Are Canadian General Internal Medicine training program graduates well prepared for their future careers?

Card, Sharon E.; Snell, Linda; O'Brien, Brian

doi:10.1186/1472-6920-6-56

Cited by 55 publications

(66 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous Canadian studies 3,4 were reviewed in terms of scope of practice and prevalence of procedural skills performed by Canadian General Internists. The initial cohort of Practice Eligibility route applicants for GIM certification was reviewed as to which procedural skills were self-reported to be performed by Canadian General Internists.…”

Section: Methodsmentioning

confidence: 99%

“…3,4 Concurrently literature suggests that Canadian GIM Graduates are not sufficiently prepared to perform procedural skills in practice. 3 GIM training is now defined as a 2-year PGY 4/5 program which builds on the "core" internal medicine training programs. 5 Current (2016) objectives of training for Internal Medicine (IM) 5 indicate that all IM residents must be competent in the procedures in Table 1 …”

Section: Résumémentioning

confidence: 99%

“…[1][2][3][4] Previous studies have shown a diversity of procedures performed in practice, with insufficient consensus as to which procedures should be routinely learned by GIM graduates. 3,4 Concurrently literature suggests that Canadian GIM Graduates are not sufficiently prepared to perform procedural skills in practice. 3 GIM training is now defined as a 2-year PGY 4/5 program which builds on the "core" internal medicine training programs.…”

Section: Résumémentioning

confidence: 99%

See 2 more Smart Citations

Procedural Skills of a General Internist - Informed by the Front Line.

Cavalcanti

Hendricks

Card

2017

Can Journ Gen Int Med

Self Cite

View full text Add to dashboard Cite

Debate has occurred over many years regarding the ideal procedural skill set for a graduate of a General Internal Medicine (GIM) training program. A mixed methods study was used to establish a list of mandatory and selective procedural skills for all graduates of a 2-year PGY4/5 GIM subspecialty training program. This list was informed by previous literature, a survey of Canadian Society of Internal Medicine (CSIM) members, and a roundtable discussion at the October 2015 CSIM meeting in Prince Edward Island. The study illustrates the remarkable diversity of practice profiles and procedural skills performed by general internists in Canada. RésuméDepuis nombre d'années, l' ensemble idéal d'habiletés qu'un diplômé d'un programme de médecine interne générale (MIG) doit maîtriser fait l' objet de débats. Une étude à méthodologie mixte a été utilisée pour dresser une liste d'habiletés particulières et obligatoires que doivent maîtriser tous les diplômés de 4 e et de 5 e année d'un programme comportant deux ans de surspécialité en médecine interne générale. Cette liste a été établie à partir de documentation existante, d'un sondage auprès des membres de la Société canadienne de médecine interne (SCMI) et d'une table ronde tenue lors du Congrès de la Société en octobre 2015 à l'Île-du-Prince-Édouard. L' étude montre la remarquable diversité des profils de pratique et des habiletés déployées par les internistes généraux au Canada.Canadian General Internists have had longstanding passionate debates regarding which procedures should be performed competently by graduates of General Internal Medicine (GIM) programs. [1][2][3][4] Previous studies have shown a diversity of procedures performed in practice, with insufficient consensus as to which procedures should be routinely learned by GIM graduates. 3,4 Concurrently literature suggests that Canadian GIM Graduates are not sufficiently prepared to perform procedural skills in practice. 3GIM training is now defined as a 2-year PGY 4/5 program which builds on the "core" internal medicine training programs. Procedural Skills of a General Internist -Informed by the Front LineRodrigo B Cavalcanti MD, MSc, FRCPC, Amy C Hendricks MD, FRCPC, Sharon E Card MD, MSc, FRCPC competence in further procedures. (Table 1). As of 2016, these would be considered mandatory procedural skills for ALL GIM graduates and therefore each GIM program must be able to provide training for proficiency in the skills in Table 1. The GIM documents were deliberately written to allow flexibility in training, ensuring that GIM trainees have the opportunity to train in additional procedures tailored to their future practice setting. Operationally this has been difficult to implement for 2 major reasons: (1) many residents do not know their future practice location in sufficient time to plan procedural training and (2) programs have had difficulty developing multiple elective training opportunities which may or may not be used.The Royal College of Physicians and Surgeons of Canada (RCPSC) has launched the...

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Résumémentioning

confidence: 99%

Section: Résumémentioning

confidence: 99%

See 1 more Smart Citation

Procedural Skills of a General Internist - Informed by the Front Line.

Cavalcanti

Hendricks

Card

2017

Can Journ Gen Int Med

Self Cite

View full text Add to dashboard Cite

show abstract

“…Differences in scope of practice often (although not always) fall along rural versus urban lines, leading to tensions between these locations. To gain this common understanding, input was sought from those practicing GIM in many locations, and was synthesized through the Canadian Society of Internal Medicine meetings and surveys; 38,39,45,46 this occurred in parallel with ongoing quality GIM training, despite the lack of recognition. The graduates of the initial unaccredited programs themselves recognized that they were providing a valuable and unique service to the populations they served, and so became increasingly united in their bid for recognition.…”

Section: Lessons Learned During Implementation Of the Disciplinementioning

confidence: 99%

“…The current objectives of training and specialty training requirements (Box 1) 37 were developed through a rigorous process of input and feedback, with a particular focus on input from those who were currently practicing as a full-scope GIM. 38,39 The objectives were developed over many iterations, requiring a focus on the precise language and terms that would capture the essence while still enabling the whole of GIM to be understood by multiple stakeholders, including the RCPSC, the public, licensing bodies and provincial governments. The objectives demonstrate commonality of scope of practice for all general internists, but recognition that GIM is operationalized differently in different communities and regions in Canada (Table 1).…”

Section: Specialty or Subspecialty?mentioning

confidence: 99%

The Evolution of General Internal Medicine (GIM)in Canada: International Implications

et al. 2016

View full text Add to dashboard Cite

A procedural skills OSCE: assessing technical and non-technical skills of internal medicine residents

Pugh

Hamstra

Wood

et al. 2014

Adv in Health Sci Educ

View full text Add to dashboard Cite

Internists are required to perform a number of procedures that require mastery of technical and non-technical skills, however, formal assessment of these skills is often lacking. The purpose of this study was to develop, implement, and gather validity evidence for a procedural skills objective structured clinical examination (PS-OSCE) for internal medicine (IM) residents to assess their technical and non-technical skills when performing procedures. Thirty-five first to third-year IM residents participated in a 5-station PS-OSCE, which combined partial task models, standardized patients, and allied health professionals. Formal blueprinting was performed and content experts were used to develop the cases and rating instruments. Examiners underwent a frame-of-reference training session to prepare them for their rater role. Scores were compared by levels of training, experience, and to evaluation data from a non-procedural OSCE (IM-OSCE). Reliability was calculated using Generalizability analyses. Reliabilities for the technical and non-technical scores were 0.68 and 0.76, respectively. Third-year residents scored significantly higher than first-year residents on the technical (73.5 vs. 62.2%) and non-technical (83.2 vs. 75.1%) components of the PS-OSCE (p < 0.05). Residents who had performed the procedures more frequently scored higher on three of the five stations (p < 0.05). There was a moderate disattenuated correlation (r = 0.77) between the IM-OSCE and the technical component of the PS-OSCE scores. The PS-OSCE is a feasible method for assessing multiple competencies related to performing procedures and this study provides validity evidence to support its use as an in-training examination.

show abstract

Are Canadian General Internal Medicine training program graduates well prepared for their future careers?

Cited by 55 publications

References 16 publications

Procedural Skills of a General Internist - Informed by the Front Line.

Procedural Skills of a General Internist - Informed by the Front Line.

The Evolution of General Internal Medicine (GIM)in Canada: International Implications

A procedural skills OSCE: assessing technical and non-technical skills of internal medicine residents

Contact Info

Product

Resources

About