Issue No. 4 -   Learning and work environments
October 22, 2015
Improving the learning and work environments for residents

FMEC PG Recommendation 3:

Recommendation #3 (Create positive and supportive learning and work environments)  encourages resident learning taking place in collaborative and supportive environments, centred on the patient and grounded in the principles of quality, safety and accountability. Five areas of focus were identified in the FMEC PG report. Addressing both positive and negative aspects of the hidden curriculum and the role of interprofessional education have been tackled first by the committee working on advancing implementation of this recommendation.

Current Implementation:
  • An examination of the impact of the hidden curriculum on residents' learning was conducted via a literature review of key articles on the subject.
  • Recommendations have been put forth to the Royal College, CFPC and CMQ Postgraduate Accreditation Working Groups to add explicit attention to the hidden curriculum in their revised accreditation standards for residency programs, including but not limited to: regularly taking stock of their hidden curriculum, promoting the positive influences and mitigating the negative influences.
  • An assessment has been undertaken to investigate how the PGME system can better provide opportunities for residents to learn and work in interprofessional and intraprofessional team-based models.
  • An upcoming workshop at Family Medicine Forum 2015 will provide a forum to further discuss how medical schools can take stock of their hidden curriculum and start to address the negative aspects and accentuate the positive components.  Please join us for this session if you are attending the conference.

To see the full recommendation and transformative actions, please consult the FMEC PG Collective Vision .

About the FMEC PG Implementation Project
The Future of Medical Education in Canada Postgraduate (FMEC PG) Implementation Project is helping to ensure that medical residents in this country continue to receive the best training possible and are able to meet the changing healthcare needs of Canadians.

The FMEC PG Implementation Project is funded by Health Canada and a consortium of four organizations: The Association of Faculties of Medicine of Canada (AFMC), The College of Family Physicians of Canada (CFPC), Le Collège des médecins du Québec (CMQ) and The Royal College of Physicians and Surgeons of Canada (The Royal College).

Reflections from Dr. Nick Busing, Project Lead

There are several vexing and ongoing challenges in trying to ensure a collaborative and supportive learning and work environment.  One is to address the hidden curriculum in a meaningful way. Much has been done to date, including a request to UGME and PGME accreditors to introduce standards that explicitly examine how our educational environments are dealing with the issue of the hidden curriculum. As well, there are many initiatives taking place at individual medical schools that are trying to influence the culture to be more supportive of all learners and faculty. Is this enough? Likely not. A full culture shift is needed to truly embrace unconditionally collaborative and supportive learning and work environments. We need to be constantly vigilant and speak out when biases enter into the system. It will take time, but it is an essential step forward.
Another challenge is to ensure patient centered collaborative care through a program of interprofessional education and interprofessional practice. The building blocks to make this happen are in place or are being put into place, but we are not there yet. There is still too much siloed activity in the IPE sandbox and not enough collaborative activity. Again, we have to work on this on a daily basis for it to become a way of the future.
These are critical issues in helping us continually move towards a more socially accountable and responsive medical education system.

D r. Nick Busing led transformative change from 2005-2013 as President and CEO of the Association of Faculties of Medicine of Canada. Prior to joining AFMC, Dr. Busing spent 20 years at the University of Ottawa's Faculty of Medicine. He is a past president of the CFPC and a past chair of the Canadian Medical Forum.