Engaging residents to choose wisely: Resident Doctors of Canada resource stewardship recommendations

Resident doctors are integral to healthcare delivery in Canada. Engaging residents in resource stewardship is important for professional development, but also as they are drivers of healthcare resource use. To date, no national resident-specific resource stewardship guideline has been developed. Resident Doctors of Canada (RDoC) in collaboration with Choosing Wisely Canada (CWC) sought to develop an evidence-informed, consensus-based list of five recommendations to promote resource stewardship. RDoC convened a taskforce with diverse geographic and specialty representation to develop candidate recommendations targeting resident resource stewardship behaviours using a consensus-based process, supported by a literature review. Residents across the country provided feedback on the candidate recommendations via an online questionnaire. The taskforce used this feedback to finalize the list. The taskforce prepared 28 candidate recommendations for consideration. A detailed literature review and consensus process narrowed this list to 12 candidate recommendations for consultation. A total of 754 residents (754/10,068 residents = 7.5%) representing all provinces and levels of residency training reviewed and ranked the candidate recommendations. The highest-ranked recommendations comprised the final list. Resident doctors are willing and able to demonstrate leadership in advancing resource stewardship by the development of a national resident-specific list of Choosing Wisely Canada recommendations.