2024 Exceptional Resident Projects

Background
Despite its numerous documented benefits, advance care planning has only been completed by a minority of Canadians. Although provincial and national resources on the topic exist, the problem remains that the public has limited knowledge of the purpose or process of engaging in advance care planning.

Methods
A review of local resources revealed that there was no short, easily mailed resource to introduce the concept of advance care planning. A pamphlet was designed as a concise manner to outline the key components of advance care planning in a visually appealing and easily comprehensible manner. The pamphlet was reviewed by the provincial leadership team. This educational tool could then be distributed across the province in virtual and physical format to patients, regardless of
whether they have a primary care provider.

Results
The pamphlet was designed in both English and in French. It was approved by Health PEI. Distribution networks have been established to target residents of Prince Edward Island ages 50 and above.

Interpretation
The pamphlet serves to introduce and remind patients of the importance of advance care planning for preserving their autonomy when they are unable to speak for themselves. It does not rely on an already overburdened medical system to implement. Future projects should consider other interventions and their impact for improving public uptake of advance care planning.

Background
There are effective and ineffective approaches to learning. In medical education, appropriate coverage of evidence-based learning strategies is lacking. Undergraduate medical learners could benefit from having foundational knowledge on learning strategies.

Methods
Review of the literature was used to help develop appropriate objectives and resources for the science of learning targeting early undergraduate medical students. Local curriculum was reviewed for current content and optimal placement of this material.

Results
Dalhousie’s undergraduate medical Professional Competencies curriculum was identified as an appropriate target for implementing a medical education tool on effective learning strategies. Both a didactic lecture (video recording) and a case-based tutorial module (text document) were developed in keeping with the current curriculum format.

Background:
This study aims to assess the impact of monthly Resident Ice Cream Rounds on the wellbeing and program satisfaction of residents in the Dalhousie Family Medicine residency programs in Cape Breton, NS.

Methods:
The study adopted a pre- and post-intervention design, enrolling all 21 Family Medicine residents on Cape Breton Island. Assessments were conducted utilizing the Physician Wellbeing Index and program-specific questions to assess satisfaction. The intervention involved five monthly Resident Ice Cream Round sessions, voluntary gatherings for peer support, debriefing, and fostering connections. Data analysis employed unpaired t-tests, with statistical significance at a p-value of 0.05.

Results:
Over the study period, the average wellbeing score increased from 3.9 / 7 (s.d. 1.94, 95% CI 2.99 - 4.81), to 4.1 / 7 (s.d. 1.44, 95% CI 3.30 - 4.83, p-value 0.782). First-year residents scored significantly higher than second-year residents pre-intervention, 4.9 vs. 2.9 / 7 (p-value 0.017) while post-intervention the scores were no longer significantly different, 3.9 vs. 4.3 / 7 (p-value 0.601). The average program satisfaction score for all residents was 3.2 / 4 (s.d. 1.14, 95% CI 2.62 - 3.68) which increased to 3.4 / 4 (s.d. 0.96, 95% CI 2.92 - 3.95, p-value 0.426) post-intervention. First-year residents consistently reported higher satisfaction than second-year residents (pre-intervention p-value 0.076, post-intervention p-value 0.112).

Interpretation:
While the results suggest a positive impact of Resident Ice Cream Rounds on overall wellbeing and program satisfaction, the study’s short duration and small sample size limit generalizability. The differing trends between first- and second-year residents warrant further exploration. Despite study limitations, the low overall wellbeing scores highlight the need for ongoing wellness monitoring and support.

As Canada becomes more linguistically diverse, the skills required to work with limited English proficiency (LEP) patients and interpreters become increasingly valuable to family medicine. This project proposes a medical education tool for third-year medical students to start developing these skills early. It incorporates evidence from current literature about existing medical education tools, the impact of simulation experiences on learner empathy, and best practice guidelines for working with interpreters. “Working with Interpreters: A Medical Education Tool for Cross-Cultural Communication” is an Objective Structure Clinical Education (OSCE)-style simulation with a preceding introductory module and post-simulation debrief.

The introductory module follows the flipped classroom model to review recommendations for working with interpreters and to prime students to reflect on the impact that language barriers can have on LEP patients. The simulation session places medical students in the LEP patient role by using the Pocket Talker device to simulate a communication barrier, and asks students to rotate through the roles of patient, interpreter, and interviewer. Suggested methods for evaluation of this tool include the Jefferson Scale of Physician Empathy (JSE) and a skills checklist to evaluate students’ competency working with interpreters.