The KAIROS Blanket Exercise: Engaging Indigenous ways of knowing to foster critical consciousness in medical education.

PURPOSE: Indigenous Peoples across Turtle Island (North America) experience ongoing health disparities tied to the effects of colonization and persistent racism toward Indigenous Peoples. Educating future clinicians to develop a critical consciousness is an important way to work toward cultural safety and improve the health care experiences of Indigenous patients. The present study evaluated the ability of the KAIROS Blanket Exercise (KBE) to foster critical consciousness. METHODS: Two hundred thirteen medical students at the University of Toronto participated in the KBE. Subsequently, 174 students completed a paper evaluation, designed to capture concepts of cultural safety and critical consciousness. Data were analyzed using quantitative and qualitative methods to identify shifts in perspectives. RESULTS: The majority of students reported the exercise altered the way they viewed those from backgrounds different from their own, and comments regarding bias, power and privilege were highlighted throughout the responses. Engaging in critical reflection through dialogue and revealing the complex sociopolitical context of Indigenous Peoples' history were emphasized as central to this transformation. CONCLUSIONS: Following participation in the KBE, medical students demonstrated a shift in their perspectives. This suggests that creating curricular space for critical pedagogy may be effective in fostering critical consciousness, ultimately encouraging reflexive practice and social action.

COVID-19: Unveiling the Role of Uncertainty in Medical Education.

This article was migrated. The article was marked as recommended. Since the start of COVID-19, we have all heard the phrase "facing unprecedented uncertainty," and it is this uncertainty that health care professionals are navigating on a daily basis. In this personal view article, I highlight the impact of uncertainty on everyday clinical practice, and the amplification of this during the current pandemic. In light of this, I argue for the value of teaching for uncertainty in medical education in a way that is transparent and intentional. Ultimately, I query whether such a curricular change might allow trainees, health care professionals and the public to feel more prepared when facing these uncertain times.

The need for narrative reflection and experiential learning in medical education: A lesson learned through an urban indigenous health elective.

In this personal view article, I discuss a formative experience I had during an Urban Indigenous Health elective in which I participated while in my final year of medical school. The elective was developed on the foundation of an experiential learning model, which is central to Indigenous pedagogy and emphasizes learning through experience and narrative reflection. By transforming medical education into a place where such concepts are integrated and valued, I argue that we will create physicians who are self-aware, compassionate and able to provide culturally safe care to all patient populations they will serve in their future practices.

Cancer Patients? Willingness to Routinely Complete the EQ-5D Instrument at Clinic Visits.

BACKGROUND: Health utility (HU) scores play an essential role in pharmacoeconomic analyses. Routine clinical administration of the EuroQol-5 Dimensions (EQ-5D) can allow for HU and health related quality of life (HRQOL) assessments in the real-world setting. OBJECTIVES: The primary goals of this study were to evaluate whether patients were willing to complete the EQ-5D instrument on a routine basis and which clinical or demographic factors influence this willingness. METHODS: 618 adult cancer survivors across multiple cancer disease sites at the Princess Margaret Cancer Centre completed an acceptability survey after completing the EQ-5D instrument. RESULTS: The mean (SD) EQ-5D score was 0.81 (0.15). Among those surveyed, 88% reported that the EQ-5D was easy to complete. 91% took under 5 minutes and 88% were satisfied with its length. 85% were satisfied with the types of questions asked on the EQ-5D. Importantly, 92% reported that they would complete the EQ-5D, even if it were used solely for research purposes; 73% agreed with the notion of completing it regularly at their clinic visits. Patients with lower EQ-5D scores (p=0.0006), and non-Caucasians (p=0.0024; 60% willing) were less willing to complete the instrument on a regular basis. Curability of tumour, disease site, age, and gender did not influence willingness. CONCLUSIONS: The majority of cancer patients across disease sites are willing to complete the EQ-5D instrument regularly, even if it were solely for research purposes, but up to 39% declined participation in the first place.