4th International Conference on Faculty Development in the Health Professions

4B1 (41)Faculty development for primary care physicians: specific challenges in the outpatient setting

Marie-Claude Audétat, Faculty of Medicine, University of Geneva, SwitzerlandCédric Gillabert, Faculty of Medicine, University of Geneva, SwitzerlandJohanna Sommer, Faculty of Medicine, University of Geneva, SwitzerlandMartine Bideau, Faculty of Medicine, University of Geneva, SwitzerlandArabelle Rieder, Faculty of Medicine, University of Geneva, Switzerland

Presenter: Marie-Claude Audétat (Faculty of Medicine, University of Geneva, Geneva, Switzerland)

Background: Many countries are confronted with a lack of primary care physicians to meet the increasing demands in healthcare. As outpatient care is at the centre of efficient health care system models, it is essential to guarantee the quality training of sufficient primary care physicians in the specific outpatient context.Summary of Work: In the context of a new compulsory clerkship in private practice for final year medical students, we identified the main difficulties and needs encountered by primary care physicians using qualitative research methods. We planned that our results would provide helpful recommendations that would shape future faculty development for these physicians.Summary of Results: Participants were motivated to transmit their enthusiasm for primary care, but found it difficult to combine their dual roles: the one of clinician, and the new challenging one of teacher. The presence of a trainee in their clinical context added new and, until then unsuspected, adaptive, cognitive and emotional loads.Discussion: Our results revealed a risk of exhaustion or frustration of the participants, making the success of the clerkship fragile, and illustrating challenges linked to its sustainability. Professionalizing the role of supervisor should contribute to help physicians by enriching their teaching skills and by making them feel more confident and efficient.Conclusion: In response to our findings, we built a longitudinal and tailored faculty development program to address the specific needs of primary care physicians in an outpatient context. This program will be presented.Take-home Message: Training and support primary care physicians is essential. Faculty development needs first to ensure that primary care physicians master teaching skills while respecting constraints of clinical practice. A longitudinal faculty development program including physicians’ conceptions of teaching and of themselves as clinical teachers, and personalized coaching will support long-term sustainability.

4B: Oral Presentations – Distributed Medical EducationLocation: 101c

25-27 August 2017Messukeskus Expo and Convention Centre, Helsinki, Finland

4B2 (74)A Balance between Consistency and Flexibility in Faculty Development in a Distributed Program: Looking for the sweet spot

Kiran Veerapen, University of British Columbia, Vancouver, CanadaKatherine Wisener, University of British Columbia, Vancouver, CanadaSara Frankenberger, University of British Columbia, Vancouver, Canada

Presenter: Katherine Wisener (University of British Columbia, Vancouver, Canada) Katherine Wisener (University of British Columbia, Vancouver, Canada)

Background: The delivery of equitable core faculty development across sites in a distributed program is challenging. In the first decade of a distributed medical program, we found that mandating the delivery of centrally developed content at sites led to dis-engagement, while complete flexibility led to loss of equity and comparability.Summary of Work: To find a solution, we sought out to determine the balance between consistency and flexibility, which would lead to both a cohesive program and engagement and innovation at distributed sites. Through collaborative planning between all Regional Faculty Development Directors, a longitudinal program comprising five workshops in core areas was developed.Summary of Results: The consistent aspects of the program included five, two-hour workshops to be delivered over the course of one academic year, addressing core topic areas in faculty development with designated outcome-based objectives for each workshop. The flexible aspects were the choice of facilitator, development of content and strategies for delivery.Discussion: With continued expansion of the distributed medical education model, these challenges will be encountered more frequently. The question of where the ‘sweet spot’ lies between consistency and flexibility across sites with varying geographical and cultural contexts will become an important one. Evaluation of this study will be informative.Conclusion: To maintain equity in a core faculty development program and engagement of faculty developers across sites, collaborative planning, iterative evaluation and review has been put in place to identify successes, challenges, and best practices. Early results (one year) from a qualitative evaluation will report on the impact of the program.Take-home Message: While faculty development targeting foundational teaching skills should be accessible to all, there are challenges in a distributed medical program. For such efforts to be successful, there is a need to identify the appropriate ‘sweet spot’ between consistency and flexibility in order to maintain comparability and encourage engagement across sites.

4B3 (78)Northern Family Medicine Residency Teaching: A Qualitative Study of the experiences

Christie Newton, University of British Columbia, Vancouver, Canada

Presenter: Christie Newton (University of British Columbia, Vancouver, Canada)

Background: At University of British Columbia the family practice residency program is distributed over 900,000km2 with over half of the 800+ teachers in rural communities.Teacher challenges in training are generally well understood; however, those specific to rural and northern communities are less well understood and faculty development needs may differ.Summary of Work: This qualitative study examined the teaching experiences of rural, northern family practice teachers. Twelve teachers (6M:6F) from northern British Columbia completed semi-structured interviews about their day-to-day experiences with learners, teaching in their community, and their relationship with the training program. Interviews were recorded, transcribed, coded and emergent themes identified.Summary of Results: Data revealed that challenges and facilitators of teaching in northern communities arise from the learner, the experience and professional identity of the teacher, and relationships both within the community and within the program. Some experiences mirror those of teachers everywhere across disciplines, others seem unique to teachers in northern communities.Discussion: Family practice training internationally is expanding and therefore becoming more widely distributed, often far from the central residency program. Teachers within northern, rural communities require faculty development support to ensure quality training of family practice residents; however, traditional programming may not address the unique teaching needs of these distributed teachers.Conclusion: Teacher challenges in family practice training are generally well documented; however,those specific to northern, rural communities are less well understood. Our date revealed some unique challenges faced by teachers in northern BC. As programs continue to become more broadly distributed faculty developers must adjust programming to address these unique needs.Take-home Message: With a better understanding of teaching challenges and facilitators in northern, rural communities we can design better faculty development support mechanisms to ensure the sustainability of these teachers, one of our most valuable educational resources.

4th International Conference on Faculty Development in the Health Professions

4B4 (95)Hybrid faculty development strategy to support geographically separated small group tutors in delivering a new course

Jana Lazor, University of Toronto, Toronto. CanadaDebra Katzman, University of Toronto, Toronto, CanadaKarizma Mawjee, Hospital for Sick Children, Toronto, CanadaLori Innes, University of Toronto, Toronto, CanadaJennife Ng, Univerisity of Toronto, Toronto, Canada

Presenter: Jana Lazor (Faculty of Medicine, University of Toronto, Toronto, Canada)

Background: A new research course, Health Sciences Research (HSR), was implemented as part of a curriculum renewal process. The course utilized 41 tutors facilitat-ing 26 small group tutorials at 7 different locations. The challenge was to ensure consistent and quality teaching given the new curriculum and wide geographic distribu-tion of teachers.Summary of Work: A “just-in-time” hybrid FD model was developed - 60 minute HSR educafe (HSR-E) (central live webinar and local peer-to-peer community). Goal was to provide tutors course-specific resources, coaching on how to run tutorials, and a community of practice of peer tutors. Utilization focused methodology was used to evaluate the model.Summary of Results: 39/41 tutors responded to the survey. 100% were aware of HSR-E, 86.5% attended at least 1/11, and 75% found them useful. Peer discussion component was reported 1.9 times more useful than webinar. Key theme based on written comments was “preference and utility of communities of practice and face-to-face FD modalities”.Discussion: The hybrid just-in-time FD model was effective to provide foundational faculty support. We identified additional needs to further develop specific teaching skills required for these new roles. Evaluation of this strategy support continuing to offer HSR-E with enhanced devel-opment of local site faculty leads and modification of live webinar content.Conclusion: An innovative FD strategy was developed to support a diverse group of geographically dispersed tutors to teach a new undergraduate medical education research course. The HSR-E met faculty needs for foun-dational information, developed a local community of practice, and created a link between central curriculum development team and local teachers.Take-home Message: The HSR-E is an effective strategy to support new teaching roles. The just-in-time hybrid model of FD is effective and is strengthened by face-to-face FD experiences led by faculty with a solid understanding of the curriculum. Collaboration between CD and FD is an essential component of curriculum reform.

4B5 (144)Transitions to the rural workforce: Exploring dental graduate intentions and destinations

Felicity Croker, College of Medicine and Dentistry, Cairns, Australia

Presenter: Felicity Croker (College of Medicine and Dentistry, Cairns, Australia)

Background: The Bachelor of Dental Surgery at James Cook University was established in 2009 as a socially accountable program to address the population health needs and workforce shortages of rural and remote Australia. Tracking graduates’ career progression enables evaluation of educational strategies designed to enable and encourage transition to rural practice.Summary of Work: Data were gathered from two sources to allow mapping of career intentions and graduate destinations. Since 2013, an exit survey data has provided data on student intentions. This has been followed by tracking graduate careers of 2013 to 2016 cohorts. Alumni are actively involved in longitudinal tracking of career paths.Summary of Results: A significant proportion of JCU dental students intended to practise outside capital cities. Factors influencing intentions are multifactorial. Many graduates planned to work initially in rural towns with progression to practice in larger regional centres. Through GIS mapping the significant contribution to the rural workforce over this time is evident.Discussion: While ongoing follow up is tracking career progression over a longer time period, the data so far suggests that the career outcomes of JCU dental graduates are aligned with regional workforce needs. However, emerging funding challenges may impact on current curriculum design enabling ongoing reliable transition to the rural workforce.Conclusion: Further research is required to compare data with intentions and destinations of from those graduating from Australia’s predominantly metropolitan dental schools. This next stage will reveal whether program design is an reliable predictor of graduate careers and will inform ongoing initiatives to build the regional, rural and remote dental workforce.Take-home Message: A socially accountable dental program is successfully educating an appropriate health workforce to meet the requirements of regional, rural and remote communities. Aligning student selection, curriculum design and clinical experiences enables and encourages transition to rural practice, as evidenced by the career pathways of dental graduates in a regional university

25-27 August 2017Messukeskus Expo and Convention Centre, Helsinki, Finland

4B6 (96)Along the axes of differences: academic programs in clinical education

Margaret Bearman, Deakin University, Melbourne, AustraliaNatalie Radomski, Monash University, Melbourne, AustraliaGabriel Reedy, King’s College London, London, UK

Presenter: Margaret Bearman (Deakin University, Melbourne, Australia)

Background: There has been an international explosion in postgraduate programs designed to prepare health professionals to take active educational roles in their clinical contexts. The drivers for the growth of these programs are generally requirements to upskill clinical educators and a concomitant push to legitimize career pathways in health professional education.Summary of Work: Academic clinical education programs recognize that clinicians teach and practice in unique and specific contexts. The aim of this presentation is to explore how academic clinical education programs are differentiated against the broader landscapes of academic and medical practice.Summary of Results: We borrow (or possibly misappropriate) a concept from anti-racist and feminist theory: ‘axes of difference’ (see Dei 2000). We conceptualize some of the connections, tensions and social arrangements that characterize academic clinical education programs and tease out what may be distinctive.Discussion: We look at the following axes:• Patients/clinicians• Trainees/trainers• Classrooms/clinics• Uniprofessional/interprofessional• Local/global• Teacher/health professionalThinking about what happens at the intersections of these axes of difference helps present potential benefits and harms of academic clinical education programs.Conclusion: Academic programs allow the possibility for educational ways of thinking to contribute to complex, dynamic, patient-centered care. At the most optimistic, programs allow different identities to exchange ideas. On the other hand, the axes of difference can collide, so that programs reduce dialogue and reinforce privilege.Take-home Message: Academic clinical education programs can invite sometimes excluded identities to contribute to education, such as patients, academics from the humanities, social scientists, culturally and linguistically diverse communities. Programs may then influence and shape healthcare practice.