Douglas Myhre - Academia.edu (original) (raw)

Papers by Douglas Myhre

Research paper thumbnail of Toxic Shock Syndrome: A Family Physician's Perspective

Canadian family physician Médecin de famille canadien, 1982

Although similar cases have been reported as far back as 1927, the term toxic shock syndrome was ... more Although similar cases have been reported as far back as 1927, the term toxic shock syndrome was coined in 1978 to describe an acute fever involving Staph. aureus. The reported mortality rate in Canada is 3.8%, but may be much higher. Association with tampon use was made in 1980, but is still unclear. Treatment remains supportive and is aimed at reducing risk of recurrence, until the role of the exotoxin can be explained. This article reviews reported cases to date, listing diagnostic criteria, signs and symptoms. A high index of suspicion for this new syndrome is recommended.

Research paper thumbnail of Attending to relationships: a necessary evolution in the clerkship

Research paper thumbnail of Factors perceived to influence rural career choice of urban background family physicians: a qualitative analysis

Canadian Medical Education Journal

Background: Urban background physicians are the main source of physician supply for rural areas a... more Background: Urban background physicians are the main source of physician supply for rural areas across Canada. The purpose of this study was to describe factors that influence rural career choice and practice location of urban background family medicine graduates. Methods: We conducted a qualitative, descriptive study employing telephone interviews with 9 urban background family medicine graduates. Those who completed residency training between 2006 and 2011 and were in rural practice, but who had an urban upbringing were asked about: when the decision for rural practice was made; factors that influenced rural career choice; and factors that influenced choice of a particular rural location. Emerging themes were identified through content analysis of interview data. Results: We identified four themes as factors influencing rural career choice - variety/broad scope of rural practice, rural lifestyle, personal relationships, and positive rural experience/physician role models. We ...

Research paper thumbnail of Does the Medical College Admission Test (MCAT) predict licensing examination performance in the Canadian context?

Canadian Medical Education Journal

Background: Research on the predictive validity of the Medical College Admissions Test (MCAT) on ... more Background: Research on the predictive validity of the Medical College Admissions Test (MCAT) on licensing examination performance is varied in its conclusions, with only a few studies examining this relationship in a Canadian context. We assessed the predictive validity of the MCAT on successful performance on the Medical Council of Canada Qualifying Examination (MCCQE) Part 1 by students attending the Cumming School of Medicine. Methods: Prospective data were collected on MCAT score and sub-section scores, MCCQE decision, multiple mini interview (MMI) performance, gender, and age. The cohort was divided into a derivation cohort (2013 and 2014) and validation cohort (2015 and 2016). Students were dichotomized into pass or fail on MCCQE. Multiple logistic regression in which our dependent variable was MCCQE Part I examination success at the first attempt was used, and potential explanatory variables were age, gender, MCAT total score, and sub-scores for the biological sciences (MC...

Research paper thumbnail of The impact of rural rotations on urban based postgraduate learners: A literature review

Research paper thumbnail of An Axiological Analysis of One Medical School’s Admissions Process

Research paper thumbnail of Scope of practice of family medicine graduates who completed a rural versus urban program

Rural and remote health, Jul 1, 2018

In Canada, rural-based family medicine residency programs were established largely in response to... more In Canada, rural-based family medicine residency programs were established largely in response to a shortage of rural physicians and the perception that urban-based training programs were not meeting the needs of rural populations. Examinations of practice patterns of physicians trained in rural and urban programs are lacking. The purpose of this study was to compare the scope of practice of family medicine graduates who completed a rural versus an urban residency program, by practice location. This was a cross-sectional, mail-out, questionnaire survey of 651 graduates who had completed the family medicine residency program at the University of Alberta or the University of Calgary, Alberta, Canada during 2006-2011. Rural program graduates lived and trained in regional settings and spent a considerable amount of time in smaller rural and remote communities for their clinical experience. The training of urban program graduates was primarily based in large urban settings and family med...

Research paper thumbnail of Implications of not matching to a first-choice discipline: a family medicine perspective

Canadian medical education journal, 2017

Family medicine is often selected as an alternate career choice by medical students who do not ma... more Family medicine is often selected as an alternate career choice by medical students who do not match to their first choice discipline. Consequently, family medicine residency programs accept and train some residents who prepared for and intended a career in another specialty. The implications of this warrant investigation. Graduates (2006-2011) of Albertan family medicine residency programs were surveyed to examine differences between physicians who indicated family medicine was their first choice discipline and those who indicated that it was not their first choice. Survey questions targeted practice location, preparedness for practice, perceptions of family medicine, lifestyle satisfaction, and well-being. Principal components analysis was used to examine the factor structure of our survey items and ANOVA and Chi square were used to compare mean scores and proportions, respectively. The overall response rate was 47.2% (307/651). Most (263) respondents reported that family medicine...

Research paper thumbnail of A critical scoping review of the connections between social mission and medical school admissions: BEME Guide No. 47

Medical teacher, Mar 26, 2017

Despite a growing focus on the social accountability of medical schools, there has been no substa... more Despite a growing focus on the social accountability of medical schools, there has been no substantive review of admissions related to the social mission of medical schools. This paper reports on a critical scoping review of the connections between social mission and medical school admissions. Searches of seven bibliographic databases identified 1258 unique articles. After filtering for relevance, 71 articles were considered for final review. The results of the data extraction were synthesized using a combination of qualitative and quantitative techniques. Five reviewers conducted 149 data extractions from 71 papers. Social missions tended to focus either on access and equity issues for applicants from underrepresented populations or on the career choices of medical graduates and how they meet particular social needs. The connection between social missions and admissions was often implied but rarely considered or evaluated directly. There was a notable absence of empirical evidence,...

Research paper thumbnail of Well-being of family medicine graduates

Canadian family physician Medecin de famille canadien, 2017

To determine family medicine graduates' professional and personal well-being, general health ... more To determine family medicine graduates' professional and personal well-being, general health status, stress levels, coping strategies, and the degree to which they felt supported or isolated in professional life; and to compare findings by sex, practice location, and location of medical school (Canadian medical graduates [CMGs] vs international medical graduates [IMGs]). Retrospective, cross-sectional survey. University of Alberta in Edmonton and the University of Calgary in Alberta. A total of 651 graduates who completed one of the family medicine residency programs during 2006 to 2011. Using a 5-point Likert scale, graduates rated their general health status, their personal and professional well-being, their level of stress, and the degree to which they felt supported or isolated in professional life. Respondents also identified important life events, their caregiving roles, and stress-coping strategies. Of 651 graduates, 307 (47.2%) responded to the survey. Personal and profe...

Research paper thumbnail of Precepting at the time of a natural disaster

The Clinical Teacher, 2016

Natural disasters strike communities that have varied degrees of preparedness, both physical and ... more Natural disasters strike communities that have varied degrees of preparedness, both physical and psychological. Rural communities may be particularly vulnerable as they often do not have the infrastructure or resources to prepare in advance. The psychological impact of a natural disaster is amplified in learners who may be temporary members of the community and therefore cannot draw on personal support during the crisis. They may turn to their clinical preceptors for guidance. The Slave Lake fire (population 6782) in May 2011 and the High River flood (population 12 920) in June 2013 are examples of natural disasters that have occurred in rural Alberta, Canada. At the time of these critical incidents, three medical students and one family medicine resident from the two provincial medical schools were participating in rotations in these communities. Although disasters occur rarely, there is a need for guidelines for preceptors from the learner perspective. Accordingly, using a modified Delphi approach, we captured the experiences of learners that were then refined into two themes, each containing three recommendations: considerations for action during a natural disaster and considerations for action after the acute crisis has passed. Although disasters occur rarely, there is a need for guidelines for preceptors from the learner perspective IMPLICATIONS: Our recommendations provide suggestions for practical solutions that build on the usual expectations of mentors and may benefit the student-teacher relationship at the time of a disaster and beyond. They are meant to initiate discussion regarding further study aimed towards creating recommendations for preceptor response that may cross disciplines.

Research paper thumbnail of Recruitment and retention of physicians in rural Alberta: the spousal perspective

Rural and remote health

The overall geographic distribution of physicians in Canada, including Alberta, is misaligned wit... more The overall geographic distribution of physicians in Canada, including Alberta, is misaligned with the population distribution. Some strategies, such as debt repayment, are currently in practice to increase recruitment and retention of physicians in rural locations. Of the factors influencing choice of practice location, 'spousal influence' is considered to play a significant role in recruitment and retention of physicians in literature. Most studies have focused on the physicians' perspective of their spouses' influence on staying in a rural location. This study is unique as it approaches rural recruitment and retention from the perspective of the physician spouse. The physician population for this study consisted of doctors practicing in rural southern Alberta. Participants were recruited via an email invitation and were invited to complete an online survey. The survey collected information regarding physician demographics and some relationship characteristics. The...

Research paper thumbnail of Practice locations of longitudinal integrated clerkship graduates: a matched-cohort study

Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la médecine rurale : le journal officiel de la Société de médecine rurale du Canada, 2016

Longitudinal integrated clerkships (LICs) have been introduced as an innovative model to impart m... more Longitudinal integrated clerkships (LICs) have been introduced as an innovative model to impart medical education. In Canada, most LIC experiences are situated in rural communities. Studies have reported equivalence in graduates from rural LICs and traditional rotation-based clerkships (RBCs) in their performance in residency, as well as in national medical licensure examinations. We sought to determine the impact of rural LICs in terms of practice location of graduates. A matched cohort was developed on the basis of student background and sex to compare practice location of rural LIC and RBC graduates. We used the χ(2) test to assess the association between type of clerkship stream and practice location. We found an association between participation in a rural LIC and rural practice location. Rural LIC programs play an important role in introducing students to rural medicine and may be an effective tool in responding to the shortage of rural practitioners.

Research paper thumbnail of VOL 60: DECEMBER @BULLET DÉCEMBRE 2014 | Canadian Family Physician @BULLET Le Médecin de famille canadien e607 Effect of the discipline of formal faculty advisors on medical student experience and career interest

Canadian Family Physician Medecin De Famille Canadien, Dec 1, 2014

Objective To examine whether the discipline (family medicine vs other specialty) of formally assi... more Objective To examine whether the discipline (family medicine vs other specialty) of formally assigned faculty advisors affected medical student experience and career interest.

Research paper thumbnail of Effect of the discipline of formal faculty advisors on medical student experience and career interest

Canadian Family Physician, Dec 1, 2014

Objective To examine whether the discipline (family medicine vs other specialty) of formally assi... more Objective To examine whether the discipline (family medicine vs other specialty) of formally assigned faculty advisors affected medical student experience and career interest.

Research paper thumbnail of Supporting Veterinary Preceptors in a Distributed Model of Education: A Faculty Development Needs Assessment

Journal of veterinary medical education, 2016

Effective faculty development for veterinary preceptors requires knowledge about their learning n... more Effective faculty development for veterinary preceptors requires knowledge about their learning needs and delivery preferences. Veterinary preceptors at community practice locations in Alberta, Canada, were surveyed to determine their confidence in teaching ability and interest in nine faculty development topics. The study included 101 veterinarians (48.5% female). Of these, 43 (42.6%) practiced veterinary medicine in a rural location and 54 (53.5%) worked in mixed-animal or food-animal practice. Participants reported they were more likely to attend an in-person faculty development event than to participate in an online presentation. The likelihood of attending an in-person event differed with the demographics of the respondent. Teaching clinical reasoning, assessing student performance, engaging and motivating students, and providing constructive feedback were topics in which preceptors had great interest and high confidence. Preceptors were least confident in the areas of student ...

Research paper thumbnail of Rural longitudinal integrated clerkships: changing interests and demographics of medical students

Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la médecine rurale : le journal officiel de la Société de médecine rurale du Canada, 2015

The University of Calgary Longitudinal Integrated Clerkship (UCLIC) is an integrated curriculum o... more The University of Calgary Longitudinal Integrated Clerkship (UCLIC) is an integrated curriculum of at least 32 weeks' duration based in rural communities. Rural LICs have been proposed as a method to respond to the needs of underserved rural communities; therefore, assessing evolving learner interest and demographics over time is of importance to rural communities. Three surveys were administered to first-year medical students at the University of Calgary from the classes of 2009, 2010 and 2015. The surveys assessed demographic information as well as interest in and attitudes toward pursuing a rural-based LIC. Overall, 42% of students (76% of decided students) reported that they would consider the rural UCLIC. Between 2009 and 2010, the proportion of students who would not consider the UCLIC decreased from 25% to 8%, and thereafter was maintained at that level. Over the same period, interest among students considering Royal College of Physicians and Surgeons of Canada (RCPSC) sp...

Research paper thumbnail of Exploring the Teaching Motivations, Satisfaction, and Challenges of Veterinary Preceptors: A Qualitative Study

Journal of Veterinary Medical Education, 2016

Optimization of clinical veterinary education requires an understanding of what compels veterinar... more Optimization of clinical veterinary education requires an understanding of what compels veterinary preceptors in their role as clinical educators, what satisfaction they receive from the teaching experience, and what struggles they encounter while supervising students in private practice. We explored veterinary preceptors' teaching motivations, enjoyment, and challenges by undertaking a thematic content analysis of 97 questionnaires and 17 semi-structured telephone interviews. Preceptor motivations included intrinsic factors (obligation to the profession, maintenance of competence, satisfaction) and extrinsic factors (promotion of the veterinary field, recruitment). Veterinarians enjoyed observing the learner (motivation and enthusiasm, skill development) and engaging with the learner (sharing their passion for the profession, developing professional relationships). Challenges for veterinary preceptors included variability in learner interest and engagement, time management, and lack of guidance from the veterinary medicine program. We found dynamic interactions among the teaching motivations, enjoyment, and challenges for preceptors. Our findings suggest that in order to sustain the veterinary preceptor, there is a need to recognize the interplay between the incentives and disincentives for teaching, to foster the motivations and enjoyment for teaching, and to mitigate the challenges of teaching in community private practice.

Research paper thumbnail of Determinants of an urban origin student choosing rural practice: a scoping review

Rural and remote health

The shortage of physicians in rural and remote communities is an ongoing problem. Many studies ha... more The shortage of physicians in rural and remote communities is an ongoing problem. Many studies have shown that the rural background of a student (ie rural origin) is a primary factor in recruiting physicians for practice in rural communities. Scoping reviews are primarily done to gauge the extent of literature on the research question at hand, typically with an intent that future research in that area is a constructive addition to pre-existing knowledge. This scoping review focuses on factors that predispose urban-origin students to choose a carrier in rural medicine. The study used Arksey and O'Malley's guidelines for a scoping review of the literature, which, in contrast to a traditional systematic review, is brief yet comprehensive. Medline (Ovid) and PubMed databases were used to review literature published between 1 January 1970 and 30 November 2014. After removing duplicates, articles were screened based on inclusion and exclusion criteria set up by the research team. ...

Research paper thumbnail of Issues related to medical students' engagement in integrated rural placements: an exploratory factor analysis

Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la médecine rurale : le journal officiel de la Société de médecine rurale du Canada, 2009

The purpose of this study was to identify and investigate the factors derived from the rural inte... more The purpose of this study was to identify and investigate the factors derived from the rural integrated community clerkship (RICC) questionnaire that influenced the decision of medical students to pursue a 36-week rural community placement option. A total of 162 first-year (n = 92) and second-year (n = 70) medical students completed the 35-item RICC questionnaire. We used qualitative interviews to develop questionnaire items, and we used subsequent descriptive statistics and exploratory factor analyses to analyze the data. Students with origins in rural communities were not significantly more likely to consider a RICC than their urban counterparts. However, students who identified family medicine as their discipline of choice were 3 times more likely to consider a RICC. Exploratory factor analysis, based on correlation of questionnaire items, determined 7 factors (themes) for the questionnaire. The questionnaire had strong internal reliability (Cronbach a = 0.94). Although generally...

Research paper thumbnail of Toxic Shock Syndrome: A Family Physician's Perspective

Canadian family physician Médecin de famille canadien, 1982

Although similar cases have been reported as far back as 1927, the term toxic shock syndrome was ... more Although similar cases have been reported as far back as 1927, the term toxic shock syndrome was coined in 1978 to describe an acute fever involving Staph. aureus. The reported mortality rate in Canada is 3.8%, but may be much higher. Association with tampon use was made in 1980, but is still unclear. Treatment remains supportive and is aimed at reducing risk of recurrence, until the role of the exotoxin can be explained. This article reviews reported cases to date, listing diagnostic criteria, signs and symptoms. A high index of suspicion for this new syndrome is recommended.

Research paper thumbnail of Attending to relationships: a necessary evolution in the clerkship

Research paper thumbnail of Factors perceived to influence rural career choice of urban background family physicians: a qualitative analysis

Canadian Medical Education Journal

Background: Urban background physicians are the main source of physician supply for rural areas a... more Background: Urban background physicians are the main source of physician supply for rural areas across Canada. The purpose of this study was to describe factors that influence rural career choice and practice location of urban background family medicine graduates. Methods: We conducted a qualitative, descriptive study employing telephone interviews with 9 urban background family medicine graduates. Those who completed residency training between 2006 and 2011 and were in rural practice, but who had an urban upbringing were asked about: when the decision for rural practice was made; factors that influenced rural career choice; and factors that influenced choice of a particular rural location. Emerging themes were identified through content analysis of interview data. Results: We identified four themes as factors influencing rural career choice - variety/broad scope of rural practice, rural lifestyle, personal relationships, and positive rural experience/physician role models. We ...

Research paper thumbnail of Does the Medical College Admission Test (MCAT) predict licensing examination performance in the Canadian context?

Canadian Medical Education Journal

Background: Research on the predictive validity of the Medical College Admissions Test (MCAT) on ... more Background: Research on the predictive validity of the Medical College Admissions Test (MCAT) on licensing examination performance is varied in its conclusions, with only a few studies examining this relationship in a Canadian context. We assessed the predictive validity of the MCAT on successful performance on the Medical Council of Canada Qualifying Examination (MCCQE) Part 1 by students attending the Cumming School of Medicine. Methods: Prospective data were collected on MCAT score and sub-section scores, MCCQE decision, multiple mini interview (MMI) performance, gender, and age. The cohort was divided into a derivation cohort (2013 and 2014) and validation cohort (2015 and 2016). Students were dichotomized into pass or fail on MCCQE. Multiple logistic regression in which our dependent variable was MCCQE Part I examination success at the first attempt was used, and potential explanatory variables were age, gender, MCAT total score, and sub-scores for the biological sciences (MC...

Research paper thumbnail of The impact of rural rotations on urban based postgraduate learners: A literature review

Research paper thumbnail of An Axiological Analysis of One Medical School’s Admissions Process

Research paper thumbnail of Scope of practice of family medicine graduates who completed a rural versus urban program

Rural and remote health, Jul 1, 2018

In Canada, rural-based family medicine residency programs were established largely in response to... more In Canada, rural-based family medicine residency programs were established largely in response to a shortage of rural physicians and the perception that urban-based training programs were not meeting the needs of rural populations. Examinations of practice patterns of physicians trained in rural and urban programs are lacking. The purpose of this study was to compare the scope of practice of family medicine graduates who completed a rural versus an urban residency program, by practice location. This was a cross-sectional, mail-out, questionnaire survey of 651 graduates who had completed the family medicine residency program at the University of Alberta or the University of Calgary, Alberta, Canada during 2006-2011. Rural program graduates lived and trained in regional settings and spent a considerable amount of time in smaller rural and remote communities for their clinical experience. The training of urban program graduates was primarily based in large urban settings and family med...

Research paper thumbnail of Implications of not matching to a first-choice discipline: a family medicine perspective

Canadian medical education journal, 2017

Family medicine is often selected as an alternate career choice by medical students who do not ma... more Family medicine is often selected as an alternate career choice by medical students who do not match to their first choice discipline. Consequently, family medicine residency programs accept and train some residents who prepared for and intended a career in another specialty. The implications of this warrant investigation. Graduates (2006-2011) of Albertan family medicine residency programs were surveyed to examine differences between physicians who indicated family medicine was their first choice discipline and those who indicated that it was not their first choice. Survey questions targeted practice location, preparedness for practice, perceptions of family medicine, lifestyle satisfaction, and well-being. Principal components analysis was used to examine the factor structure of our survey items and ANOVA and Chi square were used to compare mean scores and proportions, respectively. The overall response rate was 47.2% (307/651). Most (263) respondents reported that family medicine...

Research paper thumbnail of A critical scoping review of the connections between social mission and medical school admissions: BEME Guide No. 47

Medical teacher, Mar 26, 2017

Despite a growing focus on the social accountability of medical schools, there has been no substa... more Despite a growing focus on the social accountability of medical schools, there has been no substantive review of admissions related to the social mission of medical schools. This paper reports on a critical scoping review of the connections between social mission and medical school admissions. Searches of seven bibliographic databases identified 1258 unique articles. After filtering for relevance, 71 articles were considered for final review. The results of the data extraction were synthesized using a combination of qualitative and quantitative techniques. Five reviewers conducted 149 data extractions from 71 papers. Social missions tended to focus either on access and equity issues for applicants from underrepresented populations or on the career choices of medical graduates and how they meet particular social needs. The connection between social missions and admissions was often implied but rarely considered or evaluated directly. There was a notable absence of empirical evidence,...

Research paper thumbnail of Well-being of family medicine graduates

Canadian family physician Medecin de famille canadien, 2017

To determine family medicine graduates' professional and personal well-being, general health ... more To determine family medicine graduates' professional and personal well-being, general health status, stress levels, coping strategies, and the degree to which they felt supported or isolated in professional life; and to compare findings by sex, practice location, and location of medical school (Canadian medical graduates [CMGs] vs international medical graduates [IMGs]). Retrospective, cross-sectional survey. University of Alberta in Edmonton and the University of Calgary in Alberta. A total of 651 graduates who completed one of the family medicine residency programs during 2006 to 2011. Using a 5-point Likert scale, graduates rated their general health status, their personal and professional well-being, their level of stress, and the degree to which they felt supported or isolated in professional life. Respondents also identified important life events, their caregiving roles, and stress-coping strategies. Of 651 graduates, 307 (47.2%) responded to the survey. Personal and profe...

Research paper thumbnail of Precepting at the time of a natural disaster

The Clinical Teacher, 2016

Natural disasters strike communities that have varied degrees of preparedness, both physical and ... more Natural disasters strike communities that have varied degrees of preparedness, both physical and psychological. Rural communities may be particularly vulnerable as they often do not have the infrastructure or resources to prepare in advance. The psychological impact of a natural disaster is amplified in learners who may be temporary members of the community and therefore cannot draw on personal support during the crisis. They may turn to their clinical preceptors for guidance. The Slave Lake fire (population 6782) in May 2011 and the High River flood (population 12 920) in June 2013 are examples of natural disasters that have occurred in rural Alberta, Canada. At the time of these critical incidents, three medical students and one family medicine resident from the two provincial medical schools were participating in rotations in these communities. Although disasters occur rarely, there is a need for guidelines for preceptors from the learner perspective. Accordingly, using a modified Delphi approach, we captured the experiences of learners that were then refined into two themes, each containing three recommendations: considerations for action during a natural disaster and considerations for action after the acute crisis has passed. Although disasters occur rarely, there is a need for guidelines for preceptors from the learner perspective IMPLICATIONS: Our recommendations provide suggestions for practical solutions that build on the usual expectations of mentors and may benefit the student-teacher relationship at the time of a disaster and beyond. They are meant to initiate discussion regarding further study aimed towards creating recommendations for preceptor response that may cross disciplines.

Research paper thumbnail of Recruitment and retention of physicians in rural Alberta: the spousal perspective

Rural and remote health

The overall geographic distribution of physicians in Canada, including Alberta, is misaligned wit... more The overall geographic distribution of physicians in Canada, including Alberta, is misaligned with the population distribution. Some strategies, such as debt repayment, are currently in practice to increase recruitment and retention of physicians in rural locations. Of the factors influencing choice of practice location, 'spousal influence' is considered to play a significant role in recruitment and retention of physicians in literature. Most studies have focused on the physicians' perspective of their spouses' influence on staying in a rural location. This study is unique as it approaches rural recruitment and retention from the perspective of the physician spouse. The physician population for this study consisted of doctors practicing in rural southern Alberta. Participants were recruited via an email invitation and were invited to complete an online survey. The survey collected information regarding physician demographics and some relationship characteristics. The...

Research paper thumbnail of Practice locations of longitudinal integrated clerkship graduates: a matched-cohort study

Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la médecine rurale : le journal officiel de la Société de médecine rurale du Canada, 2016

Longitudinal integrated clerkships (LICs) have been introduced as an innovative model to impart m... more Longitudinal integrated clerkships (LICs) have been introduced as an innovative model to impart medical education. In Canada, most LIC experiences are situated in rural communities. Studies have reported equivalence in graduates from rural LICs and traditional rotation-based clerkships (RBCs) in their performance in residency, as well as in national medical licensure examinations. We sought to determine the impact of rural LICs in terms of practice location of graduates. A matched cohort was developed on the basis of student background and sex to compare practice location of rural LIC and RBC graduates. We used the χ(2) test to assess the association between type of clerkship stream and practice location. We found an association between participation in a rural LIC and rural practice location. Rural LIC programs play an important role in introducing students to rural medicine and may be an effective tool in responding to the shortage of rural practitioners.

Research paper thumbnail of VOL 60: DECEMBER @BULLET DÉCEMBRE 2014 | Canadian Family Physician @BULLET Le Médecin de famille canadien e607 Effect of the discipline of formal faculty advisors on medical student experience and career interest

Canadian Family Physician Medecin De Famille Canadien, Dec 1, 2014

Objective To examine whether the discipline (family medicine vs other specialty) of formally assi... more Objective To examine whether the discipline (family medicine vs other specialty) of formally assigned faculty advisors affected medical student experience and career interest.

Research paper thumbnail of Effect of the discipline of formal faculty advisors on medical student experience and career interest

Canadian Family Physician, Dec 1, 2014

Objective To examine whether the discipline (family medicine vs other specialty) of formally assi... more Objective To examine whether the discipline (family medicine vs other specialty) of formally assigned faculty advisors affected medical student experience and career interest.

Research paper thumbnail of Supporting Veterinary Preceptors in a Distributed Model of Education: A Faculty Development Needs Assessment

Journal of veterinary medical education, 2016

Effective faculty development for veterinary preceptors requires knowledge about their learning n... more Effective faculty development for veterinary preceptors requires knowledge about their learning needs and delivery preferences. Veterinary preceptors at community practice locations in Alberta, Canada, were surveyed to determine their confidence in teaching ability and interest in nine faculty development topics. The study included 101 veterinarians (48.5% female). Of these, 43 (42.6%) practiced veterinary medicine in a rural location and 54 (53.5%) worked in mixed-animal or food-animal practice. Participants reported they were more likely to attend an in-person faculty development event than to participate in an online presentation. The likelihood of attending an in-person event differed with the demographics of the respondent. Teaching clinical reasoning, assessing student performance, engaging and motivating students, and providing constructive feedback were topics in which preceptors had great interest and high confidence. Preceptors were least confident in the areas of student ...

Research paper thumbnail of Rural longitudinal integrated clerkships: changing interests and demographics of medical students

Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la médecine rurale : le journal officiel de la Société de médecine rurale du Canada, 2015

The University of Calgary Longitudinal Integrated Clerkship (UCLIC) is an integrated curriculum o... more The University of Calgary Longitudinal Integrated Clerkship (UCLIC) is an integrated curriculum of at least 32 weeks' duration based in rural communities. Rural LICs have been proposed as a method to respond to the needs of underserved rural communities; therefore, assessing evolving learner interest and demographics over time is of importance to rural communities. Three surveys were administered to first-year medical students at the University of Calgary from the classes of 2009, 2010 and 2015. The surveys assessed demographic information as well as interest in and attitudes toward pursuing a rural-based LIC. Overall, 42% of students (76% of decided students) reported that they would consider the rural UCLIC. Between 2009 and 2010, the proportion of students who would not consider the UCLIC decreased from 25% to 8%, and thereafter was maintained at that level. Over the same period, interest among students considering Royal College of Physicians and Surgeons of Canada (RCPSC) sp...

Research paper thumbnail of Exploring the Teaching Motivations, Satisfaction, and Challenges of Veterinary Preceptors: A Qualitative Study

Journal of Veterinary Medical Education, 2016

Optimization of clinical veterinary education requires an understanding of what compels veterinar... more Optimization of clinical veterinary education requires an understanding of what compels veterinary preceptors in their role as clinical educators, what satisfaction they receive from the teaching experience, and what struggles they encounter while supervising students in private practice. We explored veterinary preceptors' teaching motivations, enjoyment, and challenges by undertaking a thematic content analysis of 97 questionnaires and 17 semi-structured telephone interviews. Preceptor motivations included intrinsic factors (obligation to the profession, maintenance of competence, satisfaction) and extrinsic factors (promotion of the veterinary field, recruitment). Veterinarians enjoyed observing the learner (motivation and enthusiasm, skill development) and engaging with the learner (sharing their passion for the profession, developing professional relationships). Challenges for veterinary preceptors included variability in learner interest and engagement, time management, and lack of guidance from the veterinary medicine program. We found dynamic interactions among the teaching motivations, enjoyment, and challenges for preceptors. Our findings suggest that in order to sustain the veterinary preceptor, there is a need to recognize the interplay between the incentives and disincentives for teaching, to foster the motivations and enjoyment for teaching, and to mitigate the challenges of teaching in community private practice.

Research paper thumbnail of Determinants of an urban origin student choosing rural practice: a scoping review

Rural and remote health

The shortage of physicians in rural and remote communities is an ongoing problem. Many studies ha... more The shortage of physicians in rural and remote communities is an ongoing problem. Many studies have shown that the rural background of a student (ie rural origin) is a primary factor in recruiting physicians for practice in rural communities. Scoping reviews are primarily done to gauge the extent of literature on the research question at hand, typically with an intent that future research in that area is a constructive addition to pre-existing knowledge. This scoping review focuses on factors that predispose urban-origin students to choose a carrier in rural medicine. The study used Arksey and O'Malley's guidelines for a scoping review of the literature, which, in contrast to a traditional systematic review, is brief yet comprehensive. Medline (Ovid) and PubMed databases were used to review literature published between 1 January 1970 and 30 November 2014. After removing duplicates, articles were screened based on inclusion and exclusion criteria set up by the research team. ...

Research paper thumbnail of Issues related to medical students' engagement in integrated rural placements: an exploratory factor analysis

Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la médecine rurale : le journal officiel de la Société de médecine rurale du Canada, 2009

The purpose of this study was to identify and investigate the factors derived from the rural inte... more The purpose of this study was to identify and investigate the factors derived from the rural integrated community clerkship (RICC) questionnaire that influenced the decision of medical students to pursue a 36-week rural community placement option. A total of 162 first-year (n = 92) and second-year (n = 70) medical students completed the 35-item RICC questionnaire. We used qualitative interviews to develop questionnaire items, and we used subsequent descriptive statistics and exploratory factor analyses to analyze the data. Students with origins in rural communities were not significantly more likely to consider a RICC than their urban counterparts. However, students who identified family medicine as their discipline of choice were 3 times more likely to consider a RICC. Exploratory factor analysis, based on correlation of questionnaire items, determined 7 factors (themes) for the questionnaire. The questionnaire had strong internal reliability (Cronbach a = 0.94). Although generally...