Browsing by Author "Cooke, Lara J."

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    Competence committees decision-making; an interplay of data, group orientation, and intangible impressions
    (2023-10-10) Curtis, Colleen; Kassam, Aliya; Lord, Jason; Cooke, Lara J.
    Abstract Background The implementation of competency-based medical education and utilization of competence committees (CC) represents a paradigm shift in residency education. This qualitative study aimed to explore the methods used by two operational CC and their members to make decisions about progression and competence of their residents. Methods An instrumental case study methodology was used to study the CC of two postgraduate training programs. Transcripts from observed CC meetings, member interviews, and guiding documents were analyzed using a constructivist grounded theory approach to reveal themes explaining the decision-making process. Results Our study found that the CC followed a process that began within a social decision schema model and evolved to a discussion that invoked social influence theory, shared mental models, and social judgment scheme to clarify the points of contention. We identified that the CC decision-making was at risk of bias, primarily influenced by the group composition, the group orientation and individual members’ mindset, as well as their personal experiences with the trainees. Conclusions Increased awareness of the sources of bias in CC functioning and familiarity with the CC role in competency-based medical education would enable committees to provide valuable feedback to all trainees regardless of their trajectory.
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    Development of a Competency-Based "Boot Camp" Curriculum for the PGY-1 Neurology Residents
    (2018-04-30) Makkawi, Seraj Omar S.; Cooke, Lara J.; Yeung, Michael M. C.; Harrison, Alexandra C. M.
    Background: Boot camp training early in the curriculum has the potential to enhance residents’ confidence, competency, and stress hardiness in managing their patients. Goal: To develop a competency-based boot camp curriculum for PGY-1 neurology residents based on a targeted needs assessment. Methods: A multi-modal approach has been used to assess both self-reported and objective learning needs including: ITER review, an online survey of the key stakeholders, and a consensus meeting at the University of Calgary. Results: This study highlighted the need for the curriculum and the homogeneity between the self-reported learning needs by the learners and their observers as well as the objectively measured needs. Small group discussion, problem-based learning, simulation, and standardized patient encounter were the preferred methods of teaching. The preferred program length was three days. Conclusion: Based on the results of this multi-modal targeted needs assessment, a neurology boot camp curriculum is needed, and a competency-based curriculum can be developed.
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    Social Accountability of Medical Schools to Indigenous Students: A Critical Qualitative Analysis of Trainee Experiences in Western Canadian Institutions
    (2020-09-25) Ward, Rachel; Henderson, Rita Isabel; Crowshoe, Lindsay; Haines-Saah, Rebecca J.; Cooke, Lara J.
    As medical schools increasingly aspire towards diverse student bodies, external directives such as the Truth and Reconciliation Commission (TRC) of Canada’s Calls to Action may guide efforts to achieve Indigenous inclusion. This research focuses primarily on call to action number 23, in which all levels of government (and presumably bodies funded by these) are compelled to increase the number of Indigenous health care professionals in Canada. This study begins by noting that simply increasing the number of Indigenous medical students via recruitment would be an unsatisfactory response; dilemmas around retention challenge institutions to grapple with how inclusion of diverse students may be accomplished, and preparation for successful careers ensured. In order to address these challenges, this qualitative research gains insight from three Indigenous medical students and four Indigenous physicians, exploring their time as medical students and in particular the barriers and facilitators to success they experienced as learners. Data was collected through semi-structured, in-depth interviews carried out with each participant, and were analyzed using coding strategies informed by grounded theory. The findings indicate participants faced barriers to success due to the colonial legacy of institutions, including structural violence, reported to most prominently be experienced as racism. Institutional efforts to diversify student bodies were characterized as superficial if focused narrowly on simply increasing the numbers of admitted Indigenous trainees, without institutional changes for inclusion. Lack of broader efforts for inclusion played out in personal experiences among the current and former trainees, for instance in fearing judgement from others within medical schooling should one self-identify as Indigenous. Success was found in connecting with other Indigenous people in medical schools. Physical spaces on campuses were noted to facilitate such connection. Important to participants were efforts to increase the capacity to address racism towards all people within medical schools. As medical institutions aspire to acknowledge historic wrongs through Indigenous inclusion, they contribute to the underlying intention of closing gaps in health outcomes between populations in Canada. This opens opportunities for inclusion of Indigenous ways of healing and understandings of wellness as central to achieving health equity.