Family Medicine Residency Site: Abbotsford-Mission

Presenter:
Wendy Hartford

Authors:
Hartford W, Backman C, Cristancho S, Buckley H, Nimmon L

Poster Abstract:

Background: Family physicians play a critical role in chronic disease team care which can improve patient access to care and health outcomes. However, there has been little research that explores the lived experience of family physicians as they navigate chronic disease team care in distributed settings. Without this information family medicine education may not adequately prepare family physicians for distributed chronic disease team practice.

Purpose: To develop a rich understanding of the personal, relational, organizational, and structural mechanisms which shape family physician experience in distributed chronic disease team care.

Methods: This qualitative research employs a social constructivist epistemology sensitized by a social network theoretical lens. We used a qualitative descriptive study approach and collected semistructured interview data from sixteen family physicians.

Findings: Family physicians describe themselves as brokers of patient-orientated chronic disease care networks. Their labile network structure incorporated co-located and distributed collaborative care with disparate relational linkages. Family physicians negotiated care through communicative interactions within an inequitable resource landscape of concordant and discordant hierarchical structures.

Conclusion: Conceptualizing chronic disease team care as a distributed networked practice, rather than a singular co-located team offers a more grounded account of contemporary family medicine. The insights provide an educational framework that can prepare trainees for negotiation, brokerage, communication, and structural constraints that routinely shape collaborative chronic disease care.

Key words: chronic-care, network, educational framework

Learning objectives: 1). The differences between distributed and co-located team care, 2). Family physicians’ brokerage network position, 3). Catalysts and impediments of the resource landscape.

Learn more here.

Painful. Exciting. Artificial. Paternalistic. Dangerous. Helpful.
And then Steve chimed in:
“Shiatsu.” 😂 Uncomfortable at first…but really worth the learning experience.

That was how preceptors described what video reviews felt like during this morning’s faculty development session and honestly, it captured the conversation perfectly.

For many medical education programs, video review gives residents a chance to see themselves in the clinical encounter in a way they normally can’t. Sitting with a preceptor, they can pause the recording, notice what was happening in the room, reflect on how they responded, and talk through the small moments that often get lost once the visit is over. At its best, it becomes less about judging performance and more about creating space for curiosity, reflection, and growth.

We talked about moving video review away from a standard checklist:
“Did the resident demonstrate the right behaviours?”
and toward:
“What did you notice about yourself here?”

Less feeling like one is hunting for mistakes. More reflection, curiosity, and conversation about where the learner is at and how they’re responding to their patient’s cues.

But the discussion also surfaced some important tensions:
1. Residents already reflect so can video review sometimes feel paternalistic…like another program requirement to check off?

2. How safe does it feel to be recorded, both as a resident and as a patient? I have yet to find a single video review research article that delves into the patient experience and how to integrate them meaningfully into the learning experience.

3. Who has access to the video and how are privacy concerns managed?

4. And is one resident-patient encounter really enough to tell us much about someone’s behaviour, or do we need to encourage multiple recordings over time (similar to the UK model) to actually observe and note a change in resident behaviour?

Preceptors also shared what helps: supportive and non-judgemental faculty, preparing residents well in advance, sometimes being present during the recorded encounter to provide reassurance, and perhaps most importantly — preceptors experiencing video review themselves so they understand the vulnerability of being on the other side of the camera.

References:

Koehler, A. N., Knudson, M. P., Ballard, P. J., Nicolotti, L. M., Caballero-Quinones, E., & Daniel, S. S. (2023). Video review of family medicine resident clinical encounters: A tool for building emotional intelligence. Frontiers in Psychology, 14, 1188041. https://pubmed.ncbi.nlm.nih.gov/37496798/

Møller, J. E., Doherty, E., & Brøgger, M. N. (2024). “Bring your worst”: Residents’ perspectives on video review of challenging patient communication as a learning tool. PEC Innovation, 5, 100322. https://www.sciencedirect.com/science/article/pii/S2772628224000700?via%3Dihub

Robbrecht, M., Van Winckel, M., Mulder, A., & Embo, M. (2025). What is the learning effect of video review in postgraduate medical education: A systematic review. BMC Medical Education, 25, 114. https://link.springer.com/article/10.1186/s12909-024-06515-7

#MedicalEducation #FamilyMedicine #FacultyDevelopment #ReflectivePractice #ResidentEducation

Need to brush up on your skills? UBC is holding a special day training day focused on primary care procedural skills.

In-person workshop | UBC Robson Square, Vancouver, BC

Jan. 23 (Sat) | 8 a.m.–5 p.m. PCT

Audience: nurse practitioners and family physicians.

Overview: Developed by the Nurse Practitioner CPD program, this workshop offers hands-on training in common primary-care procedures. Build skills through demonstrations, supervised practice and individualized feedback.

Up to 8.25 Mainpro+ credits

To register and learn more, click here.

Orange Shirt Day, September 30, is a day to honour and uphold Survivors and Intergenerational Survivors of the Indian Residential School system, and to commemorate those who didn’t return home.

2026 Intergenerational March to Commemorate Orange Shirt Day

Join us for the 2026 Intergenerational March to commemorate Orange Shirt Day on September 30th. Hosted by the Faculties of Land and Food Systems and Forestry, this year’s event will begin at 11:45am at the amphitheater below the clock tower located at 1956 Main Mall. All members of the UBC community, families and those in solidarity are welcome to participate. For more information about the event please visit: https://forestry.ubc.ca/events/2026-intergenerational-march-to-commemorate-orange-shirt-day/

Note: The IRSHDC will be closed to the public on Orange Shirt Day while the facilities and staff hold space for elders and Survivors who will be at UBC’s Point Grey campus on September 30, 2026.

To learn more, click here.

World Heart Day: Don’t Miss a Beat

Today, September 29, is World Heart Day—an opportunity to reflect on cardiovascular disease (CVD), which remains the leading cause of death worldwide.

The World Health Organization estimates that 19.8 million people died from cardiovascular disease in 2022, representing approximately one-third of all global deaths. Heart attacks and strokes account for the vast majority of these deaths, yet much of the burden of cardiovascular disease is preventable.

This year’s World Heart Day theme, “Don’t Miss a Beat,” draws attention to something particularly relevant in primary care: cardiovascular disease does not always announce itself clearly. Hypertension may remain asymptomatic for years, risk factors accumulate quietly, and symptoms may be overlooked or attributed to something else.

For family physicians, prevention often happens in ordinary encounters: checking blood pressure, discussing smoking, physical activity and nutrition, identifying diabetes and dyslipidaemia, understanding family history, and recognizing when a seemingly minor symptom deserves another look.

World Heart Day is a useful reminder that some of our most important cardiovascular interventions are not dramatic. They happen through early recognition, prevention, conversations and continuity of care.

Sources: WHO, Cardiovascular diseases (CVDs), updated July 31, 2025; World Heart Federation, World Heart Day 2026: Don’t Miss a Beat.

What Makes a Good Clinical Note?

A useful AMA STEPS Forward resource for anyone thinking about clinical documentation and note bloat.

Physicians from the University of Wisconsin discuss how they redesigned clinical notes by asking a simple question: what actually needs to be here? Their work focused on reducing copied and unnecessary content, making clinical reasoning easier to find, and reconsidering whether the traditional SOAP format is always the most useful approach.

As AI scribes make it increasingly easy to generate more documentation, this is a good reminder that more text does not necessarily mean a better note.

Worth a listen. Write Shorter Notes: Implementing a Standardized Progress Note Template via AMA.

Hi All! Grab a coffee and join us for an early-morning conversation about how to approach video review in family medicine:

Faculty Development Dawn Patrol: Video Review in Family Medicine
Friday, October 2, 2026
0700-0800
Zoom link provided by email.

A few months ago, I came across this article and shared it with our faculty development committee: Video review of family medicine resident clinical encounters: a tool for building emotional intelligence by Koehler et al. (2023).

I know video reviews can be uncomfortable for a variety of reasons. I think some of this fear stems from how we’ve positioned the exercise. What I appreciate most about this article is that it addresses these concerns and offers a different way of thinking about video review. Rather than focusing primarily on whether a resident demonstrated the “right” observable behaviours, they position video review as a reflective exercise that helps residents build on their emotional intelligence, including noticing how they are showing up in the encounter (self-awareness), how they are responding internally (self-management), what they are noticing in the patient (social awareness), and how they adjust in response (relational management).

We’ll also explore how this approach can support more meaningful coaching conversations.

Session learning objectives:

1. Describe how video review can move beyond observation of clinical behaviours to support emotional intelligence and reflective practice.
2. Apply strengths-based questioning strategies that help residents develop self-awareness, social awareness, and relational skills during video review.
3. Identify practical approaches for creating a psychologically safe video review experience that strengthens patient-centred communication and connection.

I encourage you to read the article as it may broaden your ideas and approaches to the exercise and look forward to connecting with you in October!

~ Jacqueline

Dr. Jacqueline P. Ashby, M.Ed., M.Sc., Ed.D. 
Program Coach, UBC Family Medicine Abbotsford-Mission Residency Site
Co-Lead, Assessment, UBC Family Medicine Residency Program
jacqueline.ashby@ubc.ca

A Day in the Life of a Preceptor
A Course for Family Physicians to Advance Teaching Skills

A novel program developed by family physicians, for family physicians
Structured around teaching in a community-based office
Collaborates with Divisions of Family Practice

5 Topics

Topic 1 – September
Preparing for Teaching

• Virtual Meeting or Video
• Self-Paced E-Learning
• Small Group Case-Based Learning

Topic 2 – November
Learning Relationships

• Video
• Self-Paced E-Learning
• Small Group Case-Based Learning

Topic 3 – January
Teaching Skills (In Office)

• Virtual Meeting or Video
• Self-Paced E-Learning
• Small Group Case-Based Learning

Topic 4 – March
Teaching Skills (Virtual)

• Video
• Self-Paced E-Learning
• Small Group Case-Based Learning

Topic 5 – May
Feedback, Assessment, Observation

• Virtual Meeting or Video
• Self-Paced E-Learning
• Small Group Case-Based Learning

Small Group Case-Based Learning meetings can be combined, e.g., Topics 1 & 2 and 3 & 4.

Earn up to 17.5 Mainpro+ credits!

What participants are saying

“I would say the coolest/most relevant piece of family medicine orientation I have seen.”

“Thanks so much. I feel inspired to pass the torch.”

“We were able to discuss previous experiences we’ve had trying to build the educational alliance.”

For more information, visit dayinthepreceptorlife.med.ubc.ca or email fac.dev@ubc.ca

Another round of the Lancet picture quiz! 

“What is…?” Click here if you think you know the answer.

Bright and early yesterday morning, I had the opportunity to facilitate an Academic Half Day (AHD) session with our UBC Family Practice Abbotsford-Mission residents on an increasingly important patient-safety issue: how to respond when ransomware or a major technology outage disrupts clinical care.

We began with a roundtable exercise exploring how residents would approach a ransomware attack: Who would they immediately contact? Which tasks would be essential? What tasks needed to transfer to paper, whiteboards, and face-to-face communication? And what were the greatest risks to patient care?

Then we dove into real-world examples, including the “WannaCry” ransomware attack and the CrowdStrike outage, and examined the impact that these two events had on healthcare systems, hospitals, clinicians, and patients. I also emphasized the important role our governments and healthcare systems play in tracking and reporting these incidents, conducting thorough debriefs, and disseminating findings and recommendations following these threat-to-life crimes.

To quote Black Widow in Spider-Man: Brand New Day, “This is big, big potatoes.”

If you just look at the Change Healthcare (UnitedHealth Group) ransomware attack in 2024:
* Records affected: 192,700,000
* Data exposed: names, addresses, dates of birth, Social Security numbers, government ID numbers, health insurance and policy numbers, etc.
* Aftermath: UnitedHealth reported roughly USD 3.1 billion in cyberattack-related impacts for full-year 2024, the most expensive healthcare cyber incident ever recorded. (https://www.upguard.com/blog/biggest-data-breaches-in-healthcare)

A key message from the session that I wanted to drive home was that we all have a role in cyber preparedness. Clinicians should be alert to any phishing attempts and clear on local downtime procedures, including knowing where approved paper resources are located, protecting patient information, and working closely with clinical, privacy, and technical teams during a disruption. These events also quickly highlight the importance in understanding how to work together as a team.

This is the first time “ransomware” has been addressed with our residents in the history of our site and I want to thank our Co-Site Director, Dr. Holden Chow, for allowing me the opportunity to facilitate this exercise.

To the residents reading this post, I encourage you to consider focusing a quality improvement project on educating and preparing your clinic for a ransomware attack or major technology outage. The time invested in strengthening your clinic’s preparedness could ultimately help save someone’s life.

#MedicalEducation#Cybersecurity#Ransomware#PatientSafety#HealthCare#ClinicalEducation#EmergencyPreparedness