patient population. / Urban Bioethics

In the 1990's the Accreditation Council for Graduate Medical Education (ACGME) recognized a need to fully integrate learning outcomes assessment into the accreditation process for resident physician training programs. ACGME leaders had concluded that by increasing emphasis on curricular development and by evaluating student performance through measurement of learning outcomes, the accreditation process would become a more reliable predictor of the residency program's success. In 1994 the ACGME created an initiative that would transform the current accreditation model of minimum threshold requirements towards a student performance based model of improved learning outcomes based on curricular development. responsible for the accreditation of over 8037 physician residency training programs in the United States. One hundred fifty of these programs provide training in the specialty of pathology and its anatomic and clinical sub-disciplines (AMA , 2007). Concurrent with the beginning of the ACGME Outcomes Project (1994) , four major pathology education groups in North America entered into a collaboration to improve the quality of pathology resident training. Their focus encompassed improvements in both clinical and managerial skills . The findings of this joint study culminated in the publishing of the Graylyn Conference Report in 1995 (Smith et al., 2006). One of the major recommendations in the report was that resident training in clinical laboratory administration should be improved. National leaders in pathology education felt that these changes were necessary to accommodate the evolving role of the pathologist as a clinical and administrative leader in a rapidly changing health care delivery setting. Prior to this current investigation, no studies appear to exist that provide an in-depth analysis of the perceptions of the residency directors about the need of expanded training in laboratory administration. This quantitative study has evaluated the amount of time and priority given to managerial training, the inclusion of administration topics in the curriculum and the extent of learning outcomes assessment in administration that residency program directors believe are being linked to successful professional performance in recent graduates . / Educational Administration

A modern version of the Hippocratic Oath instructs physicians that, “prevention is preferable to cure.” As healthcare providers, physicians promote healthy behaviors to prevent social issues from becoming health issues. Firearm violence is a social issue that has led to significant morbidity and mortality making firearm related-injuries and deaths a major health crisis of our time. If physicians have a role as credible messengers and advocates for firearm injury prevention, the educational institutions that form them must have a role as well. Unfortunately, firearm injury prevention education is rare in undergraduate medical education curricula. This poses an ethical dilemma. Undergraduate medical education without firearm injury prevention education misses the opportunity to equip trainees to discuss firearm violence as a health issue. As a result, physicians’ agency to advocate, educate patients, and thus fulfill ethical obligations may be limited. In this paper, physician codes of ethics are briefly presented. A case study of educational inquiry for medical students regarding firearm injury epidemiology, violence as a public health issue, the role of physicians in firearm policy, as well as clinical bedside skills related to firearm safety and injury is described. A case for firearm injury prevention education in undergraduate medical education curricula is made. / Urban Bioethics