How can we make Choosing Wisely principles more accessible to medical students? That is the question that Students and Trainees Advocating for Resource Stewardship (STARS) leaders from Dalhousie University asked themselves before launching the Resource Stewardship Certificate Program. The online program, launched in 2024 in collaboration with Choosing Wisely Nova Scotia and expanded nationally in 2025, enables students across Canada to learn about resource stewardship principles, regardless of location. 

Marissa MacInnis and Jakalee Myette are two members of the Dalhousie STARS team who offered the Certificate Program in 2024 and 2025. Early on in her clinical training, fourth-year medical student Marissa often felt unsure of how to approach discussions around resource stewardship with patients and other clinicians. This uncertainty led her to join the STARS program at Dalhousie. 

Third-year medical student Jakalee’s interest in resource stewardship and quality improvement stems from her experience living in rural Nova Scotia, where access to resources is often more limited than in tertiary centres such as Halifax. “I was interested in learning more about resource stewardship and how I could apply it to my future practice if I do end up practicing medicine rurally.” Together, Marissa and Jakalee’s perspectives lent themselves to creating an online, open-access learning opportunity. 

The certificate program grew out of a well-received, interprofessional mini course on resource stewardship developed, and delivered by a team of STARS students at Dalhousie. After the school moved away from this format, the pair looked for another way to offer a similar learning experience. With the support of Choosing Wisely’s provincial hub in Nova Scotia, the course was able to evolve and continue to be offered as an extracurricular certificate.

In 2024, the program was piloted at Dalhousie to evaluate its structure and assess interest and engagement. At that time, the program consisted of a series of learning sessions on select Choosing Wisely themes, led by Dalhousie-affiliated clinician experts. These learning sessions were delivered exclusively in a synchronous format. A unique aspect of the program is that it also incorporates student-created cases into each session. Along with traditional lectures, participants worked collaboratively on a case related to the topic of the week. Attendees would then be asked to complete a short quiz to ensure understanding of the material. The local pilot was highly successful. At the end of the program 21 Dalhousie students received certificates.

“This was a great start,” says Marissa, “But this gap that we are trying to address in medical education doesn’t only exist at Dalhousie and in Nova Scotia. It’s a Canada-wide gap.” 

In Fall 2025, they set out to close this gap and expand the program nationally. One of the ways they achieved this was to record the sessions, enabling participants from across Canada to access the content at their convenience. Another important element of expansion was building interest. 

“The STARS program provided an existing national network to support growth,” she shares. They leveraged this network and collaborated with other STARS  leaders from medical schools across the country, to build national interest in the program and lay the groundwork for its expansion. This involved promotion on other STARS social media accounts, and on the Choosing Wisely Canada website, as well as direct outreach to program representatives.

Certificates were emailed to all students who participated in the program and attended at least two live sessions, a requirement designed to promote collaboration, connection and active participation. Sessions offered this year included emergency medicine and radiology. 

Feedback on this national program has been overwhelmingly positive. Over 155 students received certificates, more than a six-times increase from the local pilot. According to post-session evaluation surveys, more than 80 per cent of participants reported increased knowledge of resource stewardship principles and Choosing Wisely after completing the program. Dalhousie STARS have already received inquiries about the program for the 2026 academic year, and hope to launch the next cohort pit in September.

“People have said the course has given them the language to speak up when things kind of feel uncertain or wrong clinically and to question whether they are choosing wisely in practice,” Marissa and Jakalee shared. “They also greatly value the interprofessional perspectives and prefer that this learning not be limited to a physician perspective.”

On the positive impact of the program, Jakalee added, “It was fulfilling to see how many people are actually interested in resource stewardship, to the point where they were willing to sign up for this course and complete it on their own time.”

When it comes to future goals for the program, Jakalee hopes to collaborate even further with other STARS representatives. The goal is for sessions to be hosted by participating medical schools across the country, rather than being led solely by the Dalhousie University team. This would support the program’s continued growth, while bringing a broader range of speakers and perspectives to the participants.  They also plan to respond to participant feedback and strengthen cross-disciplinary involvement. In particular, they would like to increase pharmacy student participation by collaborating more closely with pharmacy STARS students.