Resident and teacher perceptions of the preceptor field note: a qualitative analysis.

Assessment of clinical teachers is a requirement by family medicine residency programs in Canada. This facilitates feedback to teachers and ensures the curriculum is delivered in an efficient and safe way. To protect resident confidentiality, preceptors often receive their teaching evaluations months to years later. Teachers have requested shorter feedback loops, greater numbers, and more frequent assessments to improve their skills. The preceptor field note (PFN) is a tool that allows learners to evaluate teachers during a single encounter providing more frequent and immediate feedback. This study documents teachers' and residents' initial impressions of the first iteration of the PFN.

L'évaluation des cliniciens enseignants est une exigence des programmes de résidence en médecine familiale au Canada. Elle procure une rétrtoaction aux enseignants et garantit que le programme d'études est dispensé de manière efficace et sûre. Pour protéger la confidentialité des résidents, les superviseurs reçoivent souvent les évaluations de leur enseignement des mois, voire des années plus tard. Les enseignants réclament des boucles de rétroaction plus courtes, et des évaluations plus nombreuses et plus fréquentes afin d'améliorer leurs compétences.La feuille de route du superviseur (FRS) est un outil qui permet aux apprenants d'évaluer les enseignants au cours d'une seule rencontre et de fournir une rétroaction plus fréquente et plus immédiate. Cette étude rend compte des premières impressions des enseignants et des résidents sur la première itération de la FRS.

Self-reported protective behaviour against West Nile Virus among pregnant women in Toronto.

OBJECTIVE: West Nile virus (WNV) is an emerging infection that can lead to substantial morbidity and mortality. Although data are limited with respect to the risk to the fetus and neonate, this risk is not inconsequential. Methods to reduce the risk of mosquito bites and WNV transmission are simple, economical, and effective in the non-pregnant population. The objective of this descriptive cross-sectional study was to assess adherence to protective behaviours against WNV in pregnant women and to determine predictors for such adherence. METHODS: A questionnaire was administered to all consenting pregnant women at two Toronto university hospitals. RESULTS: The majority of women reported practising behaviours that reduce the risk of mosquito bites and potentially of WNV infection. In this survey, between 40% and 80% of pregnant women avoided the outdoors, avoided areas with mosquitoes, and reported practising two or more personal protection behaviours. However, only 33% of pregnant women reported wearing mosquito repellent, with the majority expressing concern about the safety of repellent use during pregnancy. The majority of pregnant women cited the media or the Internet as a source of their knowledge about WNV; only 12% reported their physician as a source of such knowledge. CONCLUSION: The majority of pregnant women are aware of WNV and practise protective behaviours that reduce the risk of transmission. However, they have unjustified fetal safety concerns about the use of mosquito repellent and are thus less likely to use it.

Cerclage for the short cervix demonstrated by transvaginal ultrasound: current practice and opinion.

OBJECTIVES: (1) To elucidate the views of obstetricians with respect to the use of transvaginal ultrasound in general, and, specifically, for determining cervical length, and the conditions under which obstetricians would employ cervical cerclage based on a sonographically revealed shortened cervix; and (2) to determine the possibility of a randomized controlled trial on the use of cervical cerclage in this situation. METHODS: A 7-item questionnaire in French and English was designed and pretested. Questionnaires were mailed to 1421 physicians identified in the Canadian Medical Directory as practising obstetricians/gynaecologists in Canada. Returned questionnaires were scanned into an Access database for simple descriptive analyses. RESULTS: Responses were received from 766 physicians. Of these 766 respondents, 604 physicians indicated they continued to practise obstetrics and supplied information that was usable in the analysis. The majority of the 604 respondents (85.6%) reported that they would recommend transvaginal ultrasound only in pregnant women with 1 or more risk factors for preterm birth. Respondents were most likely to recommend a cerclage, and least unsure of their decision to do so, if the gestational age was less than 23 weeks, the cervical length was less than 1 cm, and additional risk factors for preterm birth were present. As gestational age and cervical length increased, respondents were less likely to recommend cerclage and more unsure of their decision to do so. The pattern of responses was similar for singleton and multiple pregnancies. The McDonald technique was favoured over the Shirodkar technique by 70.4% of the respondents who performed cervical cerclage procedures. Adjunctive antibiotics were used with cerclage by 52.5% and adjunctive tocolytics were employed by 37.4%. The majority (68.8%) of the respondents who performed cervical cerclage procedures stated that they would participate in a randomized controlled trial on the effectiveness of cerclage for a sonographically revealed short cervix. CONCLUSION: In the case of a short cervix determined by ultrasound, there is significant uncertainty surrounding the decision whether to place a cerclage and considerable variation in the clinical practice on its placement. In the absence of good evidence to guide clinical practice, a randomized controlled trial is being planned.