Development and evaluation of learning objectives for a medical assistance in dying curriculum for family medicine residency

Context: Medical assistance in dying (MAID) became legal across Canada when Bill C-14 was passed in 2016. Currently, little is known about the most effective strategies for providing MAID education, and the importance of integrating MAID into existing curricula.

Objective: To develop a set of learning objectives (LOs) to inform a foundational medical assistance in dying (MAID) curriculum in Canadian Family Medicine (FM) residency training programs.

Study Design: Mixed-methods were used to develop LOs based on a previously-published needs assessment. Draft LOs were evaluated and modified using a modified Delphi process and focus group, and then mapped to the existing FM residency curriculum, as well as the CFPC Priority Topics and CanMEDS-Family Medicine roles.

Setting: A large, four-site family medicine residency program in southeastern Ontario.

Population Studied: Delphi participants included key FM faculty and resident leaders, while the focus group included the faculty knowledgeable about MAID and the assessment system.

Outcome Measures: A set of LOs, proportion of LOs that map to existing FM residency curriculum, CFPC Priority Topics and CanMEDS-Family Medicine roles.

Findings: Nine LOs were developed to provide a foundational education regarding MAID. While all LOs could be mapped to the Domains of Clinical Care with the departmental curriculum, they mapped inconsistently to departmental Entrustable Professional Activities, the Priority Topics, and CanMEDS-FM roles. LOs focused on patient education and identification of patient goals were most readily mapped to existing curricular framework, while LOs with MAID-exclusive content revealed gaps in the current curriculum.

Conclusion: The developed LOs provide a guide to ensure family medicine residents obtain generalist-level knowledge to counsel their patients about MAID. These LOs can be used not only to develop FM MAID curriculum and assess competency, but also serve as a model for developing LOs and curriculum in other Canadian specialty residency programs.