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Grad RM. Assessing the relevance of research for clinicians. BMJ 2023; 380:152. [PMID: 36693655 DOI: 10.1136/bmj.p152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Roland M Grad
- Department of Family Medicine, McGill University, Montréal, QC, Canada H3S 1Z1
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Archibald D, Grant R, Tuot DS, Liddy C, Sewell JL, Price DW, Grad R, Shipman SA, Campbell C, Guglani S, Wood TJ, Keely E. Development of eConsult reflective learning tools for healthcare providers: a pragmatic mixed methods approach. BMC PRIMARY CARE 2023; 24:15. [PMID: 36647016 PMCID: PMC9841624 DOI: 10.1186/s12875-022-01948-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 12/14/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Electronic consultation (eConsult) programs are crucial components of modern healthcare that facilitate communication between primary care providers (PCPs) and specialists. eConsults between PCPs and specialists. They also provide a unique opportunity to use real-world patient scenarios for reflective learning as part of professional development. However, tools that guide and document learning from eConsults are limited. The purpose of this study was to develop and pilot two eConsult reflective learning tools (RLTs), one for PCPs and one for specialists, for those participating in eConsults. METHODS We performed a four-phase pragmatic mixed methods study recruiting PCPs and specialists from two public health systems located in two countries: eConsult BASE in Canada and San Francisco Health Network eConsult in the United States. In phase 1, subject matter experts developed preliminary RLTs for PCPs and specialists. During phase 2, a Delphi survey among 20 PCPs and 16 specialists led to consensus on items for each RLT. In phase 3, we conducted cognitive interviews with three PCPs and five specialists as they applied the RLTs on previously completed consults. In phase 4, we piloted the RLTs with eConsult users. RESULTS The RLTs were perceived to elicit critical reflection among participants regarding their knowledge and practice habits and could be used for quality improvement and continuing professional development. CONCLUSION PCPs and specialists alike perceived that eConsult systems provided opportunities for self-directed learning wherein they were motivated to investigate topics further through the course of eConsult exchanges. We recommend the RLTs be subject to further evaluation through implementation studies at other sites.
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Affiliation(s)
- Douglas Archibald
- grid.28046.380000 0001 2182 2255Department of Family Medicine, C.T. Lamont Primary Health Care Research Centre, University of Ottawa, Ottawa, Canada ,grid.418792.10000 0000 9064 3333Bruyère Research Institute, Ottawa, Canada ,grid.28046.380000 0001 2182 2255Faculty of Education, University of Ottawa, Ottawa, Canada
| | - Rachel Grant
- grid.28046.380000 0001 2182 2255Faculty of Education, University of Ottawa, Ottawa, Canada
| | - Delphine S. Tuot
- grid.266102.10000 0001 2297 6811Department of Medicine, Division of Nephrology, Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, CA USA
| | - Clare Liddy
- grid.28046.380000 0001 2182 2255Department of Family Medicine, C.T. Lamont Primary Health Care Research Centre, University of Ottawa, Ottawa, Canada ,grid.418792.10000 0000 9064 3333Bruyère Research Institute, Ottawa, Canada ,grid.412687.e0000 0000 9606 5108Ontario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Canada
| | - Justin L. Sewell
- grid.266102.10000 0001 2297 6811Department of Medicine, Division of Gastroenterology, Zuckerberg San Francisco General Hospital, University of California San Francisco, San Francisco, CA USA
| | - David W. Price
- grid.430503.10000 0001 0703 675XDepartment of Family Medicine, University of Colorado Anschutz School of Medicine, Aurora, CO USA ,The American Board of Family Medicine, Lexington, KY USA
| | - Roland Grad
- grid.14709.3b0000 0004 1936 8649Department of Family Medicine, McGill University, Montreal, Canada
| | - Scott A. Shipman
- grid.414000.10000 0000 8652 9597Association of American Medical Colleges, Washington, DC USA ,grid.254748.80000 0004 1936 8876Creighton University, Omaha, NE USA
| | - Craig Campbell
- grid.28046.380000 0001 2182 2255Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Sheena Guglani
- grid.418792.10000 0000 9064 3333Bruyère Research Institute, Ottawa, Canada ,grid.412687.e0000 0000 9606 5108Ontario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Canada
| | - Timothy J. Wood
- grid.28046.380000 0001 2182 2255Department of Innovation in Medical Education, University of Ottawa, Ottawa, Canada
| | - Erin Keely
- grid.412687.e0000 0000 9606 5108Ontario eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, Canada ,grid.28046.380000 0001 2182 2255Department of Medicine, University of Ottawa, Ottawa, Canada
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Grad R, Tang DL. Towards collective intelligence in a national community of physicians. EDUCATION FOR INFORMATION 2020. [DOI: 10.3233/efi-190338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Luconi F, Rochette A, Grad R, Hallé MC, Chin D, Habib B, Thomas A. A multifaceted continuing professional development intervention to move stroke rehabilitation guidelines into professional practice: A feasibility study. Top Stroke Rehabil 2020; 27:401-441. [PMID: 31960782 DOI: 10.1080/10749357.2019.1711339] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Rehabilitation post-stroke is critical for maximizing patient outcomes. This study assessed the feasibility of implementing and evaluating a continuing professional development (CPD) intervention aimed at increasing the uptake of stroke best practice guidelines among physiotherapists (PTs), occupational therapists (OTs) and speech-language pathologists (SLPs) in six university-affiliated stroke rehabilitation centers in Quebec, Canada. METHOD Twelve stroke best practice recommendations with reflective tools were sent weekly by e-mail. Participants' eligibility criteria included: a) profession; b) practicing more than 1 year in a stroke rehabilitation program; c) fluency in French or English; and d) basic computer literacy. Feasibility (operationalized via participation, satisfaction and relevance), cognitive impact, perceived application in practice and expected patient outcomes were measured over 24 weeks using three questionnaires and analyzed using descriptive statistics. RESULTS The sample totaled 62 of 133 eligible (47%) clinicians. Satisfaction, relevance and cognitive impact of delivered information varied across disciplines and recommendations. Agreement with the recommendations was high across disciplines. On average, three-interdisciplinary recommendations (related to post-stoke depression, post-stoke fatigue and patients' and caregivers' learning needs) were rated as the most relevant for at least one patient. The majority of clinicians would use the recommendations for a specific patient and expected health benefits by applying those recommendations. CONCLUSION This study demonstrated the feasibility of assessing the impact of a CPD intervention in stroke rehabilitation uptake and informed the design of a research program aimed at increasing the use of stroke evidence-based rehabilitation interventions.
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Affiliation(s)
- Francesca Luconi
- Continuing Professional Development (CPD), McGill University , Montreal, Quebec, Canada
| | - Annie Rochette
- CRIR - IUDPM, École de réadaptation, Université de Montréal , Montréal, Québec, Canada
| | - Roland Grad
- Department of Family Medicine, McGill University , Montréal, Québec, Canada
| | - Marie-Christine Hallé
- School of Physical and Occupational Therapy, McGill University , Montréal, Québec, Canada
| | - Diana Chin
- Chef d'administration de programme en réadaptation, CIUSSS Centre-Ouest-de-l'île-de-Montréal , Montréal, Québec, Canada
| | - Bettina Habib
- Continuing Professional Development, McGill University , Montréal, Québec, Canada
| | - Aliki Thomas
- School of Physical and Occupational Therapy, Centre for Medical Education, McGill University , Montréal, Québec, Canada
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Viera CS, Bugs BM, Carvalho ARS, Gaiva MAM, Toso BRGDO. Description of the use of integrative mixed method in neonatal nursing. Rev Esc Enferm USP 2019; 53:e03408. [PMID: 30673048 DOI: 10.1590/s1980-220x2017039303408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 07/17/2018] [Indexed: 11/22/2022] Open
Abstract
To describe the application of the integrative mixed method and its steps. Descriptive methodological study. The integrative mixed method approach was exemplified in a study conducted in neonatal nursing on maternal stress throughout the experience of premature newborns' care. Data on maternal stress level (quantitative approach) and maternal perception of care (qualitative approach) were grouped after analyzes made separately according to the analysis technique of each approach. Subsequently, quantitative and qualitative data were integrated, which originated a new set of data to be interpreted, and consequently enabled a greater understanding of the phenomenon under study and emphasized the importance of the integrative mixed method. The integration of the two approaches, qualitative and quantitative, is a denser theoretical framework with strong scientific evidence for a better understanding of the phenomenon under study than the use of a single approach, since, at the same time, it identifies the frequency of the phenomenon and the reason for its occurrence.
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Affiliation(s)
- Claudia Silveira Viera
- Universidade Estadual do Oeste do Paraná, Programa de Pós-Graduação de Biociências e Saúde, Cascavel, PR, Brazil
| | - Bruna Maria Bugs
- Universidade Estadual do Oeste do Paraná, Programa de Pós-Graduação de Biociências e Saúde, Cascavel, PR, Brazil
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Galvao MCB, Carmona F, Grand R, Pluye P, Ricarte ILM. Disseminating health evidence summaries to increase evidence use in health care. Rev Saude Publica 2018; 52:57. [PMID: 29791674 PMCID: PMC5958963 DOI: 10.11606/s1518-8787.2018052000418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 11/16/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE: To verify whether an intervention based on disseminating health evidence summaries by e-mail to health professionals increases access to health evidence databases, and whether health professionals intend to apply the evidence received by e-mail in their clinical practice. METHODS: This quantitative study started with a survey to collect demographic data and patterns of access to health evidence databases. It was followed by a longitudinal intervention, over 48 weeks, that disseminated 143 health evidence summaries to 339 health professionals with higher education degree who work in the Brazilian Unified Health System. In the longitudinal intervention phase, health professionals voluntarily assessed the received health evidence summaries using the information assessment method. Finally, the study concluded with a survey to identify changes in accessing health evidence databases. RESULTS: Of the 339 Brazilian health professionals participating in this research, 90 (26.5%) answered the initial and final surveys. After 48 weeks, there was an increase in the use of health evidence databases; 186 (54.9%) participants submitted 7,942 assessments of health evidence summaries, which were relevant for patient care in 5,409 (68%) assessments. CONCLUSIONS: The dissemination of health evidence summaries by e-mail to health professionals in Brazil increases the reported use of evidence in clinical practice.
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Affiliation(s)
- Maria Cristiane Barbosa Galvao
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Fabio Carmona
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - Roland Grand
- Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Pierre Pluye
- Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
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