Pioneering contributions in medical education
In the late 1980s, Dr. Michel Donoff initiated the documentation of feedback to residents through prescription-sized notepads, termed “field notes”. This laid the foundation for competency-based assessment in residency training evaluation. Field notes were developed as a mechanism for faculty preceptors/supervisors and residents to document progress toward meeting educational objectives. The in-training evaluation reports (ITERs) developed in the 70s often were completed at the end of rotations, with little or no evidence of ongoing supervision or coaching. Subsequently, field notes were adopted in most programs in Canada.
Rural integrated community clerkship (ICC) and pre-clinical network medical education (PNME)
Under the direction of Dr. Jill Konkin, the rural integrated community clerkship (ICC) was implemented in 2007-2008 to provide the opportunity for third-year medical students to complete the whole of that year in selected rural Alberta communities.
Through the Office of Rural and Regional Health, the pre-clinical networked medical education program (PNME) was implemented in 2010-2011. Under this program, select second-year undergraduate medical students spend four weeks of their GI block (from September to October) in a rural community providing them their first experience of clinical teaching. Both initiatives demonstrated the necessity and richness of using Alberta’s non-urban practices and educational opportunities for undergraduate medicine. The primary objective was to “immerse learners in generalist medical culture leading to an increase in the numbers of medical school graduates who choose generalist careers.”
Competency-based achievement system (CBAS)
CBAS is the overall framework for learner assessment in family medicine at the University of Alberta. Formative feedback is provided throughout training, as well as information contained in any tool for formative or summative assessments; all serve as the evidence base for summative decisions. A fundamental assumption of CBAS is the importance of continuity in education and assessment. Thanks to the efforts of Drs. Mike Donoff, Paul Humphries, Darren Nichols, Shelley Ross and Mirella Chiodo for the development, maintenance and dissemination of this nationally and internationally recognized program.
Patients, Experience, Evidence and Research (PEER)
PEER is a primary-care-led, evidence-based medicine team focused on providing relevant evidence to family physicians and primary health care providers. It evolved from the initiatives of Drs. Mike Allan, Tina Korownyk, Mike Kolber, Jessica Kirkwood and Scott Garrison. This group was responsible for one of the most successful and practical undergraduate and postgraduate programs in the Faculty of Medicine. PEER evolved from the curiosity of a small group of family physicians into a team of primary care providers who are engaged in evidence-based medicine research.
Quality and safety in family medicine/primary care and quality improvement
In 2014, under the leadership of Mirella Chiodo and Dr. David Moores, the residency program adopted educational objectives for the teaching of quality and safety in family medicine/primary care, representing one of the first such initiatives in Canada. Using the British concept of “significant events,” residents were required to document a minimum of three significant events during their program and analyze them. A significant event is anything anybody on the health care team, including patients and their families, see as important in the quality of care or the conduct of the practice. Residents are encouraged to use a significant event as a basis for their required quality improvement project. Hospital-oriented reporting and learning systems rarely identify and address the significant events that occur at in the interfaces of health services.
Research and scholarship
Research and scholarship have grown substantially with respect to the number of faculty, from four academic faculty members in 1973 to nine in 1990s and now to 38. Under the direction of research directors Dr. Neil Bell (1983-1994), Dr. Andrew Cave (1994-2006), Dr. Donna Manca (2006-2022) and recently appointed (July 2022) co-directors Dr. Ginetta Salvalaggio and Andrea Gruneir, the Department has now a proven track record of research and scholarship.
The department’s goal is to ensure through all activities that Alberta has a well-integrated, primary-care-based health care system in which all citizens have access to a family physician who provides timely, proactive, individualized, comprehensive and continuous care through an interdisciplinary team of health care professionals. They produce scholarly work to teach the discipline of family medicine and to improve clinical practice and primary health care. Thus, we are able to better address the needs of our society.
The Department of Family Medicine recognizes the contributions of many family physicians practicing in rural, regional and urban Alberta, as well as the family physicians and specialists who took responsibility to supplement core family medicine education and training with enhanced skills. For those contributors who have not been specifically mentioned in this reflection, sincerest apologies are offered.
Editor’s note: There is so much achievement in our province. We are pleased to help share stories of success. We welcome suggestions for profiles or stories marking milestones and accomplishment.
References available upon request