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A Resident’s Perspective on ICRE

During this past week, I had the amazing opportunity to attend the International Conference on Residency Education (ICRE), an annual event organized by the Royal College of Physicians and Surgeons of Canada, to present a research project addressing the concept of “Patient Ownership” in the era of resident duty hour regulations. ICRE, the world’s largest conference devoted to advancing residency education, brings together physicians and residents from all around the world, every year, to discuss the newest evidence in the fields of medical education and quality improvement. This week, an impressive 2000 delegates from 40 different countries gathered in Niagara Falls to attend workshops and presentations that centered around this year’s theme, Advancing Quality: Aligning Residency Education and Patient Care

Dr Kaveh Shojana, Editor-in-Chief of BMJ Quality & Safety Quality and Director at the Centre for Quality Improvement and Patient Safety (C-QuIPS), opened the conference with an enlightening plenary entitled “Teaching Healthcare Quality: The Next Evidence-Based Medicine.” During his presentation, he demonstrated that although improving residency education is crucial, it is seldom sufficient to improve quality of patient care, highlighting the importance of a partnership between residency education and quality improvement researchers. This plenary was enlightening as it highlighted that physician interest in quality improvement initiatives is key to implementing healthcare reforms, and that involvement within local institutions is fundamental, when targeting healthcare quality optimization.

A conference plenary panel entitled “Linking Residency Training with Quality Care: Education in Action” opened the second conference day. It brought together four experts in the field of quality improvement — Drs. Emma Vaux, Christopher P. Landrigan, Wendy Levinson and Brian M. Wong — to discuss their own quality improvement initiatives and critically apprehend the reason for their successes. A few of the initiatives discussed included the I-PASS mnemonic, which was developed to standardize verbal handovers and promote patient safety, as well as the Choosing Wisely campaign, which aims to assist physicians and patients engage in healthy conversations about unnecessary investigations, procedures and therapies to ensure quality of care. 

As part of the International Residency Leadership Summit (IRLS) stream, I took part in a facilitated workshop on leadership styles. During this seminar, we used a case-based approach to identify the features distinguishing effective and ineffective leadership styles, and discussed Goleman’s theoretical leadership model. By identifying situations in which each of the six leadership styles (commanding, visionary, affiliative, democratic, pacesetting, coaching) had the potential to positively impact the work environment, we were able to highlight the importance of adaptability in true medical leaders.  As a new resident I found this discussion extremely beneficial. It allowed me to subsequently reflect on my experiences as a medical student, and identify the distinctive characteristics that had made me identify some of my residents as positive leaders and role-models. I expect that this exercise, along with the more theoretical framework provided, will be very helpful during formal and informal interactions with more junior trainees.

In addition to its more formal sessions highlighting the importance of leadership, conflict resolution, advocacy and negotiation skills, the IRLS emphasized resident physicians’ resilience by giving them a safe space to present their Survival Stories during a session chaired by Dr. Adelle Atkinson, Program Director for the Core Pediatrics Residency program at the University of Toronto. Furthermore, it offered formal mentorship opportunities to residents, allowing them to network with experts in the field of medical education and obtain one-on-one professional development advice. As part of this program, I had the opportunity to meet with a current member of the Medical Council of Canada, who generously volunteered details from her career path, exploring the progression from residency to the various professional opportunities that came her way subsequently. “Seize the unexpected, and do what you love,” she stated: A great reminder of the importance of seeking new experiences, and craving the unknown. 

The overwhelming social media involvement at this year’s ICRE was fascinating, demonstrating the positive impact of alternate communication strategies on professional networking and community building. The inaugural ICRE Chief Residents, Dr. Stephen Gauthier (Internal Medicine resident at the University of Toronto), Dr. Peter A. Moore (Orthopaedic registrar for the Australian Orthopaedic Association’s Victoria and Tasmanian training programs) and Dr. Brie Yama (Pediatric resident at the Hospital for Sick Children/University of Toronto), played a pivotal role in promoting stakeholders’ involvement in social media as they bridged the communication between participants and speakers during all plenary sessions.  

The stimulating conference ended with a refreshing plenary by Dr Paul B. Batalden, which focused on the concept of healthcare service, as well as the importance of patient/physician “co-production” to increase satisfaction. When reflecting on this plenary, along with the previous seminars, I wondered: In the realm of theoretical frameworks, how can one practically integrate these into daily practice? It is evident that healthcare quality optimization is a multifaceted concept, which relies on both system-based and individualized alterations. From the seminars I attended the concepts of optimization of educational opportunities, physician wellness, resource stewardship, safety of care and patient ownership stood out as system-based targetable measures. Furthermore, Dr. Batalden reminded the audience of the importance of obtaining direct feedback from our patients, to ensure that the healthcare services delivered under our care are meeting their physical, emotional and social needs. At the end of the day, physicians and patients are partners, with the shared goal of optimal care, and this closing plenary acted as a great reminder.

This article is courtesy of Dr. Vanessa Masson, R1 in Pediatrics, and member of the Resident Doctors of BC Communications Committee. Follow Vanessa on Twitter @massonva.

Interested in residency education and quality improvement? The 10th anniversary International Conference on Residency Education will take Halifax by storm, from October 19-21, 2017. Interested in applying to be an ICRE Chief Resident? Don’t miss your opportunity – the call for ICRE Chief Residents closes on October 11, 2016.

author: Melissa Nilan