2019 Dean's Report

A. The working group has accomplished the following to date:

• Completed initial consultations with various Faculty of Medicine leadership and committees, as well as TAHSN partners.
• Identified key stakeholders, local clinical champions, elders and learners to populate our small format working groups (on-going).
• Conducted a review of admissions and supports, recruitment and retention as well as the learning climate and curriculum  within Canada and abroad (on-going).
• Secured a Memorandum of Understanding with Women’s College Hospital (WCH) to establish a centralized Indigenous collaborative learning/working space has begun to take shape. It is projected that this space will be ready by October 2019. An architect has been enlisted to help the space evolve over the next several months.
• The partnership with WCH, going forward, will be pivotal in cultivating a learning and working environment in which is culturally safe and where Indigenous history, values and knowledge are intrinsic -embedded in our existing colonial structures. This collaboration/partnership will be integrative and synergistic as we move forward in the development of policies, curricula and programs guided by Indigenous voices and wise practices.  

B. Over the next year, the working group aims to accomplish the following:

• Establish the Academic Advisory Circle
• Establish the Community Advisory Circle
• Establish the Elder’s Councils (one within WCH and one shared between the FoM and Dalla Lana’s Waakebiness-​Bryce Institute for Indigenous Health)
• Establish formal and informal partnership agreements - both academic and community based
• Prepare a detailed report based on visits with centres of excellence within Canada and abroad

A. The working group has accomplished the following to date:

1. Development of OLE Working Group Recommendations
Operating under the assumption that student mistreatment would be its initial (though not exclusive) focus, the working group developed recommendations organized according to the following four key areas to address mistreatment across the learner continuum: Institutional Leadership, Accountability, Clarity and Awareness.

2. Development of Mistreatment Roles and Responsibilities
Building on the recommendations of the working group, some initial roles and responsibility scoping has been completed to help inform the creation of position descriptions for the Faculty lead/ombudsperson and mistreatment advisors/advocates as well as the Faculty-level advisory council. 

3. Establishment of MD Program Working Group
A MD Program working group (Student Mistreatment Management Team), chaired by the Associate Dean, Health Professions Student Affairs, has been created to review how to more effectively communicate about and operationalize the MD Program Protocol for addressing incidents of discrimination, harassment, mistreatment and other unprofessional behavior. The work of this MD program-specific group will both inform and be informed by the OLE Working Group recommendations; in many cases, changes made to MD Program practices will act as a pilot for the longer-term Faculty-wide plans.

4.  Endorsement of the Recommendations of the TAHSNe Learning Environment Working Group 
Given that the learning environment includes our hospital partners, consultation between the OLE WG and TAHSNe LE WG is ongoing, including with respect to TAHSNe LEWG draft recommendations, including:
•    Leverage an annual review process to emphasize commitment to professionalism with all learners
•    Raise awareness with patient/families with respect to receiving care in an academic environment
•    Organizations to clearly outline procedures for managing disclosure (complaints) and process for remediation

5. Consideration of Elements of a Positive Learning Environment
Building upon recommendations from a previous learning environment working group, particularly its comprehensive articulation of the elements of a positive learning environment, OLE considered the development of a learning environment framework with enablers. While the working group agreed that the development of such a framework has merit, it agreed that it would be put aside for the time being so the group could focus on a more specific learning environment issue that is was be of the greatest interest to OLE Working Group members; namely, learner mistreatment. Future plans include returning to the development of a learning environment framework with enablers, which would include consideration of metrics.  

B. Over the next year, the working group aims to accomplish the following:

• Recruitment of Faculty Lead/Ombudsperson and establishment of Learner Mistreatment Advisory Council
• FOM Portal established for all medical learners for disclosure/reporting of LE issues
• Work plan in place re the standardization of FOM mistreatment policies and processes
• Work plan in place re the development of a FOM learning environment framework with enablers, including a communication plan 
• Development of education modules re Professionalism/Allyship/LE

A. The working group has accomplished the following to date:

The Wellness Working Group has divided into four Action Teams (Research and QI, Professional Values, Literature Review and Environmental Scan), each of which has taken responsibility for an element of the overall WG objectives. We have a large number of faculty from the basic science, rehabilitation science and clinical sectors working in these groups. Collectively, we have:

• Used preliminary data from the FoM’s ‘Voice of the Faculty” survey to help inform our goals and objectives. These data have been shared with a number of departmental Executive Committees, as well as TAHSNe and TAHSNm.
• Conducted an environmental scan by interviewing Wellness leads at peer institutions in Canada and the United States; these are all institutions known to set the standard in Wellness programs and interventions as well as publications on their efforts
• Engaged the help and expertise of UofT academic librarians to conduct two reviews of the literature. The Literature Review Action team is looking at high-quality review articles that are helping us reach agreement on definitions of wellness, burnout and resiliency, and to identify interventions that have been shown to promote wellness in faculty and in other groups such as airline pilots. The Research and QI action team has reviewed >500 abstracts and is now analyzing 90 original research articles in order to determine individual and organizational predictors of faculty burnout, wellness, resilience, work satisfaction and suicidality. We are also looking at research on interventions aimed at improving wellness. This team’s goal is to be able to inform future studies of wellness and burnout in our faculty, and to be able to track the impact of interventions. (The current Voice of the Faculty survey does have some wellness information but does not look it comprehensively).
• We have hired Dr. Pier Bryden, our Faculty of Medicine Professional Values Director. She is working closely with the Professional Values Action Team which has been working on defining our faculty values, and looking at the ways in which we interact. Dr. Bryden is conducting an external review and is collaborating with education, EDI and legal leaders in studying our policies and procedures related to discrimination and harassment.
• Lynn Wilson and Julie Maggi, co-leads of the Faculty Wellness Working Group, and Pier Bryden are part of a committee that is planning a TAHSNm/Faculty of Medicine Retreat in fall 2019. The goal of the retreat is to provide updates regarding activities and to make recommendations to TAHSN regarding moving forward in a way that is collaborative and complementary. It should be noted that a number of our TAHSN hospitals are doing excellent work in this area, including  development of a robust peer support program at SickKids and the launching of multiple initiatives at CAMH. MGH is also innovating in this area.
• Lynn Wilson is a member of the TAHSN People Wellness Initiative, which is chaired by Sarah Downey and Catherine Zahn, and is holding its introductory meeting on September 3. This group will be holding a People Wellness Retreat on behalf of the TAHSN CEOs, and will address issues relevant to staff, clinicians and learners in their hospitals.

B. Over the next year, the working group aims to accomplish the following:

• We will be submitting a comprehensive Wellness Working Group Report in fall 2019, with specific recommendations for program elements, evaluation strategies and recommended job positions. This report will include opportunities for partnership with TAHSN on the issue of wellness.
• We aim to have a Faculty Wellness Director in place by late winter/early spring 2020 along with a Faculty Wellness Strategist, who will develop programs and conduct evaluations. 
• We will conduct a Faculty Wellness survey in 2020 in order to establish a baseline.
• We will initiate a Professional Values Program which will build on current strengths in the FOM and be informed by leading practices at a number of institutions in North America. This program will be integrated across our sectors and the education continuum. We will have revised policies and procedures, and will initiate strategies and conduct faculty development that will promote professional values. 

A. The working group has accomplished the following to date:

• Conducted an environmental scan of equity, diversity and inclusion (EDI) practices across the Faculty of Medicine;
• Identified key partnerships to support EDI work;
• Identified promising practices in EDI educational campaigns;
• Prepared a summary proposal to establish an Extra-Departmental Unit (Type C) to fuel scholarship and curriculum development in this field of work; and,
• Prepared a draft EDI plan and consulted broadly in working to finalize the plan.

B. Over the next year, the working group aims to accomplish the following:

• Release the Faculty of Medicine's first Equity, Diversity & Inclusion Plan
• Launch a new centre focused on research and education in EDI

A. The working group has accomplished the following to date:

• Developed a comprehensive logic model to inform the activities, resources and outputs needed to accomplish our objective.
• Completed a literature review and used this research to facilitate focus groups comprised of a broad range of stakeholders to determine the current state of engagement of clinical faculty, as well as opportunities and recommended implementation of strategies moving forward. The summary report will inform the development of a strategic plan, communication strategy and early implementation of the plan by August 2020. 

B. Over the next year, the working group aims to accomplish the following:

• Pilot blended learning strategies guide & tools (nearing completion)
  • Using flipped classroom & computer supported collaborative interaction strategies
  • Develop a best practice guide for introducing digital learning tools into the curriculum
• Integrate blended learning strategy tools into  existing courses
  • Identify (2-3) existing courses interested in integrating digital tools and blended learning strategies to increase capacity, flexibility and reach.
  • Integrate hybrid (in person and online) teaching strategies to allow for multiple types and levels of student engagement and experience into identified courses. 
  • Review teaching and student experience and learning of technology-supported blending learning strategies to refine and improve guide to best practices.
  • Establish Faculty model and support structure for e-Moderating blended learning. 
• Identify 10 additional courses to supplement existing teaching with digital blended learning strategies and tools. 

A. The working group has accomplished the following to date:

• Conducted a review of activities underway in Toronto related to the application of Artificial Intelligence and machine learning in medicine;
• Reviewed current educational offerings in Artificial Intelligence and machine learning;
• Organized a half-day symposium on machine learning in medicine, to be offered in November 2019; and,
• Consulted broadly in preparing a proposal to establish an Extra-Departmental Unit (Type C) that will help coordinate research in the field and develop curriculum and learning modules for learners, faculty and practising health professionals. 

B. Over the next year, the working group aims to accomplish the following:

• Launch a new centre for research and education in machine learning in medicine; and,
• Expand educational offerings related to machine learning in medicine, with an emphasis on learning modules for learners and current healthcare professionals.