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Curriculum

CLINICAL, ACADEMIC AND SCHOLARLY CONTENT OF THE PROGRAM

Program Teaching Rounds
Rotation
Evaluation Of Resident Performance

Program Teaching Rounds
Trainees are dismissed from their clinical responsibilities to attend the following mandatory teaching rounds:

  1. Academic Half-day Didactic lectures (Each Tuesday from 1400 to 1600 hours at St. Michael’s Hospital)
    During the academic year, the residents attend a mandatory academic half-day every week where core topics in intensive care are reviewed. A two year core lecture series has been designed and implemented over the past 5 years and runs from September to June of each academic year. The core lecture series was developed to fulfill the education objectives as outlined in the Specialty Training Requirements. These sessions focus on normal cardiorespiratory physiology and pathophysiology of critical illness.

Most of the topics are presented in a didactic fashion. There is also hands-on learning with respect to ventilator and dialysis machine parameters and settings. Informal teaching sessions are also held on topics of the residents’ choice.

The format of the sessions includes

  • Didactic sessions ( 1- 2 per month)
  • Case based tutorials and problem-based sessions  (1 per month)
  • Simulation sessions (1 per month)
  • Research in progress rounds (2 presentations per month)
  • City wide critical care rounds (1 per month)
  • Journal Club (1 per month)
A record of attendance at the Tuesday sessions is kept. Residents are expected to attend 90% of the Tuesday sessions.
  1. Ethics Roundtable Discussions
    Once a month, during the academic half-day, an ethics principle is discussed as it pertains to the practice of critical care. Experts from the Centre for Bioethics at the University of Toronto are regularly invited to moderate discussions.
     
  2. Scenario Rounds
    Residents are assigned to present a case that presented a unique challenge in either diagnosis or management.

  3. Simulation
    Once a month, residents partake in a simulation exercise where leadership, collaborative and management skills are evaluated by teachers and peers.

  4. Journal Club
    Once a month, a resident is assigned to review and critically appraise a recent journal article. Dr. Margaret Herridge, a senior clinical epidemiologist, acts a resource person during the preparation of the presentation and also, attends the journal club to facilitate the discussion. The emphasis is on critical appraisal skills and the impact of the studies on clinical practice.

  5. City Wide Rounds (Academic half day: City Wide Rounds:  Every second Tuesday from 1700 to 1800 hours. 89 Chestnut Avenue)
    Once a month, there is a research presentation by investigators from the University of Toronto, and from other academic institutions around the world. These rounds are held by trainees and faculty members.

  6. Research in Progress Rounds: Every fourth Tuesday from 1700 to 1800 hours. St. Michael’s Hospital.

  7. Summer Physiology Course

Every July and August, the first-year residents participate in the pulmonary physiology seminar series offered by the Pulmonary Medicine Residency Training Program. The goal of these sessions is to provide trainees with knowledge and expertise in pulmonary physiology.

Technical skills are developed through the following structured programs:

  • Annual bronchoscopy course
  • Annual ACES (Adult Critical Events Simulation) Resuscitation Course for first year trainees
  • Simulation sessions (one per month)
  • Airway course (yearly – two sessions)
  • Hand –on tutorials throughout the year during their Tuesday sessions (academic half-days)

 

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Rotation (core ICU and elective teaching sessions)

        Each hospital provides their own series of seminars that include core topics in knowledge, technical skills, ethics and a journal club. A list of sessions from each hospital and elective is available on request.

The University of Toronto CCM education program is centered around the CanMEDS Physician Competency Framework. As such, each educational activity has been designed to allow the achievement of competency in each CanMEDS role.

In the role of medical expert, the resident will develop this core competency trough the following educational activities:

  • Academic half-day didactic lecture series
  • Academic half-day bioethics session
  • Scenario rounds
  • Simulation sessions
  • Journal Club
  • City wide and research in progress rounds
  • Daily bedside ICU rounds
  • Site specific ICU teaching rounds

The communicator role is mastered trough:

  • Academic half-day bioethics
  • Simulation sessions
  • Journal club presentations
  • Daily bedside ICU rounds
  • Site specific ICU presentations by fellow

The collaborator role is taught and evaluated in the following educational settings:

  • Academic half-day bioethics
  • Simulation sessions
  • Daily bedside ICU rounds

The manager role is evaluated in simulation sessions and in daily ICU bedside rounds.

The health advocate role is taught in:

  • Academic half-day bioethics sessions
  • Simulation sessions
  • Daily ICU bedside rounds

The role of scholar is reinforced in:

  • Academic half-day didactic lectures
  • Scenario rounds
  • Simulation sessions
  • Journal Club
  • City wide and research in progress rounds
  • Daily ICU bedside rounds
  • Site specific ICU teaching rounds

Professionalism is part of the following teaching tools:

  • Academic half-day bioethics session
  • Scenario rounds
  • Simulation sessions
  • Daily bedside ICU rounds

 

The CanMEDS roles and the settings in which these core competencies are taught are summarized in the table below:

 

Academic Half-day

Ethics

Scenario Rounds

Simulation

Journal Club

City Wide Rounds/Research in Progress Rounds

Daily Bedside ICU Rounds

Medical Expert

++

+

++

++

++

+

++

Communicator

 

++

 

+++

++

 

++

Collaborator

 

+

 

+++

 

 

+++

Manager

 

 

 

+++

 

 

++

Health Advocate

 

++

 

+

 

 

++

Scholar

++

 

+

+

+++

++

+

Professional

 

++

+

++

 

 

++

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EVALUATION OF RESIDENT PERFORMANCE

Two structured examinations occur yearly and are taken by all residents.

  • The SCCM MCCKAP examination (A multiple choice examination that is sponsored by the Society or Critical Care Medicine, and used by most programs in Canada. This allows the trainee to evaluate knowledge as it relates to critical care and compare their performance to other residents across Canada and the United States.
  • A structured oral examination: A series of structured scenarios developed with specific goals and objectives. The goals and objectives of each scenario is divided into core competencies and advanced competencies. Structured questions are provided to the examiners (two per station) along with suggested answers.

 

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