PGME ALL COORDINATORS MEETINGNovember 2018

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PGME DEAN’S OFFICE UPDATEMelanie Pedersen

• Accommodations and Leaves • Clinical Fellow status • Saudi Update • CaRMS Update • Accreditation (evaluations)

PRIVACY & INFORMATION SECURITY

RoadshowFALL 2018

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BACKGROUND / RECAP

Privacy and information security a top risk at UBC

Launch of “Privacy Matters” to increase awareness, education and involvement in information security.

Coordinated effort between Risk Management Services, Office of the University Counsel, UBC IT.

Faculty of Medicine is playing a role of guidance and promotion for Privacy Matters

Activities range from broad actions for all Faculty and Staff, through to individual engagements with specific units.

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APPROACH FOR FACULTY OF MEDICINE

Actions for Departments & Schools:• 15-20 min online course, 8 questions• Engagement with IT personnel on encryption practices

COMMUNICATIONS PLAN OVERVIEW

Presentations to FoM Executive (May to July

2018)

Broad Communication

to FoM Staff (Fall 2018)

Tracking of Foundational

Activities (ongoing)

FUNDAMENTALS TRAINING STATISTICS – NOV 1. 2018

https://privacymatters.ubc.ca/fundamentals-training

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Faculty of MedicinePGME Finance UpdateFY2018/19

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OVERVIEW

FY2018/19 Funding Guidelines

FY2018/19 Funding Distribution

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FUNDING GUIDELINES

Draft Ministry of Health funding letter received

Formal Scheduled Teaching (without Patient Care)

Funding based on FY2017/18 actual spending; not 3-year average

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FUNDING GUIDELINES

Competency Based Medical Education (CBME)

Program allocation: Funding based on launch schedule One-time start-up funding of $10k per program One-time faculty development funding of $15k per program 20% incremental funding based on didactic and clinical teaching with patient care Funding for Standing and Competency committees

Department allocation 20% incremental funding for CBME Lead Support or Administrative Support

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FUNDING DISTRIBUTION

All funding has been processed except for:

i. Teaching combined with patient care (to confirm the eligible rotations in One45) and CBME Discuss process: One45-CPMS-Excel

ii. CBME (new PGs created)

iii. Use of Workspace

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CONTACT INFORMATION

Chris Leong 604-875-4111 x24712Financial Analyst christopher.leong@ubc.ca

Mindy Li 604 875-4111 x24693Senior Financial Analyst mindy.li@ubc.ca

Chi Huang 604 875-4111 x24692 Associate Director chi.huang@ubc.ca

Emily CorenblithSenior Program AssistantBasic Clinical Year Training Program - RCH

• By the time physicians reach residency, depression rates are four times the national average

• One of every three new physicians will experience an episode of major depression during their training

• 50% of residents suffer from burnout – Higher prevalence in disciplines such as emergency, critical care, and family medicine

• Male physicians 70% more likely to attempt suicide

• Female physicians 250% more likely to attempt suicide

C Thompson ICRE Presentation “Physician Suicide”

• Expectations

• Work culture

• Perfectionism

• Different Hats

• Insufficient sleep is a main cause of burnout

• Myth: Human beings adapt to getting less sleep than they need

• <5 hrs sleep/night increases likelihood of malpractice, self-medicating, conflict, accident/injury, and serious errors

• Sleep deprivation decreases satisfaction with residency

• Information for prospective residents

• It is FOR their learning, not OF their learning

• Make note of negative and challenging environments

• Organization

A. Atkinson ICRE Presentation “Competency by design: How to support your residents in a new CBD world – the PA’s perspective

• Burnout Symptoms:• Exhaustion• Depersonalization• Lack of efficacy

• Performance

• Resident Wellness Office• 604 875 4111 x 23055• Toll-free: 1 855 675 3873• Email: resident.wellness@ubc.ca

• Resident Doctors of Canada• Mental Health Continuum• Resiliency Curriculum• Resiliency@residentdoctors.ca

• Crisis Intervention & Suicide Prevention Centre of BC

• Physician Health Program of BC• 24-Hour Help Line:

1-800-663-6729

• Steps for Delivering Sensitive Feedback:1. Introduce the topic2. Emphasize why the conversation

is important3. Describe the behaviour non-

judgmentally4. Discuss the potential

consequences of the behaviour empathetically

5. Ask the other person for their insight

6. Consider secondary causes7. Build an agreement on next

steps

ICRE Presentation “Giving feedback of a sensitive nature: How to say what everyone else is thinking”

• Mentoring • Faculty role play• Sleep & Hydration• Nurse educator award• Group Activities

• Forest walks• Karaoke• Painting• Sewing bees• Volleyball• Tough Mudder• Biking• Basketball• Academic Day Activities

emily.corenblith@fraserhealth.ca

• Arnedt et al., (2005) “Neurobehavioral Performance of Residents After Heavy Night Call vs After Alcohol Ingestion.” Journal of the American Medical Association. Retrieved from: https://jamanetwork.com/journals/jama/fullarticle/201473

• Atkinson, A. “Competency by design: How to support your residents in a new CBD world - the PA’s perspective.” Presented at ICRE Program Administrator’s Conference. 2018 Oct 17; Halifax, NS.

• Aulakh et al., “Giving feedback of a sensitive nature: How to say what everyone else is thinking.” Presented at ICRE Program Administrator’s Conference. 2018 Oct 18; Halifax, NS.

• Baldwin et al., (2004) “Sleep deprivation and fatigue in residents training: results of a national survey of first- and second-year residents.” Sleep. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/15124713

• Drummond, D. (2015) “Physician Burnout: Its Origin, Symptoms, and Five Main Causes. Retrieved from: https://www.aafp.org/fpm/2015/0900/p42.html

• Glaser, G. (2015) "Unfortunately, Doctors Are Pretty Good At Suicide". Journal of Medicine. Retrieved from: https://www.ncnp.org/journal-of-medicine/1601-unfortunately-doctors-are-pretty-good-at-suicide.html

• Lemire, F. (2018) “Combating Physician Burnout.” Journal of the College of Family Physicians Canada. Retrieved from: http://www.cfp.ca/content/64/6/480

• Mata et al., (2015) “Prevalence of Depression and Depressive Symptoms Among Resident Physicians A Systematic Review and Meta-analysis.” Journal of the American Medical Association. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4866499/

• Mustafa et al., (2005) Sleep and Breathing. Retrieved from: https://www.slideshare.net/brucelee55/safer-presentation

• Thompson, C. “Physician Suicide” Presented at: ICRE Program Administrators Conference. 2018 Oct 18; Halifax, NS.

• Söderström et al., (2012) “Insufficient sleep predicts clinical burnout.” Journal of Occupational Health Psychology. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/22449013

• Tsai, J. (2018) “Physicians, Depression and Burnout.” Scientific American. Retrieved from: https://blogs.scientificamerican.com/observations/physicians-depression-and-burnout/

CURRICULUM MAPPING

For CBME & Accreditation

P AO L A M AR T E N S , S E N I O R E D U C AT I O N P R O G R AM S M AN A G E R , D E P AR T M E N T O F P S Y C H I AT R Y

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THANK YOU TO THE 2018 ICRE WORKSHOP FACILITATORS

ICRE PA Workshop• Robin Szuch, Western University• Joan Binnendyk, Western University

ICRE Workshop• Joan Binnendyk, Western University• Shannon Venance, Western University• Tim Dubé, McGill University

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WHAT IS A CURRICULUM MAP

• What is taught – competencies, entrustable activities, formal curriculum• How it is taught – training experiences: inpatient clinic, consult, etc• When it is taught – Rotations/block, sequence of training• How it is assessed – miniCEX, Field note, procedure log, entrustment scale, etc.

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CURRICULUM MAPPING GAME

Creators:• Joan Binnendyk, Western University• Shannon Venance, Western University• Tim Dubé, McGill University

1. Why should I have a curriculum map?2. What are the benefits for the faculty?3. What are the benefits for the trainees?4. Who should be involved?

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CURRICULUM MAPPING GAME

1. Why should I have a curriculum map?• Identification of where trainees achieve competencies• Curriculum management• Gap analysis• Program evaluation• Development of individualized or remediation learning plans• Identification of redundancies• Quality improvement• Data reporting• Accreditation

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CURRICULUM MAPPING GAME

2. What are the benefits for the faculty?• Identifies what trainees need to learn by the end of a block/rotation• Identifies how their teaching sessions fits into the program• Identifies what trainees have learned prior to current block/rotation• Helps them choose assessment tools• Identifies a resident’s personalized learning plan• Identifies how well a resident is performing

How will we go about communicating this

information?

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CURRICULUM MAPPING GAME

3. What are the benefits for the trainees?• Identifies how a resident will be assessed• Identifies what a resident should learn during a specific block/rotation• Helps a resident develop his/her personalized learning plan• Helps a resident plan for electives• Identifies how successful the resident will be on the board exam• Identifies which blocks/rotations follow the current one

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CURRICULUM MAPPING GAME

4. Who should be involved?• Program Director• Residents• Program Administrator• CBME Lead• Educationalist• All faculty• Department Chair• Postgrad Dean• Postgrad Office

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STEPS IN DEVELOPING A CURRICULUM MAP

1. Develop an Action Plan2. Conduct a Curriculum Review3. Take an Inventory of All Information4. Decide on a Mapping Solution5. Map the Curriculum

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DEVELOP AN ACTION PLAN

• Establish timelines, goals• Form a working group (usually a sub-group of the RTC/RPC)• Schedule regular meetings• Develop and/or obtain templates for mapping activities• Engage key stakeholders early and throughout the process

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CONDUCT A CURRICULUM REVIEW

• Get clear understanding of the current curriculum• Reach out to stakeholders to get feedback – residents, faculty

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TAKE AN INVENTORY OF ALL INFORMATION

• Teaching & Learning Strategies – Academic half-days, block/rotations, research, simulations, required training experiences

• Learning Statements – specialty specific standards of training and/or competencies, learning goals and objectives, EPA’s and milestones

• Assessment Methods – OSCE, end-of-rotation assessment, direct observation

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DECIDE ON A MAPPING SOLUTION

• Who will be the users? (residents, faculty, program administrators)• What is needed? Database (info management) vs learning management system

(interactive, track progress)• Perform a needs assessment – human and financial resources, dedicated faculty,

curriculum administrator(s), database administrator(s), timelines

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DECIDE ON A MAPPING SOLUTION

• Easy access to and management of the information• Ideally helps you track the history of your curriculum map• Assists in analyzing the information – gaps, redundancies• Assists with reporting for accreditation• Ideally assists with sharing information with other stakeholders

Options:• Microsoft Excel• Custom-built• Off-the-shelf: Curriculum Trak (with customization, used by Western), One45, Elentra

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MAP THE CURRICULUM

Break it up into manageable chunks• Could begin with the stage of training, EPA’s, milestones• Could begin with a clinical experience (training experience, block/rotation)

Tips:• Takes time, iterative process, tweak along the way• Get residents involved – what’s the value of the rotation, is it possible to meet the EPA

during the rotation, etc?• If you’ll be removing a rotation, remember to communicate this early

PGME ALL COORDINATORS’MEETING

ICRE Take-Aways 2018T E S S A F E U C H U K , P R O G R AM M AN AG E R , C I P

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ACCREDITATION AND STANDARDS

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ACRONYMS• CanRAC

• CanERA

• CanAMS

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CANAMS AND STANDARDS

• https://www.canams.ca

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ACCREDITATION

Eleni Tsakumis

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ACCREDITATION – WHAT’S NEW• New accreditation standards July 1, 2019 (RCPSC & CFPC), for both competency-

based & traditional programs• Previous terminology – “A” Standards & “B” Standards, PSQ, “Red Book”• New terminology – Domains, Standards, Elements, Requirements, Indicators, CanAMS

Instrument

Old StandardsB1 – Administrative StructureB2 – Goals & ObjectivesB3 – Structure & Organization of the ProgramB4 – ResourcesB5 – Clinical, Academic & Scholarly Content

of the ProgramB6 – Assessment of Resident Performance

New StandardsDomain – Program OrganizationDomain – Education ProgramDomain – ResourcesDomain – Learners, Teachers & Administrative

StaffDomain – Continuous Improvement

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ACCREDITATION – WHAT’S NEW

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ACCREDITATION – WHAT’S NEW

Changes to accreditation standards:• Increased focus on outcomes (“Show me that it works”)• Increased clarity of expectations• Emphasis on the learning environment & continuous improvement (CQI)• Accommodation of time & competency based education models• A new standards organization framework:

• Recognition of PA role• A safe and positive learning environment for all (i.e. residents,

teachers, patients, & administrative personnel) • Administrative personnel are valued & supported in the delivery

of the residency program

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ACCREDITATION – WHAT’S NEW

Changes to accreditation survey process:• Digital accreditation management system (CanAMS) • New accreditation status, follow-ups, guiding principles, to support

increased consistency & transparency in the decision-making process• Increased emphasis on CQI• Increased focus on identification of leading practices & innovations• Rating (meets, partially meets, does not meet) for each requirement, in

addition to provision of an overarching accreditation decision, to support and inform continuous improvement (i.e. provide increased clarity with respect to areas for improvement)

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ACCREDITATION – WHAT’S NEW

• UBC Accreditation (External Review) – March 2020• upload of documentation/information to the CanAMS program profile due

Fall 2019• PDs/PAs have been given access to CanAMS

• should have received a welcome email from the Royal College• CanERA for University Personnel Training Module:

http://www.royalcollege.ca/mssites/canera-uprh/index.html#/?_k=x81bmq• CanRAC led Workshop on December 10, 2018 from 9am-1pm

• Interactive session – bring your laptop and login information• Recommend at least 1 rep per program

RESIDENT HOUSING & REIMBURSEMENTS

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MANDATORY HOUSING UPDATES FOR 2019/2020

• Timeline:o Feb 2019: PGME requests distributed training locations from programs by number of

trainees per blocko Feb-March 2019: PGME compiles requests to determine lease locations for AY 19-20o March-April 2019: PGME secures leases in locations that meet the minimum criteria and

in leased locations requests trainee personal data from programs (common deadline)o April-June 2019: PGME matches residents with available housing, notifying

programs/residents of placements and full accommodations in blocks 1-3 as a first priority

• Procedure changes: o lottery to replace “first come, first served” priority for placements as final determining

factor (where all other trainee placement criteria are equal).

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RESIDENT REIMBURSEMENTS

• PGME-level review: complex vs. standard review of reimbursement paperwork

• PGME still seeing approximately 50% of resident reimbursements requiring additional review or correction

• Contact Don Brook for questions about individual resident reimbursements:don.brook@ubc.ca

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PGME WEBSITE UPDATE

Three Phase PGME Website refresh is coming:

1. Website navigation update2. Website content update3. Access-controlled content tool to allow PGME to share

greater detail with programs (e.g. leased housing vacancies, accreditation and CBME tools/updates)

CBME/CBD

Eleni Tsakumis

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CBME / CBD• 8 programs (7 disciplines) currently in CBD

• 15 programs (12 disciplines) to launch July 2019

• Funding increases to support CBD!• Electronic platform: Elentra (Entrada) pilot starting December, final decision early 2019• Upcoming Events:

• Implementation Working Group – first meeting December 2018• CBME Workshop – February 2019

Anesthesiology Emergency Med Nephrology-Adult Surgical Foundations

OTOL Medical Oncology Nephrology-Peds Urology

Anatomical Path CCM-Peds General Internal Med Internal Medicine Radiation Oncology

Cardiac Surgery GI-Adult Geriatrics Neurosurgery Rheumatology-Adult

CCM-Adult GI-Peds General Pathology OB/GYN Rheumatology-Peds

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CBME / CBD

• What to do now?• Curriculum Map• Competency Committee• CBD Module on PGME Website

• Contact Info for any ?• Dr. Sonia Butterworth, Faculty Lead: sbutterworth@cw.bc.ca• Eleni Tsakumis, Project Manager: eleni.tsakumis@ubc.ca• Elaine Molloy, Education Coordinator: elaine.molloy@ubc.ca