Residency Match Day: 2020 What our students are experiencing, and how to help them get through it

Anticipation is the title of a memorable Carly Simon song that tends to come to mind this time of year. That’s probably because that simple word nicely describes the prevailing mood of our fourth year class. What they’re anticipating, of course, is the results of the CaRMS match, which will be released March 3rd.  

The process by which learners transition from undergraduate to postgraduate medical education has evolved into a rather jarring and extremely stressful experience (a subject for another blog/rant). It has required them to not simply consider what specialties are best suited to their interests and skills, but engage an application process that requires strategic selection of elective experiences, preparation of voluminous documents, meeting multiple deadlines (twelve, no less), and commitment of personal time and expense to travel and interviewing which, for many, spans the country in the midst of the Canadian winter. And so, as you can easily imagine, there will  not only be anticipation, but also anxiety leading up to the release. 

By approximately 12:00:05 on March 3rd, our students will know which program they’ll be entering next July. For most (hopefully all), the anticipation will end with the exhilaration and satisfaction of having successfully overcome the process. For a few (and hopefully none), it will bring a realization that their efforts to date have not been successful, that this part of their journey is not yet over, and they have to begin again. They will be profoundly disappointed. They will be afraid. They will be confused. They will need the understanding and help of the faculty who are currently supervising their training, and much help from our Student Affairs staff.    

This year, we are again prepared to provide all necessary supports, but there are a few changes to the process which I’d like to clarify for both students and the faculty that will be supervising them that day:

  1. Unlike previous years, our Undergraduate Office will not automatically receive match results the day before the full release. However, students have the option of directing CaRMS to release their results the day before (March 2nd) if they fail to match. They can do so by going into the CaRMS website and providing the appropriate permission.
  • Any unmatched students who have allowed early release will be contacted directly by myself to notify them of the result. This is for three purposes:
    • to arrange for release from clinical duties
    • to allow the student some time to prepare for the release moment the following day when most of their classmates will be hearing positive results
    • to arrange for the student to meet our student counselors who will provide personal support and begin the process for re-application through the second iteration of the residency match. 
  • Unmatched students who did not opt to provide early release will similarly be contacted and offered the same support and services after we get their results on match day.
  • Because we may not have full information in advance, we have decided to release all students from clinical obligations beginning noon on match day, until the following morning.

I’d also like to remind all faculty supervising our fourth year students on or around match day to anticipate that your student will be distracted. Please ensure your student is able to review the results at noon. If you sense he or she is disappointed with the result, please be advised that the student counselors and myself are standing by that day to help any student deal with the situation and provide support.

Fortunately, we have an outstanding Student Affairs team which has been working hard to guide the students through the career exploration and match process, and will be standing by to provide support for match day and beyond.

Dr. Renee Fitzpatrick

Assistant, Student Affairs

fitzpatr@hdh.kari.net

Dr. Erin Beattie, Careers Counselor, ebeattie@queensu.ca

Dr. Josh Lakoff Career Counselor, jml7@queensu.ca
Dr. Mike McMullen, Careers Counselor, Michael.mcmullen@kingstonhsc.ca
Erin Meyer, Assistant to Directors, Student Affairs

The team can be accessed through our Student Affairs office learnerwellness@queensu.ca, or 613-533-6000 x78451. 

Thanks for your consideration, and please feel free to get in touch with myself or any of the Student Affairs Team if you have questions or concerns about Match Day or beyond.

I leave you, and especially our fourth year soon-to-be colleagues, with the lyrics and sounds of Carly Simon’s “Anticipation”:

We can never know about the days to come
But we think about them anyway
And I wonder if I’m really with you now
Or just chasin’ after some finer day

Anticipation, anticipation
Is makin’ me late
Is keepin’ me waitin’

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Five ways to ramp up your teaching

It’s February, and despite the recent Family Day holiday, we’re still stuck in the depths of winter. Things are just a little harder to get excited about when it’s bleak, cold and snowy. Add in the task of teaching something that’s become routine, and the doldrums can be nearly certain to set in.

It can be a challenge for experts to teach introductory content. This can be further exacerbated by the cycle of teaching: each year brings another round of the same—or very similar—material. When the key advice of reminding yourself that while this is the hundredth time you’ve taught this, it’s the first time for these learners just isn’t enough, how can you get excited about teaching for the 101st time?

Here are five suggestions to ramp up your enthusiasm and freshen your teaching:

  1. Back to basics: What do you want your learners to know or be able to do when you’re done? Sometimes when teaching becomes routine, we’re in danger of losing focus on the goal. Make a quick list of your key take-away points. If you’re not sure, take some time to reflect and then make any necessary revisions to your teaching plan.
  2. Add some feedback: Add in some formative assessment either partway through your learning event, or partway through your sessions if you are teaching multiple times. This gives you—and them—feedback partway through to make sure things are clear. Formative assessment can be individual or team-based and doesn’t necessarily have marks attached. It can be as simple as an online poll to gauge understanding of a key concept.
  3. Refresh the page: Since the underlying concepts haven’t changed, it’s easy to slip into a rut of repeating yourself. Even if it’s new to this group of learners, you’ll be more engaged if you freshen your cases, or revise the background materials you assign. Is there something in the news or new research that’s timely and on-point?
  4. Toss in technology: It may strike you as gimmicky, but using technology can freshen “old” material. Consider incorporating PollEverywhere’s polling (which you can use for #2 above) or incorporating a short video for discussion. (I can set you up with a PollEverywhere account in about two minutes and teach you how to use it in 5-10 minutes).
  5. Ask for input: Bounce ideas around with colleagues, brainstorm with others teaching in your course. Ask your course director for feedback. If you’re the course director, that conversation can work both ways: ask for input from your team.

Keeping things fresh for yourself can help your learners. Your excitement and enthusiasm contributes to a climate of learning. If you’re looking for more ways to shake things up but you’d like some customized advice, get in touch with the Education Team.

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Why we teach. Why we learn.

What is it that motivates practicing doctors, nurses or any professional health care provider to take time away from their usual duties and obligations in order to teach young people whose goal is to one day replace them? 

In approaching that question, a few things are clear:

It’s not because they have to. There is no obligation or requirement for active doctors or nurses to contribute to the education of student learners.

It’s not because they need ways to fill their time.  There is no shortage of patients in need to fill their days with valuable work.

It’s not for the money. Educational activities are not a route to financial prosperity. In fact, time devoted to teaching is usually at the expense of time that could be spent in much more lucrative clinical work.

It’s not for the glory. Teaching requires most clinicians to move out of their “comfort zone”, engage activities for which they have little specific training or expertise, and subject themselves to criticism from learners who, it must be said, have high standards and expectations.

In fact, many days, it can be hard to find reasons. The day-to-day challenges can dominate attention and sap energy. They can lead to serious questioning and “why bother” attitudes.

And what motivates the students of medicine or nursing? Whether young or old, just entering medical school or in established practice, learning is a continuing, life-long pursuit. Although initially motivated by the need to pass examinations or receive various certifications, most of the learning that occurs through the career of a doctor or nurse is self-motivated and apparent only to themselves.

But then, once in a while, something happens to re-affirm the fundamental value of the medical education process.

Such a moment occurred last weekend in, of all places, a local supermarket. Two of our students, Alexandra Morra (Meds 2021) and Nabil Hawwa (Meds 2022) had just completed a busy day and were going about their grocery shopping when they heard a commotion in another part of the store. Approaching the scene, they came upon a number of people surrounding a man lying on the floor, unresponsive. Mr. Jim Morgan (who has provided us permission to share this story) was also shopping at that store that day. Mr. Morgan had suddenly lost consciousness and fell heavily to the floor. Alex and Nabil had never previously encountered a real-life cardiac arrest but responded instinctively. Relating the incident to me a couple of days later, they recall “zoning in” on the patient and going through their check list. Is he breathing? No. Is there a pulse. No. Start chest compressions. Call for an AED. Get somebody to call 911. Get the AED unpacked and hooked up. In doing all this, they found themselves working with a recent nursing school graduate who was visiting Kingston and was also shopping at that time. The three worked as a team, sharing a mutual understanding of the situation and common training in CPR techniques. There was no panic, no jostling for authority, no arguing. There was simply a common interest and focus on the welfare of this patient. An AED was quickly provided, deployed and a shock delivered with restoration of a rhythm just before paramedics arrived and continued the resuscitation which, we’re all delighted to report, was successful. Mr. Morgan was taken to hospital, stabilized and underwent cardiopulmonary bypass surgery two days later by Dr. Petsikas. Recovering in the CCU a couple of days later, he had opportunity to meet and thank Alex and Nabil, whose efforts and those of the (unfortunately as yet unidentified) nurse who they worked with were no doubt instrumental in his recovery. 

Medical students Alex Morra (L) and Nabil Hawwa (R) with Mr. Jim Morgan. Photo by Saif Elmaghraby

On reflecting on all this with me a few days later, Alex and Nabil remarked on how this incident profoundly altered their perception of the learning process. Suddenly, the long hours of work and effort were no longer merely for personal or academic achievement. Learning now had a purpose. A very real, tangible purpose. It also had a face. They now want more and are re-thinking previous assumptions about career direction.

In fact, I’ve found that students will, at some point in the course of their education and training come to what I’ve come to call the “magic moment” when something happens to make them realize that they’re now able to actually, personally influence someone’s life for the better. For most, it’s something relatively modest that perhaps only they are aware of – an accurate and previously unknown diagnosis, a test ordered that led to key information, a minor procedure well executed, comfort provided to someone in distress. For Alex and Nabil, that moment was quite public and dramatic, but all are significant, provide validation and motivate further learning as can no test result or external accolade. 

I learned of all this initially from Cheryl Pulling, who is a faculty member in the School of Nursing. I have had the pleasure of getting to know Cheryl over the years because of her leadership roles in education. Cheryl is Associate Director of Undergraduate Nursing Programs and so my counterpart in the School of Nursing. In addition to meeting in the context of various committees and interprofessional initiatives, Cheryl and I have an annual “date” at convocation where we have the great privilege of hooding our respective graduates. Cheryl also happens to be Mr. Morgan’s sister. 

Cheryl emailed me last weekend to let me know what had happened. She was communicating because, as a fellow educator, she knew I’d be thrilled to hear of this and proud of our students. Of course, she was absolutely right about that, but she was also expressing the satisfaction we all share in knowing that our efforts are yielding results. In Cheryl’s own words:

“While they are medical students, as a faculty member I am also very proud of them.  I know you would be proud if they were nursing or rehab students. We are a team in the FHS with the same goal of educating HCP for the future.”

How right she is.

And that, my friends, is why we teach.

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Focus groups: what they are and how we use them

By Theresa Suart, Educational Developer & Eleni Katsoulas, Assessment & Evaluation Consultant

Amongst the plethora of student feedback we solicit about our courses, you may wonder why we sometimes add in focus groups. What could be added to the more than a dozen questions on course evaluation and faculty feedback surveys?

The information we gather in student focus groups doesn’t replace the very valuable narrative feedback from course evaluations, rather, it allows us to ask targeted questions, clarify responses and drill down into the data.

Developed from “focused interviews” around the time of the Second World War, focus groups emerged as a key qualitative research tool in the latter half of the 20th century. Robert K. Merton, a sociologist from Columbia University, is hailed as the “father of the focus group.” (He died in 2003 at age 92.)

Merton used focused interviews to gain insight into groups’ responses to text, radio programs and films. Politicians and marketing companies soon seized upon focus groups to gauge voter and consumer trends. The Queen’s UGME Education Team uses focus groups in a targeted way to augment information gleaned from course evaluation feedback, course director’s meetings with academic reps and other feedback tools.

According to a briefing paper from Carnegie Mellon University, focus groups are “particularly effective” for eliciting suggestions for improvement. “They are also much more flexible than surveys or scales because they allow for question clarification and follow-up questions to probe vague or unexpected responses.” It also helps that faculty rate focus groups as “accurate, useful and believable”.

If you’re asked to participate in a focus group, only agree if you think you have something to contribute to the investigator’s project or purpose. (Sure, it’s fun to come for the free food, but be prepared to contribute in a meaningful way).

What you can expect when you take part in a focus group:

  • To be informed if the focus group is for research or curricular innovation (or both). Research studies must have approval from the Research Ethics Board and require specific paperwork to document informed consent. Curricular innovation focus groups are less formal, but will still respect confidentiality of participants. These might not have the same paperwork.
  • The facilitator to set the ground rules, and guide the discussion. Savvy facilitators will do this with a minimum of fuss: they will listen more than they speak. (But you can certainly ask for clarification if you’re not sure of a question).
  • A co-facilitator will likely take notes and monitor any recording equipment used. The co-facilitator may summarize after each question and solicit further input as required.
  • You’ll be asked specific questions, and engage in conversation with the other participants.

What you shouldn’t expect:

  • A venting session. This isn’t the time to just complain. A focus group is looking for constructive feedback and suggested solutions.
  • To always have your say: the facilitator may realize they have reached saturation on a particular question and will move on. This is to respect your time. (You’ll have an opportunity to send additional comments electronically afterwards if you felt there is an important point that was missed).

What you can do to prepare:

  • If the questions are provided in advance (this is best practice but not always possible on tight timelines!) you should take some time to think about them.
  • Be sure you know where the meeting room is, and arrive on time.

What you can do during:

  • Contribute, but make sure you don’t end up dominating the conversation. The facilitator will be looking for a balance of views and contributors.
  • Listen attentively to others and avoid interrupting. The facilitator will make sure everyone has a chance to contribute – you’ll get your turn.

What you can expect from data collected at a focus group:

  • It will be confidential. Different strategies are employed. For example, you may be assigned a number during the focus group and participants asked to refer to people by number (“Participant 2 said…”).
  • In a formal research study, you should be offered an opportunity to review the data transcript after it is prepared. (This is sometimes waived on the consent form, so read carefully so you can have realistic expectations of the investigator).
  • The end product is a summary of the conversation, with any emergent themes identified to answer the research questions.

What you can’t expect:

  • A magic bullet solution to a challenge in a course or class.
  • One hundred percent consensus from all participants – you can agree to disagree.
  • For all outlier opinions to be represented in the final report. These may be omitted from summary reports.

We’re always grateful to our students for donating their time to our various focus group requests throughout the year. These contributions are invaluable.

For course directors: If you think this type of data collection could be useful in your course review and revisions, feel free to get in touch. It’s one of the tools in our qualitative research toolbox and we’re happy to deploy it for you as may be appropriate.

Eleni Katsoulas eleni.katsoulas@queensu.ca

Theresa Suart theresa.suart@queensu.ca

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