Simone Dahrouge, Clare Liddy, & Douglas Archibald Department of Family Medicine RetreatMontebello, September 20, 2014

Faculty Support in Achieving Scholarship

Disclosure

The following presentation is free from bias and the presenters are not affiliated with any for-profit organizations or parties. The presenters do not have any conflict of interests to disclose and are not affiliated with any commercial entities or organizations that serve to profit from this presentation.

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Faculty/Presenter Disclosure

• Faculty: Drs. Archibald, Dahrouge, Liddy• Relationships with commercial interests:

None• Disclosure of Commercial Support: N/A • Mitigating Potential Bias: N/A

Tentative Agenda

10 min introduction and quiz

5 min – What are the scholarship objectives?

30 min – Faculty Support

Departmental support and tools

CPD/Faculty Development

Templates and Online Resources

30 min – Abstract Writing

1. WHICH OF THE FOLLOWING ARE COMPONENTS OF THE SCHOLAR ROLE?

A. Maintain and enhance professional activities through ongoing learning.

B. Critically evaluate information and its sources, and apply this appropriately to practice decisions.

C. Facilitate the learning of patients, families, students, residents, other health professionals, the public, and others, as appropriate.

D. Contribute to the creation, dissemination, application, and translation of new medical knowledge and practices.

E. All of the above.

2. WHICH OF THE FOLLOWING STATEMENTS DESCRIBES YOU MOST ACCURATELY?

A. Most of what I learned in my medical training still applies.

B. Three quarters of what I learned during my medical training still applies.

C. Half of what I learned during my training still applies.

D. None of what I learned during my medical training still applies.

3. TO FACILITATE THE LEARNING OF PATIENTS, FAMILIES, STUDENTS, RESIDENTS, OTHER HEALTH PROFESSIONALS, THE PUBLIC AND OTHERS, YOU SHOULD HAVE THE FOLLOWING SKILLS:

A. Ability to identify the learning needs of the audience.

B. Ability to select appropriate teaching strategies for the audience.

C. Ability to prepare and deliver a clear presentation that communicates the key messages.

D. Ability to provide feedback to the learners on their progress.

E. All of the above.

4. WHEN EVALUATING THE RESULTS OF A RESEARCH STUDY, ALL OF THE FOLLOWING SHOULD BE CONSIDERED EXCEPT:

A. The author’s qualifications and experience. B. The design and methodology of the study. C. The significance of the findings for clinical

practice. D. The discussion of the results.E. The recommendations for practice

5. WHEN APPRAISING THE STATISTICAL RESULTS OF A STUDY, YOU NEED TO:

A. Not worry about understanding the results, as the researcher has analyzed them for you.

B. Assume that the appropriate statistical tests have been used to answer the research question.

C. Just understand what the p-value means. D. Understand the researcher’s rationale for

the statistical tests and results.

7. THE FOLLOWING ACTIVITIES CAN BE CONSIDERED PART OF THE SCHOLAR ROLE:

A. Conducting a personal practice audit.B. Attending a journal club.C. Participating in a clinical research trial.D. Presenting a research abstract.

9. SYSTEMATIC REVIEWS INVOLVE A STRUCTURED PROCESS SIMILAR TO THAT USED IN PRIMARY RESEARCH. FOR A SUCCESSFUL SYSTEMATIC REVIEW, THE MOST IMPORTANT FACTOR IS THAT:

A. Multiple databases and search engines are available.

B. There is a clear and well-defined research focus and question.

C. There is a large team with different expertise to carry out the review.

D. Members of the team can be released to work on the project.

10. THE FOLLOWING CAN BE USED TO EVALUATE A RESIDENT’S COMPETENCE IN THE SCHOLAR ROLE:

A. Clinical scenarios at the point of care to discover scholarly questions.

B. A retrospective clinical practice audit on 10 cases to determine consistency in medical recommendations.

C. Synthesis of a literature review of a clinical topic.

D. A teaching session conducted with medical students on the critical appraisal of medical websites.

E. All of the above.

As Scholars, physicians demonstrate a lifelong commitment to excellence in practice through continuous learning, the teaching of others, the evaluation of evidence and other resources, and contributions to scholarship.

Defining the Scholar (2015)

1. Engage in the continuous improvement and enhancement of their professional activities through ongoing learning

2. Facilitate the learning of students, residents, other health care professionals, the public, and other stakeholders

 

3. Integrate best available evidence, contextualized to specific situations, and integrate it into real-time decision-making

4. Critically evaluate the integrity, reliability, and applicability of health-related research and Literature

5. Contribute to the dissemination and/or creation of knowledge and practices applicable

Key Competencies (2015 Framework)

Family physicians are able to:1. Maintain and enhance professional

activities through ongoing self-directed learning based on reflective practice

2. Critically evaluate medical information, its sources, and its relevance to their practice, and apply this information to practice decisions

3. Facilitate the education of patients, families, trainees, other health professional colleagues, and the public, as appropriate

4. Contribute to the creation, dissemination, application, and translation of new knowledge and practices

Key Competencies (FM Framework)

What can I contribute?

Teacher Program evaluation Formal and informal curricula Hidden curriculum Learner and faculty assessment Learning outcomes Needs assessment Optimization of the learning environment

What can I contribute?

OPHCRG

Online Repository for Developing Scholarship

Faculty Development

CPD

DIME

Where to get help?

WHAT DO YOU KNOW ABOUT THE SCHOLAR ROLE?

The Ottawa Primary Health Care Research Group (formerly CTLC)

DEPARTMENTAL SUPPORT AND TOOLS

Clinician Scientists in your teaching unit

Bill Hogg (Winchester)

Simone Dahrouge (Pembrooke)

Doug Archibald

Robin MacLaren (Manager)

Liz Muggah

Who we are

OHRI Doug

Manuel

Bruyère Kevin Pottie &

Barb Farrell

Melrose Lise Bjerre

Riverside Clare Liddy & Claire Kendall

Montfort MH Chomienne & Jean Grenier

Bruyère Research Institute Doug Archibald, Simone Dahrouge, & Bill Hogg

Primrose Sharon Johnston

Research & Scholarship Support for DFM Clinician Teachers (CT)

In-Unit Clinician Investigator (CI) support1

• Consultation: to develop a proposal, methods etc (hallway or meetings)

• Co-supervision / consultation: for research & scholarship FMRSP projects that CT are supervising

• Mentorship & support of scholarship: reviewing abstracts, papers, etc that CT are submitting

Central Scholarship learning opportunities for all Faculty

• RIP rounds• Faculty Development topics• Research / Scholarship presentations at

CRAG, DFM Retreat

Opportunities to Participate in Research• Invitations by CI to CT to join on funded

projects• Opportunities to pilot interventions at the

clinical sites • Opportunities to participate in recruitment

etc for projects

Support for Applications to PIME & DFM Grants and for the funded grants

• ProActive calls to all faculty• Targetted approach for interest• Discussion & mentorship in the

development of a LOI• Detailed committee feedback on LOI• Discussion & mentorship in the

development of a full proposal• Detailed committee feedback on

application• On-going support till end of grant and

beyond for publication & future funding

Support for non-funded & external funded scholarship

and research:Discussion & mentorship in:• development of

projects (research questions)

• development of grant applications

• analysis of results, • dissemination via

publication and/or presentation

• in next stepsResearch presence for “chats” at:• CaRMS, RIO day,

FMF,

In-Unit Clinician Investigator (CI) support Consultation: to develop a proposal,

methods etc. (hallway or meetings)

Co-supervision / consultation: for research & scholarship FMRSP projects that CT are supervising

Mentorship & support of scholarship: reviewing abstracts, papers, that CT are submitting

Opportunities to Participate in Research

Invitations by CI to CT to join funded projects

Opportunities to pilot interventions at the clinical sites

Opportunities to participate in recruitment for projects

Support for Applications to PIME & DFM Grants and for the funded grants

ProActive calls to all faculty Targetted approach for interest Discussion & mentorship in the development

of a LOI Detailed committee feedback on LOI Discussion & mentorship in the development

of a full proposal Detailed committee feedback on application On-going support until end of grant for

publication & future funding

Support for non-funded & external funded scholarship and research:

Discussion & mentorship in:

development of projects (research questions)

development of grant applications

analysis of results,

dissemination via publication and/or presentation

in next steps

Research presence at: CaRMS, RIO day, FMF,

Central Scholarship learning opportunities for all Faculty

RIP rounds

Faculty Development topics

Research / Scholarship presentations at CRAG, DFM Retreat

Research & Scholarship Support for DFM Residents

FMRSP (Research Projects)1

Supervision of FMRSP Research Projects• Mainly in-unit clinician Investigators (CI)

provide primary supervision on FMRSP research project (agreed up to 2 projects per CI, res may not be from that academic FHT)

• Mainly in-unit co-supervision / consultation: for research & scholarship FMRSP projects that CT in that Academic FHT are supervising

Central mentorship & support of the research skills: • development of a research question, • how to do a literature review, • how to choose methods that will answer your

research question, • Support for ethics application• how to develop and validate surveys, • how to do analysis & interpretation

Central management of research projects• Provision of “hotel space” for access to

researchers / staff / and research tools• admin & supervision support for research elective, • evaluation and ranking of research projects

Recruitment of Residents• Research table at CaRMS• CI as interviewers• Excellent research portfolio is attractive• Research elective &PGY3 Clinical Scholar programs are

attractive

In-Unit Teaching• Thursday morning teaching (as other Faculty)• Availability for consultation / methodological support in-unit

meetings or casual hallway conversations

Academic Day• Presentations of 10 minute research highlights (limited

availability)

Interaction with UGME• Participation in FMIG events• Collaboration with FMIG for summer studentship applications• Employment of UGME students on research projects (with and

without scholarship)

OPHCRG

Online Repository for Developing Scholarship

Faculty Development

CPD

DIME

Where to get help?

Online Repository – Tool Box

A Category in the Tool Box

Resource to Assist with Writing a Manuscript

uOttawa Scholar Resources

Biostatistics Summer Courses, Epidemiology Department 2013 General Information booklet

Course Website

Events and Workshops (including critical appraisal), The University of Ottawa Journal of Medicine

The Writing Centre, University of Ottawa

Health Services Library, University of Ottawa

Faculty Development Workshops, (including Teaching Skills), Faculty of Medicine

Research Project Example, Department of Family Medicine

Free Ethics Tutorial, TCPS2:

Scholar Program Example, Department of Family Medicine

Conduct Literature Searches and Reviews

University of Toronto. (2010). The literature review: A few tips on conducting it.

Centre for Evidence Based Medicine

Example: Educational RX

Critiquing Research Articles

PowerPoint Presentations

Bates. (2011) Powerpoint: Presentation Tips.

Practical Links for Learning

University of Toronto. (2010). The literature review: A few tips on conducting it.

Bates. (2011) Powerpoint: Presentation Tips.

Erren T, Bourne P. (2007). Ten Simple Rules for a Good Poster Presentation

CEBM. (2013). Critical Appraisal

Abstract Guidelines for Papers, ACPI

List of Resources to Help with Medical Writing

Events and Workshops (including critical appraisal), The University of Ottawa Journal of Medicine

The Writing Centre, University of Ottawa

Health Services Library, University of Ottawa

OPHCRG

Online Repository for Developing Scholarship

Faculty Development

CPD

DIME

Where to get help?

Faculty Development and CPD

Everything you wanted to know about PubMed

Introduction to designing and developing CME activities

Introduction to CME accreditation

Medical education research - How do I get started?

Successful career transitions in medicine

Mentoring of young academics – common stressors faced by junior faculty, postdoctoral fellows or residents

Creating an Academic Poster – What are your hang-ups?

Tips for Getting Started in Research and Scholarship

• Find a mentor• Join an existing research team• Start Small• Get Help• Put together a team• Be Persistent

Group activity – Writing a Conference Abstract

Acknowledgement

UBC Family Practice Janusz Kaczorowski, Colleen Kirkham,

Ian Martin, Marisa Collins

What is an abstract?

A mini paper

One paragraph

Describes what you are going to discuss, present or write about

Gives reader an overview of your project

Source of new ideas

Gets reader interested

Why abstracts are important?

It is the only part of an article that many people read (apart from your TITLE)

It is the only part of an article that many journals will make freely accessible through search engines (PubMed)

Why structured abstract?

To provide basic information that readers need

To evaluate whether an article is methodologically sound

To improve the retrieval of literature in electronic searches

Elements of a structured abstract

Depends on the discipline, journal or conference

Word limit (50 to 400 words)

Objectives, Methods, Results, Conclusion

Background, Objective, Design, Setting, Patients, Intervention, Measurements and Main Results, Limitations, and Conclusion

Key words

Good title

Title

The most-read parts of a paper/article

Ideally 10–12 words long

Include the scope of the investigation, the study design and the goal

A description of what was investigated -- not the results or conclusions

Easy to understand

Avoid jargon or unfamiliar acronyms or abbreviations

Examples of good titles (BMJ, Academic Medicine)

Birth order of twins and risk of perinatal death related to delivery in England, Northern Ireland, and Wales, 1994-2003: retrospective cohort study

The State of Ultrasound Education in U.S. Medical Schools: Results of a National Survey

Assessing Effective Teaching: What Medical Students Value when Developing Evaluation Instruments

Authors

The list of authors should be restricted to those individuals who actually carried out the study, conceived it, designed it, gathered and/or analyzed the data, and wrote the abstract

The author who will present the abstract should be listed first

Every listed author should read and approve the abstract before it is submitted

Make sure that you put it in your CV!

Abstract: 5 key questions

Why did you start?What did you try to do?What did you do?What did you find?What does it mean?

Why did you start? (introduction / background / context)

Summarize, in one sentence, the current state of knowledge in relation to the work you are presenting:

BACKGROUND: Exenatide therapy is effective in combination with metformin or sulfonylureas for treating type 2 diabetes. Thiazolidinediones (TZDs) also are commonly used, but the efficacy of exenatide with a TZD has not been reported.

BACKGROUND: Faculty development programs have been criticized for their limited assessment methods, focused only on the learners and limited to satisfaction measures or self-reported behavior changes. Assessment of organizational impact is lacking.

What did you try to do?(Aims / Objectives/ Purpose)

State the aim of your study, purpose or question (including hypothesis).

OBJECTIVE: To evaluate the effectiveness of a parenting program as a preventive intervention with parents of preschool children considered to be at risk of developing conduct disorder.

PURPOSE: To explore the impact of faculty education fellowship graduates on their organization and how that impact occurred.

What did you do? (Methods I)

DESIGN: Describe the basic design of your study. Use descriptors such as double blind, placebo controlled RCT, cohort, case control, survey, case series, cost-effectiveness analysis, focus groups or interviews, etc.

DESIGN: Pragmatic randomised controlled trial using a block design with allocation by area.

DESIGN: qualitative study of 13 departments across three institutions, partnered with the George Washington University School of Medicine and Health Sciences.

What did you do? (Methods II)

SETTING: Describe setting of your study (academic or community family practice, hospital, ED).

SETTING: Women's homes; antenatal and ultrasound clinics in 13 maternity units in Wales.

What did you do? (Methods III)

PARTICIPANTS: State key eligibility criteria and provide numbers of participants and how they were selected.

PARTICIPANTS:233 (exenatide group, n = 121; placebo group, n = 112) patients with type 2 diabetes that was suboptimally controlled with TZD treatment (with or without metformin). Mean (±SE) baseline glycated hemoglobin A1c level was 7.9% ± 0.1%.

PARTICIPANTS: In-depth interviews with 13 supervisors and 25 peers of graduates were conducted in fall 2012.

What did you do? (Methods IV)

INTERVENTION/INSTRUMENT: Describe key features of your intervention (if applicable).

INTERVENTION: Subcutaneous abdominal injections of 10 µg of exenatide or placebo twice daily, added to a TZD (with or without metformin) for 16 weeks.

INTERVENTION: Behavioral group counseling and 8 weeks of therapy with nicotine nasal spray or transdermal nicotine.

What did you do? (Methods V)

MAIN OUTCOME MEASURES (if applicable):

MAIN OUTCOME MEASURES: Participants' views and commonly observed responses during consultations and interviews.

MAIN OUTCOME MEASURES: Form of response (eg, answering machine), content of message, and physician and practice characteristics.

MAIN OUTCOME MEASURES: Triangulation, purposive sampling, rich descriptions, and member checks minimized bias and optimized transferability.

What did you find (Results)

RESULTS: Give main results of your study. If research is in progress, state anticipated results.

Results (RCT)

RESULTS: Exenatide treatment reduced hemoglobin A1c level (mean difference, –0.98% [95% CI, –1.21% to –0.74%]), serum fasting glucose level (mean difference, –1.69 mmol/L [–30.5 mg/dL] [CI, –2.22 to –1.17 mmol/L {–40.0 to –21.1 mg/dL}]), and body weight (mean difference, –1.51 kg [CI, –2.15 to –0.88 kg]). Sixteen percent of patients in the exenatide group and 2% of patients in the placebo group discontinued treatment because of adverse events. In the exenatide group, 40% (n = 48) of patients experienced nausea (mostly mild [n = 21] or moderate [n = 19]), 13% experienced vomiting, and 11% experienced hypoglycemia. In the placebo group, 15% of patients experienced nausea, 1% experienced vomiting, and 7% experienced hypoglycemia.

RESULTS (Survey)

RESULTS: Of 514 after-hours messages from family physicians’ offices, 421 were obtained from answering machines, 58 were obtained from answering services, 23 had no answer, 2 gave pager numbers, and 10 had other responses. Message content ranged from no AHC instructions to detailed advice; 54% of messages provided a single instruction, and the rest provided a combination of instructions. Content analysis identified 815 discrete instructions or types of response that were classified into 7 categories: 302 instructed patients to go to an emergency department; 122 provided direct contact with a physician; 115 told patients to go to a clinic; 94 left no directions; 76 suggested calling a housecall service; 45 suggested calling Telehealth; and 61 suggested other things. About 22% of messages only advised attending an emergency department, and 18% gave no advice at all. Physicians who were female, had Canadian certification in family medicine, held hospital privileges, or had attended a Canadian medical school were more likely to be directly available to their patients.

RESULTS (Qualitative)

RESULTS: A model of how graduates of a faculty education fellowship transfer learning to peers and their organizations emerged. Analysis of interview responses showed that in the presence of environmental facilitators, graduates exhibited enhanced confidence and five new behaviors. Graduates raised peer awareness, which leading to changes in individual and group practices and development of shared peer understanding. Analysis suggests they facilitated a culture of continuous learning around teaching, scholarship, and leadership.

RESULTS (anticipated)

RESULTS: It is anticipated that the post MI group will suffer significantly more guilt than the risk factor group as a result of life style choices, age, and sex.

What does it mean? (Conclusions)

CONCLUSIONS: Report only those conclusions that are directly supported by your results, along with any implications for clinical practice.CONCLUSIONS: This study enhances traditional assessment of faculty education fellowship programs by examining the impact that graduates had on peers and work groups. A model is proposed for how graduates interact with and impact work group processes and practices. This model can facilitate more comprehensive program assessments, which can demonstrate program impact beyond the individual participant.

Some general advice

Follow the instructions!

Use simple sentences

Stay away from abbreviations, acronyms and jargon

Have someone read your abstract

Hands-on clinic

Form groups of 3-4 Each group will be assigned 1-2 abstracts

Work as a group ~10-15 minutes on each abstract

Present revised abstracts to the larger group