Moving toward co-production: five ways to get a grip on collaborative implementation of Movement Behaviour curricula in undergraduate medical education

Several "calls to action" have imposed upon medical schools to include physical activity content in their overextended curricula. These efforts have often neither considered medical education stakeholders' views nor the full complexity of medical education, such as competency-based learning and educational inflation. With this external pressure for change, few medical schools have implemented physical activity curricula. Moreover, Canada's new 24-Hour Movement Guidelines focus on the continuum of movement behaviours (physical activity, sedentary behaviour, and sleep). Thus, a more integrated process to overcome the "black ice" of targeting all movement behaviours, medical education stakeholder engagement, and the overextended curriculum is needed. We argue for co-production in curriculum change and offer five strategies to integrate movement behaviour curricula that acknowledge the complexity of the medical education context, helping to overcome our "black ice." Our objectives were to investigate 24-Hour Movement Guideline content in the medical curriculum and develop an integrated process for competency-based curriculum renewal. Stakeholders were equal collaborators in a two-phased environmental scan of 24-Hour Movement Guideline content in the Queen's University School of Medicine. Findings and a working curriculum map highlight how new, competency-based content may be embedded in an effort to guide more relevant and feasible curriculum changes.

When the labs closed: graduate students’ and postdoctoral fellows’ experiences of disrupted research during the COVID-19 pandemic

Government imposed lockdown measures in response to the COVID-19 pandemic resulted in widespread laboratory closures. This study aimed to examine the impact of this disruption on graduate students and postdoctoral fellows completing laboratory-based research in Canada. We used an anonymous online survey and semi-structured interviews to document the experiences of graduate students and postdoctoral fellows during laboratory closures and following the transition to working from home. We employed a mixed-method approach using survey and interview data to identify shared experiences, concerns, and supports. The emotions reported by respondents at different points during laboratory closures align with the Kübler-Ross model of grief following change. Respondents describe closure processes as chaotic and confusing, primarily resulting from inconsistent communication. Respondents reported increased indications of distress while working from home. Concerns about how COVID-19 might impact trainees were identified, including decreasing competitiveness of applicants while limiting future employment opportunities. Finally, we outline five types of supports that can be implemented by supervisors and administrators to support graduate students and postdoctoral fellows to return to the laboratory. Overall, we document shared experiences of respondents during the COVID-19 laboratory shutdown and identify areas of improvement in the event widespread laboratory closures occur in the future.

Development of a knowledge translation platform for ataxia: Impact on readers and volunteer contributors

Background

Dissemination of accurate health research information to patients and families has become increasingly important with the rise of the internet as a means of finding health information. However, the public faces several barriers to accessing research information, including paywalls and technical jargon. One method to bridge this gap between patients, families, and research is using lay summaries. SCAsource is an online knowledge translation platform where peer-reviewed research papers on ataxia are translated into lay summaries. This online platform was launched in September 2018, with the goal of making ataxia research more accessible and understandable to patients and families. A secondary goal is to provide opportunities for ataxia researchers to develop and hone their knowledge translation skills, altogether improving the quality of patient communication in the ataxia community.

Aim

The aim of this study was to measure the impact of SCAsource on its readers and volunteer contributors after one year of activity. This is to ensure SCAsource is meeting its goals of (1) improving access and understanding of ataxia research to lay audiences, and (2) improving knowledge translation skills of volunteer contributors.

Methods

Two online surveys were launched, one for readers and one for volunteers. Each survey had a combination of multiple-choice, Likert-scale type, and open-ended short-answer questions. Descriptive quantitative analysis was used for respondent characteristics and Likert-type data. A grounded theory coding approach was used to analyze narrative feedback data.

Results

We found that SCAsource has mutually beneficial outcomes for both lay person readers and volunteer contributors. Readers have an increased understanding of ataxia research and access to up-to-date information on recent publications. Volunteers develop knowledge translation skills and have increased confidence in communicating results to lay audiences. Areas of improvement were identified to be incorporated into the platform.

Conclusion

We demonstrated that SCAsource improves access to information and understanding of research to lay audiences, while providing opportunities for researchers to develop knowledge translation skills. This framework can potentially be used by other rare disease organizations to launch and evaluate their own knowledge translation websites.

Student Reflections on the Queen's Accelerated Route to Medical School Programme

CONTEXT

Since its inception more than 150 years ago, the School of Medicine at Queen's University has aspired 'to advance the tradition of preparing excellent physicians and leaders in health care by embracing a spirit of inquiry and innovation in education and research'. As part of this continuing commitment, Queen's School of Medicine developed the Queen's University Accelerated Route to Medical School (QuARMS). As Canada's only 2-year accelerated-entry premedical programme, QuARMS was designed to reduce training time, the associated expense of medical training, and to encourage a collaborative premedical experience. Students enter QuARMS directly from high school and then spend 2 years enrolled in an undergraduate degree programme. They then are eligible to enter the first-year MD curriculum. The 2-year QuARMS academic curriculum includes traditional undergraduate coursework, small group sessions, and independent activities. The QuARMS curriculum is built on 4 pillars: communication skills, critical thinking, the role of physician (including community service learning [CSL]), and scientific foundations. Self-regulated learning (SRL) is explicitly developed throughout all aspects of the curriculum. Medical educators have defined SRL as the cyclical control of academic and clinical performance through several key processes that include goal-directed behaviour, use of specific strategies to attain goals, and the adaptation and modification to behaviours or strategies that optimize learning and performance. Based on Zimmerman's social cognitive framework, this definition includes relationships among the individual, his or her behaviour, and the environment, with the expectation that individuals will monitor and adjust their behaviours to influence future outcomes.

OBJECTIVES

This study evaluated the students' learning as perceived by them at the conclusion of their first 2 academic years.

METHODS

At the end of the QuARMS learning stream, the first and second cohorts of students completed a 26-item, 4-point Likert-type instrument with space for optional narrative details for each question. A focus group with each group explored emergent issues. Consent was obtained from 9 out of 10 and 7 out of 8 participants to report the 2015 survey and focus group data, respectively, and from 10 out of 10 and 9 out of 10 participants to report the 2016 survey and focus group data, respectively. Thematic analysis and a constructivist interpretive paradigm were used. A distanced facilitator, standard protocols, and a dual approach assured consistency and trustworthiness of data.

RESULTS

Both analyses were congruent. Students described experiences consistent with curricular goals including critical thinking, communication, role of a physician, CSL, and SRL. Needs included additional mentorship, more structure for CSL, more feedback, explicit continuity between in-class sessions, and more clinical experience. Expectations of students towards engaging in independent learning led to some feelings of disconnectedness.

CONCLUSIONS

Participants described benefit from the sessions and an experience consistent with the curricular goals, which were intentionally focused on foundational skills. In contrast to the goal of SRL, students described a need for an explicit educational structure. Thus, scaffolding of the curriculum from more structured in year 1 to less structured in year 2 using additional mentorship and feedback is planned for subsequent years. Added clinical exposure may increase relevance but poses challenges for integration with the first-year medical class.