Obesity education for front-line healthcare providers.

BACKGROUND: To assess the effect of an interprofessional educational activity on professional skills, attitudes, and perceived challenges toward obesity management among front-line healthcare providers. METHODS: A one-day interprofessional obesity education activity was organized for healthcare providers across various disciplines. All participants were invited to complete an anonymous survey pre- and post-event, and at six-month post-event. The survey was created based on a comprehensive list of perceived skills, professional attitudes and challenges toward obesity intervention compiled from existing literature. RESULTS: Sixty-seven healthcare providers completed the survey pre- and post-event. Participants reported increases in professional skills such as their ability to assess weight (p = 0.04), to address weight management issues (p < 0.001), to teach/motivate patients toward physical activity (p < 0.001) and healthy eating practices (p = 0.001), to use behavior modification techniques (p < 0.001), and to deal with family issues (p < 0.001). Professional attitudes: practitioners felt more educated/competent in obesity management (P < 0.001), learned where to refer patients (p < 0.001), were more comfortable in discussing obesity in managing obesity (p < 0.001), were less likely to avoid the topic (p = 0.004) and felt less frustrated with the low success rate (p = 0.030). Enhancement in professional attitudes remained 6 months after the event. Improvements were mainly associated with male gender, younger age, fewer years of professional practice and healthcare professionals other than physicians. No statistically significant changes in perceived challenges were found after the educational event. CONCLUSION: Results of this study showed that this interprofessional learning activity contributed to the improvement of professional skills and attitudes of front-line healthcare providers caring for those who are obese or at risk for obesity. The positive results of this interprofessional learning activity aligns with the training needs identified by healthcare practitioners in previous studies, and suggest that this design and content could be used to guide future educational programming in the care of obese people.

Peer-assisted debriefing of multisource feedback: an exploratory qualitative study.

BACKGROUND: The Manitoba Physician Achievement Review (MPAR) is a 360-degree feedback assessment that physicians undergo every 7 years to retain licensure. Deliberate reflection on feedback has been demonstrated to encourage practice change. The MPAR Reflection Exercise (RE), a peer-assisted debriefing tool, was developed whereby the physician selects a peer with whom to review and reflect on feedback, committing to change. This qualitative study explores how physicians who had undergone the MPAR used the RE, what areas of change are identified and committed to, and what they perceived as the role of reflection in the MPAR process. METHODS: The MPAR RE was piloted out to a cohort of MPAR-reviewed physicians. Thematic analysis was conducted on completed exercises (n = 61). Semi-structured interviews were conducted with individuals (n = 6) who completed the MPAR RE until saturation was reached. RESULTS: Physicians reviewed feedback with a range of peers, including colleagues, staff, and spouses. Many physicians were surprised by feedback, both positive and negative, but interviewees found the RE useful in processing feedback. Areas where physicians committed to change were diverse, covering all CanMEDS roles. Most physicians identified themselves as being successful in implementing change, though time, habit, and structures were cited as barriers. CONCLUSIONS: Peer-assisted debriefing can assist reflection of multisource feedback. It is easy to implement, is not resource-intensive, and feedback implies that it is effective at promoting change. Participants, with the aid of peers, identified areas for change, developed approaches for change, and largely thought themselves successful at implementing changes. Areas of change included all seven CanMEDS roles.

Simplified Summative Temporal Bone Dissection Scale Demonstrates Equivalence to Existing Measures.

INTRODUCTION: Emphasis on patient safety has created the need for quality assessment of fundamental surgical skills. Existing temporal bone rating scales are laborious, subject to evaluator fatigue, and contain inconsistencies when conferring points. To address these deficiencies, a novel binary assessment tool was designed and validated against a well-established rating scale. METHODS: Residents completed a mastoidectomy with posterior tympanotomy on identical 3D-printed temporal bone models. Four neurotologists evaluated each specimen using a validated scale (Welling) and a newly developed "CanadaWest" scale, with scoring repeated after a 4-week interval. RESULTS: Nineteen participants were clustered into junior, intermediate, and senior cohorts. An ANOVA found significant differences between performance of the junior-intermediate and junior-senior cohorts for both Welling and CanadaWest scales ( P < .05). Neither scale found a significant difference between intermediate-senior resident performance ( P > .05). Cohen's kappa found strong intrarater reliability (0.711) with a high degree of interrater reliability of (0.858) for the CanadaWest scale, similar to scores on the Welling scale of (0.713) and (0.917), respectively. CONCLUSION: The CanadaWest scale was facile and delineated performance by experience level with strong intrarater reliability. Comparable to the validated Welling Scale, it distinguished junior from senior trainees but was challenged in differentiating intermediate and senior trainee performance.

Changing Health Professionals' Attitudes and Practice Behaviors Through Interprofessional Continuing Education in Oral-Systemic Health.

Integration of oral-systemic science into clinical care holds promise for improving patient outcomes and presenting opportunities for individuals in various health care professions to learn with, from, and about each other. The aim of this study was to examine whether an interprofessional continuing education program dedicated to oral-systemic health improved participants' attitudes toward interprofessional education and collaboration between dental and non-dental health care professionals and whether it influenced the physicians' practice of screening for debilitating oral diseases. The study took place in 2014 and used a mixed-methods approach, consisting of Readiness for Interprofessional Learning Scale (RIPLS) surveys conducted before, immediately after, and six months after the intervention, as well as surveys of self-reported practice behaviors and semi-structured interviews. A total of 231 health care professionals participated in the lectures and roundtable discussions. Of those, 134 responded to the pre-program survey (58% response rate), 110 responded to the post-program survey (48% response rate), and 58 responded to the survey six months after the program (25% response rate). The participants' median total RIPLS score at baseline was 76.5, which increased significantly immediately following the program (81.0) but returned to baseline six months later (76.5). Participants' RIPLS domain scores also increased significantly by profession from before to after the event, with effects returning to baseline after six months. Significantly more physicians reported screening for caries and periodontal disease after the intervention. An overall theme of "learning with, from, and about each other" was drawn from the interviews with 15 participants. The physicians took away a message of "just look in the mouth," while the dental professionals reported feeling valued as members of the health care team. Although reported improvements in oral-systemic health practice immediately after the intervention were encouraging, further research is necessary to understand why collaborative behaviors were not sustained.

Retention in a 10-year cohort of internationally trained family physicians licensed in Manitoba.

INTRODUCTION: International medical graduates (IMGs) seeking licensure in Canada have been recruited to practise in medically underserviced areas, but retention of these physicians remains a concern. This study explored retention of IMG family physicians in Manitoba and its predictors. METHODS: We used data from the University of Manitoba, provincial registries and Manitoba Health. Inclusion criteria were IMGs who completed University of Manitoba IMG training or assessment programs, and their return-of-service. Practice location, certification and licensure status were examined. We used logistic regression to consider the effects of a mentorship program, Manitoba residency at application, IMG program and years since program graduation on retention. RESULTS: A total of 197 IMGs met the inclusion criteria. Most IMGs (63.5%) remained in Manitoba, and 59.2% of this group practised outside of Winnipeg. Of those remaining in Manitoba, most (69.6%) held full provincial licensure and national certification. The regression model was significant (χ24 = 13.94, p = 0.007), explaining 10% of the variance in retention. Two predictors were significant: years since program graduation and Manitoba residency at the time of application. CONCLUSION: Long-term retention of IMG physicians remains a concern. Potential interventions likely to increase retention, such as Manitoba residency at application and a focus on mentorship programs, should be further explored.

INTRODUCTION: Des diplômés de facultés de médecine étrangères (DFME) désireux d'obtenir un permis d'exercice au Canada ont été recrutés pour exercer en régions sous-desservies, mais la fidélisation de ces médecins demeure préoccupante. Cette étude a examiné la fidélisation des médecins de famille DFME au Manitoba et les facteurs permettant de la prédire. METHODS: Nous avons utilisé des données de l'Université du Manitoba, des registres provinciaux et du ministère de la Santé du Manitoba. Pour être inclus dans l'étude, les DFME devaient avoir suivi une formation adaptée à leur situation à l'Université du Manitoba ou avoir participé à un programme d'évaluation à cette même université, et avoir conclu une entente de retour de service. Le lieu de pratique, la certification et le type de permis obtenu ont été relevés. Nous avons utilisé une régression logistique pour tenir compte de l'effet sur la fidélisation des éléments suivants : avoir participé à un programme de mentorat, habiter au Manitoba au moment de demander l'admission au programme, avoir participé à un programme destiné aux DFME et nombre d'années écoulées depuis l'obtention du diplôme associé à ce programme. RESULTS: En tout, 197 DFME répondaient aux critères d'inclusion. La plupart des DFME (63,5 %) sont restés au Manitoba et, de ce groupe, 59,2 % pratiquent à l'extérieur de Winnipeg. Parmi ceux qui sont restés au Manitoba, la plupart (69,6 %) détenaient un permis d'exercice sans restriction et une certification nationale. Le modèle de régression logistique a été significatif (χ24 = 13,94, p = 0,007), ce qui explique la variation de 10 % du taux de fidélisation. Deux facteurs de prédiction ont été significatifs : le nombre d'années écoulées depuis l'obtention du diplôme du programme et le fait d'habiter au Manitoba au moment de postuler. CONCLUSION: La fidélisation à long terme des médecins DFME demeure préoccupante. Il faudrait explorer davantage des interventions axées sur les facteurs susceptibles d'améliorer la fidélisation, notamment le fait que les postulants habitent au Manitoba au moment de présenter leur demande et l'importance à accorder aux programmes de mentorat.