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Environmental Scan

National Literature Reviews

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Intellectual Property
The AFMC will own and store all data collected during this environmental scan project, including all completed literature reviews with annotated bibliography of key sources, the interview template and complete transcripts, and the final report. The UofT/UdeM group agrees to refrain from publishing any papers in advance of completion of the final report for The Future of Medical Education in Canada project (31 May 2009). Following completion of the project, the AFMC encourages publications by the consultant team members from project data. The UofT/UdeM consortium will have exclusive rights to publications from the data for the first 18 months following official completion of the project (31 May 2009). After this period, the data will be available for anyone to use. If and when review papers, summary documents and reports prepared by the members of the consultant team or authors they engage for the purpose of writing review papers are copied, distributed or otherwise cited, the names of individual authors will be cited. Publications arising from the environmental scan portion of the Future of Medical Education in Canada project will indicate financial support from Health Canada, the Association of Faculties of Medicine of Canada, the University of Toronto Wilson Centre for Research in Education and Centre de pédagogie appliquée aux sciences de la santé, Université of Montréal.

Hodges BD, Albert M, Akseer S, Arweiler D, Bandiera G, Byrne N, Charlin B, Karazivan P, Kuper A, Maniate J, Millette B, Noyeau E, Parker S, Reeves S

A team of researchers at the Wilson Centre for Research in Education, University of Toronto and le Centre de pédagogie appliquée aux sciences de la santé (CPASS), l’Université de Montréal were funded by the Association of Faculties of Medicine of Canada (AFMC) to undertake a national environmental scan regarding the future of undergraduate medical education in Canada. As part of this comprehensive scan, a series of more than 30 review papers were commissioned. The purpose of these reviews was to broadly scan the published and "grey" literatures in medical education with the goal of identifying key issues, challenges and innovations that could be used to support and extend the more impressionistic data collected during the key informant interviews and expert panels conducted for the project. As well, each author was asked to construct a general reference list and an annotated bibliography of a few key articles related to each topic. Taken together, the whole set of review papers provide a very valuable source of data for those running or reforming medical schools and for those developing innovation and research in medical education.

The commissioning of literature reviews began before any other sources of project data were available. Thus, the initial process of commissioning rested on a list of important topics developed jointly by the AMFC Future of Medical Education in Canada Steering Committee and the Wilson Centre/CPASS research team. Together, a list of approximately 30 key topics was identified and clustered into 5 overarching domains. The original 5 domains were: Curriculum Content, Pedagogical Issues Affecting the Medical Education System, Culture(s) of Medical Education, External Issues Affecting the Medical Education System, and Higher Order Constructs. There were between 4 and 12 topics assigned to each of these 5 overarching "clusters". Two members of the research team were assigned to each cluster. Cluster leaders then went about commissioning authors from across Canada to write the more than 30 papers.

Commissioned literature review papers took two forms. Where it was known that review papers already existed in the area (eg. interprofessional education, assessment) a "brief" review was commissioned. Brief reviews took the form of a 5-10 page focus "review of reviews". Brief reviews summarized the key finding of existing reviews, identified where possible innovations, provided a set of overarching implications for undergraduate medical education and concluded with a general reference list and annotated bibliography,

Where it appeared that there were no existing reviews of a topic, an "in-depth" review was commissioned. These much longer papers (ranging from 10 to 30 pages) provided detailed literature reviews in addition to a list of innovations, implications, references and an annotated bibliography as for the brief reviews.

As literature review papers were submitted, they were read and reviewed by the cluster leaders, by the members of the research team and by the AFMC FMEC Steering Committee. In a few cases additional external reviewers were invited to read the paper and to suggest further points or references for consideration in a revised version.

Over the summer of 2008, most of the papers were available and data from other project sources such as in they key informant interviews and expert panels was available. This gave the research team an opportunity to reflect on the cluster structure and to identify gaps in the commissioned papers. As a result, the clusters and their associated papers were reorganized and a few additional papers were commissioned. These included papers and reviews focusing on Health Inequities, Technology and Medical Education, Primary Care, and the CanMEDS roles in Undergraduate Education.

This book contains the final version of the literature review process of the Future of Medical Education in Canada Environmental Scan. In total there are 34 literature review papers - 24 brief reviews and 10 in depth reviews - a total of 550 pages. Sixty-two authors from all parts of Canada generously gave of their time to produce these reviews, many of which will be published in peer-reviewed journals at the conclusion of the project.

The final cluster structure is:

  1. Medical Education and Society
  2. The Purpose, Function and Governance of Medical Schools
  3. Medical Students: Selection, Support and Assessment of competence
  4. Curriculum Design and Implementation
  5. Contemporary Content Topics

This book contains several features that will assist those using it to easily access the contents, including:

  1. A Table of Contents including all papers using the Cluster Structure above
  2. An alphabetical list of authors
  3. A summary abstract for each review paper
  4. A key-word index

Papers were commissioned in both English and French. Some have been translated in full and some have summary abstracts in both languages.

Literature review paper authors gave generously of their time to create an unparalleled set resource for the Future of Medical Education in Canada project. Taken together, this book of reviews provides a rich resource of theoretical and practical background for most of the contemporary issues and challenges of medical education in Canada. As well, it provides a number of innovations, best practices and a comprehensive set of reference and annotated bibliographies. The data provided in these literature reviews has been combined with the more impressionistic data generated by the key informant interviews and expert panels that are also part of this project, including the Young Leaders Forum, Blue Ribbon Panel, Data Needs and Access Group, and the international consultations. This integration takes the form of 10 "issue analysis papers" - one for each 10 key priority areas identified and listed in a separate volume (Volume 3) of this environmental scan. Each issue analysis paper integrates information from all project sources, providing evidence-based recommendations, information on innovations and references to assist with planning and implementation.