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Babenko O, Au L, Koppula S, Szafran O. Longitudinal Study of Family Medicine Residents' Clinical Teaching After Participation in the Residents-as-Teachers Program. Fam Med 2023; 55:539-543. [PMID: 37696023 PMCID: PMC10622039 DOI: 10.22454/fammed.2023.690209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
BACKGROUND AND OBJECTIVE Residents-as-teachers (RAT) programs provide opportunities for residents to gain teaching skills. Published studies have assessed RAT programs largely at a single point in time rather than longitudinally. To address this gap, we examined (a) longitudinal trends in RAT participants' interest, comfort, confidence, skill, and familiarity with aspects of clinical teaching; and (b) subsequent involvement in clinical teaching. METHODS We conducted a longitudinal survey of one cohort of family medicine residents (N=56) who participated in the RAT program during residency. We collected data before and after the RAT program and at one and three years into practice (2016-2020). We measured outcomes including interest, comfort, confidence, skill, familiarity with aspects of clinical teaching and involvement in clinical teaching. We performed longitudinal analysis using repeated measures analysis of variance. RESULTS Response rates at four data collections were 63% (n=35), 66% (n=37), 55% (n=31), and 34% (n=19), respectively. We observed consistent trends in interest, comfort, confidence, skill, and familiarity with aspects of clinical teaching; mean scores increased from before to after the RAT program and subsequently decreased in the early years in practice. At 1 and 3 years in practice, 71% and 74% of respondents, respectively, reported being involved in teaching, primarily teaching medical students. CONCLUSIONS The RAT program appears to be a positive contributing influence on family medicine graduates' perceived preparedness to teach and their involvement in teaching after graduation from residency. A relatively high proportion of residents are involved in teaching in the early years in practice.
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Affiliation(s)
- Oksana Babenko
- Department of Family Medicine, University of AlbertaAlberta, EdmontonCanada
| | - Lillian Au
- Department of Family Medicine, University of AlbertaAlberta, EdmontonCanada
| | - Sudha Koppula
- Department of Family Medicine, University of AlbertaAlberta, EdmontonCanada
| | - Olga Szafran
- Department of Family Medicine, University of AlbertaAlberta, EdmontonCanada
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Grad R, Reynolds DL, Antao V, Bell NR, Dickinson JA, Johansson M, Singh H, Szafran O, Thériault G. Screening for primary prevention of fragility fractures: How much time does it take? Can Fam Physician 2023; 69:537-541. [PMID: 37582590 PMCID: PMC10426367 DOI: 10.46747/cfp.6908537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Affiliation(s)
- Roland Grad
- Associate Professor in the Department of Family Medicine at McGill University in Montréal, Que.
| | - Donna L Reynolds
- Assistant Professor in the Department of Family and Community Medicine and the Dalla Lana School of Public Health at the University of Toronto in Ontario
| | - Viola Antao
- Associate Professor in the Department of Family and Community Medicine at the University of Toronto
| | - Neil R Bell
- Professor in the Department of Family Medicine at the University of Alberta in Edmonton
| | - James A Dickinson
- Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary in Alberta
| | - Minna Johansson
- Family doctor, Director of the Global Center for Sustainable Healthcare, and Adjunct University Lecturer in the School of Public Health and Community Medicine at the University of Gothenburg in Sweden
| | - Harminder Singh
- Associate Professor in the Department of Internal Medicine and the Department of Community Health Sciences at the University of Manitoba in Winnipeg and in the Department of Hematology and Oncology for CancerCare Manitoba
| | - Olga Szafran
- Associate Director of Research in the Department of Family Medicine at the University of Alberta
| | - Guylène Thériault
- Academic Lead for the Physicianship Component and the Director of Pedagogy at Outaouais Medical Campus in the Faculty of Medicine at McGill University
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Grad R, Reynolds DL, Antao V, Bell NR, Dickinson JA, Johansson M, Singh H, Szafran O, Thériault G. Dépistage en prévention primaire des fractures de fragilisation. Can Fam Physician 2023; 69:e165-e169. [PMID: 37582593 PMCID: PMC10426352 DOI: 10.46747/cfp.6908e165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Affiliation(s)
- Roland Grad
- Professeur agrégé au Département de médecine familiale de l'Université McGill à Montréal (Québec).
| | - Donna L Reynolds
- Professeure adjointe au Département de médecine familiale et communautaire et à l'École Dalla Lana de santé publique de l'Université de Toronto (Ontario)
| | - Viola Antao
- Professeure agrégée au Département de médecine familiale et communautaire de l'Université de Toronto
| | - Neil R Bell
- Professeur au Département de médecine familiale de l'Université de l'Alberta à Edmonton
| | - James A Dickinson
- Professeur au Département de médecine familiale et au Département des sciences de la santé communautaire de l'Université de Calgary (Alberta)
| | - Minna Johansson
- Médecin de famille, directrice du Centre mondial pour des soins de santé durables et chargée de cours universitaires adjointe à l'École de santé publique et de médecine communautaire de l'Université de Gothenburg en Suède
| | - Harminder Singh
- Professeur agrégé au Département de médecine interne et au Département des sciences de la santé communautaire à l'Université du Manitoba à Winnipeg, et au Département d'hématologie et d'oncologie médicale à ActionCancer Manitoba
| | - Olga Szafran
- Directrice associée de la recherche au Département de médecine familiale de l'Université de l'Alberta
| | - Guylène Thériault
- Directrice du volet Rôle du médecin et directrice de la Pédagogie au Campus Outaouais de la Faculté de médecine de l'Université McGill
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Torti J, Koppula S, Szafran O, Duerksen K, Barton M. International medical graduates' experiences with caring for cross-cultural patient populations: Qualitative study in Alberta. Can Fam Physician 2023; 69:557-563. [PMID: 37582601 PMCID: PMC10426355 DOI: 10.46747/cfp.6908557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
OBJECTIVE To explore experiences of international medical graduate (IMG) FPs in providing cross-cultural patient care and to identify rewards and challenges they experienced when caring for patients of cultural backgrounds different from their own. DESIGN Descriptive qualitative study. SETTING Family medicine primary care practices in Alberta. PARTICIPANTS Eighteen IMG FPs practising in the metropolitan areas of Edmonton or Calgary in Alberta as of May 2013. METHODS Individual face-to-face or telephone interviews were conducted using a semistructured interview guide. Seventeen interviews occurred between July and August 2013 and 1 took place in August 2014. All interviews were audiorecorded and transcribed verbatim. Transcribed data were subject to thematic analysis. MAIN FINDINGS International medical graduates identified several rewarding aspects of caring for patients with cultural backgrounds different from their own, including learning about different cultures, perceiving that appointments are more succinct, and advocating for patients whom they perceive to be at a disadvantage. Family physicians also identified several challenges associated with caring for patients of different cultural backgrounds, including encountering language barriers, perceiving that visits take longer, and experiencing patients' lack of acceptance of FPs with cultural backgrounds different from their own. CONCLUSION Cultural differences between FPs and patients can enhance or undermine doctor-patient relationships. The results of this study speak to the need for cultural competency training for FPs practising in culturally diverse settings.
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Affiliation(s)
- Jacqueline Torti
- Assistant Professor in the Department of Medicine and Scientist in the Centre for Education Research and Innovation in the Schulich School of Medicine and Dentistry at Western University in London, Ont.
| | - Sudha Koppula
- Associate Professor in the Department of Family Medicine at the University of Alberta in Edmonton
| | - Olga Szafran
- Associate Director of Research in the Department of Family Medicine at the University of Alberta
| | - Kimberley Duerksen
- Research Coordinator in the Department of Family Medicine at the University of Alberta
| | - Martina Barton
- Director of International Medical Graduates in the Department of Family Medicine in the Cumming School of Medicine at the University of Calgary in Alberta
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Babenko O, Gentilini S, Turner N, Szafran O, Koppula S. Psychological need fulfillment in virtual teaching: insights of residents and faculty. Int J Med Educ 2023; 14:77-83. [PMID: 37351937 PMCID: PMC10693391 DOI: 10.5116/ijme.6488.2625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 06/13/2023] [Indexed: 06/24/2023]
Abstract
Objective To explore benefits and challenges experienced by residents and faculty when teaching in virtual settings. Methods This was a qualitative descriptive study employing one-on-one semi-structured interviews with 10 residents and 12 faculty in the Department of Family Medicine at the University of Alberta, Canada, from May 2021 to May 2022. Participants were recruited via social media, resident and department events and email lists. Interview transcripts were analyzed descriptively and thematically employing the Self-Determination Theory (SDT) framework to map the identified benefits and challenges as facilitators and barriers to fulfilling teacher's basic psychological needs for autonomy, competence, and relatedness in virtual settings. Results Resident and faculty participants used virtual technology not only to deliver education, but also leveraged various platform features to support their needs in virtual settings. The emerging themes within benefits and challenges of virtual teaching were amenable to mapping onto three basic psychological needs of the SDT framework - autonomy (e.g., increased accessibility; lack of control over teaching environment), competence (e.g., increased self-confidence; technological limitations hindering skill development), and relatedness (e.g., timely exchange of information; difficulty with professional identity formation). Conclusions Despite the inherent challenges, teaching in virtual settings can support teachers' psychological needs. Recommendations for the future delivery and facilitation of virtual learning include: giving high priority to engagement and active participation; nurturing autonomy and greater individual responsibility for learning; and creating an environment of emotional support. The SDT-informed strategies shown to be effective in in-person teaching need to be examined for their applicability in virtual settings.
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Affiliation(s)
- Oksana Babenko
- Department of Family Medicine, University of Alberta, Canada
| | | | - Nathan Turner
- Department of Family Medicine, University of Alberta, Canada
| | - Olga Szafran
- Department of Family Medicine, University of Alberta, Canada
| | - Sudha Koppula
- Department of Family Medicine, University of Alberta, Canada
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Horvey S, Babenko O, Szafran O, D'Hont T, Heyes K, Pontin D. Yellowknife: Canada's First Circumpolar Family Medicine Residency Site. Acad Med 2023; 98:699-702. [PMID: 36574280 DOI: 10.1097/acm.0000000000005134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PROBLEM Canada's Northwest Territories (NWT), like other regions in the circumpolar north primarily inhabited by Indigenous peoples, faces challenges in recruiting and retaining physicians. Communities in this vast, diverse region depend largely on external medical professionals for health care. Consequently, these communities receive discontinuous medical care from physicians who lack local knowledge and are available only temporarily. The shortage of physicians for people residing in northern Canada requires a sustainable, long-term solution. APPROACH The authors describe establishing Canada's first circumpolar family medicine residency training site in Yellowknife, NWT. The site was launched in 2020 as a partnership between the University of Alberta, Alberta Health Services, and 3 local health authorities in the NWT. The residency site, which bases residents in the local community, is expected to positively impact family physician recruitment and retention by allowing residents to build connections with local communities and identify as a northern physician. OUTCOMES As of fall 2022, 4 residents had trained with the Yellowknife family medicine residency site. Two of these 4 residents graduated in 2022, both of whom plan to continue practicing medicine in the NWT. Residents have positively influenced medical care in the NWT, providing care in close to 20 small and remote communities. The presence of residents decreased appointment wait-times for some teams by as much as 60%, improved primary care screening, and enabled the provision of medical services at critical times. Furthermore, their presence has fostered academic spirit in the medical communities and had a positive impact on the communities as a whole. NEXT STEPS The authors provide key insights and lessons learned from the establishment of the remote residency site. To develop and improve the site, continuous program evaluation is planned.
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Affiliation(s)
- Samantha Horvey
- S. Horvey is assistant professor and assistant residency program director, Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Oksana Babenko
- O. Babenko is associate professor, Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Olga Szafran
- O. Szafran is associate research director, Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Thomsen D'Hont
- T. D'Hont is a family medicine resident, Yellowknife Family Medicine Residency Site, Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Kajsa Heyes
- K. Heyes is a family medicine resident, Yellowknife Family Medicine Residency Site, Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - David Pontin
- D. Pontin is codirector, Yellowknife Family Medicine Residency Site, Department of Family Medicine, University of Alberta, Edmonton, Alberta, and clinical lead, Medical Education, Yellowknife, Northwest Territories, Canada
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Thériault G, Grad R, Dickinson JA, Singh H, Antao V, Bell NR, Szafran O. Gare aux torts causés par les surdiagnostics engendrés par le dépistage, l’abaissement des seuils de diagnostic et par la découverte d’incidentalomes. Can Fam Physician 2023; 69:e33-e37. [PMID: 36813513 PMCID: PMC9945899 DOI: 10.46747/cfp.6902e33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Guylène Thériault
- Directrice du volet Rôle du médecin et directrice de la Pédagogie au Campus Outaouais de la Faculté de médecine de l'Université McGill à Montréal (Québec).
| | - Roland Grad
- Professeur agrégé au Département de médecine familiale de l'Université McGill
| | - James A Dickinson
- Professeur au Département de médecine familiale et au Département des sciences de la santé communautaire à l'Université de Calgary (Alberta)
| | - Harminder Singh
- Professeur agrégé au Département de médecine interne et au Département des sciences de santé communautaire à l'Université du Manitoba à Winnipeg et au Département d'hématologie et d'oncologie médicale à ActionCancer Manitoba
| | - Viola Antao
- Professeure agrégée au Département de médecine familiale et communautaire de l'Université de Toronto (Ontario)
| | - Neil R Bell
- Professeur au Département de médecine familiale de l'Université de l'Alberta à Edmonton
| | - Olga Szafran
- Directrice associée de la recherche au Département de médecine familiale de l'Université de l'Alberta
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Thériault G, Grad R, Dickinson JA, Singh H, Antao V, Bell NR, Szafran O. Beware of overdiagnosis harms from screening, lower diagnostic thresholds, and incidentalomas. Can Fam Physician 2023; 69:97-100. [PMID: 36813526 PMCID: PMC9945906 DOI: 10.46747/cfp.690297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Affiliation(s)
- Guylène Thériault
- Academic Lead for the Physicianship Component and the Director of Pedagogy at Outaouais Medical Campus in the Faculty of Medicine at McGill University in Montréal, Que.
| | - Roland Grad
- Associate Professor in the Department of Family Medicine at McGill University
| | - James A Dickinson
- Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary in Alberta
| | - Harminder Singh
- Associate Professor in the Department of Internal Medicine and the Department of Community Health Sciences at the University of Manitoba in Winnipeg and in the Department of Hematology and Oncology for CancerCare Manitoba
| | - Viola Antao
- Associate Professor in the Department of Family and Community Medicine at the University of Toronto in Ontario
| | - Neil R Bell
- Professor in the Department of Family Medicine at the University of Alberta in Edmonton
| | - Olga Szafran
- Associate Director of Research in the Department of Family Medicine at the University of Alberta
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Torti JMI, Szafran O, Kennett SL, Bell NR. Interprofessional care of patients with type 2 diabetes mellitus in primary care: family physicians’ perspectives. BMC Prim Care 2022; 23:74. [PMID: 35395729 PMCID: PMC8990268 DOI: 10.1186/s12875-022-01688-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 04/05/2022] [Indexed: 11/10/2022]
Abstract
Background There is a lack of understanding of the team processes and factors that influence teamwork and medication management practices in the care of patients with type 2 diabetes mellitus (T2DM). The purpose of the study was to explore physicians’ perspectives of barriers and facilitators to interprofessional care of patients with T2DM within team-based family practice settings. Methods This was a qualitative, descriptive study. Participants included physicians affiliated with a primary care network providing care to patients with T2DM in an interprofessional team-based primary care setting in Edmonton, Alberta, Canada. Participants’ contact information was obtained from the publicly available College of Physicians and Surgeons of Alberta and respective primary care network websites. Interview questions addressed physicians’ perspectives on factors or processes that facilitated and hindered the care and medication management of adult patients with T2DM in primary care team-based clinical practice. Interviews were audio-recorded, transcribed, and analyzed using qualitative content analysis and a constant comparative approach. Results A total of 15 family physicians participated in individual interviews. Family physicians identified facilitators of interprofessional team-based care and medication management of patients with T2DM in three theme areas—access to team members and programs, knowledgeable and skilled health professionals, and provision of patient education by other health professionals. Two themes emerged as barriers to interprofessional care – lack of provider continuity and the loss of skills from delegation of tasks. Conclusion Family physicians perceive both benefits and risks to interprofessional team-based care in caring for patients with T2DM. Successful functioning of team-based care in family practice will require overcoming traditional professional roles.
Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01688-w.
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Dickinson JA, Thériault G, Grad R, Bell NR, Szafran O. Évaluer les nouveaux tests de dépistage. Can Fam Physician 2022; 68:e310-e317. [PMID: 36376045 PMCID: PMC9833176 DOI: 10.46747/cfp.6811e310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- James A Dickinson
- Professeur au Département de médecine familiale et au Département des sciences de la santé communautaire à l'Université de Calgary (Alberta).
| | - Guylène Thériault
- Directrice du volet Rôle du médecin et directrice de la Pédagogie au Campus Outaouais de la Faculté de médecine de l'Université McGill à Montréal (Québec)
| | - Roland Grad
- Professeur agrégé au Département de médecine de famille de l'Université McGill
| | - Neil R Bell
- Professeur au Département de médecine familiale de l'Université de l'Alberta à Edmonton
| | - Olga Szafran
- Directrice associée de la recherche au Département de médecine familiale de l'Université de l'Alberta
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Dickinson JA, Thériault G, Grad R, Bell NR, Szafran O. Assessing new screening tests: Panacea or profligate? Can Fam Physician 2022; 68:815-822. [PMID: 36376046 PMCID: PMC9833156 DOI: 10.46747/cfp.6811815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- James A. Dickinson
- Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary in Alberta.,Correspondence Dr James A. Dickinson; e-mail
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Grad R, Antao V, Bell NR, Dickinson JA, Rezkallah R, Singh H, Szafran O, Waugh E, Thériault G. What should educators teach to improve preventive health care? Can Fam Physician 2022; 68:583-588. [PMID: 35961717 PMCID: PMC9374074 DOI: 10.46747/cfp.6808583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Roland Grad
- Associate Professor in the Department of Family Medicine at McGill University in Montréal, Que.
| | - Viola Antao
- Associate Professor in the Department of Family and Community Medicine at the University of Toronto in Ontario
| | - Neil R Bell
- Professor in the Department of Family Medicine at the University of Alberta in Edmonton
| | - James A Dickinson
- Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary in Alberta
| | | | - Harminder Singh
- Associate Professor in the Department of Internal Medicine and the Department of Community Health Sciences at the University of Manitoba in Winnipeg and in the Department of Medical Oncology and Hematology at CancerCare Manitoba; he is also Adjunct Scientist at the CancerCare Manitoba Research Institute
| | - Olga Szafran
- Associate Director of Research in the Department of Family Medicine at the University of Alberta
| | - Earle Waugh
- Professor Emeritus and Emeritus Director of the Centre for Health and Culture in the Department of Family Medicine at the University of Alberta
| | - Guylène Thériault
- Academic Lead for the Physicianship Component and Director of Pedagogy at Outaouais Medical Campus in the Faculty of Medicine at McGill University
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Grad R, Antao V, Bell NR, Dickinson JA, Rezkallah R, Singh H, Szafran O, Waugh E, Thériault G. Que devraient enseigner les éducateurs pour améliorer les soins de santé préventifs? Can Fam Physician 2022; 68:e241-e247. [PMID: 35961714 PMCID: PMC9374081 DOI: 10.46747/cfp.6808e241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Roland Grad
- Professeur agrégé au Département de médecine familiale de l'Université McGill à Montréal (Québec).
| | - Viola Antao
- Professeure agrégée au Département de médecine familiale et communautaire de l'Université de Toronto (Ontario)
| | - Neil R Bell
- Professeur au Département de médecine familiale de l'Université de l'Alberta à Edmonton
| | - James A Dickinson
- Professeur au Département de médecine familiale et au Département des sciences de la santé communautaire de l'Université de Calgary (Alberta)
| | | | - Harminder Singh
- Professeur agrégé au Département de médecine interne et au Département des sciences de la santé communautaire de l'Université du Manitoba à Winnipeg, et au Département d'hématologie et d'oncologie médicale à ActionCancer Manitoba; il est également scientifique adjoint à l'Institut de recherche d'ActionCancer Manitoba
| | - Olga Szafran
- Directrice adjointe de recherche au Département de médecine familiale de l'Université de l'Alberta à Edmonton
| | - Earle Waugh
- Professeur émérite et directeur émérite du Centre de santé et de culture au Département de médecine familiale de l'Université de l'Alberta
| | - Guylène Thériault
- Directrice du volet Rôle du médecin et directrice du Centre de pédagogie au Campus Outaouais de la Faculté de médecine de l'Université McGill
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Antao V, Grad R, Thériault G, Dickinson JA, Szafran O, Singh H, Rezkallah R, Waugh E, Bell NR. Going against the status quo in screening: Call to action to improve teaching in preventive health care. Can Fam Physician 2022; 68:340-344. [PMID: 35552217 PMCID: PMC9097728 DOI: 10.46747/cfp.6805340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Viola Antao
- Associate Professor in the Department of Family and Community Medicine at the University of Toronto in Ontario.
| | - Roland Grad
- Associate Professor in the Department of Family Medicine at McGill University in Montréal, Que
| | - Guylène Thériault
- Academic Lead for the Physicianship Component and Director of Pedagogy at Outaouais Medical Campus in the Faculty of Medicine at McGill University
| | - James A Dickinson
- Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary in Alberta
| | - Olga Szafran
- Associate Director of Research in the Department of Family Medicine at the University of Alberta in Edmonton
| | - Harminder Singh
- Associate Professor in the Department of Internal Medicine and the Department of Community Health Sciences at the University of Manitoba in Winnipeg, and in the Department of Medical Oncology and Hematology at CancerCare Manitoba; he is also Adjunct Scientist at the CancerCare Manitoba Research Institute
| | | | - Earle Waugh
- Professor Emeritus and Emeritus Director of the Centre for Health and Culture in the Department of Family Medicine at the University of Alberta
| | - Neil R Bell
- Professor in the Department of Family Medicine at the University of Alberta
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Antao V, Grad R, Thériault G, Dickinson JA, Szafran O, Singh H, Rezkallah R, Waugh E, Bell NR. À l’encontre du statu quo en matière de dépistage. Can Fam Physician 2022; 68:e140-e145. [PMID: 35552220 PMCID: PMC9097729 DOI: 10.46747/cfp.6805e140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Viola Antao
- Professeure agrégée au département de médecine familiale et communautaire à l'Université de Toronto (Ontario).
| | - Roland Grad
- Professeur agrégé au département de médecine familiale à l'Université McGill à Montréal (Québec)
| | - Guylène Thériault
- Directrice du volet Rôle du médecin et directrice du centre de pédagogie au Campus Outaouais de la Faculté de médecine de l'Université McGill
| | - James A Dickinson
- Professeur au département de médecine familiale et au département des sciences de santé communautaire à l'Université de Calgary (Alberta)
| | - Olga Szafran
- Directrice adjointe de recherche au Département de médecine familiale de l'Université de l'Alberta à Edmonton
| | - Harminder Singh
- Professeur agrégé au département de médecine interne et au département des sciences de santé communautaire à l'Université du Manitoba à Winnipeg et au département d'hématologie et d'oncologie médicale à ActionCancer Manitoba; il est également scientifique adjoint à l'Institut de recherche d'ActionCancer Manitoba
| | | | - Earle Waugh
- Professeur émérite et directeur émérite du centre de santé et de culture du département de médecine familiale de l'Université de l'Alberta
| | - Neil R Bell
- Professeur au département de médecine familiale à l'Université de l'Alberta
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Waugh E, Myhre D, Beauvais C, Thériault G, Bell NR, Dickinson JA, Grad R, Singh H, Szafran O. Preventive screening in women who have sex with women. Can Fam Physician 2021; 67:830-836. [PMID: 34772710 PMCID: PMC8589139 DOI: 10.46747/cfp.6711830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Earle Waugh
- Professor Emeritus and Emeritus Director of the Centre for Health and Culture in the Department of Family Medicine at the University of Alberta in Edmonton.
| | - Douglas Myhre
- Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary in Alberta
| | - Cassandre Beauvais
- Clinical Instructor in the Department of Family Medicine and Emergency Medicine at the University of Montreal in Laval, Que
| | - Guylène Thériault
- Academic Lead for the Physicianship Component and Director of Pedagogy at Outaouais Medical Campus in the Faculty of Medicine at McGill University in Montreal, Que
| | - Neil R Bell
- Professor of Research in the Department of Family Medicine at the University of Alberta
| | - James A Dickinson
- Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary
| | - Roland Grad
- Associate Professor in the Department of Family Medicine at McGill University
| | - Harminder Singh
- Associate Professor in the Department of Internal Medicine and the Department of Community Health Sciences at the University of Manitoba in Winnipeg and in the Department of Hematology and Oncology at CancerCare Manitoba
| | - Olga Szafran
- Associate Director of Research in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary
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Ding M, Koppula S, Szafran O, Au L, Babenko O. Mindsets of Early-Career Family Physicians Trained in Competency-Based Education. PRiMER 2021; 5:39. [PMID: 34841214 PMCID: PMC8612592 DOI: 10.22454/primer.2021.389603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION The objective of this study was to examine the mindsets (mastery, performance approach, performance avoidance) of early-career family physicians following graduation from a competency-based education residency program. METHODS This was a longitudinal, cohort, survey study of family medicine residents at a large Canadian university. The 2015-2017 cohort of family medicine residents was surveyed at three time points: (1) at the end of residency training; (2) at 1 year in clinical practice; and (3) at 3 years in clinical practice. We used Baranik et al's instrument to measure three types of mindsets. We performed descriptive and multivariate analyses using SPSS 26.0 software. RESULTS Irrespective of the time in practice, mean scores were the highest on the mastery mindset and the lowest on the performance avoidance mindset measures (P<.001). Over time, the mastery mindset scores tended to decrease (P=.04). CONCLUSION Family physicians trained in competency-based education continued to be mastery-oriented in the first 3 years of clinical practice. This finding is reassuring given that the mastery mindset is associated with professional well-being and long-term success. Nonetheless, because mastery mindset scores appeared to decrease over time, residency programs need to ensure graduating residents are equipped with knowledge and tools to remain mastery-oriented throughout the course of their professional careers.
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Affiliation(s)
- Mao Ding
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - Sudha Koppula
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - Olga Szafran
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - Lillian Au
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - Oksana Babenko
- Department of Family Medicine, University of Alberta, Edmonton, Canada
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Szafran O, Woloschuk W, Torti JMI, Palacios Mackay MF. Intimidation, harassment, and discrimination during family medicine residency training: a mixed methods study. BMC Med Educ 2021; 21:173. [PMID: 33743683 PMCID: PMC7980613 DOI: 10.1186/s12909-021-02623-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/15/2021] [Indexed: 05/26/2023]
Abstract
BACKGROUND The importance of wellbeing of family medicine residents is recognized in accreditation requirements which call for a supportive and respectful learning environment; however, concerns exist about learner mistreatment in the medical environment. The purpose of this study was to to describe family medicine graduates' perceived experience with intimidation, harassment and discrimination (IHD) during residency training. METHODS A mixed-methods study was conducted on a cohort of family medicine graduates who completed residency training during 2006-2011. Phase 1, the quantitative component, consisted of a retrospective survey of 651 graduates. Phase 2, the qualitative component, was comprised of 11 qualitative interviews. Both the survey and the interviews addressed graduates' experience with IHD with respect to frequency and type, setting, perpetrator, perceived basis for IHD, and the effect of the IHD. RESULTS The response rate to the survey was 47.2%, with 44.7% of respondents indicating that they experienced some form of mistreatment/IHD during residency training, and 69.9% noting that it occurred more than once. The primary sources of IHD were specialist physicians (75.7%), hospital nurses (47.8%), and family physicians (33.8%). Inappropriate verbal comments were the most frequent type of IHD (86.8%). Graduates perceived the basis of the IHD to be abuse of power (69.1%), personality conflict (36.8%), and family medicine as a career choice (30.1%), which interview participants also described. A significantly greater proportion IMGs than CMGs perceived the basis of IHD to be culture/ethnicity (47.2% vs 10.5%, respectively). The vast majority (77.3%) of graduates reported that the IHD experience had a negative effect on them, consisting of decreased self-esteem and confidence, increased anxiety, and sleep problems. As trainees, they felt angry, threatened, demoralized, discouraged, manipulated, and powerless. Some developed depression or burnout, took medication, or underwent counselling. CONCLUSIONS IHD continued to be prevalent during family medicine residency training, with it occurring most frequently in the hospital setting and specialty rotations. Educational institutions must work with hospital administrators to address issues of mistreatment in the workplace. Residency training programs and the medical establishment need to be cognizant that the effects of IHD are far-reaching and must continuously work to eradicate it.
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Affiliation(s)
- Olga Szafran
- Department of Family Medicine, University of Alberta, 6-10 University Terrace, Edmonton, Alberta, T6G 2T4, Canada.
| | - Wayne Woloschuk
- Cumming School of Medicine, University of Calgary, Room 701B, Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada
| | - Jacqueline M I Torti
- Centre for Education Research & Innovation, Schulich School of Medicine & Dentistry, Western University, Suite 100, Medical Sciences Building, London, Ontario, N6G 2V4, Canada
| | - Maria F Palacios Mackay
- Interdisciplinary Centre for Education Innovation (CIED) Santo Tomás, Universidad Santo Tomás, Arturo Prat 866, Piso 5, CP 4100000, Concepción, Chile
- Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada
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Dickinson JA, Thériault G, Singh H, Grad R, Bell NR, Szafran O. Too soon or too late? Choosing the right screening test intervals. Can Fam Physician 2021; 67:100-106. [PMID: 33608359 DOI: 10.46747/cfp.6702100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- James A Dickinson
- Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary in Alberta.
| | - Guylène Thériault
- Academic Lead for the Physicianship Component and Director of Pedagogy at Outaouais Medical Campus in the Faculty of Medicine at McGill University in Montreal, Que
| | - Harminder Singh
- Associate Professor in the Department of Internal Medicine and the Department of Community Health Sciences at the University of Manitoba in Winnipeg and in the Department of Hematology and Oncology at CancerCare Manitoba
| | - Roland Grad
- Associate Professor in the Department of Family Medicine at McGill University
| | - Neil R Bell
- Professor and Associate Director of Research, Department of Family Medicine at the University of Alberta in Edmonton
| | - Olga Szafran
- Professor and Associate Director of Research, Department of Family Medicine at the University of Alberta in Edmonton
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Dickinson JA, Thériault G, Singh H, Grad R, Bell NR, Szafran O. Trop tôt ou trop tard? Can Fam Physician 2021; 67:e48-e55. [PMID: 33608370 PMCID: PMC8324119 DOI: 10.46747/cfp.6702e48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- James A Dickinson
- Professeur au département de médecine familiale et au département des sciences de santé communautaire de l'Université de Calgary en Alberta.
| | - Guylène Thériault
- Responsable universitaire du volet Rôle du médecin et directrice de la pédagogie au Campus médical Outaouais de la Faculté de médecine de l'Université McGill à Montréal, Québec
| | - Harminder Singh
- Professeur agrégé au département de médecine interne et au département des sciences de santé communautaire de l'Université du Manitoba à Winnipeg, et au département d'hématologie et d'oncologie à ActionCancer Manitoba
| | - Roland Grad
- Professeur agrégé au département de médecine de famille de l'Université McGill
| | - Neil R Bell
- Professeur et directrice adjointe de recherche au Département de médecine familiale de l'Université de l'Alberta à Edmonton
| | - Olga Szafran
- Professeur et directrice adjointe de recherche au Département de médecine familiale de l'Université de l'Alberta à Edmonton
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Sloychuk J, Szafran O, Duerksen K, Babenko O. Association Between Family Medicine Residents' Mindsets and In-Training Exam Scores. PRiMER 2020; 4:33. [PMID: 33426482 DOI: 10.22454/primer.2020.796230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Introduction In medical practice, a mastery mindset is important for engaging in lifelong learning. The objective of this study was to examine the association between family medicine residents' scores on mindset measures and their performance on in-training examinations (ITE). Methods This was a secondary data analysis of a cohort of family medicine residents. Following ethics approval, residents' ITE scores from each of the 2 years of residency were linked with residents' responses to a mindsets survey that they had taken at the midpoint of residency training. Multiple regression analysis was used to investigate the relationship between residents' mindset scores and their ITE scores. Of 85 residents, 46 (54%) had complete data for the three data collection points. Results Residents' ITE scores in year 1 were most predictive of their ITE scores in year 2 (β=0.72; P<.001). Mastery mindset scores were negatively associated with residents' performance on the ITE in year 2 (β=-0.29; P=.004). Conclusion While the observed negative relationship between residents' mastery mindset scores and their ITE performance may be disconcerting, it is not surprising. In clinical settings, residents are individually coached by preceptors and provided with specific, actionable feedback to support their learning. With respect to formative assessments, residents likely require explicit training on how to use their assessment results (ITE scores) to support their self-directed learning. This finding has practical implications for residency programs in using ITEs as formative assessments.
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Affiliation(s)
- Janelle Sloychuk
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Olga Szafran
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Kimberley Duerksen
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Oksana Babenko
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
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Thériault G, Breault P, Dickinson JA, Grad R, Bell NR, Singh H, Szafran O. Preventive health care and the media. Can Fam Physician 2020; 66:811-816. [PMID: 33208420 PMCID: PMC8302440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Guylène Thériault
- Academic Lead for the Physicianship Component and the Director of Pedagogy at the Outaouais Medical Campus of McGill University's Faculty of Medicine in Gatineau, Que.
| | - Pascale Breault
- Clinical Lecturer in the Department of Family Medicine at Laval University in Quebec city, Que
| | - James A Dickinson
- Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary in Alberta
| | - Roland Grad
- Associate Professor in the Department of Family Medicine at McGill University
| | - Neil R Bell
- Professor in the Department of Family Medicine at the University of Alberta in Edmonton
| | - Harminder Singh
- Associate Professor in the Department of Internal Medicine and the Department of Community Health Sciences at the University of Manitoba in Winnipeg and in the Department of Hematology and Oncology of CancerCare Manitoba
| | - Olga Szafran
- Associate Director of Research in the Department of Family Medicine at the University of Alberta
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Thériault G, Breault P, Dickinson JA, Grad R, Bell NR, Singh H, Szafran O. [Not Available]. Can Fam Physician 2020; 66:e287-e292. [PMID: 33208439 PMCID: PMC8302437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Guylène Thériault
- Directrice du volet Rôle du médecin et directrice de la Pédagogie au Campus médical de l'Outaouais de la Faculté de médecine de l'Université McGill (Gatineau, Québec).
| | - Pascale Breault
- Chargée de cours cliniques au Département de médecine familiale de l'Université Laval à Québec (Québec)
| | - James A Dickinson
- Professeur au Département de médecine familiale et au Département des sciences de la santé communautaire à l'Université de Calgary (Alberta)
| | - Roland Grad
- Professeur agrégé au Département de médecine de famille de l'Université McGill
| | - Neil R Bell
- Professeur au Département de médecine familiale de l'Université de l'Alberta à Edmonton
| | - Harminder Singh
- Professeur agrégé au Département de médecine interne et au Département des sciences de la santé communautaire de l'Université du Manitoba à Winnipeg, et au Département d'hématologie et d'oncologie de CancerCare Manitoba
| | - Olga Szafran
- Directrice associée de recherche au Département de médecine familiale de l'Université de l'Alberta
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Dickinson JA, Thériault G, Singh H, Szafran O, Grad R. Rethinking screening during and after COVID-19: Should things ever be the same again? Can Fam Physician 2020; 66:571-575. [PMID: 32817029 PMCID: PMC7430792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- James A Dickinson
- Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary in Alberta.
| | - Guylène Thériault
- Academic Lead for the Physicianship Component and the Director of Pedagogy at Outaouais Medical Campus in the Faculty of Medicine at McGill University in Montreal, Que
| | - Harminder Singh
- Associate Professor in the Department of Internal Medicine and the Department of Community Health Sciences at the University of Manitoba in Winnipeg and in the Department of Hematology and Oncology for CancerCare Manitoba
| | - Olga Szafran
- Associate Director of Research in the Department of Family Medicine at the University of Alberta in Edmonton
| | - Roland Grad
- Associate Professor in the Department of Family Medicine at McGill University
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Szafran O, Myhre D, Torti J, Schipper S. Factors perceived to influence rural career choice of urban background family physicians: A qualitative analysis. Can Med Educ J 2020; 11:e21-e30. [PMID: 32802224 PMCID: PMC7378147 DOI: 10.36834/cmej.56976] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Urban background physicians are the main source of physician supply for rural communities across Canada. The purpose of this study was to describe factors that are perceived to influence rural career choice and practice location of urban background family medicine graduates. METHODS We conducted a qualitative, descriptive study employing telephone interviews with 9 urban background family physicians practicing in rural locations. Those who completed residency training between 2006 and 2011, were in rural practice, and had an urban upbringing were asked: when the decision for rural practice was made; factors that influenced rural career choice; and factors that influenced choice of a particular rural location. Emerging themes were identified through content analysis of interview data. RESULTS We identified four themes as factors perceived to influence rural career choice - variety/broad scope of rural practice, rural lifestyle, personal relationships, and positive rural experience/physician role models. We also identified factors in four areas perceived to influence the choice of a particular rural practice location - having lived in the rural community, spousal influence, personal lifestyle, and comfort with practice expectations. CONCLUSION Decisions for rural career choice and rural practice location by practicing urban background family medicine graduates are based on clinical practice considerations, training experience, as well as personal and lifestyle factors.
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Affiliation(s)
- Olga Szafran
- Department of Family Medicine, University of Alberta, Alberta, Canada
| | - Douglas Myhre
- Department of Family Medicine, Cumming School of Medicine and at the time of the study was Associate Dean, Distributed Learning and Rural Initiatives, University of Calgary, Alberta, Canada
| | - Jacqueline Torti
- At the time of the study Department of Family Medicine, University of Alberta. Alberta, Canada. Presently Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
| | - Shirley Schipper
- Faculty of Medicine & Dentistry and Associate Professor, Department of Family Medicine, University of Alberta, Alberta, Canada
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Thériault G, Grad R, Dickinson JA, Breault P, Singh H, Bell NR, Szafran O. To share or not to share: When is shared decision making the best option? Can Fam Physician 2020; 66:327-331. [PMID: 32404450 PMCID: PMC7219806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Guylène Thériault
- Academic Lead for the Physicianship Component and Director of Pedagogy at Outaouais Medical Campus in the Faculty of Medicine at McGill University in Montreal, Que.
| | - Roland Grad
- Associate Professor in the Department of Family Medicine at McGill University
| | - James A Dickinson
- Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary in Alberta
| | - Pascale Breault
- Clinical Lecturer in the Department of Family Medicine at Laval University in Quebec
| | - Harminder Singh
- Associate Professor in the Department of Internal Medicine and the Department of Community Health Sciences at the University of Manitoba in Winnipeg and in the Department of Hematology and Oncology for CancerCare Manitoba
| | - Neil R Bell
- Professor in the Department of Family Medicine at the University of Alberta in Edmonton
| | - Olga Szafran
- Associate Director of Research in the Department of Family Medicine at the University of Alberta
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Thériault G, Grad R, Dickinson JA, Breault P, Singh H, Bell NR, Szafran O. [Not Available]. Can Fam Physician 2020; 66:e149-e154. [PMID: 32404467 PMCID: PMC7219816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Guylène Thériault
- Responsable universitaire du volet Rôle du médecin et directrice de la pédagogie au Campus Outaouais de la Faculté de médecine de l'Université McGill à Montréal (Québec).
| | - Roland Grad
- Professeur agrégé au département de médecine de famille de l'Université McGill
| | - James A Dickinson
- Professeur au département de médecine familiale et au département des sciences de santé communautaire de l'Université de Calgary (Alberta)
| | - Pascale Breault
- Chargée d'enseignement clinique au département de médecine familiale de l'Université Laval (Québec)
| | - Harminder Singh
- Professeur agrégé au département de médecine interne et au département des sciences de santé communautaire de l'Université du Manitoba à Winnipeg, et au département d'hématologie et d'oncologie à ActionCancer Manitoba
| | - Neil R Bell
- Professeur au département de médecine familiale de l'Université de l'Alberta à Edmonton
| | - Olga Szafran
- Directrice adjointe de la recherche au département de médecine familiale de l'Université de l'Alberta
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Grad R, Thériault G, Singh H, Dickinson JA, Szafran O, Bell NR. [Not Available]. Can Fam Physician 2019; 65:e329-e335. [PMID: 31413037 PMCID: PMC6693590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Roland Grad
- Professeur agrégé à la Faculté de médecine de famille de l'Université McGill, à Montréal, au Québec.
| | - Guylène Thériault
- Vice-doyenne associée de l'éducation médicale satellite et leader académique de la section Formation des médecins, Campus médical outaouais de la Faculté de médecine de l'Université McGill
| | - Harminder Singh
- Professeur agrégé au Département de médecine interne et au Département des sciences de la santé communautaire à l'Université du Manitoba à Winnipeg, et au Département d'hématologie et d'oncologie de CancerCare Manitoba
| | - James A Dickinson
- Professeur à la Faculté de médecine familiale et au Département des sciences de la santé communautaire de l'Université de Calgary, en Alberta
| | - Olga Szafran
- Directrice adjointe de recherche au Département de médecine familiale de l'Université de l'Alberta à Edmonton
| | - Neil R Bell
- Professeur agrégé au Département de médecine de famille à l'Université de l'Alberta
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Grad R, Thériault G, Singh H, Dickinson JA, Szafran O, Bell NR. Age to stop? Appropriate screening in older patients. Can Fam Physician 2019; 65:543-548. [PMID: 31413022 PMCID: PMC6693611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Roland Grad
- Associate Professor in the Department of Family Medicine at McGill University in Montreal, Que.
| | - Guylène Thériault
- Associate Vice Dean of Distributed Medical Education and Academic Lead for the Physicianship Component at Outaouais Medical Campus in the Faculty of Medicine at McGill University
| | - Harminder Singh
- Associate Professor in the Department of Internal Medicine and the Department of Community Health Sciences at the University of Manitoba in Winnipeg and in the Department of Hematology and Oncology of CancerCare Manitoba
| | - James A Dickinson
- Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary in Alberta
| | - Olga Szafran
- Associate Director of Research in the Department of Family Medicine at the University of Alberta in Edmonton
| | - Neil R Bell
- Professor in the Department of Family Medicine at the University of Alberta
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Thériault G, Bell NR, Grad R, Singh H, Szafran O. Teaching shared decision making: An essential competency. Can Fam Physician 2019; 65:514-516. [PMID: 31300437 PMCID: PMC6738478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Guylène Thériault
- Assistant Dean of Distributed Medical Education for McGill University and Academic Lead for the Physicianship Component for the Outaouais Medical Campus in Montreal, Que.
| | - Neil R Bell
- Professor in the Department of Family Medicine at the University of Alberta in Edmonton
| | - Roland Grad
- Associate Professor in the Department of Family Medicine at McGill University in Montreal
| | - Harminder Singh
- Associate Professor in the Department of Internal Medicine and the Department of Community Health Sciences at the University of Manitoba in Winnipeg and in the Department of Hematology and Oncology of CancerCare Manitoba
| | - Olga Szafran
- Associate Director of Research in the Department of Family Medicine at the University of Alberta
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Thériault G, Bell NR, Grad R, Singh H, Szafran O. [Not Available]. Can Fam Physician 2019; 65:e321-e324. [PMID: 31300447 PMCID: PMC6738479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Guylène Thériault
- Vice-doyenne à l'enseignement médical décentralisé de l'Université McGill et responsable des études du volet Médecine du Campus médical de l'Outaouais à Montréal, au Québec.
| | - Neil R Bell
- Professeur au Département de médecine de famille de l'Université de l'Alberta à Edmonton
| | - Roland Grad
- Professeur agrégé au Département de médecine de famille de l'Université McGill à Montréal
| | - Harminder Singh
- Professeur agrégé au Département de médecine interne et au Département des sciences de la santé communautaire de l'Université du Manitoba à Winnipeg et au Département d'hématologie et d'oncologie de CancerCare Manitoba
| | - Olga Szafran
- Directrice associée de la recherche au Département de médecine de famille de l'Université de l'Alberta
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Dickinson JA, Grad R, Wilson BJ, Bell NR, Singh H, Szafran O, Thériault G. Quality of the screening process: An overlooked critical factor and an essential component of shared decision making about screening. Can Fam Physician 2019; 65:331-336. [PMID: 31088870 PMCID: PMC6516683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- James A Dickinson
- Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary in Alberta.
| | - Roland Grad
- Associate Professor in the Department of Family Medicine at McGill University in Montreal, Que
| | - Brenda J Wilson
- Associate Dean and Professor in the Division of Community Health and Humanities at Memorial University of Newfoundland in St John's
| | - Neil R Bell
- Professor in the Department of Family Medicine at the University of Alberta in Edmonton
| | - Harminder Singh
- Associate Professor in the Department of Internal Medicine and the Department of Community Health Sciences at the University of Manitoba in Winnipeg and in the Department of Hematology and Oncology of CancerCare Manitoba
| | - Olga Szafran
- Associate Director of Research in the Department of Family Medicine at the University of Alberta
| | - Guylène Thériault
- Associate Vice Dean of Distributed Medical Education and the Academic Lead for the Physicianship Component at Outaouais Medical Campus in the Faculty of Medicine at McGill University
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Dickinson JA, Grad R, Wilson BJ, Bell NR, Singh H, Szafran O, Thériault G. Qualité du processus de dépistage. Can Fam Physician 2019; 65:e185-e191. [PMID: 31088883 PMCID: PMC6516691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- James A Dickinson
- Professeur au Département de médecine familiale et au Département des sciences de la santé communautaire de l'Université de Calgary, en Alberta.
| | - Roland Grad
- Professeur agrégé au Département de médecine de famille de l'Université McGill, à Montréal, au Québec
| | - Brenda J Wilson
- Doyenne associée et professeure à la Division de santé communautaire et d'humanités à l'Université Memorial de Terre-Neuve, à Saint John's
| | - Neil R Bell
- Professeur au Département de médecine familiale à l'Université de l'Alberta, à Edmonton
| | - Harminder Singh
- Professeur agrégé au Département de médecine interne et au Département des sciences de la santé communautaire à l'Université du Manitoba, à Winnipeg, et au Département d'hématologie et d'oncologie de CancerCare Manitoba
| | - Olga Szafran
- Directrice adjointe de recherche au Département de médecine familiale de l'Université de l'Alberta, à Edmonton
| | - Guylène Thériault
- Vice-doyenne associée de l'éducation médicale satellite et leader académique de la section Formation des médecins au Campus médical Outaouais de la Faculté de médecine de l'Université McGill
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Szafran O, Kennett SL, Bell NR, Torti JMI. Interprofessional collaboration in diabetes care: perceptions of family physicians practicing in or not in a primary health care team. BMC Fam Pract 2019; 20:44. [PMID: 30871513 PMCID: PMC6419394 DOI: 10.1186/s12875-019-0932-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 03/06/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND In Canada, most patients with type 2 diabetes mellitus (T2DM) are cared for in the primary care setting in the practices of family physicians. This care is delivered through a variety of practice models ranging from a single practitioner to interprofessional team models of care. This study examined the extent to which family physicians collaborate with other health professionals in the care of patients with T2DM, comparing those who are part of an interprofessional health care team called a Primary Care Network (PCN) to those who are not part of a PCN. METHODS Family physicians in Alberta, Canada were surveyed to ascertain: which health professionals they refer to or have collaborative arrangements with when caring for T2DM patients; satisfaction and confidence with other professionals' involvement in diabetes care; and perceived effects of having other professionals involved in diabetes care. Chi-squared and Fishers Exact tests were used to test for differences between PCN and non-PCN physicians. RESULTS 170 (34%) family physicians responded to the survey, of whom 127 were PCN physicians and 41 were non-PCN physicians (2 not recorded). A significantly greater proportion of PCN physicians vs non-PCN physicians referred patients to pharmacists (23.6% vs 2.6%) or had collaborative working arrangements with diabetes educators (55.3% vs 18.4%), dietitians (54.5% vs 21.1%), or pharmacists (43.1% vs 21.1%), respectively. Regardless of PCN status, family physicians expressed greater satisfaction and confidence in specialists than in other family physicians or health professionals in medication management of patients with T2DM. Physicians who were affiliated with a PCN perceived that interprofessional collaboration enabled them to delegate diabetes education and monitoring and/or adjustment of medications to other health professionals and resulted in improved patient care. CONCLUSIONS This study sheds new insight on the influence that being part of a primary care team has on physicians' practice. Specifically, supporting physicians' access to other health professionals in the primary care setting is perceived to facilitate interprofessional collaboration in the care of patients with T2DM and improve patient care.
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Affiliation(s)
- Olga Szafran
- Department of Family Medicine, University of Alberta, 6-10 University Terrace, Edmonton, Alberta T6G 2T4 Canada
| | - Sandra L. Kennett
- Edmonton Oliver Primary Care Network, Family Medicine Clinic, Misericordia Community Hospital, Edmonton, Alberta Canada
- Primary Care, Health Canada, Suite 730, 9700 Jasper Avenue, Edmonton, Alberta T5J 4C3 Canada
| | - Neil R. Bell
- Department of Family Medicine, University of Alberta, Family Medicine Clinic, Misericordia Community Hospital, 16940 - 87 Avenue, Edmonton, Alberta T5R 4H5 Canada
| | - Jacqueline M. I. Torti
- Department of Family Medicine, University of Alberta, Health Sciences Addition Room 110, London, Ontario N6A 5C1 Canada
- Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, Health Sciences Addition Room 110, London, Ontario N6A 5C1 Canada
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Wilson BJ, Bell NR, Grad R, Thériault G, Dickinson JA, Singh H, Groulx S, Szafran O. Practice organization for preventive screening. Can Fam Physician 2018; 64:816-820. [PMID: 30429176 PMCID: PMC6234927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Brenda J Wilson
- Associate Dean and Professor in the Division of Community Health and Humanities at Memorial University of Newfoundland in St John's.
| | - Neil R Bell
- Professor in the Department of Family Medicine at the University of Alberta in Edmonton
| | - Roland Grad
- Associate Professor in the Department of Family Medicine at McGill University and Senior Investigator at the Lady Davis Institute in Montreal, Que
| | - Guylène Thériault
- Associate Vice Dean of Distributed Medical Education and Academic Lead for the Physicianship Component at Outaouais Medical Campus at McGill University
| | - James A Dickinson
- Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary in Alberta
| | - Harminder Singh
- Associate Professor in the Department of Internal Medicine and the Department of Community Health Sciences at the University of Manitoba in Winnipeg and in the Department of Hematology and Oncology for CancerCare Manitoba
| | - Stéphane Groulx
- Assistant Clinical Professor in the Department of Community Health Sciences at the University of Sherbrooke and Associate Researcher at the Charles-LeMoyne Hospital Research Centre in Sherbrooke, Que
| | - Olga Szafran
- Associate Director of Research in the Department of Family Medicine at the University of Alberta in Edmonton
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Wilson BJ, Bell NR, Grad R, Thériault G, Dickinson JA, Singh H, Groulx S, Szafran O. [Not Available]. Can Fam Physician 2018; 64:e477-e482. [PMID: 30429191 PMCID: PMC6234924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Brenda J Wilson
- Doyenne associée et professeure à la Division de santé communautaire et d'humanités à l'Université Memorial of Newfoundland à St.-John's.
| | - Neil R Bell
- Professeur au Département de médecine de famille à l'Université de l'Alberta, à Edmonton
| | - Roland Grad
- Professeur agrégé au Département de médecine de famille de l'Université McGill et chercheur principal à l'Institut Lady Davis à Montréal, au Québec
| | - Guylène Thériault
- Vice-doyenne associée de l'éducation médicale satellite et leader académique de la section Formation des médecins Campus médical Outaouais de l'Université McGill
| | - James A Dickinson
- Professeur à la Faculté de médecine familiale et au Département de Sciences de la santé communautaire de l'Université de Calgary, en Alberta
| | - Harminder Singh
- Professeur agrégé au Département de médecine interne et au Département des Sciences de la santé communautaire à l'Université du Manitoba à Winnipeg, et au Département d'hématologie et d'oncologie de CancerCare Manitoba
| | - Stéphane Groulx
- Professeur clinique adjoint au Département des sciences de la santé communautaire à l'Université de Sherbrooke et chercheur agrégé au Centre de recherche de l'Hôpital Charles-Le Moyne à Sherbrooke, au Québec
| | - Olga Szafran
- Directrice adjointe de recherche au Département de médecine familiale de l'Université de l'Alberta à Edmonton
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Singh H, Dickinson JA, Thériault G, Grad R, Groulx S, Wilson BJ, Szafran O, Bell NR. Overdiagnosis: causes and consequences in primary health care. Can Fam Physician 2018; 64:654-659. [PMID: 30209095 PMCID: PMC6135119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Harminder Singh
- Associate Professor in the Department of Internal Medicine and the Department of Community Health Sciences at the University of Manitoba in Winnipeg and in the Department of Hematology and Oncology for CancerCare Manitoba.
| | - James A Dickinson
- Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary in Alberta
| | - Guylène Thériault
- Associate Vice Dean of Distributed Medical Education and Academic Lead for the Physicianship Component at Outaouais Medical Campus at McGill University in Montreal, Que
| | - Roland Grad
- Associate Professor in the Department of Family Medicine at McGill University and Senior Investigator at the Lady Davis Institute in Montreal
| | - Stéphane Groulx
- Assistant Clinical Professor in the Department of Community Health Sciences at the University of Sherbrooke and Associate Researcher at the Charles-LeMoyne Hospital Research Centre in Sherbrooke, Que
| | - Brenda J Wilson
- Associate Dean and Professor in the Division of Community Health and Humanities at Memorial University of Newfoundland in St John's
| | - Olga Szafran
- Associate Director of Research, in the Department of Family Medicine, at the University of Alberta in Edmonton
| | - Neil R Bell
- Professor, in the Department of Family Medicine at the University of Alberta in Edmonton
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Singh H, Dickinson JA, Thériault G, Grad R, Groulx S, Wilson BJ, Szafran O, Bell NR. [Not Available]. Can Fam Physician 2018; 64:e373-e379. [PMID: 30209110 PMCID: PMC6135136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Harminder Singh
- Professeur agrégé au Département de médecine interne et au Département des sciences de la santé communautaire de l'Université du Manitoba à Winnipeg et au Département d'hématologie et d'oncologie pour CancerCare Manitoba.
| | - James A Dickinson
- Professeur au Département de médecine familiale et au Département des sciences de la santé communautaire de l'Université de Calgary (Alberta)
| | - Guylène Thériault
- Vice-doyenne associée de l'éducation médicale satellite et leader académique de la section Formation des médecins au Campus médical Outaouais de la Faculté de médecine de l'Université McGill à Montréal (Québec)
| | - Roland Grad
- Professeur agrégé au Département de médecine de famille de l'Université McGill et chercheur principal à l'Institut Lady Davis à Montréal
| | - Stéphane Groulx
- Professeur clinicien adjoint au Département des sciences de la santé communautaire de l'Université de Sherbrooke et chercheur associé au Centre de recherche de l'Hôpital Charles-Le Moyne à Sherbrooke (Québec)
| | - Brenda J Wilson
- Doyenne associée et professeure à la Division de santé communautaire et d'humanités à l'Université Memorial of Newfoundland à St.-John's (Terre-Neuve)
| | - Olga Szafran
- Directrice associée de la Recherche Département de médecine familiale de l'Université de l'Alberta à Edmonton
| | - Neil R Bell
- Professeur, les 2 au Département de médecine familiale de l'Université de l'Alberta à Edmonton
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Myhre D, Szafran O, Schipper S, Dickinson J, Janke F. Scope of practice of family medicine graduates who completed a rural versus urban program. Rural Remote Health 2018; 18:4514. [PMID: 30059629 DOI: 10.22605/rrh4514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION In Canada, rural-based family medicine residency programs were established largely in response to a shortage of rural physicians and the perception that urban-based training programs were not meeting the needs of rural populations. Examinations of practice patterns of physicians trained in rural and urban programs are lacking. The purpose of this study was to compare the scope of practice of family medicine graduates who completed a rural versus an urban residency program, by practice location. METHODS This was a cross-sectional, mail-out, questionnaire survey of 651 graduates who had completed the family medicine residency program at the University of Alberta or the University of Calgary, Alberta, Canada during 2006-2011. Rural program graduates lived and trained in regional settings and spent a considerable amount of time in smaller rural and remote communities for their clinical experience. The training of urban program graduates was primarily based in large urban settings and family medicine clinical experience was based in the community. Practice location (rural, urban) was classified by population size of the town/city at which physicians practiced. Scope of practice was ascertained through four domains of care: types of care, clinical procedures, practice settings and specific populations. Items within each domain were rated on a five-point scale (1='not part of practice', 5='element of core practice'). Mean rating scores for items in the domains of care were compared between urban and rural program graduates using ANOVA. RESULTS A total of 307 (47.2%) graduates responded to the survey, of whom 173 were categorized as urban program graduates and 59 as rural program graduates. Overall, rural program graduates exhibited a broader scope of practice in providing postnatal care, intrapartum care/deliveries, palliative care, office-based and in-hospital clinical procedures, emergency care, in-hospital care, home visits, long-term care, and caring for rural and Aboriginal populations. Irrespective of program completed, those in a rural practice location had a broader scope of practice than those in urban practice. Urban and rural program graduates in rural locations tended to have a similar scope of practice. In urban locations, rural program graduates were more likely to include intrapartum care/deliveries as part of their clinical practice. Rural program graduates were more likely to practice in rural locations than urban program graduates. CONCLUSION A combination of site of training (rural or urban program) and location of practice appear to work together to influence scope of practice of family physicians. A conceptual framework that summarizes the factors that have been reported to be associated with the scope of family practice is proposed.
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Affiliation(s)
- Douglas Myhre
- Cumming School of Medicine, Health Sciences Centre, Foothills Campus, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Olga Szafran
- Faculty of Medicine & Dentistry, University of Alberta
| | | | | | - Fred Janke
- Faculty of Medicine & Dentistry, University of Alberta
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Dickinson JA, Pimlott N, Grad R, Singh H, Szafran O, Wilson BJ, Groulx S, Thériault G, Bell NR. Screening: when things go wrong. Can Fam Physician 2018; 64:502-508. [PMID: 30002025 PMCID: PMC6042667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- James A Dickinson
- Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary in Alberta.
| | - Nicholas Pimlott
- Professor in the Department of Family and Community Medicine at the University of Toronto in Ontario and Scientific Editor of Canadian Family Physician
| | - Roland Grad
- Associate Professor in the Department of Family Medicine at McGill University in Montreal, Que
| | - Harminder Singh
- Associate Professor in the Department of Internal Medicine and the Department of Community Health Sciences at the University of Manitoba in Winnipeg and in the Department of Hematology and Oncology for CancerCare Manitoba
| | - Olga Szafran
- Associate Director of Research in the Department of Family Medicine at the University of Alberta in Edmonton
| | - Brenda J Wilson
- Associate Dean and Professor in the Division of Community Health and Humanities at Memorial University of Newfoundland in St John's
| | - Stéphane Groulx
- Assistant Clinical Professor in the Department of Community Health Sciences at the University of Sherbrooke and Associate Researcher at the Charles-Le Moyne Hospital Research Centre in Sherbrooke, Que
| | - Guylène Thériault
- Associate Vice Dean of Distributed Medical Education and the Academic Lead for the Physicianship Component at Outaouais Medical Campus in the Faculty of Medicine at McGill University
| | - Neil R Bell
- Professor in the Department of Family Medicine at the University of Alberta
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Dickinson JA, Pimlott N, Grad R, Singh H, Szafran O, Wilson BJ, Groulx S, Thériault G, Bell NR. [Not Available]. Can Fam Physician 2018; 64:e299-e306. [PMID: 30002039 PMCID: PMC6042665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- James A Dickinson
- Professeur à la Faculté de médecine familiale et au Département des sciences de la santé communautaire de l'Université de Calgary en Alberta.
| | - Nicholas Pimlott
- Professeur au Département de médecine familiale et communautaire de l'Université de Toronto, en Ontario, et est rédacteur scientifique pour Le Médecin de famille canadien
| | - Roland Grad
- Professeur agrégé à la Faculté de médecine de famille de l'Université McGill, à Montréal, au Québec
| | - Harminder Singh
- Professeur agrégé au Département de médecine interne et au Département des sciences de la santé communautaire à l'Université du Manitoba à Winnipeg, et au Département d'hématologie et d'oncologie de CancerCare, au Manitoba
| | - Olga Szafran
- Directrice adjointe de recherche au Département de médecine familiale de l'Université de l'Alberta à Edmonton, en Alberta
| | - Brenda J Wilson
- Doyenne associée et professeure à la Division de santé communautaire et d'humanités de l'Université Memorial of Newfoundland à St.-John's
| | - Stéphane Groulx
- Professeur clinique adjoint au Département des sciences de la santé communautaire de l'Université de Sherbrooke et chercheur agrégé au Centre de recherche de l'Hôpital Charles-Le Moyne à Sherbrooke, au Québec
| | - Guylène Thériault
- Vice-doyenne associée de l'éducation médicale satellite et leader académique de la section Formation des médecins au Campus médical Outaouais de la Faculté de médecine de l'Université McGill, au Québec
| | - Neil R Bell
- Professeur agrégé au Département de médecine familiale de l'Université de l'Alberta
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Dickinson JA, Bell NR, Grad R, Singh H, Groulx S, Szafran O. [Not Available]. Can Fam Physician 2018; 64:e225-e231. [PMID: 29760270 PMCID: PMC5951665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- James A Dickinson
- Professeur au Département de médecine familiale et au Département des sciences de la santé communautaire de l'Université de Calgary.
| | - Neil R Bell
- Professeur au Département de médecine familiale de l'Université de l'Alberta à Edmonton
| | - Roland Grad
- Professeur agrégé au Département de médecine de famille de l'Université McGill à Montréal, au Québec
| | - Harminder Singh
- Professeur agrégé au Département de médecine interne et au Département des sciences de la santé communautaire de l'Université du Manitoba à Winnipeg, et au Département d'hématologie et d'oncologie pour CancerCare Manitoba
| | - Stéphane Groulx
- Professeur clinicien adjoint au Département des sciences de la santé communautaire de l'Université de Sherbrooke, au Québec, et chercheur associé au Centre de recherche de l'Hôpital Charles-Le Moyne à Sherbrooke
| | - Olga Szafran
- Directrice associée de la Recherche au Département de médecine familiale de l'Université de l'Alberta
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Dickinson JA, Bell NR, Grad R, Singh H, Groulx S, Szafran O. Choosing guidelines to use in your practice. Can Fam Physician 2018; 64:357-362. [PMID: 29760255 PMCID: PMC5951650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- James A Dickinson
- Professor in the Department of Family Medicine and the Department of Community Health Sciences at the University of Calgary in Alberta.
| | - Neil R Bell
- Professor in the Department of Family Medicine at the University of Alberta in Edmonton
| | - Roland Grad
- Associate Professor in the Department of Family Medicine at McGill University in Montreal, Que
| | - Harminder Singh
- Associate Professor in the Department of Internal Medicine and the Department of Community Health Sciences at the University of Manitoba in Winnipeg and in the Department of Hematology and Oncology for CancerCare Manitoba
| | - Stéphane Groulx
- Assistant Clinical Professor in the Department of Community Health Sciences at the University of Sherbrooke in Quebec and Associate Researcher at the Centre de recherche de l'Hôpital Charles-Le Moyne in Sherbrooke
| | - Olga Szafran
- Associate Director of Research in the Department of Family Medicine at the University of Alberta
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Szafran O, Kennett SL, Bell NR, Green L. Patients’ perceptions of team-based care in family practice: access, benefits and team roles. J Prim Health Care 2018; 10:248-257. [DOI: 10.1071/hc18018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
ABSTRACT INTRODUCTION The increasing complexity of health care and escalating prevalence of multiple chronic conditions have driven interprofessional team-based care in family practice. Most published studies examine team-based care from the perspective of health professionals. The purpose of this study was to examine patients’ perceptions of team-based care in family practice. METHODS This was a waiting room survey conducted in five family medicine academic teaching clinics in Edmonton, Alberta, Canada. Patients aged ≥18 years were invited to participate in a survey addressing patient access to team-based care, perceived benefits, preferred health professional and team member roles. RESULTS Of the 44.3% (565/1274) of respondents, 41.8% (231/552) reported receiving care from a team of health professionals, primarily for chronic disease management or pharmacy consultations. While there was a consistent pattern of patient perception that many aspects of care did not worsen with team-based care, improvements in knowledge of their medical condition (67.4%); the care received (65.0%); access to care (51.1%); ability to self-care (48.9%) and maintain their independence (43.7%); and overall health (51.1%) were reported. Some patients felt that team-based care reduced emergency visits (34.6%) and hospitalisations (29.9%), and 44.1% of patients felt that they had an active role on the team and made decisions about their care together with health professionals. CONCLUSION Patients perceive that team-based care in family practice has improved their knowledge and access to care, overall health and avoided some emergency department visits and hospital admissions. The findings support the continued development of team-based care in family practice.
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Szafran O, Torti JM, Kennett SL, Bell NR. Family physicians’ perspectives on interprofessional teamwork: Findings from a qualitative study. J Interprof Care 2017; 32:169-177. [DOI: 10.1080/13561820.2017.1395828] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Olga Szafran
- Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
| | | | - Sandra L Kennett
- Clinical Nurse Specialist, Edmonton Oliver Primary Care Network, Family Medicine Clinic, Misericordia Community Hospital, Edmonton, Alberta, Canada
| | - Neil R Bell
- Department of Family Medicine, University of Alberta, Family Medicine Clinic, Misericordia Community Hospital, Edmonton, Alberta, Canada
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Szafran O, Woloschuk W, Torti JMI, Myhre D. Well-being of family medicine graduates. Can Fam Physician 2017; 63:e432-e439. [PMID: 29025820 PMCID: PMC5638491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To determine family medicine graduates' professional and personal well-being, general health status, stress levels, coping strategies, and the degree to which they felt supported or isolated in professional life; and to compare findings by sex, practice location, and location of medical school (Canadian medical graduates [CMGs] vs international medical graduates [IMGs]). DESIGN Retrospective, cross-sectional survey. SETTING University of Alberta in Edmonton and the University of Calgary in Alberta. PARTICIPANTS A total of 651 graduates who completed one of the family medicine residency programs during 2006 to 2011. MAIN OUTCOME MEASURES Using a 5-point Likert scale, graduates rated their general health status, their personal and professional well-being, their level of stress, and the degree to which they felt supported or isolated in professional life. Respondents also identified important life events, their caregiving roles, and stress-coping strategies. RESULTS Of 651 graduates, 307 (47.2%) responded to the survey. Personal and professional well-being and general health status were rated as very good or excellent by 72.0%, 76.6%, and 74.7% of graduates, respectively. Overall, 39.3% reported high or extremely high levels of stress, with CMGs exhibiting significantly higher stress levels than IMGs (P = .02). Stress scores were inversely related to personal and professional well-being and health status. In terms of coping strategies, a significantly greater proportion of female than male graduates reported talking to colleagues (76.5% vs 64.3%; P = .026) and seeking professional counseling (18.7% vs 6.1%; P = .002). Also, a significantly greater proportion of IMGs than CMGs (52.9% vs 32.5%; P = .003), as well as those in rural (35.8%) or urban (49.3%) practices than those in metropolitan locations (30.1%) (P = .03), turned to spiritual or religious practices for stress management. Of all respondents, 54.8% felt highly or extremely supported and 18.4% felt isolated in their professional lives. CONCLUSION While family medicine graduates are primarily healthy and have a strong sense of personal and professional well-being, many experience high levels of stress. Coping strategies generally include social contact with family, friends, or colleagues and differ by sex, whether respondents are CMGs or IMGs, and practice location. Professional isolation appears to be prevalent in both rural and urban practice locations. Physician well-being programs should include a multifaceted approach to accommodate a range of physician preferences.
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Affiliation(s)
- Olga Szafran
- Associate Director of Research in the Department of Family Medicine at the University of Alberta in Edmonton.
| | - Wayne Woloschuk
- Director of Program Evaluation in the Office of Undergraduate Medical Education in the Cumming School of Medicine at the University of Calgary in Alberta
| | - Jacqueline M I Torti
- Graduate research assistant in the Department of Family Medicine at the University of Alberta
| | - Douglas Myhre
- Associate Dean of Distributed Learning and Rural Initiatives in the Cumming School of Medicine at the University of Calgary
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Abstract
BACKGROUND AND OBJECTIVE Family physicians regularly encounter clinical uncertainty and ambiguity and thus, are expected to engage in on-going learning to respond to changing needs of family practice. Using Achievement Goal Theory, the objective of this study was to examine motivations for learning of family medicine residents in a competency-based program. METHOD This was a cross-sectional study, employing a survey methodology with family medicine residents at the mid-point of training at a Canadian university. Multivariate analyses of variance and covariance were used to examine residents' goal orientations (performance approach, mastery approach, performance avoidance, mastery avoidance) for the group as a whole and to test for the effects of residents' gender and program stream (urban/rural), respectively. RESULTS A total of 52 (67%) residents completed the survey. Overall, residents scored highest on mastery approach and lowest on performance avoidance, thus, exhibiting adaptive motivations for learning. Male residents demonstrated higher levels of performance approach, performance avoidance, and mastery avoidance than female residents. No significant differences in goal orientations were found between urban and rural residents. CONCLUSIONS Family medicine residents trained in the culture of competency-based education appear to be mastery approach oriented. This motivation orientation is critical in the dynamic practice of family medicine and is consistent with the life-long learning mandate of the medical profession.
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Affiliation(s)
- Oksana Babenko
- a Department of Family Medicine , University of Alberta , Edmonton , Canada
| | - Olga Szafran
- a Department of Family Medicine , University of Alberta , Edmonton , Canada
| | - Sudha Koppula
- a Department of Family Medicine , University of Alberta , Edmonton , Canada
| | - Lillian Au
- a Department of Family Medicine , University of Alberta , Edmonton , Canada
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Triscott JA, Szafran O, Waugh EH, Torti JM, Barton M. Cultural transition of international medical graduate residents into family practice in Canada. Int J Med Educ 2016; 7:132-41. [PMID: 27149322 PMCID: PMC4860287 DOI: 10.5116/ijme.570d.6f2c] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 04/12/2016] [Indexed: 05/16/2023]
Abstract
OBJECTIVE To identify the perceived strengths that international medical graduate (IMG) family medicine residents possess and the challenges they are perceived to encounter in integrating into Canadian family practice. METHODS This was a qualitative, exploratory study employing focus groups and interviews with 27 participants - 10 family physicians, 13 health care professionals, and 4 family medicine residents. Focus group/interview questions addressed the strengths that IMGs possess and the challenges they face in becoming culturally competent within the Canadian medico-cultural context. Qualitative data were audiotaped, transcribed, and analyzed thematically. RESULTS Participants identified that IMG residents brought multiple strengths to Canadian practice including strong clinical knowledge and experience, high education level, the richness of varied cultural perspectives, and positive personal strengths. At the same time, IMG residents appeared to experience challenges in the areas of: (1) communication skills (language nuances, unfamiliar accents, speech volume/tone, eye contact, directness of communication); (2) clinical practice (uncommon diagnoses, lack of familiarity with care of the opposite sex and mental health conditions); (3) learning challenges (limited knowledge of Canada's health care system, patient-centered care and ethical principles, unfamiliarity with self-directed learning, unease with receiving feedback); (4) cultural differences (gender roles, gender equality, personal space, boundary issues; and (5) personal struggles. CONCLUSIONS Residency programs must recognize the challenges that can occur during the cultural transition to Canadian family practice and incorporate medico-cultural education into the curriculum. IMG residents also need to be aware of cultural differences and be open to different perspectives and new learning.
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Affiliation(s)
| | - Olga Szafran
- Department of Family Medicine, University of Alberta, Canada
| | - Earle H. Waugh
- Department of Family Medicine, University of Alberta, Canada
| | | | - Martina Barton
- Department of Family Medicine, University of Calgary, Canada
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Al Sayah F, Szafran O, Robertson S, Bell NR, Williams B. Nursing perspectives on factors influencing interdisciplinary teamwork in the Canadian primary care setting. J Clin Nurs 2014; 23:2968-79. [DOI: 10.1111/jocn.12547] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Fatima Al Sayah
- School of Public Health; University of Alberta; Edmonton AB Canada
| | - Olga Szafran
- Department of Family Medicine; University of Alberta; Edmonton AB Canada
| | | | - Neil R. Bell
- Department of Family Medicine; University of Alberta; Edmonton AB Canada
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Kolber M, Sharif N, Marceau R, Szafran O. Family practice patients' use of acetylsalicylic acid for cardiovascular disease prevention. Can Fam Physician 2013; 59:55-61. [PMID: 23341662 PMCID: PMC3555659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To determine the prevalence of acetylsalicylic acid (ASA) use among family practice patients and the proportions of patients using ASA for primary and secondary cardiovascular prevention. DESIGN Cross-sectional, self-reported, waiting room questionnaire. SETTING Two family medicine clinics in Alberta. PARTICIPANTS Patients 50 years of age and older. MAIN OUTCOME MEASURES Overall prevalence of ASA use, proportion of ASA use for primary or secondary cardiovascular prevention, ASA use by patient age and sex, the proportion of patients who initiated ASA therapy on the advice of a physician, adverse events, and patient beliefs about ASA therapy. RESULTS A total of 807 patients completed the questionnaire; the response rate was 89.1%. Overall, 39.8% of patients reported taking ASA regularly. Of those who took ASA, 87.0% did so for cardiovascular prevention (53.1% for primary prevention and 46.9% for secondary prevention). Of patients taking ASA for primary prevention, 62.8% did so upon the advice of their family physicians. Patients who took ASA believed that the benefits of taking ASA outweighed the risks; those who did not take ASA were unsure of the benefit-to-risk profile. CONCLUSION Many family practice patients take ASA, and more than half of those taking ASA take it for primary cardiovascular prevention. Family physicians appear to have an influence on patients' decisions to take ASA. Educating family physicians and patients about the potential benefits and risks of ASA therapy would help promote the use of ASA in those who might receive the greatest overall benefit.
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Affiliation(s)
- Michael Kolber
- Department of Family Medicine, 1706 College Plaza, University of Alberta, Edmonton, AB T6G 2C8.
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