Narrative means to professional ends: new strategies for teaching CanMEDS roles in Canadian medical schools.

PROBLEM ADDRESSED: Medical students in training are rarely encouraged to engage in reflective thinking around clinical encounters. Writing exercises can be an effective route for encouraging student reflection. OBJECTIVE OF PROGRAM: The purpose of this pilot project was to determine if using reflective writing in teaching the CanMEDS roles helps to increase students' understanding of the roles in the clinical context. PROGRAM DESCRIPTION: A pilot project was undertaken with 10 third-year medical students at the University of Toronto in Ontario. Students wrote about a different CanMEDS role for each session based on supplied writing prompts. Students also completed a Narrative Reflection Tool at the end of each group session. A selection of writing samples was assessed for reflection and for an understanding of the CanMEDS roles. Students were also given an opportunity to provide feedback on the program. CONCLUSION: Students demonstrated a good grasp of the CanMEDS roles, strong reflective capacity, and engagement in the learning process. Results suggest reflective writing has an important role in encouraging personal reflection and reflective thinking in the clinical context.

A randomized controlled trial of mindfulness-based stress reduction to manage affective symptoms and improve quality of life in gay men living with HIV.

UNLABELLED: To determine whether MBSR groups would help gay men living with HIV improve psychosocial functioning and increase mindfulness compared to treatment-as-usual (TAU). METHODS: 117 participants were randomized 2:1 to MBSR or TAU. No new psychosocial or psychopharmacological interventions were initiated within 2 months of baseline. Standardized questionnaires were administered pre-, postintervention and at 6 months. An intent-to-treat analysis found significant benefits of MBSR: at post-intervention and 6 months follow up, MBSR participants had significantly lower avoidance in IES and higher positive affect compared to controls. MBSR participants developed more mindfulness as measured by the Toronto Mindfulness Scale (TMS) including both TMS subscales, curiosity and decentering, at 8-week and 6 months. For the sample as a whole, increase in mindfulness was significantly correlated with reduction in avoidance, higher positive affect and improvement in depression at 6 months. MBSR has specific and clinically meaningful effects in this population.