{"title":"A critical analysis of The Royal College of Physicians and Surgeons of Canada examination experience.","authors":"Malcolm M MacFarlane","doi":"10.36834/cmej.79678","DOIUrl":"10.36834/cmej.79678","url":null,"abstract":"<p><p>The Royal College of Physicians and Surgeons of Canada (RCPSC) plays a leading role in specialty and subspecialty post graduate medical education (PGME) in Canada. As the RCPSC accredits PGME programs, these programs are structured to meet the RCPSC Competence by Design model and their CanMEDS roles. RCPSC Certification is required by Medical Regulatory Agencies (MRAs) across Canada as a condition of entry to independent practice. The RCPSC relies heavily on the use of high-stakes subject examinations as a key component of its Certification process. Recently, questions have been raised regarding the usefulness of such high-stakes examinations. If such examinations are to be fair and equitable, they must be designed and implemented in accordance with best practices for educational testing and the processes for implementation and grading must be transparent and fair. This paper reviews the recent literature on high-stakes examinations and best practices in examination construction, references the findings of a survey of RCPSC examination experiences conducted by the Society for Canadians Studying Medicine Abroad exploring the perception of respondents, and raises concerns regarding RCPSC examinations related to validity, reliability, and fairness. The paper concludes by recommending closer scrutiny of RCPSC examination processes by interested stakeholders and by provincial MRA's who delegate entry to practice decisions to the RCPSC.</p>","PeriodicalId":72503,"journal":{"name":"Canadian medical education journal","volume":"16 2","pages":"79-90"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Disclosure of bad news: a challenging practice?","authors":"Vitorino Modesto Dos Santos, Kin Modesto Sugai","doi":"10.36834/cmej.80918","DOIUrl":"10.36834/cmej.80918","url":null,"abstract":"","PeriodicalId":72503,"journal":{"name":"Canadian medical education journal","volume":"16 2","pages":"93"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Constellations and the sound of hooves.","authors":"James S Huntley","doi":"10.36834/cmej.81116","DOIUrl":"10.36834/cmej.81116","url":null,"abstract":"","PeriodicalId":72503,"journal":{"name":"Canadian medical education journal","volume":"16 2","pages":"97-98"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Diagnostic hypothesis generation through engaged peer observation: a quantitative descriptive study in a clinical simulation context].","authors":"Stéphanie Benoît, Diane Bouchard-Lamothe, Manon Denis-Leblanc, Isabelle Burnier","doi":"10.36834/cmej.77080","DOIUrl":"10.36834/cmej.77080","url":null,"abstract":"<p><strong>Background: </strong>Learning clinical reasoning (CR) requires practice in a variety of educational settings. As part of the clinical simulation sessions at the University of Ottawa's Faculty of Medicine, pre-clerkship students are paired in dyads to increase the number of practical clinical cases before the clerkship. One student plays the role of a Clinical Student (CS) and the other alternates as a Student Observer (SO). This quantitative descriptive study aims to compare the diagnostic hypothesis generation by SOs with that of CSs to support the usefulness of engaged peer observation as a CR learning strategy in clinical simulation settings.</p><p><strong>Methods: </strong>Following an interview with a simulated patient, CSs and SOs were asked to generate two diagnostic hypotheses in an electronic form. Responses were compiled, categorized, and compared in terms of equivalent diagnostic hypotheses within the same dyad. The difference in frequency distribution of equivalent hypotheses was statistically analyzed using a chi-square calculation.</p><p><strong>Results: </strong>The percentage of dyads with at least one equivalent diagnostic hypothesis ranged from 83% to 100%, depending on the scenario. The number of equivalent hypotheses between SOs and CSs was statistically significant (<i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>SOs appear to be able to generate diagnostic hypotheses similar to those of CSs. The results support the use of engaged peer observation as a learning strategy for CR in clinical simulation settings in pre-clerkship medical education.</p>","PeriodicalId":72503,"journal":{"name":"Canadian medical education journal","volume":"16 2","pages":"38-42"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lina Shoppoff, Christine Mathew, Kaite Burkholder Harris, Laura Muldoon, Sydney Persaud, Sophia Kelly-Langer, Elisha Davidson, Moira Alie, Carissa Grondin, Claire E Kendall
{"title":"Teaching compassion through a community-led, experiential learning activity for undergraduate medical students: the Empathy Project.","authors":"Lina Shoppoff, Christine Mathew, Kaite Burkholder Harris, Laura Muldoon, Sydney Persaud, Sophia Kelly-Langer, Elisha Davidson, Moira Alie, Carissa Grondin, Claire E Kendall","doi":"10.36834/cmej.79452","DOIUrl":"10.36834/cmej.79452","url":null,"abstract":"<p><p>We co-facilitated a mandatory community-led experiential learning activity for medical students with the Alliance to End Homelessness Ottawa that demonstrates the feasibility and positive impact of incorporating community-led learning into the medical school curriculum.</p>","PeriodicalId":72503,"journal":{"name":"Canadian medical education journal","volume":"16 2","pages":"74-76"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Optimizing feedback reception: a scoping review of skills and strategies for medical learners.","authors":"Jennifer Rowe, Diane Bouchard-Lamothe, Teagan Haggerty, Jake Engel, Cole Etherington, Manvinder Kaur, Etienne Vincent, Nibras Ghanmi, Preet Gujral, Valentina Ly, Sylvain Boet","doi":"10.36834/cmej.79722","DOIUrl":"10.36834/cmej.79722","url":null,"abstract":"<p><strong>Background: </strong>Feedback remains essential to a learner's professional development. Most feedback literature focuses on provision of feedback, and there is a lack of evidence-based data to support learners in developing skills to receive, evaluate and use feedback, independently of context. This scoping review mapped the literature regarding strategies and skills that optimize medical learners' reception to feedback.</p><p><strong>Methods: </strong>Investigators conducted searches in MEDLINE, Embase, ERIC, APA PsycINFO and Web of Science Core collection from inception to May 2023. Study inclusion criteria were primary evidence sources, and strategies or skills for improved feedback reception for medical learners. Data were screened and extracted by pairs of independent reviewers. Investigators summarized study characteristics, outcomes, educational methods, and interventions.</p><p><strong>Results: </strong>Of 7692 total studies, six provided strategies and skills to improve feedback reception. Delivery of education was via workshops (<i>n</i> = 5 studies) that proposed cognitive, reflective and experiential learning activities, all reporting learners' self-perceived improvement of feedback behaviour. Nine strategies and seven tools were identified, focusing on general approach, soliciting or evaluating feedback.</p>","PeriodicalId":72503,"journal":{"name":"Canadian medical education journal","volume":"16 2","pages":"48-62"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Can relaxation exercises improve students' OSCE grades: a prospective study.","authors":"Damien Massalou, Jérôme Doyen, Fabien Almairac, Pierre-Simon Rohrlich, Jean-Paul Fournier, Clair Vandersteen, Nirvana Sadaghianloo","doi":"10.36834/cmej.77739","DOIUrl":"10.36834/cmej.77739","url":null,"abstract":"<p><strong>Introduction: </strong>OSCE (Objective Structured Clinical Examination) are a means of assessing health profession students. However, they are a source of stress or anxiety for students. The aim of our study was to improve medical students' performance during OSCEs by using human performance optimization techniques (HPOT).</p><p><strong>Methods: </strong>Naïve students for OSCE were divided into blocks of five, randomized to HPOT and control groups. Before starting their OSCE circuit, HPOT blocks underwent a 30-minute preparation session. Anxiety was assessed before and after the OSCE using a Visual Analogic Scale (VAS).</p><p><strong>Results: </strong>We randomized and assigned 206 students to 41 blocks of which 20 were HPOT and 21 were control. Anxiety before the exam was significantly reduced thanks to the HPOT procedure with a median value of six and four on the VAS respectively before and after the relaxation session (<i>p</i> = 0.001). The final exam score was not associated with pre-OSCE anxiety (<i>p</i> = 0.5). The HPOT procedure did not improve the final score (<i>p</i> = 0.4). Interestingly, the final score was inversely correlated with the final median anxiety VAS reading after the exam (<i>p</i> = 0.01): students with the lowest anxiety VAS achieved better scores.</p><p><strong>Conclusion: </strong>Relaxation, conscious breathing, and positive reinforcement methods reduced students' anxiety prior to their OSCE; however, these techniques did not improve their scores.</p>","PeriodicalId":72503,"journal":{"name":"Canadian medical education journal","volume":"16 2","pages":"43-47"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kristina H Pulkki, Shamira Pira, Meredith Young, Grace M Scott, Carol Nhan, Kevin Fung, Gabriella Le Blanc, Lily Hp Nguyen
{"title":"Considering the potential unintended consequences of RateMDs: an exploratory study in one specialty.","authors":"Kristina H Pulkki, Shamira Pira, Meredith Young, Grace M Scott, Carol Nhan, Kevin Fung, Gabriella Le Blanc, Lily Hp Nguyen","doi":"10.36834/cmej.77821","DOIUrl":"10.36834/cmej.77821","url":null,"abstract":"<p><strong>Background: </strong>Websites that facilitate communication between patients regarding their experiences with individual physicians are now relatively commonplace. Given patient-generated ratings are publicly available, physicians could use these to access rarely available patient feedback. We explored the content of reviews associated with low physician ratings and consider the potential benefits and consequences of relying on this form of freely available data to support individual life-long learning.</p><p><strong>Methods: </strong>We conducted an exploratory qualitative descriptive study. We collected narrative comments associated with low numerical ratings on one physician-rating website (RateMDs) drawn from one specialty in Canada. Written reviews associated with low numerical ratings (≤2/5) for Canadian otolaryngologists were collected yielding a total of 878 comment sets that were analyzed deductively and iteratively.</p><p><strong>Results: </strong>We found that patient comments described poor performance in areas that aligned, for the most part, with the CanMEDS roles including Professional, Communicator, and Leader; specifically referring to management of the clinical environment, administrative staff, and trainees.</p><p><strong>Conclusion: </strong>While not intended for physician feedback, physicians could access patient-to-patient ratings and associated written reviews as a means to identify areas of practice improvement. However, this represents an unintended use of these websites. While speculative, access to patient-to-patient rating websites could negatively impact physician confidence or self-worth - representing a negative consequence of their use. The utilization of these data for potential self-improvement represents an unintended use of patient-to-patient ratings and so may be accompanied by unintended consequences for physicians who use these data as potential feedback, and patients who contribute to physician rating sites.</p>","PeriodicalId":72503,"journal":{"name":"Canadian medical education journal","volume":"16 2","pages":"17-24"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}