Optimize Our Learning Environments

Ecosystem of Collaboration

Ecosystem of Collaboration

Optimize our learning environments to deepen the integration of wellness, respect and resilience (focusing on optimizing our learning environments), including the promotion of professional values.

A learning environment that is welcoming and supportive across the continuum is integral to learner/trainee health and wellbeing.

Consider and address where possible how curricular structures and wellness/resiliency programming can enable and support the heath and wellbeing of learners/trainees, faculty and staff.

Ensure there is clarity (and, where possible, harmonization/ integration) regarding relevant mistreatment policies, procedures, reporting practices/expectations, and corresponding supports.

Develop an integrated encounter/record information system.

Provide training/development opportunities to faculty, staff and students that is tailored to principles, roles and responsibilities.

The Team

Decanal Sponsor: Patricia Houston

Key Collaborator(s)

  • OHPSA and PGME Office of Resident Wellness
  • Medical students, residents, fellows, and other FoM students
  • Department Chairs
  • TAHSNe Learner Environment Task Force; HUEC; Hospital VPs Education
  • John Bohnen, Senior Advisor to the Dean on Clinical Affairs
  • Relevant FoM and University offices/officers (e.g. Associate Dean, Inclusion and Diversity; FoM Diversity Strategist; Communications; Sexual Violence Prevention and Support Centre)
  • Faculty development providers
  • Focusing on improving faculty wellness working group (via Lynn Wilson)
  • Ontario Medical Association Physician Health Program (PHP)
  • Other medical schools
  • Parents, caregivers, significant others
  • Other to be determined

Working Group Members:

  • Decanal Sponsor: Patricia Houston
  • Working Group Co-Chairs: Tony Pignatiello (Associate Dean, OHPSA, MD Program) and Heather Flett (Associate Director, Resident Wellness)
  • Medical student, resident/PARO, fellow, and other FoM student representation
  • PGME program director, MD curriculum director, Departmental, and Hospital representation
  • FoM Diversity Strategist
  • Faculty development representative(s)
  • Education scientist/individual(s) who have produced learning environment scholarship

Staff Support: Paul Tonin; OHPSA; PGME Office of Resident Wellness

The Action Plan

Strategies:

With the assumption that student mistreatment will be the primary (though not exclusive) focus of the working group, the following four-pronged strategy will provide a framework for the discussion, identification, prioritization and evaluation of specific tasks. This framework was informed by available survey data (e.g. CGQ, course evaluations, voice of surveys), education scholarship and accreditation requirements, which will also inform the work of the working group.

  1. Raise Awareness about forms/types of mistreatment, where it’s occurring, ‘first contact’ disclosure and reporting options, etc. This will of course require clarity about what is considered mistreatment, roles and responsibilities, ‘procedural clarity’, etc.; tailored messaging, mentoring, training and faculty development; and institutional accountability.
  2. Ensure Clarity about what is considered mistreatment, principles, roles and responsibilities, ‘procedural clarity’ including harmonization where possible, etc. Some high-level issues may include: definitions of mistreatment; how University or hospital jurisdiction is determined; balance between multiple ‘first contact’ disclosure/reporting options and centralized monitoring, tracking and reporting; how context (e.g. social-cultural histories, including with respect to micro-aggressions) can be taken into account; balance between ‘informal’ and ‘formal’ resolutions; balance between rehabilitative or restorative approach with the option for progressive disciplinary action where appropriate (including in relation to faculty appointments).; responsibilities and procedures for formal reporting and resolution. This will require wide consultation, including with departmental and hospital partners.
  3. Provide Support through tailored mentoring, training and faculty development. This tailored support should align with principles as well as identified roles and responsibilities and corresponding procedures. Also, recognizing that learners are active agents in the learning environment, and not just or only passive recipients of bad behaviour, consider how to enable and empower learners to change and subvert problematic influences, interactions and practices experienced in the learning environment. Finally, “providing support” should include consideration of how curricular structures and wellness/resiliency programming can enable and support the heath and wellbeing of learners/trainees, faculty and staff.
  4. Accountability – Consider how to most effectively track and report mistreatment in order to demonstrate that mistreatment policies and procedures are not empty vehicles, but rather can and do lead to change.

Steps:

  1. Establish a working group to:
    • review the available survey data, relevant education scholarship, and accreditation requirements
    • determine if the strategies defined above are appropriate
    • determine if there are other issues and corresponding strategies
    • determine what issues/strategies are in/out of scope (particularly in relation to items that the University can lead/take action on)
    • consult widely, as appropriate
    • identify short- medium- and long-term visions, and prioritize specific tasks to support achievement of those visions, including consideration of and consultation about available/necessary resources, viability and sustainability
    • oversee the development of tailored project plans, including scope, timelines, budget and metrics/evaluation plan
  2. Communicate, consult and refine as appropriate.

Timeline

December 2018/January 2019: Identify working group members and schedule working group meetings

Winter/spring 2019: Agree on working definition of learning environment in order to make in/out of scope determinations; discuss, identify and refine priorities, including steps necessary for development and implementation

Spring/summer 2019: Development of tailored project plans

Metrics:

To be determined by the working group in accordance with the four strategic components outlined above, but informed by the specific projects identified by the working group.

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