Laura Marcotte - Academia.edu (original) (raw)
Papers by Laura Marcotte
Canadian Journal of General Internal Medicine, Jun 11, 2022
Defining General Internal Medicine (GIM) has been difficult due to the tension between ensuring f... more Defining General Internal Medicine (GIM) has been difficult due to the tension between ensuring flexibility for varied environments and the need for national standards. With the launch of competency-based medical education, the Royal College of Physicians and Surgeons of Canada Specialty Committee in GIM (SCGIM) (national standard-setting body) had the opportunity to explicitly define the discipline via elaboration of the GIM competencies and Entrustable Professional Activities (EPAs). Defining the EPAs is the essence of defining the tasks of the discipline. We describe our SCGIM approach to the continuous review of the theoretical written documentation around EPAs in the "real world environment" in order to continuously refine the EPAs and ensure they are facilitating skill attainment. Major lessons learned (1) centralized feedback with simple reporting and multiple input is best; (2) there is tension between theory (perfect EPAs) and practical implementation; (3) it takes time to see how the EPAs are performing. Résumé Il a été difficile de définir la médecine interne générale (MIG) en raison de la tension entre la nécessité d'assurer la souplesse pour des environnements variés et le besoin de normes nationales. Grâce au lancement de la formation médicale par compétences, le comité de spécialité en MIG (CSMIG) du Collège royal des médecins et chirurgiens du Canada (organisme national de normalisation) a eu l' occasion de définir explicitement la discipline en élaborant les compétences en MIG et les activités professionnelles confiables (APC). Définir les APC consiste essentiellement à définir les tâches de la discipline. Nous décrivons notre approche du CSMIG
Canadian Journal of Diabetes, 2014
Les énergies marines sont considérées par un nombre croissant d'acteurs politiques et économiques... more Les énergies marines sont considérées par un nombre croissant d'acteurs politiques et économiques français comme des filières stratégiques permettant de répondre aux exigences énergétiques et climatiques de court, moyen et long termes. Les conditions de démarrage et les perspectives de développement de ces marchés émergents dépendent fondamentalement des spécificités et du potentiel de la ressource exploitée, ainsi que de la maturité des technologies. Aujourd'hui, les incertitudes se concentrent sur l'attractivité socio-économique des projets et la définition de subventions publiques adaptées, qui conditionnent la dynamique de pénétration des technologies. Dans cette contribution, les résultats de modélisation sur l'évolution des coûts complets de production des différentes technologies, dont les hypothèses de base ont été affinées avec un ensemble d'industriels français de référence, ont permis de dresser les conditions de démarrage de chacun des segments des énergies marines, ainsi que d'établir une prospective de ces marchés en France et au niveau mondial d'ici à 2030. Les deux segments technologiquement les plus matures, l'éolien offshore et l'hydrolien, sont en mesure de se développer de façon imminente, tandis que le houlomoteur est encore en phase de structuration technologique, et repose à ce stade sur des conditions de démarrage similaires à celles que connaît l'hydrolien, avec des technologies permettant de valoriser l'énergie des vagues à proximité des côtes. Le déficit de compétitivité structurel de l'Energie Thermique des Mers vis-à-vis des autres énergies marines est quant à lui compensé par ses caractéristiques énergétiques (notamment la production d'électricité de base) et sa pertinence en zone insulaire, où les coûts de production sont significativement plus élevés que dans les territoires continentaux. Mots-clés : Énergies marines-Eolien offshore (posé et flottant)-Hydrolien-Houlomoteur-Energie Thermique des Mers (ETM)-Coûts de production-Prospective de marchés
Canadian Medical Education Journal, 2019
In competency-based medical education (CBME), assessment is learner-driven; learners may fail to ... more In competency-based medical education (CBME), assessment is learner-driven; learners may fail to progress if assessments are not completed. The General Internal Medicine (GIM) program at Queen’s University uses an educational technique known as scaffolding in its assessment strategy. The program applies this technique to coordinate early assessments with specific scheduled learning experiences and gradually releases the responsibility for assessment initiation to residents. Although outcomes of this innovation are still under investigation, we feel it has been valuable in supporting resident assessment capture and timely progression through stages of training. Other residency training programs could easily implement this technique to support the transition to Competency by Design.
Canadian Medical Education Journal, 2019
Construct Competency Based Medical Education (CBME) is designed to use workplace-based assessment... more Construct Competency Based Medical Education (CBME) is designed to use workplace-based assessment (WBA) tools to provide observed assessment and feedback on resident competence. Moreover, WBAs are expected to provide evidence beyond that of more traditional mid- or end-of-rotation assessments [e.g., In Training Evaluation Reports (ITERs)]. In this study, we investigated the quality of feedback in General Internal Medicine (GIM), by comparing WBA and ITER assessment tools. Background WBAs are hypothesized to improve written and numerical feedback to support the development and documentation of competence. In this study, we investigated residents’ and preceptors’ perceptions of WBA validity, usability, and reliability and the extent to which WBAs differentiate residents’ performance when compared to ITERs. Approach We used a mixed methods approach over a three-year period, including perspectives gathered from focus groups, interviews, along with numerical and narrative comparisons bet...
Canadian family physician Médecin de famille canadien, 2006
To investigate what happens to the serum creatinine (SC) levels of people with initial mild eleva... more To investigate what happens to the serum creatinine (SC) levels of people with initial mild elevations in SC; whether a stable, non-progressive elevation in SC level is the most common scenario; how common a progressive increase in SC is among primary care patients; and how often primary care patients with substantial elevations in SC (>300 micromol/L) progress to end-stage renal disease. Retrospective analysis of laboratory data and chart review. Queen's University Family Medicine Centre in Kingston, Ont. All patients who had SC levels measured at a nearby hospital laboratory between January 1994 and December 1998. Recently recorded height and weight measurements, latest SC measurements (if available), whether patients had been referred to nephrologists, comorbidity, medications being taken, whether patients were currently undergoing dialysis or had received a renal transplant, and whether patients had died. In the 1434 charts of eligible patients, 64 (4.5%) had elevated ini...
Canadian Medical Education Journal
Construct: Competence Based Medical Education (CBME) is designed to use workplace-based assessmen... more Construct: Competence Based Medical Education (CBME) is designed to use workplace-based assessment (WBA) tools to provide observed assessment and feedback on resident competence. Moreover, WBAs are expected to provide evidence beyond that of more traditional mid- or end-of-rotation assessments [e.g., In Training Evaluation Records (ITERs)]. In this study we investigate competence in General Internal Medicine (GIM), by contrasting WBA and ITER assessment tools.Background: WBAs are hypothesized to improve and differentiate written and numerical feedback to support the development and documentation of competence. In this study we investigate residents’ and faculty members’ perceptions of WBA validity, usability, and reliability and the extent to which WBAs differentiate residents’ performance when compared to ITERs. Approach: We used a mixed methods approach over a three-year period, including perspectives gathered from focus groups, interviews, along with numerical and narrative com...
Canadian Journal of General Internal Medicine
A 57-year-old woman presented with headache, palpitations and hypertension associated with mictur... more A 57-year-old woman presented with headache, palpitations and hypertension associated with micturition and was found to have a bladder tumour on imaging. During cystoscopy, with manipulation of the mass, the patient became symptomatic and hypertensive, and a catecholamine-secreting paraganglioma was suspected. Biochemical testing confirmed the diagnosis of paraganglioma of the urinary bladder and she underwent successful resection after preoperative treatment with alpha- and beta-adrenergic blockade and volume expansion. In this article, we outline the prevalence of extra-adrenal paragangliomas and their possible genetic basis. We also overview the diagnosis, perioperative management, follow-up testing and prognosis of these tumours.
Internal Medicine Journal
Canadian Medical Education Journal , 2019
In competency-based medical education (CBME), assessment is learner-driven; learners may fail to ... more In competency-based medical education (CBME), assessment is learner-driven; learners may fail to progress if assessments are not completed. The General Internal Medicine (GIM) program at Queen's University uses an educational technique known as scaffolding in its assessment strategy. The program applies this technique to coordinate early assessments with specific scheduled learning experiences and gradually releases the responsibility for assessment initiation to residents. Although outcomes of this innovation are still under investigation, we feel it has been valuable in supporting resident assessment capture and timely progression through stages of training. Other residency training programs could easily implement this technique to support the transition to Competency by Design.
Canadian Journal of General Internal Medicine, Jun 11, 2022
Defining General Internal Medicine (GIM) has been difficult due to the tension between ensuring f... more Defining General Internal Medicine (GIM) has been difficult due to the tension between ensuring flexibility for varied environments and the need for national standards. With the launch of competency-based medical education, the Royal College of Physicians and Surgeons of Canada Specialty Committee in GIM (SCGIM) (national standard-setting body) had the opportunity to explicitly define the discipline via elaboration of the GIM competencies and Entrustable Professional Activities (EPAs). Defining the EPAs is the essence of defining the tasks of the discipline. We describe our SCGIM approach to the continuous review of the theoretical written documentation around EPAs in the "real world environment" in order to continuously refine the EPAs and ensure they are facilitating skill attainment. Major lessons learned (1) centralized feedback with simple reporting and multiple input is best; (2) there is tension between theory (perfect EPAs) and practical implementation; (3) it takes time to see how the EPAs are performing. Résumé Il a été difficile de définir la médecine interne générale (MIG) en raison de la tension entre la nécessité d'assurer la souplesse pour des environnements variés et le besoin de normes nationales. Grâce au lancement de la formation médicale par compétences, le comité de spécialité en MIG (CSMIG) du Collège royal des médecins et chirurgiens du Canada (organisme national de normalisation) a eu l' occasion de définir explicitement la discipline en élaborant les compétences en MIG et les activités professionnelles confiables (APC). Définir les APC consiste essentiellement à définir les tâches de la discipline. Nous décrivons notre approche du CSMIG
Canadian Journal of Diabetes, 2014
Les énergies marines sont considérées par un nombre croissant d'acteurs politiques et économiques... more Les énergies marines sont considérées par un nombre croissant d'acteurs politiques et économiques français comme des filières stratégiques permettant de répondre aux exigences énergétiques et climatiques de court, moyen et long termes. Les conditions de démarrage et les perspectives de développement de ces marchés émergents dépendent fondamentalement des spécificités et du potentiel de la ressource exploitée, ainsi que de la maturité des technologies. Aujourd'hui, les incertitudes se concentrent sur l'attractivité socio-économique des projets et la définition de subventions publiques adaptées, qui conditionnent la dynamique de pénétration des technologies. Dans cette contribution, les résultats de modélisation sur l'évolution des coûts complets de production des différentes technologies, dont les hypothèses de base ont été affinées avec un ensemble d'industriels français de référence, ont permis de dresser les conditions de démarrage de chacun des segments des énergies marines, ainsi que d'établir une prospective de ces marchés en France et au niveau mondial d'ici à 2030. Les deux segments technologiquement les plus matures, l'éolien offshore et l'hydrolien, sont en mesure de se développer de façon imminente, tandis que le houlomoteur est encore en phase de structuration technologique, et repose à ce stade sur des conditions de démarrage similaires à celles que connaît l'hydrolien, avec des technologies permettant de valoriser l'énergie des vagues à proximité des côtes. Le déficit de compétitivité structurel de l'Energie Thermique des Mers vis-à-vis des autres énergies marines est quant à lui compensé par ses caractéristiques énergétiques (notamment la production d'électricité de base) et sa pertinence en zone insulaire, où les coûts de production sont significativement plus élevés que dans les territoires continentaux. Mots-clés : Énergies marines-Eolien offshore (posé et flottant)-Hydrolien-Houlomoteur-Energie Thermique des Mers (ETM)-Coûts de production-Prospective de marchés
Canadian Medical Education Journal, 2019
In competency-based medical education (CBME), assessment is learner-driven; learners may fail to ... more In competency-based medical education (CBME), assessment is learner-driven; learners may fail to progress if assessments are not completed. The General Internal Medicine (GIM) program at Queen’s University uses an educational technique known as scaffolding in its assessment strategy. The program applies this technique to coordinate early assessments with specific scheduled learning experiences and gradually releases the responsibility for assessment initiation to residents. Although outcomes of this innovation are still under investigation, we feel it has been valuable in supporting resident assessment capture and timely progression through stages of training. Other residency training programs could easily implement this technique to support the transition to Competency by Design.
Canadian Medical Education Journal, 2019
Construct Competency Based Medical Education (CBME) is designed to use workplace-based assessment... more Construct Competency Based Medical Education (CBME) is designed to use workplace-based assessment (WBA) tools to provide observed assessment and feedback on resident competence. Moreover, WBAs are expected to provide evidence beyond that of more traditional mid- or end-of-rotation assessments [e.g., In Training Evaluation Reports (ITERs)]. In this study, we investigated the quality of feedback in General Internal Medicine (GIM), by comparing WBA and ITER assessment tools. Background WBAs are hypothesized to improve written and numerical feedback to support the development and documentation of competence. In this study, we investigated residents’ and preceptors’ perceptions of WBA validity, usability, and reliability and the extent to which WBAs differentiate residents’ performance when compared to ITERs. Approach We used a mixed methods approach over a three-year period, including perspectives gathered from focus groups, interviews, along with numerical and narrative comparisons bet...
Canadian family physician Médecin de famille canadien, 2006
To investigate what happens to the serum creatinine (SC) levels of people with initial mild eleva... more To investigate what happens to the serum creatinine (SC) levels of people with initial mild elevations in SC; whether a stable, non-progressive elevation in SC level is the most common scenario; how common a progressive increase in SC is among primary care patients; and how often primary care patients with substantial elevations in SC (>300 micromol/L) progress to end-stage renal disease. Retrospective analysis of laboratory data and chart review. Queen's University Family Medicine Centre in Kingston, Ont. All patients who had SC levels measured at a nearby hospital laboratory between January 1994 and December 1998. Recently recorded height and weight measurements, latest SC measurements (if available), whether patients had been referred to nephrologists, comorbidity, medications being taken, whether patients were currently undergoing dialysis or had received a renal transplant, and whether patients had died. In the 1434 charts of eligible patients, 64 (4.5%) had elevated ini...
Canadian Medical Education Journal
Construct: Competence Based Medical Education (CBME) is designed to use workplace-based assessmen... more Construct: Competence Based Medical Education (CBME) is designed to use workplace-based assessment (WBA) tools to provide observed assessment and feedback on resident competence. Moreover, WBAs are expected to provide evidence beyond that of more traditional mid- or end-of-rotation assessments [e.g., In Training Evaluation Records (ITERs)]. In this study we investigate competence in General Internal Medicine (GIM), by contrasting WBA and ITER assessment tools.Background: WBAs are hypothesized to improve and differentiate written and numerical feedback to support the development and documentation of competence. In this study we investigate residents’ and faculty members’ perceptions of WBA validity, usability, and reliability and the extent to which WBAs differentiate residents’ performance when compared to ITERs. Approach: We used a mixed methods approach over a three-year period, including perspectives gathered from focus groups, interviews, along with numerical and narrative com...
Canadian Journal of General Internal Medicine
A 57-year-old woman presented with headache, palpitations and hypertension associated with mictur... more A 57-year-old woman presented with headache, palpitations and hypertension associated with micturition and was found to have a bladder tumour on imaging. During cystoscopy, with manipulation of the mass, the patient became symptomatic and hypertensive, and a catecholamine-secreting paraganglioma was suspected. Biochemical testing confirmed the diagnosis of paraganglioma of the urinary bladder and she underwent successful resection after preoperative treatment with alpha- and beta-adrenergic blockade and volume expansion. In this article, we outline the prevalence of extra-adrenal paragangliomas and their possible genetic basis. We also overview the diagnosis, perioperative management, follow-up testing and prognosis of these tumours.
Internal Medicine Journal
Canadian Medical Education Journal , 2019
In competency-based medical education (CBME), assessment is learner-driven; learners may fail to ... more In competency-based medical education (CBME), assessment is learner-driven; learners may fail to progress if assessments are not completed. The General Internal Medicine (GIM) program at Queen's University uses an educational technique known as scaffolding in its assessment strategy. The program applies this technique to coordinate early assessments with specific scheduled learning experiences and gradually releases the responsibility for assessment initiation to residents. Although outcomes of this innovation are still under investigation, we feel it has been valuable in supporting resident assessment capture and timely progression through stages of training. Other residency training programs could easily implement this technique to support the transition to Competency by Design.