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      “R1 Nightmares”: a resident-led on-call medical emergency simulation course for junior residents Translated title: Cauchemars de R1: un cours de simulation pour les urgences durant la garde dirigé par des résidents et destiné aux résidents juniors

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          Abstract

          Implication Statement

          On-call medical emergencies can be a source of anxiety for junior medical residents. Senior resident teachers are well-positioned to teach a safe approach to managing on-call emergencies, and simulation-based training has educational and patient safety advantages. We describe the implementation of a resident-facilitated, on-call emergency simulation course for first-year residents. The course was low-cost, time-efficient, increased residents’ self-rated comfort with acutely deteriorating patients and was highly recommended by participants. The “R1 Nightmares” course could be adapted for other residency programs and institutions.

          Translated abstract

          Énoncé des implications de la recherche

          Les urgences durant la garde peuvent être une source d’anxiété pour les résidents juniors. Les résidents seniors se trouvent en situation privilégiée pour enseigner une approche sûre de la gestion des urgences sur la garde. De plus, la formation basée sur la simulation présente des avantages sur le plan pédagogique et sur le plan de la sécurité des patients. Nous décrivons la mise en œuvre d’un cours de simulation d’urgences survenant durant le service de garde destiné aux résidents de première année et animé par leurs collègues séniors. Nécessitant peu de temps et de ressources financières, le cours a permis aux résidents d’améliorer leur niveau de confort auprès des patients dont l’état se détériore rapidement et il a été fortement recommandé par les participants. Le cours «Cauchemars de R1» peut être adapté à d’autres programmes de résidence et à d’autres établissements.

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          The transition from medical student to junior doctor: today's experiences of Tomorrow's Doctors.

          CONTEXT Medical education in the UK has recently undergone radical reform. Tomorrow's Doctors has prescribed undergraduate curriculum change and the Foundation Programme has overhauled postgraduate education. OBJECTIVES This study explored the experiences of junior doctors during their first year of clinical practice. In particular, the study sought to gain an understanding of how junior doctors experienced the transition from the role of student to that of practising doctor and how well their medical school education had prepared them for this. METHODS The study used qualitative methods comprising of semi-structured interviews and audio diary recordings with newly qualified doctors based at the Peninsula Foundation School in the UK. Purposive sampling was used and 31 of 186 newly qualified doctors self-selected from five hospital sites. All 31 participants were interviewed once and 17 were interviewed twice during the year. Ten of the participants also kept audio diaries. Interview and audio diary data were transcribed verbatim and thematically analysed with the aid of a qualitative data analysis software package. RESULTS The findings show that, despite recent curriculum reforms, most participants still found the transition stressful. Dealing with their newly gained responsibility, managing uncertainty, working in multi-professional teams, experiencing the sudden death of patients and feeling unsupported were important themes. However, the stress of transition was reduced by the level of clinical experience gained in the undergraduate years. CONCLUSIONS Medical schools need to ensure that students are provided with early exposure to clinical environments which allow for continuing 'meaningful' contact with patients and increasing opportunities to 'act up' to the role of junior doctor, even as students. Patient safety guidelines present a major challenge to achieving this, although with adequate supervision the two aims are not mutually exclusive. Further support and supervision should be made available to junior doctors in situations where they are dealing with the death of a patient and on surgical placements.
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            Dimensions and psychology of peer teaching in medical education.

            Peer teaching, an educational arrangement in which one student teaches one or more fellow students, is applied in several forms in medical education. A number of authors have linked peer teaching to theories of education and psychology. Yet no comprehensive overview of what theory can offer to understand dynamics of peer teaching has been previously provided. A framework is designed to categorize forms of peer teaching, distinguishing three dimensions: distance in stage of education, formality of the educational setting and size of the group taught. Theories are categorized in two dimensions: theories that explain benefits of peer teaching from a cognitive versus a social-psychological perspective, and theories that explain benefits for peer learners versus peer teachers. Both dimensional frameworks help to clarify why and in what conditions peer teaching may help students to learn.
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              Peer-assisted learning in medical education: A systematic review and meta-analysis.

              The prevalence of peer-assisted learning (PAL) featuring alongside the core medical curriculum is increasing; however, the evidence base for PAL's efficacy on academic performance is limited. This systematic review of randomised studies of PAL in medical school sets out to assess the impact of PAL on academic outcomes in medical school and evaluate whether PAL confers a benefit in specific educational contexts.
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                Author and article information

                Journal
                Can Med Educ J
                Can Med Educ J
                CMEJ
                Canadian Medical Education Journal
                Canadian Medical Education Journal
                1923-1202
                26 May 2022
                01 September 2022
                September 2022
                : 13
                : 5
                : 101-103
                Affiliations
                [1 ]Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Alberta, Canada;
                [2 ]Division of Respirology, Department of Medicine, University of Toronto, Ontario, Canada;
                [3 ]Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Alberta, Canada;
                [4 ]Department of Internal Medicine, Cumming School of Medicine, University of Calgary, Alberta, Canada;
                [5 ]Department of Emergency Medicine, Queen’s University, Ontario, Canada.
                Author notes
                Correspondence to: Erica D McKenzie, Foothills Medical Centre, 1403 29 Street NW Calgary, Alberta, Canada T2N 2T9; email: Erica.McKenzie@ 123456ucalgary.ca
                Article
                CMEJ-13-101
                10.36834/cmej.73858
                9588192
                36310898
                b77ee8a1-7116-4798-80b2-985c9f7f452c
                © 2022 McKenzie, Sugarman, Savage, Lee, Thornton, Chaplin, Altabbaa; licensee Synergies Partners.

                This is an Open Journal Systems article distributed under the terms of the Creative Commons Attribution License. ( https://creativecommons.org/licenses/by-nc-nd/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is cited.

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