H2SUM Trainee Portal
H2SUM is an enhanced skills program for family physicians and is supported by the UBC Enhanced Skills department, Vancouver Coastal Health Department of Family and Community Practice, and the BC Centre for Excellence in HIV/AIDS. Trainees in this program will expand their knowledge, skills, and behaviors in order to better support patients and communities affected by HIV, hepatitis, substance use disorders, mental health disorders. Cultural safe and humble medical practice is essential to this work.
Competency-basedtraining
The majority of learning will be work-based, occurring in primary care offices, outpatient clinics, and select acute care services. The competencies are primarily higher-order cognitive tasks that are sufficiently complex to challenge family doctors who are already highly skilled professionals. Work-based learning is supported by readings and online modules that deal with social, cultural, and scientific knowledge that underly clinical practice.
Milestones
The majority of learning will be work-based, occurring in primary care offices, outpatient clinics, and select acute care services. The competencies are primarily higher-order cognitive tasks that are sufficiently complex to challenge family doctors who are already highly skilled professionals. Work-based learning is supported by readings and online modules that deal with social, cultural, and scientific knowledge that underly clinical practice.
High level intended learningoutcomes for H2SUM
On completion of this program, family physician trainees will be able to:
- Collaboratively create safe spaces for patients and colleagues to work and heal in, by applying cultural humility and safety, trauma-informed care, principles of reciprocity and equity, anti-racism, and other anti-oppressive practices. This is supported by a practice of critical self-reflection and openness to feedback from others (communicator, collaborator, scholar, professional, health advocate, manager)
- Act as a resource for viral hepatitis detection and management in their defined community (medical expert, scholar, advocate, manager, communicator, collaborator)
- Provide longitudinal, comprehensive, and affirming care for those living with substance use disorders with special attention to opioids use disorder and harm reduction, mobilizing resources to overcome obstacles. (collaborator, communicator, advocate, scholar, professional, medical expert)
- Evaluate complex mental health presentations and collaborate with patients, advocates, mental health teams, and family members (when appropriate) to create a treatment plan (medical expert, manager, advocate, professional, collaborator, communicator)
- Provide compassionate, collaborative, non-judgemental, longitudinal, primary care-orientated care to those living with and at risk of HIV infection (advocate, communicator, scholar, collaborator, manager, professional)
H2SUM-ESP PillarsJAN 2022
On completion of the H2SUM enhanced skills program, family doctors will have enhanced skills, knowledge, and behaviors in five areas:
Culturally Safe and Humble Care
Viral Hepatitis
Substance use medicine competencies
Mental Health Disorders
HIV
Portfolio
A comprehensive portfolio will be the vessel that holds assessment materials, assignments, journal articles, and reflections. You will build your portfolio as you progress through the H2SUM program. The portfolio is an electronic storage space that is accessible to you and your learning team. Your coach will meet regularly with the you and support you in achieving competencies and provide feedback on your development and reflections. You will choose a coach based on their professional, academic, and community interests and abilities. If it arises that working with a selected coach is not sufficient to meet your needs or there is conflict between you, another coach will be arranged. The coach (or coaches) do not need to be physicians. Regular reflection on the learning process, articles/readings, interesting interactions in the workplace, and personal development is expected. Time will be allotted for you to do these reflections as they are essential skills and are competencies in the program. The portfolio can be overwhelming if too many items are included; you are advised to be selective and choose items that are evidence of progress towards competency. There are be requirements for reflections in the portfolio, which may constitute self-reflection or journaling, summary of a discussion, perspectives on journal articles or writings etc. If you experience challenges with the portfolio, you are encouraged to talk with your mentor. The portfolio will be assessed by the program director and the trainee collaboratively. Portfolio feedback:
- You and the program director, Dr. Val Montessori will have 1-2 feedback sessions and a final meeting
- Mentors may give ongoing feedback
FieldNotes
Field notes(FNs) are brief documents created collaboratively between learners and teachers and are a tool for narrative, formative feedback, and both positive and constructive criticism. FNs can be directly observed or based on reviews between teachers and trainees, and they are useful for day-to-day feedback and for competence reviews. Ideally, FNs do not take more than a couple of minutes to complete. FNs will be the primary tool in H2SUM to collect feedback and document the building of competence and are a major component of the comprehensive portfolio. Field notes can be grouped into categories or “stacks” based on CANMEDs roles or the 5 pillars in the H2SUM program.
Reflections
Critical self-reflection is widely recognized as an essential skill and habit for clinicians, especially as a fundamental component to cultural safety and humility. Indigenous health professionals, scholars, leaders, and community members continually emphasize the need for health care providers to understand the colonial past and present, and to reflect on their role in maintaining or dismantling structures of coloniality and racism. Development of humility, self-awareness, and reflective habits will be an emphasis in the H2SUM program. You will have dedicated time each week for reflective and self-awareness activities.
AdditionalLearnings
- Donoff, M. G. (2009). Field notes: Assisting achievement and documenting competence. Canadian Family Physician, 55(12), 1260–1262. https://www.cfp.ca/content/55/12/1260
- Driessen, E., Van Der Vleuten, C., Schuwirth, L., Van Tartwijk, J., & Vermunt, J. (2005). The use of qualitative research criteria for portfolio assessment as an alternative to reliability evaluation: A case study. Medical Education, 39(2), 214–220. https://doi.org/10.1111/j.1365-2929.2004.02059.x
- Jones, R., Crowshoe, L., Reid, P., Calam, B., Curtis, E., Green, M., Huria, T., Jacklin, K., Kamaka, M., Lacey, C., Milroy, J., Paul, D., Pitama, S., Walker, L., Webb, G., & Ewen, S. (2019). Educating for Indigenous Health Equity: An International Consensus Statement. Academic Medicine, 94(4), 512–519. https://doi.org/10.1097/ACM.0000000000002476
- Lafond, M., Johnson, H., Charles, G., & al, et. (2020). In Plain Sight Addressing Indigenous-specific Racism and Discrimination in B.C. Health Care Addressing Racism Review December 2020 Data Report.
- Sylvestre, P., Castleden, H., Denis, J., Martin, D., & Bombay, A. (2019). The tools at their fingertips: How settler colonial geographies shape medical educators’ strategies for grappling with Anti-Indigenous racism. Social Science & Medicine, 237, 112363. https://doi.org/10.1016/j.socscimed.2019.112363
- Veracini, L. (2011). Introducing: Settler colonial studies. Settler Colonial Studies, 1(1), 1–12. https://doi.org/10.1080/2201473X.2011.10648799
- Wolfe, P. (2006). Settler colonialism and the elimination of the native. Journal of Genocide Research, 8(4), 387–409. https://doi.org/10.1080/14623520601056240
AdditionalResources
- REACH line: http://bccfe.ca/healthcare-resources/reach-line
- RACE line: http://www.raceconnect.ca/
- Prescribing tools: http://bccfe.ca/drug-treatment-program/how-obtain-hiv-medication