The Bridge

Connecting through education in the Faculty of Medicine & Dentistry University of Alberta ISSUE NO. 1

2019

Contents 4

Reaching out for deeper connection

8

Indigenous Health Initiatives Program a personal passion for new director

11 Dentistry, dental hygiene students give back

14 Medical Laboratory Science overhaul brings rich, experiential learning opportunities

17 Simulation training brings on the light-bulb moments

20 Academic Technologies office pursues educational innovation

24 Education Quality and Accreditation office moves into support role

28 Development and support key to attracting, retaining world-class faculty

32 Students take the lead in peer support

35 Caring for the whole student 39 Creative pursuits bring fresh perspective to medicine, healing

43 Associate dean positions MD program as national leader in research, social accountability

46 Residents, supervisors move toward competency-based medical education

49 Rural medical education: Boundless opportunities

52 Global Medical Summer Study

THE BRIDGE DIRECTOR, COMMUNICATIONS & MARKETING SALENA KITTERINGHAM

WRITER / COPY EDITOR / PROOFREADER SASHA ROEDER MAH

NATASIA DESIGNS NATASIA MARTIN

CONTRIBUTING WRITER KERI SWEETMAN

ISSUE NO. 1 – 2019

Message from Shirley Schipper Vice-Dean, Education I am truly grateful to be working within

and reflect the health needs of our

the Faculty of Medicine & Dentistry

communities. We need to ensure that

(FoMD) as a clinician educator.

our learning outcomes are maintained

I have the pleasure of working with

to the highest standards and continue

engaged students, incredible teachers,

to make us a world-class institution for

inspiring scientists and medical leaders.

health education. Our goal is to be a hub

Education is lifelong for most of us in

for innovative and creative minds that

the health professions. Our curiosity

share our faculty’s values of integrity,

and desire to develop to our fullest

inclusion and passion for knowledge.

potential improve the lives of those

Our vision for education focuses on:

around us and within the populations 1. Our learning environment.

that we serve.

We aim to ensure a humanistic The Faculty of Medicine & Dentistry at the University of Alberta stands as one of the premier health education

and supportive environment that enhances learning.

2. Our programs. We continue to

centres in Canada, attracting

build on interprofessional and

outstanding talents and forming

collaborative initiatives within

future leaders. Our undergraduate

and between FoMD programs.

programs include medicine, dentistry,

3. Our faculty. We must support,

dental hygiene, medical laboratory

engage and sustain our faculty

science and radiation therapy. We

within a culture of educational

offer numerous residency, graduate

scholarship and excellence.

4. Our communities. We engage

and postgraduate programs.

communities in reciprocal learning As Vice-Dean, Education, it is my role

opportunities with our pentagram

to ensure that our education programs

partners and through respectful

are innovative, flexible and adaptive,

collaboration.

SHIRLEY SCHIPPER, MD, CCFP, FCFP VICE-DEAN, EDUCATION FACULTY OF MEDICINE & DENTISTRY, UNIVERSITY OF ALBERTA

UNIVERSITY OF ALBERTA

3

Reaching out for deeper connection BUILDING RELATIONSHIPS THE CORE OF SUPERIOR MEDICAL CARE

4

ISSUE NO. 1 – 2019

Jack Zhang was in his second year in

volunteers intend to return to

the MD program when the Faculty

make this an annual event, says

of Medicine & Dentistry hosted its

Helly Goez, co-ordinator of the

first ever LGBTQ “human library-

four-year physicianship course.

type experience” a half-day of

Goez collaborated with MD student

intimate conversation designed

Derek Fehr, ’19 MD, and community

to foster understanding of the

representatives to design the

unique challenges LGBTQ patients

sessions as part of six hours of new

experience in encounters with the

LGBTQ curriculum.

health-care system. “The experience was a valuable opportunity for me to

“I found it very rewarding to see

learn about vulnerability, humility,

participants’ currently held beliefs

sympathy and empathy,” he recalls.

and perceptions be challenged,”

“These are foundations to being a

says volunteer Lowell Acorda. “It’s

good physician, in my opinion, and

important that marginalized voices

can only be learned from candid

are represented and heeded … in

interactions in a safe environment.”

having more informed, and even affirming, health-care professionals,

About 160 MD students—the

we can improve the quality of health

readers—and 20 community

care provided to those within the

volunteers—the books—took

LGBTQ community as well as create

part in the session, the first of

confidence in our health-care system.”

its kind in Canada. Many of the

Helly Goez, Assistant Dean, Diversity Photo: Laughing Dog Photography

Artwork: Natasia Designs UNIVERSITY OF ALBERTA

5

THE BRIDGE

Social engagement like this has been

faculty’s MD and Arts & Humanities

a movement in medical education

in Health & Medicine programs.

since 1995, when the World Health Organization urged medical schools to

Experiences like the PIE allow future

orient their education and research to

doctors to cultivate sensitivity to

meeting the needs of the communities

patients as human beings. Memorizing

they serve.

facts and studying textbooks are crucial aspects of becoming a

Explains Jill Konkin, Associate Dean,

competent physician, says Goez,

Community Engagement, “our

but “we are touching people in their

priorities are to be determined in

lowest moments in their lives, where

partnership with the community.”

there is so much insecurity and fear.”

And that means getting out from

Compassion must be a part of those

behind textbooks and into dialogue

interactions. “The relationships built

with the people being served.

in this program will help make more empathetic physicians,” Hillier says.

GETTING TO KNOW YOU Another part of the four-year physicianship course, the Patient

HEALING HISTORICAL WOUNDS

Immersion Experience (PIE)

The inaugural Indigenous Academic

pairs students over the span of

Day at the Alexis Nakoda Sioux Nation

two years with people living with

in 2016 was eye-opening for both

chronic illness. They go to doctor

medical residents and patients. “Prior

appointments together and spend

to this session many residents had

social time together as well, allowing

not been to a First Nations reserve,”

the students an in-depth look into the

says Cara Bablitz, ’07 Bsc, ’11 MD,

everyday battles these patients face.

who organized the event after working with the Indigenous Health Program

Tracey Hillier, Associate Dean, MD

to deliver primary care at the Alexis

program, says: “The idea is to come

Nakota Sioux Nation, about an hour

at this encounter from the lens of the

northwest of Edmonton. Her father,

patient. Students get to hear from the

a Métis physician, has been a source

patient about their lived experience

of inspiration for her work to reduce

with the health-care system and hear

health inequities.

from their families.” In 2018, more

6

than 160 students took part in the

“The impact that our medical

program, a joint effort between the

schools can have in our Indigenous

FACULTY OF MEDICINE & DENTISTRY

ISSUE NO. 1 – 2019

communities in Alberta can be

and barriers Indigenous patients

enormous,” says Alika Lafontaine,

face in our health-care system. This

U of A lecturer and anesthesiologist,

knowledge was not presented to us

member of the board of governors for

with a spirit of condemnation, but

First Nations University of Canada

a spirit that welcomed partnership

and collaborative team leader for

and reconciliation, a true cultural

Indigenous Health Alliance.

immersion experience,” says Danika Leung, second-year resident and part

A second Indigenous Health

of the planning committee for the

Academic event took place at

Academic Day.

Poundmaker’s Lodge in August 2018, where elders shared meaningful

“A majority of the residents’

conversations with first- and second-

encounters with Indigenous peoples

year residents at the site of a former

prior to this day were in a medical

residential school. It was a powerful

setting, which could create a skewed

opportunity to learn from Indigenous

picture of who Indigenous people

community members about the

are,” says Bablitz, clinical lecturer in

culture, health issues and barriers to

the Department of Family Medicine.

health care they face.

“This day allows resident physicians to see the resilience and strength of our

“We were exposed to solemn topics

people at a site that is working towards

such as the history of Indigenous

Indigenous healing and wellness.”

peoples in Canada, and prejudice

The Patient Immersion program concludes with a creative art exhibit by the students, representing their insights and learning experience from the patient-mentor.

Photo supplied

UNIVERSITY OF ALBERTA

7

Tibetha Kemble, Director, Indigenous Health Initiatives Program Photo: Jordan Carson

Indigenous Health Initiatives Program a personal passion for new director When Maskwacis Elder Rick Lightning was a young boy in the Indian Residential School (IRS) system, the care he and his fellow students received from health professionals was rudimentary at best. Tibetha Kemble recalls Elder Lightning sharing with her the trauma he experienced and how it ultimately shaped his unease as a father, when sending his children for doctor checkups or dentist appointments.

8

ISSUE NO. 1 – 2019

“Canada has a long and dark history

The ensuing 20 years have seen that

with Indigenous health that has

gap narrow marginally but, says

left a legacy of mistrust, anxiety

Kemble, “we’re not even halfway to

and fear of the health-care system

what that commission recommended,

among many Indigenous peoples.

which is the training of 10,000 new

Health professionals are a part of this

Indigenous physicians over 10 years.”

legacy,” says Kemble, Director of the Faculty of Medicine & Dentistry’s

To be part of the solution, Kemble

Indigenous Health Initiatives

and her team know they need to reach

Program (IHIP) since the fall of

prospective students early. Her office

2017. “Indigenous physicians play a

is working on a plan that focuses

crucial role in building back that trust

on engaging Indigenous junior high

and facilitating safe relationships.”

and elementary students to provide the kinds of exposure and valuable

Kemble—along with administrator

hands-on experiences that foster a

Kenton Boutillier, within

sense of place and belonging within

the Division of Community

the professions.

Engagement—remains committed to and focused on achieving the

The IHIP is also working to support

mandate of the IHIP program,

the faculty in building relationships

which is to recruit and support a

with treaty organizations, individual

growing body of future Indigenous

First Nations, First Nation Education

health professionals throughout

Authorities and other Indigenous

the faculty’s five undergraduate

representative organizations to

programs. Since its inception in

encourage community members

1988, the IHIP has focused on

to consider a future in the health

addressing the lack of First Nation,

professions. If we can spark an

Métis and Inuit students entering

interest in science, says Kemble, and

into and completing the medical

build awareness among Indigenous

doctor degree at the U of A. It has

youth about the journey into health

since broadened its scope to include

professions and beyond, students will

all of the health-profession streams.

be better situated to enter the faculty.

In 1996, the Royal Commission

The U of A recently eliminated a

on Aboriginal People found one

quota system that limited the number

Indigenous physician for every

of Indigenous students admitted

33,000 Indigenous people in Canada,

to its MD program through the

compared to one for every 515 people

IHIP process. Starting in fall 2019

in the non-Indigenous population.

and during the next admissions

UNIVERSITY OF ALBERTA

9

THE BRIDGE

application cycle, all Indigenous

To that end, following the release of

students who meet all eligibility

the Truth and Reconciliation’s final

requirements through IHIP will be

report and Calls to Action in early

offered a place in the medical school.

2016, an Indigenous Health Course

In addition, beginning in September

Working Group was established to

2019, and for each of the next four

design a new curriculum. Members

years, the MD program will award

from health sciences and community

four new full-tuition scholarships to

partners worked together on modules

entering Indigenous students.

that will teach health-science undergraduates and medical students

Recruiting Indigenous students is

about the history and legacy of

only part of Kemble’s mandate. IHIP

harmful colonial policy and the legacy

provides holistic, individualized

of Indian Residential Schools. These

supports for Indigenous students

legacies underpin the longstanding

currently in the faculty. “I’m really

health and social inequities

excited about creating a community,

experienced disproportionately by

because that’s fundamental to our

Indigenous people. The historic

Indigenous way of being,” she says.

collaboration—answering the Truth

This means establishing an advisory

and Reconciliation Commission’s

council of elders to offer teachings

call to action No. 24—resulted in

about culture and medicine, and

a 12-module course being piloted

creating a powerful mentorship

this academic year. “Our work on

network with Indigenous graduates

this together demonstrates a real

who are practising in the community.

commitment to partnership and to

It also means a robust calendar of

create a space for Indigenous health

cultural events to keep members of

here in the faculty,” says Kemble,

the Indigenous community within the

“and that’s meaningful.”

faculty connected to each other and to remind each other ‘you’re not alone’.

Kemble says the work she is doing is deeply personal for her. “As a

There are more signs of hope than

First Nations woman, through this

of struggle, stresses Kemble. Today,

program, I get to be a part of shifting

“there is a desire among non-

the system in whatever small way

Indigenous students, faculty and staff

that I can to improve the health,

to start to learn about Indigenous

well-being and social location of

people and work in partnership and

Indigenous people.”

collaboration to strengthen our connection to each other.”

10

FACULTY OF MEDICINE & DENTISTRY

Photo: John Ulan

Dentistry, dental hygiene students give back COMMUNITY OUTREACH INSTILS SENSE OF SOCIAL RESPONSIBILITY

When Alexandra Sheppard, ’93 DH, was a dental hygiene student at the University of Alberta more than 20 years ago, the only external placement she did was at an Edmonton psychiatric institution and at the northern satellite clinics in High Level.

Now, as Assistant Director of Dental Hygiene Clinical Education in the School of Dentistry, Sheppard supervises students who do placements in the inner city, long-term care facilities, a rehabilitation hospital and in northern Alberta.

Some of the students even travel to Central America with dental missions.

UNIVERSITY OF ALBERTA

11

THE BRIDGE

Paul Major, Chair, School of Dentistry Photo: Jordan Carson

“We teach them basic dentistry

along with homeless people and those

and dental hygiene, but with that,

from lower-income groups.

we teach them how to be socially responsive,” says Paul Major, Chair

It can be an eye-opener for the

of the School of Dentistry. “If we

students, most of whom are in their

can instil this, then we’ve done a

early 20s and often from middle-

good job, and the only way this can

class backgrounds. Although they

happen is to immerse them in the

get an orientation prior to their first

community and provide meaningful

visit, Sheppard says the first rotation

experiences.”

can be daunting, especially when the clinic was in a dingy, cramped

Karen Ho, ’17 DH, says opportunities

room in the basement. Thanks

to work in the community are

to the school’s Dentistry for Life

what make the U of A program so

fundraising campaign, donor support

outstanding compared to others in

has enabled an expansion of the

the country.

Boyle McCauley Health Centre to a bigger, brighter location.

BOYLE MCCAULEY HEALTH CENTRE

“Once you see how much the service

Dental hygiene students treat patients

says dental hygiene graduate Ilona

at this inner-city centre twice a week

Kaliszuk. “People are so grateful for

as part of their curriculum, and as

the care.”

is needed, it’s a great experience,”

part of the new clinic expansion, dental students will join them there on regular rotations starting this academic year. They see Indigenous, new-immigrant and refugee patients,

12

FACULTY OF MEDICINE & DENTISTRY

ISSUE NO. 1 – 2019

SHINE

SMILE PROGRAM

In addition to the weekday curriculum

Dental hygiene students volunteer

rotations, dental and dental hygiene

to go out into the community to give

students also volunteer their time at

presentations to schools, day-care

Boyle McCauley on Saturdays through a

centres, Stollery Children’s Hospital

program called SHINE (Student Health

patients and other organizations.

Initiatives for the Needs of Edmonton).

The visits are organized by students.

SHINE is organized by students, who find licensed dentists from the

Throughout the 2017–’18 school

community to attend as supervisors.

year, 31 presentations reached 440 children between the ages of 12

The energy of the young volunteers

months and 12 years.

makes visiting the SHINE clinic a positive experience for many patients.

“I’ve always had bad experiences with

RURAL OUTREACH

dentists, but SHINE was different,” says

Dental and dental hygiene students

patient Monica Baker. “The students

all do a two-week rotation in northern

were friendly. They put me at ease.”

Alberta clinics in La Crete, High Level or McLennan, where they have the

GLENROSE REHABILITATION HOSPITAL AND LONG-TERM CARE FACILITIES

opportunity to do a wide range of dental work because many patients in those areas don’t have access to regular dental care.

As part of their curriculum, dental hygiene and dental students do regular rotations at the Glenrose, which

INTERNATIONAL MISSIONS

doubled the capacity of its dental

Dental and dental hygiene students

clinic in 2012. The dental clinic at the

volunteer to go on dental missions

Glenrose is outfitted with medical

with two not-for-profit Edmonton

lifts where patients who are elderly,

organizations, Dentistry for All and

medically compromised or have limited

Kindness in Action. Through these

mobility can be treated. Dental hygiene

organizations, between 10 and 25

students also do rotations in long-term-

students provide care in countries

care facilities, performing assessments

such as Guatemala and Nicaragua

and oral care and providing dental

each year. The students also hold an

hygiene education to the staff. Under

annual charity ball to raise money for

supervision by their instructors, they

the missions. They raised more than

learn to care for patients with dementia

$100,000 at the 2018 event.

and other medical conditions.

UNIVERSITY OF ALBERTA

13

Medical Laboratory Science overhaul brings rich, experiential learning opportunities HANDS-ON TRAINING CRUCIAL TO MASTER EMERGING TECHNOLOGIES, SAYS DIRECTOR

With big data, artificial intelligence and precision health making strides in medical research and practice, the University of Alberta’s Medical Laboratory Science program is in the midst of major changes to ensure the professionals coming out of its program are ready to hit the ground running.

The four-year undergraduate degree, which celebrated its 60th anniversary in 2018, sees

Lisa Purdy, Assistant Dean,

an annual intake of 29 students seeking both

Graduate Student Affairs

certification as a medical laboratory technologist and the enhanced theoretical knowledge that comes with having earned a degree. It’s the only degree-

and Director, Division of Medical Laboratory Science Photo: Laughing Dog

granting program of its kind in Western Canada, and director Lisa Purdy wants to see it grow.

Massive change is ahead in this field. “With the way technology is going, we need to be developing lab professionals who will be change agents, and who can help other health professionals manage the new technology,” she says.

14

FACULTY OF MEDICINE & DENTISTRY

ISSUE NO. 1 – 2019

To get ahead of the demand, Purdy is creating a new master’s degree in Medical Laboratory Science. In the process of working its way through university governance, the graduate program is so ahead of the curve, it will “create a professional that Alberta Health Services may not yet even have a job description for.”

Launching a master’s program necessitated an overhaul of the undergraduate degree as well, a process Purdy welcomes as a chance to analyze and shift the desired program outcomes to better reflect current U of A focuses such as ethics and community outreach. An example of this is the recent elimination of the upper quota on the number of Indigenous students admitted to the Medical Laboratory Sciences program.

“We need to be socially accountable as health professionals; we need to train our students to be more culturally aware”, says Purdy.

The technical program’s focus has always been on making sure students are prepared to meet national certification criteria. Purdy says that won’t change, but the best health professionals of the future will also be intent on serving, giving back and engaging in the community. A professionalism course will be offered throughout the program’s three years, with opportunities to explore what being an ethical and engaged member of the community looks like. Purdy is also exploring a future option for a rural rotation to address underserved community needs.

It’s in the final undergraduate year that the most sweeping curriculum changes appear, addressing the emerging technologies learners need to master. A series of one-credit courses—offered over three weeks online and one weekend

Nikki Yurkiw and Rachel McKellar, medical laboratory science graduates from the class of 2018 Photo: Melissa Fabrizio

UNIVERSITY OF ALBERTA

15

THE BRIDGE

hands-on in the lab—focus on advanced training in processes such as mass spectrometry and flow cytometry, neither of which are new technologies but are continually being called into action in new and different ways. “We have been teaching mass spec for years,” clarifies Purdy, “but most of it has been didactic.

Now we want our students to get their hands on those instruments and become really proficient at using them, to address the growing need in clinical service.”

Because the modules are mostly online, they’ll be accessible not only to students in the undergraduate program, but also—in partnership with the Faculty of Extension—to professionals looking to advance their career development. This shift to online learning and making learning more accessible to non-degree students is brand new for the program and a necessity to ensure practising technologists keep up their professional development.

The proposed MSc in Laboratory Medicine & Pathology with Specialization in Medical Laboratory Science—which Purdy hopes to see launch in the fall of 2022—goes even further to ensure students enter their profession ready to embrace its fast pace of change. Purdy has proposed for the MSc four areas of specialization that reflect current and future needs: Bioinformatics & Molecular Diagnostics; Laboratory Leadership; Research & Development and Laboratory Utilization & Applied Statistics.

16

FACULTY OF MEDICINE & DENTISTRY

Photo: Ed Ellis

Simulation training brings on the light-bulb moments RISK-FREE, HANDS-ON PRACTICE CRUCIAL TO MEDICAL EDUCATION

17

THE BRIDGE

Late one night in anesthesia resident

The first class of radiation

Kristin Radtke’s second year, she

therapists graduated

found herself responding to a complicated emergency call for a patient in respiratory distress. One glance told her that the situation—

in June 2017.

From left: Sarah Sun, Ariel Letcher and Miranda Bowler Photo: Laughing Dog

an unco-operative patient in recovery from recent surgery, with some serious medical complications—would be far

Dentistry until the end of 2018, has

more complex than the straightforward

seen first-hand the power of crisis

cases she’d encountered in textbooks.

resource management training, where residents must simulate an operation

Recalling that day, Radtke credits her

while instructors add increasingly

simulation training in crisis resource

unpredictable and complicated

management (CRM) for helping her

factors. “We start with something

manage a dynamic and dangerous

relatively simple, then push people out

situation. “Simulation practice in

of their comfort zone,” he explains,

remaining calm and slowing down

“then do a facilitated debriefing,

the mind, situational awareness,

dissecting communication skills, crisis

using material and human resources,

management skills and leadership.”

communicating and decisiveness are the things that saved the day for

Simulation isn’t just about crisis

me,” she says.

training. Fairly early in medical school, students encounter basic task training

18

Neil Gibson, Director of Simulation

with simulators for one-to-one

in the Faculty of Medicine &

procedures such as starting an IV or

FACULTY OF MEDICINE & DENTISTRY

ISSUE NO. 1 – 2019

What’s new?

“We’re going through a generational shift with respect to technology and how we approach medical education,” Gibson says, “so it’s no longer just the early adopters. Academic faculty, no longer just clinical faculty, are beginning to realize it needs to be part of their academic careers.” To serve that need, Gibson is collaborating with Alberta Health Services to adapt existing AHS training modules into faculty development courses in simulation. His longterm plan involves working with IDEAS office Director Carol Hodgson to create a professional simulation certification for faculty and residents.

using an ultrasound machine. Every

linear accelerator, a procedure room

August before students head out for

and the audiovisual components

clinical placements, they take a two-

required to record students’ learning

week “link block” using simulation

so they can be given informative

to polish their basic-task skills.

feedback by instructors.

There’s also a move to involve more simulation in medical examination

“The students absolutely love it,” says

procedures, augmenting multiple

Susan Fawcett, Director, Radiation

choice, written and oral exams.

Therapy program. “It’s where everything comes together and where

APPLYING CLINICAL REASONING TO LEARNING SCENARIOS

their ‘aha’ moments begin to happen.

This is where the rubber meets the road. The students take everything they have learned in their theoretical

The radiation therapy clinical

courses and put it all together in the

learning suite at the Cross Cancer

simulated environment.”

Institute boasts an OSCE-informed Photos: Ed Ellis

UNIVERSITY OF ALBERTA

19

Academic Technologies office pursues educational innovation

20

FACULTY OF MEDICINE & DENTISTRY

ISSUE NO. 1 – 2019

When Academic Technologies first launched about six years ago, its mandate was to create and implement a learning management system, an online way of organizing course material. That mandate has changed considerably, to reflect the needs and wishes of a tech-savvy and information-hungry world, both on campus and beyond.

“Today, our job is to support all faculty and students within the Faculty of Medicine & Dentistry with respect to their teaching and learning, as it relates to technology,” says Lyn Sonnenberg, Director of Academic Technologies.

“Our job is also to lead, in terms of innovation.”

Students come into this program as ‘digital natives,’ says Sonnenberg, and they expect cutting-edge help and the flexibility that comes with access to technology, such as vodcasts and podcasts, and even—hopefully in a year’s time, she says—a tablet dissection table as an enhancement

“WE’RE LEADING THE CHARGE ACROSS THE UNIVERSITY OF ALBERTA IN OPEN EDUCATIONAL RESOURCE ADVOCACY.”

to human cadaver dissections.

To address the shift toward technology-supported learning, Sonnenberg says her office is working to promote systemic changes. First, they’re identifying early-adopting faculty to train staff who may not be quick to independently embrace new technology, so more classes will offer options students expect.

Second, while the university can certainly improve its own resources, the online world is already awash in valuable content for medical students. The trick, says Sonnenberg, is to make sure they know how to sift critically through biased and inaccurate information. “Currently, various programs are striving to develop critical thinking and analytical skills earlier in their programs.”

And finally, with the increased volume of information students are expected to absorb, Sonnenberg stresses, it’s more important than ever for the

Lyn Sonnenberg, Director, Academic Technologies (second from right)and the team Photo: Jordan Carson UNIVERSITY OF ALBERTA

21

THE BRIDGE

Retain is a multidimensional educational tool—board game, card game and digital simulator—that trains practitioners in neonatal resuscitation.

administration to grant learners the freedom to pursue their education their way. “Traditionally we’ve said, ‘if you’re not physically present here, you’re not learning,’ and what we know about this generation of learners is that’s not how they want to learn.”

THE BUILDING BLOCKS The office of Academic Technologies spent much of the last year building an educational technologies framework, meant to define the competencies and reach of the team. Central to the framework are seven capabilities, says Sonnenberg—education, design, development, collaboration, leadership, administration and expertise.

What began as a homegrown project has grown into a nationwide initiative to define best ed-tech practices in all post-secondary institutions across Canada.

In partnership with the University of Ottawa, the office has been leading targeted focus groups and compiling responses to national surveys to formalize the framework for all participants and define a national community of practice around those seven pillars.

22

FACULTY OF MEDICINE & DENTISTRY

ISSUE NO. 1 – 2019

OPENING BORDERS “We’re leading the charge across the University of Alberta in open educational resources (OER) advocacy,” says Sonnenberg. This practice puts research out in the open, usually online, legally accessible for free to everyone.

Sonnenberg says today’s academics are warming up to this concept, a major shift from the traditional focus on protecting intellectual property. Within the faculty, the School of Dentistry has embraced open educational resources, with pilot projects also underway from Hematology, Medical Laboratory Science and Dental Hygiene.

Sonnenberg imagines one day having an open-education medical school, “where anyone in the community could listen to or be part of different lectures.”

SERIOUS FUN The design team at Academic Technologies may have the most fun, collaborating with faculty and external contributors on gamification that facilitates training in the classroom and beyond.

With the help and input of various faculty members, designer Patrick von Hauff has developed clinical problem-solving card sets in the areas of obesity management, general dentistry, emergency medicine and hematology.

“Students need to cultivate a comfort with uncertainty and the flexibility to respond to change and adapt strategy,” he says, and these cards present complex clinical scenarios that encourage learners to think on their feet in a safe setting.

The design team supplies professional resources, too. Thomas Jeffery is part of the team behind Retain, a multi-dimensional educational tool—board game, card game and digital simulator—that trains practitioners in neonatal resuscitation. Prompted by the needs of medical residents, Retain is now being used by students, nurses and other team members working in neonatal intensive care units. “You can use it on your own, in a group, on a break, in the middle of the night,” says Jeffery, highlighting yet another way Academic Technologies is revolutionizing and personalizing learning.

UNIVERSITY OF ALBERTA

23

Education Quality and Accreditation office moves into support role NEW ASSISTANT DEAN BUILDS TOOLS THAT EMPOWER FACULTY

24

ISSUE NO. 1 – 2019

It has been four years since the

To foster EQI, Lai is focusing on two

University of Alberta’s MD program

streams: electronic infrastructure and

was recognized by the governing

tools that encourage active learning.

bodies of both Canadian and American medical schools with a highly

Much of the first stream involves the

successful accreditation. This year,

design of data dashboards. “I realized

the MD program has undergone both

we need a better system to collect and

an interim accreditation review and a

store all of our faculty’s accreditation

quality assurance unit review. Much of

information,” he says, “to retain our

the work done by faculty and students

vast amounts of business knowledge

to see that accreditation come to

and have a continuous quality

fruition is a credit to the office of

improvement process.” Responding to

Education Quality and Accreditation.

that need, and in collaboration with his team and the Department of Computer

With new assistant dean Hollis Lai at

Science, Lai custom-designed for the

the helm—and the next accreditation

MD program a software accreditation

process not due for four more years—

management system to hold all

the focus of the office is shifting

information previously kept in

somewhat. “Now is the time where we

unwieldy email chains and paper files.

can actually make the improvement strides and embed the accreditation

Programs other than MD are

process within each of the programs

beginning to express an interest in data

so that they can do the work that they

dashboards, which enable aggregation,

need to,” says Lai. He envisions a

review and communication of vast

move away from oversight and toward

quantities of information. “I’m

collaboration. “My passion is to make

passionate about cross-pollination,

an impact on educational quality

seeing the various tools that we’ve built

improvement (EQI), enabling and

benefit the entirety of the faculty and

empowering all programs to deliver a

streamline their workflow,” says Lai.

higher quality of education.”

Dentistry is changing how they organize their clinic, and Lai has designed a dashboard to help them manage that. They piloted the system over the summer and will formally Hollis Lai, Assistant Dean,

implement its use this academic

Education Quality and

year. And a computerized platform

Accreditation Photo: Jordan Carson

for administering assessments is now being used not just by the MD UNIVERSITY OF ALBERTA

25

THE BRIDGE

program, but also by Dental Hygiene,

place makes it easier to give timely,

Dentistry and Pharmacy. It has also

relevant feedback to our students.”

been adopted with enthusiasm by Postgraduate Medical Education in

At the same time, Lai is working

its new competency-based medical

to encourage faculty development

education, which involves more

in active learning. This student-

frequent and meaningful assessments

centred method features two-way

of residents’ work.

communication and takes the instructor out from behind a podium and into more of a learning-coach role. It invites students into the

“I FEEL LIKE IMPLEMENTING ACTIVE LEARNING AND BLENDED LEARNING IS WHERE THE NEXT BIG SHIFT WILL BE FOR OUR FACULTY.”

education process in ways that passively listening to a lecture cannot.

He worked with the office of Academic Technologies to design a card game that shares with instructors various active learning techniques and tools for lesson planning. Dentistry has taken the lead in trying the cards, he says, and he is now bringing a similar

Lai customizes his tools to the unique

tool to the MD program and beyond.

workflow of each program, but one

“We can design the best curriculum in

factor remains constant: The focus is

the world, but at the end of the day, if

always user-friendly, intuitive solutions

we are still lecturing for the full hour,

that anyone can use without a great

it is going to be difficult for students to

deal of training. As for how these tools

keep up,” he says.

benefit learners, says Lai, “with the shift toward customized learning, having all

“I feel like implementing active learning

of the information in one easy-to-use

and blended learning is where the next big shift will be for our faculty.”

26

FACULTY OF MEDICINE & DENTISTRY

ISSUE NO. 1 – 2019

Faculty Service Officers design and deliver valuable researchintensive undergraduate programming One of about 45 Faculty Service Officers (FSOs) in the Faculty of Medicine & Dentistry, Rachel Milner plays an integral academic role as a teacher in the Department of Biochemistry. The FSO agreement enables academics like her in the basic science departments such as biochemistry, pharmacology and physiology, or programs such as Radiation Therapy, to focus intensely on teaching, while other FSOs focus on research.

their senior-year research projects.

“The FSO agreement changes the traditional academic model that says you must focus on research and teaching in equal measure, recognizing that in certain fields such as medical research, it is almost impossible to focus adequately on both of those things at the same time,” Milner explains.

“This is the third year we have been offering it,” Milner says. “In my role as student adviser, I encourage students to take the certificate if you’re even thinking of doing grad school, but also if you want to pursue medical school or go out into the big wide world of industry.”

Initially hired in 2000 to redesign the senior undergraduate research laboratory skills course in the undergraduate biochemistry program, Milner’s ongoing mission is to align learning outcomes with program objectives and to prepare students for

“Biochemistry and the other basic medical sciences are so research intensive ... and I believe if you don’t do research, you haven’t really learned the discipline. You can learn a whole bunch of facts but to really be a biochemist, you have to do biochemical research,” says Milner.

Recently, Milner was instrumental in the creation of the Certificate in Biomedical Research.

Milner says FSOs have been pivotally important in the quality of undergraduate programming in the medical sciences. “We work as a network and collaborate a lot on improving our education programs and research opportunities for students.”

UNIVERSITY OF ALBERTA

27

Development and support key to attracting, retaining world-class faculty SEVERAL OFFICES ENCOURAGE ACADEMIC GROWTH OPPORTUNITIES The University of Alberta’s Faculty of Medicine & Dentistry has a rich history of attracting world-class clinicians and academics.

Once they’re here, what supports are in place to retain them and encourage their growth and development?

28

ISSUE NO. 1 – 2019

FACULTY DEVELOPMENT

Beyond polishing their skills,

The mandate for Mia Lang, Associate

says Lang, workshops are a great

Dean, Faculty Development, is to

opportunity for faculty to develop

“guide the individual faculty member to

relationships with peers and mentors.

optimize their professional skills, such

“I’d like to see us move away from our

as teaching, leadership and research

individual, siloed activities to more of

skills.” A new set of faculty evaluation

a community approach.”

committee standards come into effect July 1, 2019, to recognize, encourage and reward the changing contributions

IDEAS OFFICE

of faculty in cutting-edge areas such

The IDEAS office, launched in the

as education scholarship, showcasing

fall of 2017, is working to build a

research and development in health-

community of health-profession

professions education.

scholars to improve health professions education (HPE)

Lang’s office supports and facilitates

scholarship. The office does this by

a number of faculty-development

building relationships and providing

workshops every year. She’s encouraged

more supportive infrastructure and

by the popularity last year of a

personnel, says IDEAS Director and

graduate student supervisor seminar

J. Allan Gilbert Chair in Medical

on improving mentorship skills, and a

Education Research, Carol Hodgson.

three-part clinical reasoning workshop to help teachers assess how they

IDEAS aims to support all faculty and

respond to their students’ diverse

is particularly focused on members

needs. “We have to be very nimble

whose appointments have less than

about identifying different learner

40 per cent research. These faculty

needs and we need to think about why

often do not have the time or training

we ask the questions we ask,” Lang

to do all the scholarly work required

says. “Is it to help us assess them, or is

for merit increases or promotion.

it to help them learn?”

Support from the IDEAS team helps them develop HPE research through all its stages, from initial questions to final publications.

From left, Denise Campbell-Scherer, Associate Dean, Lifelong Learning

“Collaborations on presentations,

Carol Hodgson, Director, IDEAS office

publications and grants are the core of

Mia Lang, Associate Dean, Faculty

an office to support scholarship,” says

Development

Hodgson, “but the IDEAS team are also

Photo: Jordan Carson

very proud of their teaching through UNIVERSITY OF ALBERTA

29

THE BRIDGE

faculty and professional development,

existing knowledge. “Everything we

primarily through the Teaching

do is wasted if we can’t implement

Scholars Program. It is through this

it,” she explains. “Our office will

training that IDEAS hopes to build a

also help build capacity for quality

community of HPE scholars.”

improvement, which will play a key role in 21st-century continuous

LIFELONG LEARNING

professional development.”

The office of Lifelong Learning

The Physician Learning Program

fills a different niche, says Denise

(PLP) carries out projects with data

Campbell-Scherer, associate dean,

and human-centred design elements,

as the academic home for faculty

and can also pair practitioner teams

interested in implementation

with end users “to mobilize the tacit

science, or the application of

knowledge and lived experiences of

A closer look at Physician Learning Program The major programmatic grant (between Alberta Health and the Alberta Medical Association) in the office of Lifelong Learning is the Physician Learning Program (PLP). Working with physician leads, PLP designs and carries out projects that focus on gaps in clinical practice that exist despite strong evidence about what is appropriate. In addition to stand-alone projects, five pillars help organize projects. Here’s a snapshot of what’s happening: • Digestive health: Improving colonoscopies, in partnership with the Alberta Colorectal Cancer Screening program and the Digestive Health Strategic Clinical Network; • Antimicrobial stewardship: Partnering with AHS Antimicrobial Stewardship Committee, among others, to help physicians and teams better understand appropriate antibiotic use, in support of Choosing Wisely Canada; • Metabolic disease: Multiple projects tackling issues around obesity, diabetes and hypertension; • Patients Collaborating with Teams (PaCT): Primary Health Care Integration Network initiative designed to help primary care teams better support patients who require significant support to maintain their health; • Marginalized populations: Creating a searchable, online interactive map of the services and resources in Calgary and Edmonton that might benefit inner-city patients with high acute-care needs, in support of key partner Addiction Recovery and Community Health (ARCH).

30

FACULTY OF MEDICINE & DENTISTRY

ISSUE NO. 1 – 2019

families, patients, clinicians,” says

level planning and decision-making,

Campbell-Scherer. PLP projects create

to advocate for reduced burnout and

effective solutions to health-care needs.

better morale among faculty.

Campbell-Scherer’s team will grow

“Struggling faculty are often both a

in the coming months from the

symptom and a contributor to toxic

current seven to up to 15. “We’re

work and learning environments,”

also working to increase our reach

adds Lewis.

and impact of PLP projects through liaising with well-developed system stakeholder networks; this extends the scale and spread of the

EQUITY, DIVERSITY AND INCLUSION

innovations that are found through

Helly Goez, Assistant Dean,

our collective work.”

Diversity, says her office is well supported by the faculty’s formal

ADVOCACY & WELLBEING

diversity and equitable recruitment policies. She works hard to

The office formerly known as Learner

promote the understanding that all

Advocacy and Wellness has been

faculty experience different social

rebranded as the Office of Advocacy

intersectionalities, which bring the

& Wellbeing to enhance engagement

potential for stress and workplace

and wellness through the full Faculty

suffering. “We know that when people

of Medicine & Dentistry continuum:

are discriminated against because of

from undergraduate and postgraduate

their diversity it impacts their well-

learners to graduate students and

being and hinders their productivity.”

now also faculty members.

“We all deserve to feel good when we The new office will have an assistant

come to work,” summarizes Goez.

dean for faculty wellness, says Melanie

“When we hire a person we open the

Lewis, Associate Dean, Advocacy

gate, but to keep them, we need to

& Wellbeing. She envisions the new

value their contribution and show it

assistant dean participating in high-

in a meaningful way.”

UNIVERSITY OF ALBERTA

31

Students take the lead in peer support CLUBS, WORKSHOPS HELP FUTURE MEDICAL PROFESSIONALS DEVELOP LEADERSHIP, COMPASSION

Photos: Jordan Carson

32

ISSUE NO. 1 – 2019

Students taking the University of Alberta’s Medical Laboratory Science degree went to their program director, Lisa Purdy, last year with an unusual suggestion: They wanted a self-defence course.

Working evening shifts as part of their clinical training, some were worried about walking to public transit late at night. Purdy agreed to fund the self-defence course but challenged them to do more.

Why not offer self-help workshops every month throughout the academic year?

And so was born the Medical Laboratory Science program’s Student Wellness Nights, with a nutritionist talking about budget meal-planning, a study room with puppies, yoga, a talk from a financial adviser and, yes, a self-defence session. While it was funded by

Top photo: Carter Smith

the Medical Laboratory Sciences

Bottom photo: Paul Barber

program, all the planning and executing was done by the students.

Fourth-year student Denise Alano is vice-president of wellness for the Medical Laboratory Students Association and will oversee the Wellness Nights this academic year. “In this program, the faculty already open their doors to students who may need help and support and they do a very good job at that,” says Alano. “But we also figured it’s very important for us as students to reinforce that we do support each other.”

Purdy agrees that it’s vital for the students to take the lead in support groups.

“We need to foster leadership within our trainees, because otherwise how are they going to practise that when they get out into the health-care environment?”

UNIVERSITY OF ALBERTA

33

THE BRIDGE

Students in the Undergraduate Medical Doctor program have their own Mental Health Advocates team, which holds events and workshops throughout the academic year. One workshop last year dealt with talking about suicide. “We looked at it through the clinical lens about how to talk with a patient,” says Paul Barber, a second-year medical student and team leader, “but one of our subtle goals was to help facilitate that conversation between students as well.”

From left, Denise Alano and Gloria Kwon.

The team’s biggest project is the student-led Mental Health Week, whose capstone event is Mental Health Monologues, where students take to the stage of Dewey’s pub to share personal stories. The Monologues event, which has been running about four years at the U of A, has since been adopted on other campuses across Canada.

While funding for the events comes mainly from the Medical Students Association, Barber says the Mental Health Advocates team gets incredible support from the Advocacy & Wellbeing office.

“It’s vital that students take on these peer-support roles,” says Barber. “You are not always going to have a board or a faculty member to facilitate these conversations.

So teaching students to do that themselves is incredibly empowering.”

Melanie Lewis, Associate Dean of the Advocacy & Wellbeing office, agrees. “I think a lot of this stuff has to come from peers; it can’t be top-down. And our job in those cases is to support students in any way we can.”

For many years, the medical students have also run a program called Coffee with Clerks, which matches incoming first-year medical students with third-year students who are beginning their clinical placements, known as clerkships.

Carter Smith, a fourth-year student who was one of the organizers last year, says the matches give first-year students “a link, an ear, somebody who has been through it all, who can answer your questions and help with some of the anxiety.” Almost all first- and third-year students take part and the partnerships usually last two years.

34

FACULTY OF MEDICINE & DENTISTRY

Melanie Lewis, Associate Dean, Advocacy & Wellbeing Photo: Melissa Fabrizio

Caring for the whole student ADVOCACY & WELLBEING OFFICE IS HERE FOR ACADEMIC, MENTAL-HEALTH SUPPORT

35

THE BRIDGE

The core philosophy of the Alberta Medical Association is that asking for help is a sign of strength. But

WHY IS THIS OFFICE IMPORTANT IN A MEDICAL SCHOOL?

cultivating that willingness in physicians to be vulnerable and seek

There’s a stigma that persists in the

support begins in the Faculty of

medical profession around asking for

Medicine & Dentistry.

help or admitting one is suffering, says Lewis. “You feel like you’re less

It’s here that the faculty’s office of

than; you’re not as good as or as cool

Advocacy & Wellbeing serves a crucial

as or as well-adjusted as everyone

role, says Associate Dean Melanie

else; everybody’s coping better.” And

Lewis. “Our goal is to ensure that

sometimes, in the service of making

students meet their best academic

excellent physicians, student wellness

and personal potential, and that

ends up at the bottom of a long list of

we address any barriers that are

priorities. She says it’s important to

hampering them.”

build in students the habit of seeking help from the moment they enter

WHAT IS THE MANDATE OF A TYPICAL LEARNER ADVOCACY OFFICE? It is mandated through accreditation that all MD programs must have an office of student affairs, but only over

school, through clinical placements and residency and beyond.

HOW DOES THE OFFICE COLLABORATE WITH STUDENTS?

the past several years have such offices

The Office of Advocacy & Wellbeing’s

evolved to focus more on student

involvement in student wellness

well-being, both physical and mental.

initiatives begins during the annual

“We are unique in that we include

peer-support orientation week, when,

postgraduate and graduate learners

together with students, they plan

under one office,” says Lewis.

events that, as Lewis says, “introduce a supportive culture in which the students will have each other’s backs.” It’s not just her office that does the heavy lifting around student support: “The students have always been a major advocate at the table to get advocacy and wellness needs met in an official capacity.”

36

FACULTY OF MEDICINE & DENTISTRY

ISSUE NO. 1 – 2019

HOW FAR-REACHING IS THE SUPPORT OFFERED

BY THE OFFICE OF ADVOCACY & WELLBEING?

decreased due to government funding and in 2017, 68 graduating medical students in Canada did not get a match.

The office supports students in myriad ways, from information about wellness and financial literacy embedded in the curriculum to individual psychological and career counselling services. “I want students to know that there are multiple doors here with multiple people students can trust that they can go to,” including a full-time

“I WANT STUDENTS TO KNOW THAT THERE ARE MULTIPLE DOORS HERE WITH MULTIPLE PEOPLE STUDENTS CAN TRUST THAT THEY CAN GO TO.”

psychologist and four assistant deans

— MELANIE LEWIS, ASSOCIATE DEAN,

who help with academic appeals,

ADVOCACY & WELLBEING

advice to deal with harassment or intimidation and conflict resolution, among other stressors.

At the U of A’s medical school, “We are a confidential, safe space.

counselling to undergo the match

Students can come here knowing they

process is embedded as part of the

can unload whatever they need to,”

MD curriculum. “With less residency

says Lewis, “whether it’s addiction

positions available, many students

issues, or depression, or severe

have heightened concerns, especially

academic peril, and feel safe that this

for students pursuing specialties

information isn’t going to hurt their

where the demand substantially

academic reputation.”

outstrips the supply,” says Lewis.

The MD program and the Advocacy

WHAT IS THE MOST PRESSING ISSUE FACING MEDICAL STUDENTS?

& Wellbeing office all work together to help students succeed and provide support for each stage of the process.

Additional resources include resume

These days, Lewis sees a significant

reviews and practice interviews for

uptick in students seeking career

students with faculty and volunteer

counselling after having been

residents. They help unmatched

unmatched for the medical residency

students broaden their scope of

of their choice. Each year the number

potential specialties and connect

of residency positions available for

them with specialists to shadow.

Canadian medical graduates has UNIVERSITY OF ALBERTA

37

THE BRIDGE

“If they are still unmatched, we

have been very successful in the

create programs where they can

following match.”

stay as undergraduate students in the MD program and pursue special

“We have a commitment to our

training in research (MD STIR)

students,” says Lewis. “We are

or an MD/MBA program. Students

not going to leave them alone in

who have pursued that extra year

this journey.”

Soft skills for self-help “I think every aspect of our faculty should be promoting health and wellbeing,” says Pamela Brett-MacLean, Director, Arts & Humanities in Health & Medicine (AHHM) program, and a selection of electives from her program are doing just that. Newest among the offerings is Healer’s Art, held here for the first time last spring. The course was designed by Rachel Remen (University of San Francisco) and has since been embraced by medical schools across North America. Healer’s Art has proven to be a powerful experience for both facilitators and learners, says Brett-MacLean, a co-lead for the pilot course.

• With only 20 students per session— five per facilitator for intimate group discussions—Healer’s Art provides a safe, non-judgmental space for personal growth and to help students understand the need for both self-care and deep empathy as they pursue their medical school journey. Topics in the seminar include grief and loss, compassion, stress prevention and what it means to truly embrace medicine as a calling.

38

• Over the course of eight hours, Introduction to Mindfulness teaches students techniques for stress management, focus and concentration. Students learn how practising mindfulness can improve their communication skills, openness to collaboration and ability to lead through example.

• In Spirituality and Health, students learn about the significance of spiritual care for some patients, and are asked to delve into the role of spirituality in their own lives and how that will impact the care they provide.

FACULTY OF MEDICINE & DENTISTRY

Creative pursuits bring fresh perspective to medicine, healing

Pamela Brett-MacLean, Director, Arts & Humanities in Health & Medicine program Art from Under the Surface by Marilène Oliver in the McMullen Gallery at the University of Alberta Hospital Photo: Jordan Carson

39

THE BRIDGE

The Arts & Humanities in Health &

Today, AHHM’s reach extends to

Medicine (AHHM) program was born

students, faculty, practitioners and

in 2006, to encourage development of

the broader community.

skilled, reflexive and compassionate health professionals who can foster relationships between the arts,

STUDENT LIFE

humanities, social sciences and

“Using the arts, you engage many

medicine. AHHM is the second office

more aspects of the collective

of its kind in Canada. Says director

intelligence of the group,” says

Pamela Brett-MacLean: “I believe

Brett-MacLean. “It’s not just a

the importance of an office like mine

cognitive exercise; it makes difficult

is to bring a different disciplinary

discussions more human-centred

perspective, different ways of thinking

and engages the emotion.”

and knowing, to support questioning that can lead to new visions for

Students in the Faculty of Medicine

medicine. Arts and humanities are

& Dentistry are encouraged

always asking philosophical questions

to experience that ‘collective

about who we are, how to live, how

intelligence’ with an array of electives.

to be together, and it’s helpful to

Communicating Care: A Theatre-Based

create a formal space that recognizes

Approach offers an interactive and

and welcomes those who want to ask

impactful 12 hours practising presence

those questions.”

and mindful attention to patients

Through the elective Communicating Care: A Theatre-Based Approach, UAlberta med students use improvisational exercises and role-playing scenarios to check their assumptions and help them communicate better with patients.

Photo: Ed Ellis

40

FACULTY OF MEDICINE & DENTISTRY

ISSUE NO. 1 – 2019

through experiential theatre exercises.

REAL-WORLD APPLICATIONS

The Art of Observation takes students to the Art Gallery of Alberta to cultivate

At the helm at AHS, Yiu has carried the

clear, unbiased visual observation,

values of AHHM into the community

a skill that is crucial to practising

with a unique storytelling program

medicine. Spirituality and Health

that brings complex diagnoses into the

pairs students with hospital chaplains,

realm of the deeply human. Patients

encouraging them to understand that

and loved ones are invited to share on

caring for spiritual needs is an integral

the AHS Youtube channel their stories

part of holistic health care.

of illness, treatment, recovery and death, putting a human face to what

Brett-MacLean is particularly proud of

can be complicated medical issues.

the three-week open-study electives

“We need to understand the personal

that draw students from other medical

situation to provide holistic care,”

schools across North America in their

stresses Yiu. “When we don’t have

third and fourth years.

the complete story and we only focus on the technology, therapeutics and

Along with enthusiastic participation

diagnostics, we lose the bigger picture.”

in curricular offerings, students in the faculty have followed the lead

Like storytelling, visual art can

of AHHM and created their own

be a powerful tool in humanizing

committee, which Brett-MacLean

medicine. School of Dentistry

expects will create a number of

associate professor Minn Yoon

initiatives, including the existing

wanted to support patients with

book club, which welcomes incoming

highly invasive head and neck

medical students.

cancers, beyond traditional medical treatment. Along with Brett-

Students also shared personal stories

MacLean and an interdisciplinary

about the importance of a humanistic

team of researchers, she paired local

approach to health care at an AHHM

artists with patients to create an

booth at the faculty’s second annual

exhibit that in early 2017 began its

Festival of Health last spring. The

life in an Edmonton art gallery and,

idea was born from a special public

most recently, spent the summer at

presentation by former interim dean

Chicago’s International Museum of

and AHHM co-director Verna Yiu

Surgical Science. Through painting,

(now CEO and President of Alberta

sketch, sculpture and video, FLUX:

Health Services) about the power of

Responding to Head and Neck Cancer

storytelling in health care.

offers an intimate portrait of the ways in which this illness can turn a UNIVERSITY OF ALBERTA

41

THE BRIDGE

life upside down. Collaborating with a visual artist to illustrate the effects of her illness was an unexpected gift for participant Kimberley Flowers, recovering from tongue cancer.

“The art helped me understand experiences I felt that there simply aren’t words for,” she says.

On Brett-MacLean’s wish list for the future is more-stable funding for programs like these. “It’s good for

Verna Yiu, President and CEO, Alberta

all of us,” she says, “for students, for

Health Services, is harnessing the power

patients, for the community.”

of storytelling to transform culture.

Photo: Supplied

All the world’s a stage Twice a year, theatre director David Diamond visits the U of A from Vancouver to work with various programs within the faculty. He facilitates theatre-based group workshops around wellness, team functioning, moral distress— whatever topic is most pressing, says Brett-MacLean.

Together with the Division of Community Engagement, the Indigenous Health Initiatives Program and numerous other community partners, AHHM also helps organize performances of Diamond’s Theatre for Living interactive play, šxʷʔam̓ət (home).

Created and performed by a mixed Indigenous and non-Indigenous cast and production team, the play about reconciliation has been performed at the Boyle Street Community League and webcast on campus in the

42

Medical Sciences Building.

This inclusive, open and highly creative approach to a complex and painful issue invites students— who need no artistic background to participate—to stretch beyond their comfort zone and think about their future role as medical professionals in advancing reconciliation.

Responses from students have shown just how helpful it was to use the lens of theatre. Catherine Deschenes, MD ’21, says: “It helped me—and I think it helped quite a few audience members—to see more concrete ways to enable reconciliation.” Aulora Oleynick, MD ’20, agrees. ““šxʷʔam̓ət was a unique and powerful experience that not only allowed the audience to view issues surrounding reconciliation, but to deeply engage with the issues.”

FACULTY OF MEDICINE & DENTISTRY

Associate dean positions MD program as national leader in research, social accountability

Tracey Hillier, Associate Dean, MD program Photo: Melissa Fabrizio

43

THE BRIDGE

The MD program in the Faculty of Medicine & Dentistry has seen a major shift in the past several years, says associate dean Tracey Hillier, with both curriculum and instructional approaches changing to reflect the increasingly diverse needs of students and the community they will eventually serve.

“While some schools focus mainly on research and others focus more on accountability to local populations, the University of Alberta is developing programs of excellence across multiple areas, developing student-led curricular change,” says Hillier. She is focusing the program’s drive to position itself as a nationwide leader on two fronts: social accountability and research.

What makes the U of A the perfect place for both? “We’re leveraging the relationships that have come from our strong Division of Community Engagement,” for one, says Hillier, “and world-class researchers and facilities.

We’re also able to be exceptionally adaptable in our ability to respond to changing health-care needs of the community because of our innovative faculty and our strong partnerships with students.”

SOCIAL ACCOUNTABILITY Hillier has prioritized making changes to the recruitment process to draw a more diverse population of medical students. “We need to look like the community we’re representing; we need to have people from a broad variety of backgrounds.” While the Division of Community Engagement is charged with recruiting from rural and Indigenous populations, the MD program also engages in outreach to city high schools. “But we now know that is too late,” says Hillier, “so we are now going out to junior highs, because toward the end of junior high is when most are making choices about their future.”

The MD program has also reviewed its admissions processes to break down barriers to diversity. To help reduce bias, Assistant Dean of Diversity Helly Goez suggested an implicit association test for all admissions interviewers. This test can be tremendously effective, Goez says. “It gives scenarios to someone on a computer to show them their scores within biases such as gender and skin tone,” she explains. Implicit bias training was implemented last year for those involved with admissions selection, says Hillier, and the committee will continue to use the process.

44

FACULTY OF MEDICINE & DENTISTRY

ISSUE NO. 1 – 2019

It’s now mandatory that all MD students participate in some form of community service, says Hillier, a way for those students who come from a more privileged background to build an understanding of the challenges faced by disadvantaged populations.

“We’re also piloting a new social-justice learning community for those who are exceptionally interested in serving marginalized populations,” says Hillier.

Developed in collaboration with the Division of Community Engagement and interested students, this focused program will see enhancements to the core curriculum—which already contains elements of social accountability throughout all four years—and more opportunities to train in places and with mentors who serve vulnerable populations. Students will have an opportunity from the moment they begin their first year to declare an interest in joining this community.

SPOTLIGHT ON RESEARCH Regarding a revitalized focus on research, says Hillier, “we need physician scientists who are going to solve the health-care problems of the future, and we equally need to support excellence from that end of the spectrum.” Beginning this academic year, students interested in learning more about research and improving those skills can declare an interest and join a pilot of the new research learning community.

The community, created in collaboration with students, will encompass people with graduate degrees, students in the MD program and those within the MD STIR (Special Training in Research) program. Facilitated by the MD office, they’ll share knowledge and nurture each other’s research interests, with the support of both external guest speakers and top-notch researchers within the faculty. Hillier is also hoping to encourage students to further pursue their interests in medical research through the MD/PhD program.

Eventually the research learning community will become more structured.

“We’re hoping for a series of seminars that rotates every two years,” says Hillier.

But in its infancy, it will exist mainly as an informal gathering of MD students and faculty who share a passion for research.

UNIVERSITY OF ALBERTA

45

Residents, supervisors move toward competency-based medical education NEW APPROACH ‘JUST MAKES EDUCATIONAL SENSE,’ SAYS ASSOCIATE DEAN, POSTGRADUATE MEDICAL EDUCATION

ISSUE NO. 1 – 2019

Competency-based medical education

“Just because you put a person in

(CBME) began gaining traction as a

a situation for a certain amount of

preferred method of resident training

time, doesn’t mean they’re going

about eight years ago, when the College

to learn what they need to,” says

of Family Physicians of Canada made a

Kearney. “When you understand

gradual introduction of the methodology

how people learn, you say, ‘How

to family medicine residents nationwide.

could this not be better?’ It just

The University of Alberta’s Faculty of

makes educational sense. We’re

Medicine & Dentistry Postgraduate

not throwing time out the door,

Medical Education program is now part

but now ‘three months of pediatric

of the broader national shift to CBME,

anesthesia’ does not necessarily

and last year began with two programs:

mean you’re good to go. Some of you

Anesthesiology and Otolaryngology. Six

can finish in two months, some of

more have since been added.

you may need four.”

CBME is based on a better

You may imagine that the most

understanding of how people learn.

important difference between

“In the past, curricula have been

traditional time-based residency

written in the form of objectives, using

training and CBME involves a move

very traditional educational language,”

away from rigid time limits for the

says Ramona Kearney, Associate Dean,

completion of rotations. But that’s

Postgraduate Medical Education.

only a small piece of what’s changed, explains Kearney.

While the vast majority of residents have proceeded smoothly through

In the traditional approach to

their rotations under the traditional

resident training, a supervisor

model, about 15 per cent needed a

assumes that all graduates come with

bit of extra support to succeed, says

a common toolkit of abilities. “So as

Kearney. And those people were often

soon as they arrive, you’ll give them

slipping through cracks in the system.

a task, and they’ll go off and do it.”

“They were struggling, not passing their

The new approach critiques whether

rotations, with no one telling them

that’s a fair way to train for success.

exactly what they need to change” and suddenly being told, after four years of

“They’re not cookie-cutter people;

building bad habits, they weren’t going

they all have strengths and

to be successful. “That’s something we

weaknesses in different areas,” says

really wanted to change.”

Kearney. With CBME, residents are given the chance to first work

Artwork: Natasia Designs

through a task with their supervisor, UNIVERSITY OF ALBERTA

47

THE BRIDGE

who observes and gives constructive

Supervisors are being taught to teach

feedback before sending them out

and assess differently. They proceed

to work alone with patients. “In

through a series of training modules,

terms of psychological safety as a

developed in partnership with the

learner, you’re not being put into a

Faculty Development office. They

situation you’ve not been in before,

begin with a broad introduction to the

so you should have more confidence

concept of CBME and work through

in what you’re doing,” says Kearney.

more specific skill development such as how to educate using a coaching model.

Another benefit of CBME is that

“WHEN YOU UNDERSTAND HOW PEOPLE LEARN, YOU SAY, ‘HOW COULD THIS NOT BE BETTER?’ ”

no one supervisor has to make a

— RAMONA KEARNEY

no end-of-rotation evaluation now,”

pass or fail decision on a resident’s performance, which can be challenging for the supervisor and threaten the teacher-learner relationship. “There’s says Kearney. Instead, assessments are collected from the app, submitted to a portfolio and shared at least four times

Frequent observations of daily

a year with a competence committee,

workplace events and situations—

who then meet with the resident’s

toward achieving revised outcomes

academic adviser to determine the

called entrustable professional

resident’s readiness to move on.

activities—continue throughout the

48

residency. Before CBME, a resident

Kearney has already seen powerful

might go through a two-month

evidence of the effectiveness of

rotation and receive feedback twice.

CBME. Last year, at the very first

And that feedback might have

four-month competence committee

either been friendly but unhelpful

meeting, it was clear that a resident

(“You’re fun to work with”) or

was struggling, she recalls. “That

negative but too general (“You need

would not have happened in the old

to read more”). Now, with the help

system, probably not until second

of an app, residents complete an

year. That was early detection as a

electronic self-assessment at the end

direct result of daily feedback, and

of every shift and share it with their

from that, they were able to make an

supervisor, who will input their own

educational plan for that resident.

feedback and assessment.

This is an amazing improvement.”

FACULTY OF MEDICINE & DENTISTRY

Rural medical education: Boundless opportunities LEAVING EDMONTON FOR TRAINING BROADENS HORIZONS FOR STUDENTS, RESIDENTS

Jill Konkin, Associate Dean, Division of Community Engagement Photo: Jordan Carson

On any weekday at the University

and towns in Alberta, in northern

of Alberta’s Faculty of Medicine &

Canada and in rural and urban

Dentistry, hundreds of students

centres across the globe. When

from more than 20 departments can

it comes to learning and clinical

be seen in the halls and classrooms

placements, the faculty encourages

of the Edmonton Clinical Health

its students to spread their wings.

Academy. It’s a busy place.

“We want students to go out and learn But students from the faculty can

in different places because we want

also be found in large and small

them to go out and work in different

health settings in other cities

places,” says Jill Konkin, Associate

UNIVERSITY OF ALBERTA

49

THE BRIDGE

Rural Integrated Community Clerkship In 2017, the U of A’s Rural Integrated Community Clerkship marked a decade of immersing medical students into the daily routine of rural physicians.

Rather than completing their core rotations in Edmonton, third-year medical students in the rural clerkship program spend 10 months living and learning in northern and central Alberta rural communities, where they are based in family medicine clinics under the mentorship of local physician preceptors and follow patients to all venues of care including the hospital inpatient ward, operating room, labour and delivery suite, patients’ homes, public health clinics and more.

To date, about 190 participants have been placed in communities such as Camrose, Edson, Hinton, Ponoka, St. Paul, Sylvan Lake, Westlock and Whitecourt.

Students who do the rural clerkship are more likely to choose careers as family doctors or generalists, often working in underserved communities, but also go into other competitive specialities.

Andrew Halladay, MD ’13, completed the Rural Integrated Community Clerkship program and now practises as a family physician in Whitecourt and is a preceptor. “This is an excellent program,” he says. “I don’t think I would be as good a doctor today if I didn’t go through it.”

Dean, Division of Community Engagement.

“If all we ever do is have them learn next to the Walter C. Mackenzie Health Sciences Centre … then that’s all they’ll know and that’s all they’ll feel is important.”

For undergraduate medical students, the Rural Integrated Community Clerkship (ICC), a core clerkship opportunity, allows them to meet all the competencies of the third-year MD program in rural Alberta. There is also a second-year gastrointestinal course delivered outside of Edmonton and a mandatory thirdyear, one-month rural placement for those not in the ICC. About 25 to 30 medical students also do placements overseas each year in various countries. One of the faculty’s long-running international partnerships is with the Patan Academy of Health Sciences, based in Kathmandu, Nepal.

“Patan is a school that is oriented toward graduating physicians who will serve the needs of their communities, particularly rural,” says Konkin. “We are learning from them as well.”

Ramona Kearney, Associate Dean of Postgraduate Medical Education, says rural-based programs are one way her office connects medical residents to the community.

50

FACULTY OF MEDICINE & DENTISTRY

ISSUE NO. 1 – 2019

“We have two years of family

The idea is if that’s your home

medicine residency situated

base and that’s where you train,

either in the city or in three of our

we hope that will entice (residents)

smaller urban communities … . Fort

to start a practice in one of those

McMurray, Grande Prairie and Red

smaller areas.”

Deer are the three home bases for 40 of our residents in family medicine.

Radiation therapy: Unleashing Alberta’s next generation of cancer care The U of A’s Radiation Therapy program launched in September 2014. The degree includes classes on the U of A campus, a five-week clinical introduction and an eight-month clinical placement at the Cross Cancer Institute and at the Tom Baker Cancer Centre in Calgary.

Susan Fawcett, Director, Radiation Therapy program, says the Tom Baker partnership was mandated by the Alberta government when it chose U of A to offer the radiation therapy degree, with an expectation that it would be a provincial program. Eventually, some shorter placements will take place in smaller cancer centres in Lethbridge, Red Deer and Grande Prairie.

Radiation therapy is specialized in terms of technology. “Each centre develops different expertise and may not treat all types of tumours,” says Kari Osmar, the U of A’s clinical faculty educator at the Tom Baker Cancer Centre. Students must develop the full scope of clinical and professional competencies to pass their national exams and meet the radiation therapy program outcomes.

Students wouldn’t be able to accomplish that at only one centre, adds Fawcett.

Radiation therapy graduate Kristi Ngo, ’18 BScRdThpy, was grateful for the mentoring at both the Cross and the Tom Baker centres. “It really opens your eyes as to how things can be done differently to accomplish the same goal.

It helps you become a better radiation therapist because you’re not so rigid in your thinking.”

Ngo and all her 2018 classmates have been hired by either the Tom Baker Centre or the Cross Cancer Institute.

UNIVERSITY OF ALBERTA

51

Renny Khan, Director, International Programs Photo: Jordan Carson

Global Medical Summer Study FOUR-WEEK PROGRAM GIVES INTERNATIONAL STUDENTS A TASTE OF CANADA’S HEALTH SYSTEM

52

ISSUE NO. 1 – 2019

Every summer, a group of select

WHY A SUMMER SCHOOL?

medical students from top schools

To best serve those students

in China—and, more recently,

without taking away resources

Thailand—gathers at the University

from the MD program, Khan and

of Alberta for a crash course

Fedorak decided on a summer

in Canadian health care. The

school. “It works for the vacation

intensive four-week Global Medical

season in Asia, and it works because

Summer Program introduces some

our students are off school at that

of Asia’s best and brightest to

time,” says Khan, which means

what it’s like to study and practise

increased faculty availability and

medicine in Canada.

improved accessibility to oncampus housing. Every summer, the

This elite summer school was

program serves about 30 carefully

designed and implemented

selected students from the upper

three years ago by the Faculty of

echelons of the partner schools.

Medicine & Dentistry’s Director of International Programs, Renny Khan, together with late dean Richard Fedorak and a small advisory group.

WHAT DO THE FOUR WEEKS INCLUDE? Khan calls the program “medical school in a box.” The students get

WHERE DID THE IDEA FOR THE GLOBAL MEDICAL SUMMER PROGRAM COME FROM?

a taste of the Canadian system through lectures, discovery learning and small-group discussion sessions with U of A faculty, MD and PhD students. Perhaps most important,

“China is innovating its health-care

local physicians and advisers to the

system and looking at international

program—especially family doctors

models,” explains Khan. Several years

John Chiu and Fang Ba—recruit

ago, a handful of Chinese medical

colleagues in family medicine

schools—including Peking University

and a few other specialities to

(“the No. 1 ranked university in

open up their clinics for weeklong

China,” says Khan); Fudan; Zhejiang;

observation sessions.

China Medical University and Jilin University—reached out to the U of A, seeking a partnership that would show their best medical students Canada’s medical-education and health-care systems.

UNIVERSITY OF ALBERTA

53

THE BRIDGE

HOW IS THIS DIFFERENT FROM COMPARABLE PROGRAMS AT OTHER SCHOOLS? Khan says this is a unique program in North America. “When we did the research before starting, we found other programs in places that offered general summer courses.

What we could provide to our partners and students was a very strong, interesting, innovative and engaging academic experience with opportunity for observation sessions; nobody else is doing that.”

In other summer schools, he continues, “the students are left on their own” to find housing and get to know the city. Here, the program coordinator helps connect the visiting students with housing and the group gets together outside of instruction time for shared meals and outings.

“We really take care of these students.”

WHAT IS THE GOAL OF THE SUMMER SCHOOL? “We are aiming to influence future leadership in education, clinical

Young Physicians Training Program As a complement to the Global Summer Medical Program, the U of A is the international partner of choice in the Young Physicians Training Program.

Over the next three to four years, one particular stream of the program in Family Medicine will bring six to eight young Chinese physicians and academic leaders from Zhejiang province to the Faculty of Medicine & Dentistry in six-month blocks for “trainthe-trainer” education. Once back home, these doctors will help to develop a curriculum and share what they’ve learned with an extended group of up to 200 general practitioners.

This significant Chinese pilot project is intended to demonstrate to the government the crucial part family doctors could play in their health-care system.

HOW DOES THE PROGRAM BENEFIT U OF A STUDENTS AND FACULTY?

practice and research,” says Khan.

54

“These students are going to become

The summer school “builds our brand

physicians in the top health systems

among elite universities in China

in their countries, and we’re giving

and other countries and creates a

them a snapshot of how that works

lot of opportunities for us,” Khan

in Canada, and how we train for the

says. “They have a big vision and

system in Canada.”

as they’re rising, we want to be in FACULTY OF MEDICINE & DENTISTRY

ISSUE NO. 1 – 2019

that company.” The program also

somewhat rote learning, where the

generates revenue. “We charge a

teacher stands up and lectures and

tuition and we earmark a significant

the learning is passive. The whole

portion of that revenue for our

meaning of ‘teach’ is very different

medical students to go out on global

here,” says Khan. “It’s more

exchanges.” Most exciting to Khan

interactive—like a conversation—

is the reciprocity factor. Local

and they embrace that.” They also

students—MD and PhD students have

express surprise at how much

opportunities to teach and mentor

hands-on practice local medical

during the summer school—get to

students get compared to them.

learn about a very different approach

By far the difference most noted,

to health care. This has proven a

though, is the crucial role the family

particularly exciting side-benefit, says

doctor plays in Canadian health

Khan: “I want to prepare our future

care, a role that doesn’t exist in the

physicians for the globalized world.”

Chinese medical system.

“THESE STUDENTS ARE GOING TO BECOME PHYSICIANS IN THE TOP HEALTH SYSTEMS IN THEIR COUNTRIES, AND WE’RE GIVING THEM A SNAPSHOT OF HOW THAT WORKS IN CANADA, AND HOW WE TRAIN FOR THE SYSTEM IN CANADA.”

HOW WOULD YOU LIKE TO SEE THIS PROGRAM GROW? While the project was piloted in partnership with Chinese schools, Khan says, he sees enormous potential for growth. “If we’re going to call this a global summer school, it should encompass a breadth of countries and partners that we work with, so we have been expanding.”

New to the program, for example, is a partnership with Thai school Thammasat University. “My vision is to have a broad representation of regions and expand the number of

WHAT FEEDBACK HAVE YOU RECEIVED FROM VISITING STUDENTS?

positions in the program.”

Visiting Chinese students are surprised by western instructional methods. “Teaching in China is still UNIVERSITY OF ALBERTA

55

OFFICE OF ADVANCEMENT

2J2.00 Walter C. Mackenzie Health Sciences Centre 8440 - 112 Street Edmonton, AB Canada T6G 2R7 UALBERTA.CA/MEDICINE E advadmin@ualberta.ca P 780-492-6621

Faculty of Medicine & Dentistry – University of Alberta @UAlberta_FoMD @UAlberta_FoMD