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Visit our web page http://umanitoba.ca/faculties/medicine/education/ed_dev/ for full details on all Medical Education Events. 1 In This Issue: Competency-based Medical Educaon 1 This Issue - Faculty Development 1 Well ‘rounded’ Com- petency-based Medi- cal Educators 3 Classroom Innova- ons: TBL and MCQs 5 To Be or Not to Be 6 Research Highlights 7 Featured Colleague 8 Conference Reports 9 FAQ 10 Sustainability and Med Ed 11 MED ED NEWS Spring/Summer 2014 Volume 4 No. 2 Department of Medical Education, College o f M e dicin e Y ou may have noced that the buzz at the College of Medicine lately is all about competency-based medical educaon (CBME). This is because PGME and Med Ed recently hosted Peter Ferguson, MD, as a vising professor to relay the Univer- sity of Toronto’s experience with implemenng CBME in their postgraduate ortho- pedic program. In his presentaon, Dr. Ferguson shared the approach they took implemenng CBME, as well as the lessons learnt along the way. You may be sur- prised to hear that, based on their experience, although high quality residents ex- cel in CBME, poorly performing residents get the most benefit out of this type of program, as they are idenfied early and subsequently remediated appropriately. Check in regularly at the PGME website for further updates hp://umanitoba.ca/ facules/medicine/educaon/pgme/canmeds.html. Competency-based Medical Education by Joanne Hamilton W elcome to our spring issue of Med Ed News, with its focus on Faculty Devel- opment. The term faculty development is used with varying emphasis de- pending on the discipline and the context. Within the College of Medicine’s De- partment of Medical Educaon, our faculty development programs exist to sup- port the teachers and educaonal administrators, as they, in turn, guide medical learners. This support primarily involves acvies aimed at teaching and learning development, but also includes career development and administrave develop- ment. This broad goal is based on the recognion of the value of a medical educa- on learning community. Faculty Development programs aim to support this dy- namic community and encourage its growth as a collaborave creave environ- ment where individuals can be both a learner and a leader in educaonal innova- ons. Please read on to see what Faculty Development looks like around the Ban- natyne Campus. (connued page 2) This Issue - Faculty Development by Stephanie Giberson-Kirby
Transcript
Page 1: MED ED NEWS - University of Manitoba · PGME and Med Ed joint venture. The planning and preparation for that event provided many opportunities for faculty development needs to be

Visit our web page http://umanitoba.ca/faculties/medicine/education/ed_dev/ for full details on all Medical Education Events. 1

In This Issue:

Competency-based Medical Education

1

This Issue - Faculty Development

1

Well ‘rounded’ Com-petency-based Medi-cal Educators

3

Classroom Innova-tions: TBL and MCQs

5

To Be or Not to Be 6

Research Highlights 7

Featured Colleague 8

Conference Reports 9

FAQ 10

Sustainability and Med Ed

11

MED ED NEWS Spring/Summer 2014 Volume 4 No. 2

Department of Medical Education, College of Medicine

You may have noticed that the buzz at the College of Medicine lately is all about competency-based medical education (CBME). This is because PGME and Med

Ed recently hosted Peter Ferguson, MD, as a visiting professor to relay the Univer-sity of Toronto’s experience with implementing CBME in their postgraduate ortho-pedic program. In his presentation, Dr. Ferguson shared the approach they took implementing CBME, as well as the lessons learnt along the way. You may be sur-prised to hear that, based on their experience, although high quality residents ex-cel in CBME, poorly performing residents get the most benefit out of this type of program, as they are identified early and subsequently remediated appropriately. Check in regularly at the PGME website for further updates http://umanitoba.ca/faculties/medicine/education/pgme/canmeds.html.

Competency-based Medical Education by Joanne Hamilton

Welcome to our spring issue of Med Ed News, with its focus on Faculty Devel-opment. The term faculty development is used with varying emphasis de-

pending on the discipline and the context. Within the College of Medicine’s De-partment of Medical Education, our faculty development programs exist to sup-port the teachers and educational administrators, as they, in turn, guide medical learners. This support primarily involves activities aimed at teaching and learning development, but also includes career development and administrative develop-ment. This broad goal is based on the recognition of the value of a medical educa-tion learning community. Faculty Development programs aim to support this dy-namic community and encourage its growth as a collaborative creative environ-ment where individuals can be both a learner and a leader in educational innova-tions. Please read on to see what Faculty Development looks like around the Ban-natyne Campus. (continued page 2)

This Issue - Faculty Development by Stephanie Giberson-Kirby

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Continued from Page 1

Formal faculty development activities include annual learning events offered with different methods, modes and time frames. Informal support is also offered through con-sultation, coaching, and partnerships to support education innovations.

This issue of Med Ed News highlights two of these partnerships. First, Med Ed, Med-IT and Dr. Adrian Gooi part-nered to created a pilot involving team-based learning and the crea-tion of a student multiple-choice question bank. Second, the recent full-day program, “Competency-based Medical Education: Building Towards Implementation” was a PGME and Med Ed joint venture. The planning and preparation for that event provided many opportunities for faculty development needs to be identified, as our college starts the shift to a competency-based curricu-lum. These needs will be considered in our faculty development program-ming for 2014/2015.

As always, the Med Ed team is keen to hear about your ideas on how we can support your work in education and teaching innovations. Let us know about your faculty develop-ment needs!

Nothing is constant except change...

During the past four and a half years, Cindy Lewkiw pro-vided valuable administrative support as Program Administrator for the Department of Medical Education. Due to a recent re-structuring within the Division of Continuing Professional Devel-opment (CPD), Cindy’s responsibilities have been shifted to CPD Dentistry and CPD Medicine. Thank you Cindy, for your past work in the Department of Medical Education and your help during the transition phase to your new position.

While Dr. Bertram Unger remains a active research member of the Department of Medical Education, he has relocated his office to the Thorlakson Building at the HSC. This move will facili-tate his research work and the supervision of his students and laboratory staff. Bertram’s email address remains the same but his telephone number has changed to 204-787-8667. We are pleased that he continues to drop in at 260 Brodie to keep us abreast of his research and share his often witty, literary banter.

We are pleased to welcome Heather Long as a new Research Associate with the Medical Education team! Heather earned her Bachelor and Master of Science degrees at the University of Manitoba. She will be working directly with the Lead Research Associate, Stephanie Armstrong. Heather will be contributing her experience with qualitative research approaches and famili-arity with the University of Manitoba and the Winnipeg Regional Health Authority. Welcome, Heather!

This Issue: Fac Dev Changes

Staffing

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Following a request from the Dean of Medicine, an annual series of Medical Education Grand

Rounds was initiated in 2013. These interactive lectures/rounds were facilitated by medical educa-tion leaders from University of Manitoba and other leading academic medical institutions. The intent of the Grand Rounds is to focus on a hot topic in medical educa-tion and link theory and practice of effective medi-cal education programming. These links are pur-posely formed by working with other programs and departments and reinforced through the an-nual faculty development events.

Med Ed was pleased to work with PGME to bring Dr. Peter Ferguson to our campus on May 13, 2014. Dr. Ferguson shared his CBME experiences with three groups during his visit: the Manitoba senior healthcare leadership, Bannatyne faculty via the noon Med Ed Grand Rounds, and the PGME program teams in an afternoon workshop.

The Med Ed Grand Rounds attracted a capacity crowd who listened intently to Dr. Ferguson’s de-scription of the evolution and outcomes of the University of Toronto CMBE program. He de-

Well ‘Rounded’ Competency-based Medical Educators by Stephanie Giberson-Kirby

scribed the perfect storm in postgraduate training that is the result of a decrease in resident work hours, resident lifestyle changes, increased patient safety focus, hospital efficiency issues, and an ever-increasing body of knowledge. The response to the storm was the implementation of a CBME program. Dr. Ferguson provided practical steps and resources, including curriculum maps, assessment plans, and evaluation templates. He also emphasized the value of sharing resources and looking to the literature for best practices, and other CBME projects. (See p. 4).

The influence of the CBME rounds was immediately reflected in the next faculty development event; the May CPD/Med Ed Journal Club involved a energetic discussion and clarification of the language and the-ory that underpins CBME. We look forward to fur-ther opportunities to round-out critical issues in medical education as our programs evolve.

Stephanie Giberson-Kirby, Dr. Peter Ferguson and Jo-

anne Hamilton discuss faculty development needs for

CBME. Photo—Dan Gwozdz

To date, the Grand Rounds have focused on three topics:

Medical Education Research—UGME, PGME and Beyond—September, 2013

Building a Community of Educators—December, 2013

Competency–based Medical Education (CBME)—May, 2014

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Further Reading: CBME

Dr. Peter Ferguson, presenting on CBME Curriculum to UM medical educators. Photo—Dan Gwozdz

Where we are headed

Hodges BD. A Tea-steeping or i-DOC Model for Medical Education. Acad Med. 2010;85(9): S34-S44

Dr. Brian Hodges compares the time-based and outcomes-based models of medical education and suggests how to create a hybrid.

How we are going to get there

Holmboe ES, Ward DS, Reznick RK, Katsufrakis PJ, Leslie KM, Patel VL, Ray DD, Nelson EA. Fac-ulty development in assessment: The missing link in competency-based medical education. Acad Med. 2011,86(4):460-67.

The authors state “We know enough about gen-eral principle and educational theory to build and implement faculty development in assess-ment to move CBME forward and improve train-ing for the benefit of the public.” This paper provides direction on where and how this might be accomplished.

What it might look like

Ferguson PC, Kraemer W, Nousiainen M, Safir O, Sonnadara R, Alman B, Reznick R. Three-year experience with an innovative, modular com-petency-based curriculum for orthopaedic training. J Bone Joint Surg Am. 2013: e166(1-6) http:/dx.doi.org/10.2106/JBJS.M.00314.

In this article, our May 13, 2014 guest, Dr. Peter Ferguson provides the rationale and processes used for CBME implementation with orthopae-dic surgical training by the University of Toron-to .

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Classroom Innovations: TBL and MCQs

by Stephanie Giberson-Kirby with Adrian Gooi

which suggests that group review improves the quality of questions, 1 and that student performance improves when students are involved in creating questions. 2,3

A survey of the process revealed that the students in-volved felt that the class-created MCQ question bank was a valuable resource and that they would be inter-ested in collaborating with the class to create practice questions for future sessions.

This pilot highlighted the need to work within a sup-portive medical education community where theory may be combined with practice to the benefit of stu-dents, instructors and the curriculum.

1. Wallach, P. M., Crespo, L. M., Holtzman, K. Z., Galbraith, R. M., &Swanson, D. B. (2006). Use of a committee review process to im-prove the quality of course examinations. Advances in Health Sci-ences Education, 11(1), 61-68.

2. Denny, P., Hamer, J., Luxton-Reilly, A., & Purchase, H. (2008).PeerWise: Students Sharing Their Multiple Choice Questions. In Proceedings of the Fourth International Workshop on Computing Education Research (pp. 51–58). New York, NY, USA: ACM. doi:10.1145/1404520.1404526.

3. Foos, P. W., Mora, J. J., & Tkacz, S. (1994). Student study tech-niques and the generation effect. Journal of Educational Psycholo-gy, 86(4), 567–576. doi:10.1037/0022-0663.86.4.567.

91% of students felt that the class-created MCQ question bank was a valuable re-source

86% of students would be interested in collaborating with the class for creating practice questions in future sessions

As an enthusiastic medical educator, Dr. Adrian Gooi is keen to try new teach-

ing techniques and tools. He is also com-mitted to the development of quality as-sessment tools. With a little help from his friends in Med Ed and IT, Dr. Gooi piloted a team-based learning approach to develop-ing a student-generated question bank.

First, students created their own multiple-choice questions (MCQs) based on self-study materials. Then, in teams, the stu-dents reviewed their questions which pro-vided opportunity for content clarification at a peer level. Next, select questions were reviewed with the class as a whole. Finally, Dr. Gooi vetted the questions and incorpo-rated them into a question bank that stu-dents could access for formative learning. Dr. Gooi’s approach follows the literature

Team Based Learning: Med students in Theatre A

Photo—Sandra Schönwetter

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To Be or Not to Be? *

HaMLET and the Evolution of Journal Club

by Stephanie Giberson-Kirby

A lthough we have come a long way from the clinical learning methods of Shakespeare’s time, we grap-ple, at times, with some of the same questions of identity and purpose in a world that is dramatically chang-ing around us. In an academic setting, part of our identity rests in our knowledge base and the act of sharing and adapting that knowledge to the benefit of our learners and patients. Historically, guilds served this func-tion in a face-to-face world of communication. In the industrial age, information became reproducible and transportable, albeit with limitations. Hence, clinicians formed journal clubs in order to share the then scarce journals and learn together. In our current information age, the challenge is one of managing endless sources of information and discerning that which contributes to our knowledge as educators in healthcare circa 2014.

As a result of input from participants, a new program entitled HaMLET was created for the discussion and debate of emerging issues, both within academic literature and beyond, of interest to educators from across the healthcare professions. The acronym HaMLET was coined in an attempt to evoke the sense of commu-nity and shared purpose that was voiced by our participants—Healthcare professions educators all Meeting to Learn, Educate and Teach. This new program has received a positive response as is evident by the increas-ing attendance that has required moving to a larger room! Also there is a line-up of volunteer facilitators keen to share their interests throughout 2014. HaMLET is scheduled to occur four times a year, from 12:00-1:00 pm; watch for posters and emails for specific dates and topics. While department and discipline specific journal clubs continue to thrive across healthcare, it is clear that the community of learners that support HaMLET also want to be part of this collegial group. Come Join Us!

For more information on the CPD/MedEd “Classic” Journal Club or the HaMLET Discussion Forum contact Stephanie Giberson-Kirby .

An engaging discussion regarding the use of Action Re-

search methodologies at a recent HaMLET

Photo — Dan Gwozdz

At the Bannatyne Campus, the Medical Education Journal Club /Discussion Forum had functioned successfully for many years. A gap in the facilitation of the club in 2012-13 provided an opportunity to reflect upon the value and function of this faculty development program. Should it continue to be, or perhaps take a different form? To an-swer this question, members of the Bannatyne academic community were invited to a presentation and brain storming session on September 18, 2013 which encour-aged discussion and/or written feedback on the future of the program. Faculty members from medicine, dentistry and medical rehabilitation attended. As a learning commu-nity, we had the opportunity to direct how journal club might be or might not be developed.

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Following the path of medical education from under-graduate to continuing professional development, Stephanie and our new Research Associate Heather Long are working with many research collaborators on a full agenda of projects!

Select Projects

The Undergraduate Medical Education Curriculum Re-newal project has completed another cycle of evalua-tions with the Class of 2014, 2015, and 2016 cohorts. We look forward to seeing the emerging data trends as this project continues until Spring 2018.

An analysis of retention rates of International Medical Graduates (IMGs) in Manitoba has revealed an encour-aging picture: 68% of IMGs who have been trained or assessed to practice in Manitoba are staying in prac-tice in the province. Next steps will include interviews with IMGs to understand factors that contribute to this retention.

As PGME begins to transition to Competency By Design and CanMEDS 2015, the Department of Medical Edu-cation is embarking on research to understand the im-pact of this new approach on faculty, residents, and health services. Stay tuned to hear how this project develops!

Bertram’s projects involve the work of graduate and undergraduate students, a post-doctoral fel-low, and several surgical residents. He is actively collaborating with colleagues from the Depart-ments of ENT and General Surgery as well as the Faculty of Engineering. Current projects include:

Developing Anatomy curriculum develop-ment software for the iOS platform,

Analyzing the use of stereovision in surgicalskills training,

3D printing for temporal bone surgical skillstraining,

Haptic force feedback system for surgicalskills training,

Mixed and Augmented Reality for ENT sur-gical skills training,

Laryngoscopic force and motion analysis, Endoscopic game controller for surgical

training, Validation of ultrasound training platform

metrics Inflatable Internal Pelvic Haemosta-sis System Development.

Research Highlights

by Stephanie Armstrong and Bertram Unger

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Ingrid has been with Med Ed for almost 14 years. Original-

ly she was responsible for both postgraduate and undergradu-ate communication skills train-ing. Now she is part time work-ing with postgrad, with physi-cians in practice, and with IMGs (international medical gradu-ates). She facilitates communi-cation skills remediation ses-sions with residents and physi-cians in practice. Ingrid also offers faculty development on specialized topics such as the Calgary Cambridge Com-munication model, motivational interviewing, and sharing bad news. Her expertise is in demand for CPD, resulting in workshops in Brandon, Morden-Winkler, Minnedosa and Steinbach. As a member of the Inter-professional Education Communication Skills Working Group, Ingrid has been involved with two huge ses-sions and is currently developing another session on conflict in teams. The following conversation is ex-cerpted from a short interview with Ingrid.

What did you do before you worked here?

I was a counselling psychologist at Student Counselling Services on the main campus. I was also in private practice and did employee assistance work. While there, I taught a course in the Faculty of Education on communication skills.

What is one enjoyable aspect of your job?

I really enjoy teaching; I like the interaction with the learners. I find it fun and I like being a performer—I like being on stage, being in front of people. And I like developing new programs and trying innovative types of things that would seem to be needed or relevant.

What inspires or motivates you?

Doing things that are new, new ways of teaching, of

Featured Colleague: Ingrid Toews

uncovering new areas of communication skills that haven’t been done before.

What is one thing you’ve learned while working here?

I’ve learned a lot about medicine. Every time I assess people on communication skills, I’m also looking at their history taking, for example, so I’ve picked up a lot. I still don’t know near as much as a doctor. But that part’s been fun. I’ve also learned that change takes time, but does happen. So I try and enjoy those moments where you realize that things really have changed. We still have a ways to go, but there are very few people who are say-ing “Oh communication skills—those are soft skills.” The residents, the international doctors, they are really em-bracing the patient-centered communication skills. It’s been exciting to see that you just don’t give up; you just keep going.

What might someone be surprised to learn about you?

I teach yoga. I play with the Urban Jazz Trio—I am the leader and play piano.

What are you currently reading?

My yoga teacher whom I studied with for years just pub-lished her first book: Yoga Fiction Yoga Truth by Sandra Sammartino. Also, The Power of Now by Eckhardt Tolle. It’s all about being present, mindfulness and meditation.

Whom do you find fascinating and why?

Right now it’s Eckhardt Tolle. What he talks about is very yoga related too, the yoga philosophy of higher con-sciousness, being mindful, present. I took a course in mindfulness-based stress reduction program at a yoga studio, and I’m hoping to train as a facilitator. It was de-veloped by John Kabat-Zinn who works in the Faculty of Medicine, University of Massachusetts.

Interviewed by Anita Ens— Photo by Dan Gwozdz

The Center for Mindfulness at University of Massachusetts Medical School http://www.umassmed.edu/cfm/index.aspx

Photo—Dan Gwozdz

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Members of Med Ed attended a number of en-gaging conferences in the past year. The fol-

lowing abbreviated reports represent selected high-lights.

Ottawa Conference/ Canadian Conference in Medical Education (CCME) Ottawa, April 25-29, 2014 Transforming Healthcare Through Excellence in Assessment and Evaluation

This spring, Canadian medical educators were fortu-nate to have the 16th Ottawa Conference combined with the 12th CCME. The Ottawa Conference is an international event which this year returned to its roots in Canada’s capital. CCME is the conference of choice for medical educators in Canada. The focus of the conference was timely in light of the recent pro-motion of competency based education across Cana-da. Preconference events included one on the na-tional promotion of clinician educators in medical schools and meetings of interest groups (arts and humanities, narrative medicine, informatics, faculty development) where we shared teaching practices and curriculum ideas. Workshops we attended in-cluded topics such as teaching clinical reasoning, us-ing simulation, and technology in education.

Society for Academic Continuing Medical Education (SACME) Cincinnati, Ohio, May 1-4, 2014

SACME represents a group of CME/CPD educators from both the United States and Canada, including profes-sionals from medical schools, teaching hospitals and specialty societies. The spring meeting focused heavily on maintenance of certification, as well as integrating quality improvement and educational initiatives of hos-pitals and CPD centers. We attended workshops on using social media in medical education and develop-ing a common terminology in CPD educational inter-ventions.

Conference Presentations

Stephanie Armstrong presented her research on Patient Engagement in the Continuing Professional Development of Family Physicians to the AFMC CPD Research Group at the Canadian Conference on Medical Education (CCME) in Ottawa. This presentation received a great response from other CPD researchers and will hopefully lead to collabo-rations with other institutions as well as other pa-tient groups.

Facilitating Reflection Through Peer-Assisted De-briefing: Feedback from the MPAR Reflection Exer-cise, a collaboration with Dr. José François Stepha-nie Armstrong, Dr. Jeff Sisler, and Jeff Toews, was presented at the CCME conference and at the So-ciety for Academic Continuing Medical Education in Cincinnati, Ohio. Audience members were keen to hear how this exercise was implemented and the type of feedback it has received.

Dr. Bertram Unger and research team members presented at multiple meetings this last year in-cluding the Medicine Meets Virtual Reality confer-ence in Los Angeles, California, the Royal College Simulation Summit in Vancouver last fall, and the recent Canadian and American meetings of the Otolaryngological Head and Neck Surgery Socie-ties. Dr. Unger and his team recently published in the Journal of Otolaryngology and Head and Neck Surgery as well as in Studies in Health Technology and Informatics, and Surgical Endoscopy.

Conference Reports by Stephanie Armstrong and Bertram Unger

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FAQ

Medical Education is made up of a number of learning environments, with at least

three inter-related curricula: our stated and formal curriculum; the unscripted,

informal curriculum; and the set of influences that relate to our organiza-

tional structure and culture often known as the hidden curriculum.2 With-

in this hidden curriculum there are aspects that are positive in nature

(such as collegiality and networking strategies) but others that can be

counterproductive (such as deterring students to pursue certain careers

in medicine, or reinforcing hierarchies). Within the Future of Medical

Education in Canada report from the AFMC, the hidden curriculum is one

of ten priority areas to be addressed.3

Changing and challenging the hidden curriculum requires that we identify

it and acknowledge its effect.3 Policy development, evaluation, resource

allocation, and institutional slang/nomenclature are common domains where

the hidden curriculum is often present or has an impact,2 and present good

starting points for discussion. Tools and techniques for identifying and under-

standing the hidden curriculum are described in the medical education litera-

ture,4,5 (for example, see Figure 1).

Addressing the hidden curriculum is critical for medical schools, as its nega-

tive effects on areas such as our graduates’ views of patients, professions and

organizational processes can have significant consequences for healthcare outcomes and healthy

workplaces. Its positive effects also need to be identified and used to the advantage of all our

learners.

1. Good BJ. Medicine, rationality, and experience: an anthropological perspective. The Lewis Henry Morgan Lectures. Cambridge,UK: Cambridge University Press; 1995.

2. Hafferty FW. Beyond curriculum reform: confronting medicine’s hidden curriculum. Acad Med 1998;73(4):403-7.3. Busing N. The future of medical education in Canada (FMEC): A collective vision for MD education. Ottawa: The Association of

Faculties of Medicine of Canada (AFMC); 2010.4. Haidet P. Kelly A. Chou C. The Communication, Curriculum, and Culture Study Group. Characterizing the patient-centeredness

of hidden curricula in medical schools: development and validations of a new measure. Acad Med 2005;80(1):44-50.5. Mossop L, Dennick R. Hammond R. Robbe I. 2013. Analyzing the hidden curriculum: use of a cultural web. Med Educ

2013;47:134-143.

symbols

stories

routines

rituals

control

systems

organizational

systems

power

structures

Figure 1

A potential framework to identify the

positive and negative influences of the

hidden curriculum.5

What is the Hidden Curriculum? How can it be identified?

Answer by Joanne Hamilton

“Why are you wasting my time? Just get to the important stuff” – Chief resident to a medical student, as

quoted in “Medicine, Rationality and Experience: An Anthropological Perspective”. 1

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Pedometer Challenge: Team building and greater self-

awareness

On January 13, 2014, two teams of four from Med Ed participated in

HSC Wellness’ six-week Pedometer Challenge along with 85 other

teams. Each team member tracked daily totals of activity (steps and

equivalents) and the number of fruits and vegetables eaten. Med Ed

participants discovered how, in some cases, few steps they actually

took during a usual work day and became more aware of their food con-

sumption and activity habits. The Wellness program gave all participants

a pedometer to keep. In addition, two Med Ed members won partici-

pant prizes.

Commuter Challenge

Along with other University of Manitoba employees and students, Med

Ed participants took part in the nation-wide commuter challenge from June 1-6, . Each tracked her commuting by

means other than single-driver vehicles, including walking, running, biking, bussing, and car-pooling.

Here at U of M, we are part of a community that’s working toward “a more sustainable place in which to learn, work and play” within a broader mandate to “improve sustainability and operate in a way that respects and

supports our environment” (Sustainability). Within Med Ed, we have taken that challenge to heart, joining in two local efforts in the areas of food, transportation, and active living.

Anita cycling to work

Photo —Anita Ens

Sustainability and Med Ed by Anita Ens

The Department of Medical Education Phone: 204-272-3102

260 Brodie Centre 727 McDermot Avenue Fax: 204-480-1372

Winnipeg, MB R3E 3P5

[email protected]

Issue Editor: Stephanie Giberson-Kirby

Contributors: Joanne Hamilton, Stephanie Giberson-Kirby, Adrian Gooi, Stephanie Armstrong, Bertram Unger, Anita Ens

Proofreading: Karen DePape


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