Since the 1980s National Flying Laboratory Centre has used the Jetstream family of aircraft as a flying classroom, providing university students and developing professionals with real-world exposure to theoretical concepts in the form of practical flight test instruction. Recently the Jetstream was replaced with a newer Saab-340B. The work in this paper presents an experimental analysis of instruction using the Jetstream, compared with known best practices, to inform its replacement process. Flight activities were observed, and participating students (n = 60) were surveyed at four set intervals to establish their mood and interest towards the module. A pen and paper test, comparing what participants learned compared to a controlled group was also administered. While the module was still able to excite, motivate and re-contextualise previously taught information to students, upgrades to the aging technology suite, specifically to support data analysis and briefing was one of the greatest needs from the newer aircraft.

A survey was performed in the Spring of 1995 to map postgraduate education world-wide in animal welfare and ethics. Twenty-one universities in ten countries on three continents were identified, that either offered, or had definite plans to start, postgraduate courses relating to animal welfare and/or ethics. Of these universities nine were European, one Australian, one New Zealand, one Canadian and nine were American. In Australia, Canada and the United States courses are given during a semester or quarter of a semester, while in Europe short but concentrated courses or seminars are more common, with several of them aimed at practising veterinarians rather than at postgraduate students. Interest in the subject of animal welfare and ethics seems to be increasing. Many of the existing courses were started during recent years, and two of the most comprehensive programmes offered were started in 1995. Also, four chairs in animal welfare were recently established or were advertised in Europe at the time of this survey. One chair had been established in 1994, in New Zealand, one was to be advertised in the United States and one in Canada. Another trend is towards the establishment of ‘centres’ for the study of animal welfare issues. Associated with these new chairs and centres, educational programmes will probably be started. Few of the present courses focus mainly on farm animal issues, instead they cover a large spectrum of the human-animal relationship. Ethics is a minor part of the courses as compared to the science and animal welfare components.

Innovation Concept: Global health fieldwork is valuable for Canadian residents, but is often trainee-organized, short-term, unsupervised, and lacking in preparation and debriefing. In contrast, we have developed a Certificate Program which will be offered to University of Toronto (UofT) emergency medicine (EM) trainees in their final year of residency. This 6-month Program will complement the Transition to Practice stage for residents interested in becoming leaders in GHEM. Methods: We completed a multi-phase needs assessment to inform the structure and content of a GHEM Certificate Program. Phase 1 consisted of 9 interviews with Program Directors (PDs), Assistant PDs, and past fellows from existing GH fellowships in Canada and USA to understand program structure, curriculum, fieldwork and funding. In Phase 2 we interviewed 4 PDs and fellows from UofT fellowship programs to understand local administrative structures. In Phase 3 we collected feedback from 5 UofT residents and 7 faculty with experience in global health to assess interest in a local GHEM Program. All interview data was reviewed and best practices and lessons learned from key stakeholders were summarized into a proposed outline for a 6-month GHEM Certificate Program. Curriculum, Tool, or Material: The Program will comprise of 1) 3 months of preparatory work in Toronto followed by 2) 3 months of fieldwork in Addis Ababa, Ethiopia. Fieldwork will coincide with activities under the Toronto-Addis Ababa Academic Collaboration in Emergency Medicine (TAAAC-EM). The GHEM trainee's work will support TAAAC-EM activities. Preparatory months will include training in specific competencies (POCUS, teaching, tropical medicine, QI) and meetings between the trainee and a UofT mentor to design an academic project. During fieldwork, the trainee will do EM teaching (75% of time) and complete their academic project (25% of time). A UofT supervisor will accompany, orient and supervise the trainee for their first 2 weeks in Addis. Throughout fieldwork, the trainee will be required to debrief with their UofT mentor weekly for academic and clinical mentoring. One AAU faculty member will be identified as a local supervisor and will participate in all evaluations of the trainee during fieldwork. Conclusion: This Program will launch with a call for applications in July 2021, expecting the first trainee to complete the Program in 2022-23. We anticipate that this Program will increase the number of Canadian EM trainees committed to global health projects and partnerships throughout their career.

The second and final year of the Erasmus Plus programme ‘Innovative Education and Training in high power laser plasmas’, otherwise known as PowerLaPs, is described. The PowerLaPs programme employs an innovative paradigm in that it is a multi-centre programme, where teaching takes place in five separate institutes with a range of different aims and styles of delivery. The ‘in-class’ time is limited to 4 weeks a year, and the programme spans 2 years. PowerLaPs aims to train students from across Europe in theoretical, applied and laboratory skills relevant to the pursuit of research in laser plasma interaction physics and inertial confinement fusion. Lectures are intermingled with laboratory sessions and continuous assessment activities. The programme, which is led by workers from the Hellenic Mediterranean University and supported by co-workers from the Queen’s University Belfast, the University of Bordeaux, the Czech Technical University in Prague, Ecole Polytechnique, the University of Ioannina, the University of Salamanca and the University of York, has just finished its second and final year. Six Learning Teaching Training activities have been held at the Queen’s University Belfast, the University of Bordeaux, the Czech Technical University, the University of Salamanca and the Institute of Plasma Physics and Lasers of the Hellenic Mediterranean University. The last of these institutes hosted two 2-week-long Intensive Programmes, while the activities at the other four universities were each 5 days in length. In addition, a ‘Multiplier Event’ was held at the University of Ioannina, which will be briefly described. In this second year, the work has concentrated on training in both experimental diagnostics and simulation techniques appropriate to the study of plasma physics, high power laser matter interactions and high energy density physics. The nature of the programme will be described in detail, and some metrics relating to the activities carried out will be presented. In particular, this paper will focus on the overall assessment of the programme.

Introduction: There is increasing evidence to support the integration of simulation into medical training; however, no national emergency medicine (EM) simulation curriculum currently exists. Using Delphi methodology, we aimed to identify and establish content validity evidence for EM curricular content best suited for simulation-based training to inform national postgraduate EM training. Methods: A national panel of experts in EM simulation-related education iteratively rated potential curricular topics, on a 4-point scale, to determine those best suited for simulation-based training. After each round, responses were analyzed and topics scoring <2/4 were removed. Remaining topics were resent to the panel for further ratings until consensus was achieved, defined as Cronbach α ≥ 0.95. At conclusion of the Delphi process, topics that were rated ≥3.5/4 were considered core curricular topics, while those rated 3.0-3.5 were considered extended curricular topics. Results: Forty-four experts from 13 Canadian centres participated. Two hundred and eighty potential curricular topics, in 29 domains, were generated from a systematic review of the literature, analysis of relevant educational documents and a survey of Delphi panelists. Three rounds of Delphi surveys were completed before consensus was achieved, with response rates ranging from 93-100%. Twenty-eight topics, in 8 domains, reached consensus as core curricular topics. An additional 35 topics, in 14 domains, reached consensus as extended curricular topics. Conclusion: Delphi methodology allowed for achievement of expert consensus and content validation of EM curricular content best suited for simulation-based training. These results provide a foundation for improved integration of simulation into postgraduate EM training and can be used to inform a national simulation curriculum to supplement clinical training and optimize learning.

Introduction: The literature reveals that residents spend significant amounts of time working with and charting in electronic medical records (EMR). As adoption of EMRs accelerates among emergency medicine (EM) departments, postgraduate programs will need to adapt curricula related to communication in the patient record. In order to make targeted changes, clinician-educators need a better understanding of how the documentation practices of trainees develop and change over residency, as well as the challenges they face in effectively charting. We gathered the perspectives of EM residents on data entry in the EMR to identify opportunities for such change. Methods: We recruited residents from all five years of the Royal College EM residency program at Queen's University and conducted focus groups from August to October 2018. Data collection was audio recorded and later transcribed. Line-by-line coding was performed independently by both AR and NP. A final codebook was validated by ZH. The codebook was then thematically analyzed to identify and characterize themes from the data. The study was approved by the Queen's University Health Sciences Research Ethics Board. Results: 15 EM residents participated. Groups discussed similar challenges with charting, including time constraints, ensuring sufficient, but appropriate detail, variable preceptor expectations, and an inability to draw diagrams. All residents noted formal teaching of the SOAP note framework during medical school and reported receiving an introductory EMR session. Groups highlighted the importance of feedback, especially from physicians with medicolegal experience. They also described more informal learning strategies, including receiving tips from preceptors during shifts and reading the notes of others. They also reported that changes in their documentation practices as junior and senior residents were largely due to a graduation of responsibility and medicolegal considerations. Conclusion: Our results suggest there is a lack of formal postgraduate training for EM residents with respect to documentation in the EMR with reliance on informal teaching and feedback. Future work should explore opportunities to address this gap with various educational strategies, including the development of specific objectives, application of consistent expectations, modelling of excellent chart notes in teaching, and instruction by preceptors with medicolegal experience.

Introduction: Competency-based medical education (CBME) affirms that trainees will receive timely assessments and effective feedback about their clinical performance, which has inevitably raised concerns about assessment burden. Therefore, we need ways of generating assessments that do not rely exclusively on faculty-produced reports. The main object of this research is to investigate how data already collected in the electronic health record (EHR) might be meaningfully and appropriately used for assessing emergency medicine (EM) trainees independent and interdependent clinical performance. This study represents the first step in exploring what EHR data might be utilized to monitor and assess trainees clinical performance Methods: Following constructivist grounded theory, individual semi-structured interviews were conducted with 10 EM faculty and 11 EM trainees, across all postgraduate years, to identify EHR performance indicators that represent EM trainees independent and interdependent clinical actions and decisions. Participants were presented with a list of performance indicators and asked to comment on how valuable each would be in assessing trainee performance. Data analysis employed constant comparative inductive methods and occured throughout data collection. Results: Participants created, refined, and eliminated performance indicators. Our main result is a catalogue of clinical performance indicators, described by our participants, as reflecting independent and/or interdependent EM trainee performance that are believed to be captured within the EHR. Such independent indicators include: number of patients seen (according to CTAS levels), turnaround time between when a patient is signed up for and first orders are made, number of narcotics prescribed. Meanwhile, interdependent indicators include, but are not limited to, length of stay, bounce-back rates, ordering practices, and time to fluids. Conclusion: Our findings document a process for developing EM trainee report cards that incorporate the perspectives of clinical faculty and trainees. Our work has important implications for distinguishing between independent and interdependent clinical performance indicators.

A survey of psychiatrists with a special interest in CBT was conducted by email correspondence to answer two main questions: ‘What are the uses and the usefulness of the cognitive behavioural model within the day-to-day practice of psychiatrists?’ and ‘What are the most important roles of the consultant medical psychotherapist who has specialized in CBT?’ Despite the constraints of a low response rate the results still reflected the views of 46 psychiatrists who were particularly experienced in the area of CBT. They reported that the cognitive behavioural model was useful in general psychiatric settings, in particular in the engagement of patients, improving client's insight, adherence to medications, and for trainee supervision. The responders reaffirmed previously held views about the role of the consultant medical psychotherapist (CBT), in particular the roles of the assessment and management of complex cases, of taking responsibility for patients with a combination of medical and psychological issues and of teaching CBT to psychiatrists and other mental health professionals. The challenges of translating CBT competencies into generic non-CBT psychiatric settings are discussed, with the important potential role of the medical psychotherapist in this respect. The key skill of formulating cases in secondary care is emphasized.

Some education scholars view student self-esteem as very important to the learning process. However, in relation to clinical supervision, it has also been noted that supervisor overconcern about student self-esteem can lead to avoidance of negative feedback or giving feedback that is too vague to be useful. This article examines the role of self-esteem in relation to assessment and feedback practices in clinical training. A review of educational and clinical literature on self-esteem was undertaken, and suggested that differentiation between self-esteem and self-efficacy provides a more useful framework for supervisors than focus on self-esteem alone. Feedback about specific skills, and developing better coherence between supervisor and student assessment of the student's skills, are important components of clinical training. Suggestions are provided for guiding innovation in supervision and clinical training.

Competencies for psychiatric training have been developed that reflect what psychiatrists have to be able to do in order to function in their role. Although the need for a formally delivered psychotherapy experience is assumed and associated competencies are represented in the curriculum, it is not clear which competencies thereby achieved can be translated into generic practice. This paper reports the outcomes of a workshop held at an academic regional meeting of the Royal College of Psychiatrists. Potential competencies to be achieved following training and experience in CBT were presented. Small group review of the frameworks and subsequent feedback demonstrated broad support for requirements of CBT knowledge and attitudinal competencies that could inform day-to-day practice, within a generic psychotherapeutic skills framework. New competencies that were related to CBT and considered meaningful in daily psychiatric practice emerged. Further development of these ideas from the workshop in this paper leads to a set of coherent competencies that would be helpful in non-CBT specialist practice and are congruent with the context of generic psychiatric practice. These enable models of training other than the delivery of a single ‘brief’ psychotherapy case to be considered.