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      Lessons learned from a student-driven initiative to design and implement an Organ and Tissue Donation course across Canadian medical schools

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          Abstract

          The competencies required of the well-trained physician are constantly evolving, and medical education must adapt accordingly. In response, a growing number of influential medical education licensing and accreditation bodies have proposed frameworks that outline society’s expectations of physician competencies. In Canada, undergraduate and graduate curricula have undergone major changes to meet the specifications of the CanMEDS framework, and similar efforts are underway internationally. Nonetheless, ensuring the values enshrined within such frameworks become integral to a physician’s identity remains challenging. We believe that student-led curricular initiatives represent a novel way of approaching this shifting medical education landscape.

          In this article, we reflect on lessons we learned as medical students spearheading an initiative to change how organ and tissue donation is taught in Canadian medical schools. Citing relevant medical education literature where applicable, we include a detailed description of our approach as a roadmap for students contemplating their own curricular innovations. By outlining the factors influencing this project’s implementation, as well as the benefits and limitations of student participation in curriculum reform, we offer educators a fresh perspective on optimizing the student role in this important process. Ultimately, the authors argue that not only can student participation render curricular content more accessible to learners, but that the responsibilities students take on in this role naturally lead to the development of CanMEDs-based competencies such as advocacy, scholarship, and inter-professionalism.

          Electronic supplementary material

          The online version of this article (10.1007/s40037-018-0454-5) contains supplementary material, which is available to authorized users.

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          Competency is not enough: integrating identity formation into the medical education discourse.

          Despite the widespread implementation of competency-based medical education, there are growing concerns that generally focus on the translation of physician roles into "measurable competencies." By breaking medical training into small, discrete, measurable tasks, it is argued, the medical education community may have emphasized too heavily questions of assessment, thereby missing the underlying meaning and interconnectedness of how physician roles shape future physicians. To address these concerns, the authors argue that an expanded approach be taken that includes a focus on professional identity development. The authors provide a conceptual analysis of the issues and language related to a broader focus on understanding the relationship between the development of competency and the formation of identities during medical training. Including identity alongside competency allows a reframing of approaches to medical education away from an exclusive focus on "doing the work of a physician" toward a broader focus that also includes "being a physician." The authors consider the salient literature on identity that can inform this expanded perspective about medical education and training.
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            Understanding the experience of being taught by peers: the value of social and cognitive congruence.

            Medical schools use supplemental peer-teaching programs even though there is little research on students' actual experiences with this form of instruction. To understand the student experience of being taught by peers instead of by faculty. We conducted focus groups with first- and second-year medical students participating in a supplemental peer-teaching program at one institution. From the learner focus group themes, we developed a questionnaire and surveyed all first-year students. Focus groups revealed four learner themes: learning from near-peers, exposure to second-year students, need for review and synthesis, teaching modalities and for the peer-teachers, the theme of benefits for the teacher. Factor analysis of the survey responses resulted in three factors: second-year students as teachers, the benefit of peer-teachers instead of faculty, and the peer-teaching process. Scores on these factors correlated with attendance in the peer-teaching program (P < .05). Students valued learning from near-peers because of their recent experience with the materials and their ability to understand the students' struggles in medical school. Students with the highest participation in the program valued the unique aspects of this kind of teaching most. Areas for improvement for this program were identified.
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              Issues of validity in openly ideological research: Between a rock and a soft place

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                Author and article information

                Contributors
                alexandra.fletcher@mail.mcgill.ca
                Journal
                Perspect Med Educ
                Perspect Med Educ
                Perspectives on Medical Education
                Bohn Stafleu van Loghum (Houten )
                2212-2761
                2212-277X
                1 October 2018
                1 October 2018
                October 2018
                : 7
                : 5
                : 332-336
                Affiliations
                [1 ]ISNI 0000 0004 1936 8649, GRID grid.14709.3b, Faculty of Medicine, , McGill University, ; Montreal, QC Canada
                [2 ]ISNI 0000 0004 1936 8227, GRID grid.25073.33, Department of Neurology, , McMaster University, ; Hamilton, ON Canada
                [3 ]ISNI 0000 0004 1936 8649, GRID grid.14709.3b, Department of Psychiatry, , McGill University, ; Montreal, QC Canada
                [4 ]ISNI 0000 0000 9064 4811, GRID grid.63984.30, Pediatric Intensive Care Unit, , McGill University Health Center, ; Montreal, QC Canada
                [5 ]ISNI 0000 0001 2218 112X, GRID grid.416099.3, Neurology Unit, , Montreal General Hospital, ; Montreal, QC Canada
                Article
                454
                10.1007/s40037-018-0454-5
                6191399
                30276671
                2b4982f9-9839-413f-9b23-faee293d496c
                © The Author(s) 2018

                Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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                © The Author(s) 2018

                Education
                undergraduate medical education,peer-assisted learning,course design,competency development,advocacy,organ donation

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