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An Initiative of

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Creating a culture of health and well-being through equity, compassion, and respect.

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The Culture of Academic Medicine Initiative (CAMi) encourages Canadian academic medicine institutions to adopt and implement best practices and initiatives that foster respectful, inclusive, and health-promoting environments for the well-being of all.

This initiative also seeks to empower individuals in academic medicine to collectively strive towards embedding equity, compassion, respect, safe spaces, and self-care into the fabric of our communities.

Equity

Equity is the promotion of fairness and justice for each individual that considers historical, social, systemic, and structural issues that impact experience and individual needs.

Compassion

Having empathy for one’s experiences provides perspective and fosters authentic relationships. Treating others with compassion promotes well-being and enhances mental health.

Respect

Respect is foundational and facilitates a feeling of acceptance. It is not until people feel accepted that they can place trust, and truly be open.

Safe Spaces

When there is an intention to create safe spaces, we enable progress — we support bravery, celebrate differences, challenge conventional thinking, and foster a sense of belonging.

Self-Care

We are human. We are vulnerable. We must give ourselves the time, space, and encouragement to prioritize and practise self-care.

The Okanagan Charter

AFMC has endorsed the Okanagan Charter: An international Charter for Health Promoting Universities and Colleges, and through CAMi works with the 17 faculties towards implementation and action.

Your Stories

CAMi is committed to recognizing and celebrating the small but mighty interactions and experiences that have had an impact on our community and our ability to learn together.

An initiative of AFMC

The Association of Faculties of Medicine of Canada (AFMC) recognizes that promoting health and well-being is essential to achieving the full potential of all those engaged in academic medicine.

With special thanks to…

The Canadian Medical Association, MD Financial Management Inc. and Scotiabank together proudly support CAMi by AFMC, one of several initiatives that comprise their 10-year, $115 million commitment to supporting the medical profession and advancing health in Canada.

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CAMi is also made possible by the Canadian Federation of Medical Students (CFMS)

Equity

Equity refers to achieving parity in policy, process and outcomes for historically and/or currently underrepresented and/or marginalized people and groups while accounting for diversity.

It considers power, access, opportunities, treatment, impacts and outcomes, in three main areas:

Representational equity: the proportional participation at all levels of an institution; Resource equity: the distribution of resources in order to close equity gaps; and Equity-mindedness: the demonstration of an awareness of, and willingness to, address equity issues.

In the university context, equity requires the creation of opportunities for historically, persistently, or systemically marginalized populations of students, staff, and faculty to have equal access to education, programs, and growth opportunities that are capable of closing achievement gaps. This requires recognizing that not everyone is starting from the same place or history, and that deliberate measures to remove barriers to opportunities may be needed to ensure fair processes and outcomes.

For more information visit equity.ubc.ca

Compassion​

A strong feeling of sympathy for people who are suffering and a desire to help them.

Empathy has been shown to positively influence physician – patient relationships as well as interactions between physicians. It has been linked to “lower burnout, higher well-being…”[1][2][3][4] According to the CMA, empathetic communication is key to creating a better medical culture.[5] Treating oneself with compassion improves wellbeing and mental health.[6]

[1] Thomas MR, Dyrbye LN, Huntington JL, Lawson KL, Novotny PJ, Sloan JA, Shanafelt TD: How do distress and well-being relate to medical student empathy? A multicenter study. J Gen Intern Med. 2007, 22: 177-183. 10.1007/s11606-006-0039-6.

[2] DiLalla LF, Hull SK, Dorsey JK: Effect of gender, age, and relevant course work on attitudes toward empathy, patient spirituality, and physician wellness. Teach Learn Med. 2004, 16: 165-170. 10.1207/s15328015tlm1602_8.

[3] Shanafelt TD, West C, Zhao X, Novotny P, Kolars J, Habermann T, Sloan J: Relationship between increased personal well-being and enhanced empathy among internal medicine residents. J Gen Intern Med. 2005, 20: 559-564. 10.1007/s11606-005-0102-8

[4] Kelm, Z., Womer, J., Walter, J.K. et al. Interventions to cultivate physician empathy: a systematic review. BMC Med Educ 14, 219 (2014). https://doi.org/10.1186/1472-6920-14-219

[5] Canadian Medical Association, Empathy in medicine, 2020. Accessible here: https://www.cma.ca/physician-wellness-hub/content/empathy-in-medicine

[6] What is compassion and how can we measure it? A review of definitions and measures

Respect

Politeness, honour, and care shown towards someone or something that is considered important.

Respect is associated with optimal patient experience, good communication and morale[1][2]. Medical students/learners need to be treated “with respect because it models for learners what is expected of them as physicians in interactions with vulnerable others”[3]

[1] Sokol-Hessner L, Folcarelli PH, Annas CL, Brown SM, Fernandez L, Roche SD, Sarnoff Lee B, Sands KE; Practice of Respect Delphi Study Group. A Road Map for Advancing the Practice of Respect in Health Care: The Results of an Interdisciplinary Modified Delphi Consensus Study. Jt Comm J Qual Patient Saf. 2018 Aug;44(8):463-476. doi: 10.1016/j.jcjq.2018.02.003. Epub 2018 Jun 13. PMID: 30071966.

[2] Leape LL, Shore MF, Dienstag JL, Mayer RJ, Edgman-Levitan S, Meyer GS, Healy GB. Perspective: a culture of respect, part 1: the nature and causes of disrespectful behavior by physicians. Acad Med. 2012 Jul;87(7):845-52. doi: 10.1097/ACM.0b013e318258338d. PMID: 22622217.

[3] Karnieli-Miller O, Taylor AC, Cottingham AH, Inui TS, Vu TR, Frankel RM. Exploring the meaning of respect in medical student education: an analysis of student narratives. J Gen Intern Med. 2010 Dec;25(12):1309-14. doi: 10.1007/s11606-010-1471-1. Epub 2010 Aug 17. PMID: 20714822; PMCID: PMC2988154.just

Safe Spaces​

Safety — The state of being safe and protected from danger or harm.

An environment where everyone is free to express oneself without fear of judgment, shame or retribution while feeling comfortable to report concerns or incidents.

Evidence[1] shows “a strong association between psychological safety and trainee satisfaction with the clinical learning environment”[2] Achieving psychological safety creates positive professional experiences due to a strong sense of belonging and also encourages innovation, as people feel safe to explore new ideas and challenge conventional thinking.[3]

[1] Torralba KD, Loo LK, Byrne JM, Baz S, Cannon GW, Keitz SA, Wicker AB, Henley SS, Kashner TM. Does Psychological Safety Impact the Clinical Learning Environment for Resident Physicians? Results From the VA’s Learners’ Perceptions Survey. J Grad Med Educ. 2016 Dec;8(5):699-707. doi: 10.4300/JGME-D-15-00719.1. PMID: 28018534; PMCID: PMC5180524.

[2] Torralba, K.D., Jose, D. & Byrne, J. Psychological safety, the hidden curriculum, and ambiguity in medicine. Clin Rheumatol 39, 667–671 (2020). https://doi.org/10.1007/s10067-019-04889-4

[3] Fartoon M. Siad, Doreen M. Rabi, Harassment in the Field of Medicine: Cultural Barriers to Psychological Safety, CJC Open, Volume 3, Issue 12, Supplement, 2021, Pages S174-S179, ISSN 2589-790X, https://doi.org/10.1016/j.cjco.2021.08.018.

Self-Care

The act of caring for yourself, for example by eating and sleeping well, taking exercise and getting help so that you do not become ill.

“Physicians must acknowledge that they are subject to normal human limitations and attend to rest, breaks, sleep, personal relationships, and individual needs.”[1] This applies to all individuals in academic medicine including learners, educators and researchers. Shanafelt calls physicians to embrace their human qualities and to stop reinforcing the mindset of perfectionism in medicine.

[1] Shanafelt TD. Physician Well-being 2.0: Where Are We and Where Are We Going? Mayo Clin Proc. 2021 Oct;96(10):2682-2693. doi: 10.1016/j.mayocp.2021.06.005. PMID: 34607637.