Investigating the frail elderly patient with lower bowel symptoms: what do we do now and can we improve?

Aims: To assess the utility of flexible sigmoidoscopy (FS) and minimal preparation CT (MPCT) in investigating lower gastrointestinal (LGI) symptoms in elderly patients who are too frail to undergo colonoscopy or spiral CT.

Methods: All FS examinations performed in patients aged over 70 between 1 January and 31 December 2008 were analysed. Predictors of usefulness were determined using multivariable analysis.

Stillbirth and newborn mortality in India after helping babies breathe training.

Objective: This study evaluated the effectiveness of Helping Babies Breathe (HBB) newborn care and resuscitation training for birth attendants in reducing stillbirth (SB), and predischarge and neonatal mortality (NMR). India contributes to a large proportion of the worlds annual 3.1 million neonatal deaths and 2.

The importance of illness perceptions, quality of life and psychological status in patients with ulcerative colitis and Crohn's disease.

The present study investigates illness perceptions of inflammatory bowel disease patients in an outpatient population, examining whether these illness perceptions are related to disease severity, quality of life and psychological adjustment. A cohort of 102 inflammatory bowel disease outpatients was prospectively enrolled on the study. The participants completed a questionnaire assessing illness perceptions, anxiety, depression and disease-specific symptoms.

Long-term outcomes for surgeons from 3- and 4-year medical school curricula.

Background: New approaches are needed to ensure that surgical trainees attain competence in a timely way. Traditional solutions have focused on the years spent in surgic al training. We sought to examine the outcomes of graduates from 3-year versus 4-year medical schools for differences in surgeon performance based on multisource feedback data.

Acute Care of At-Risk Newborns (ACoRN): quantitative and qualitative educational evaluation of the program in a region of China.

Background: The Acute Care of at-Risk Newborns (ACoRN) program was developed in Canada for trained health care providers for the identification and management of newborns who are at-risk and/or become unwell in the first few hours or days after birth. The ACoRN process follows an 8-step framework that enables the evaluation and management of babies irrespective of the experience or expertise of the caregiving individual or team. This study assesses the applicability of the program to Chinese pediatric practitioners.

Moving into medical practice in a new community: the transition experience.

Introduction: Physicians undertake many transitions during the course of a medical career. The purpose of this study was to explore the experiences of physicians who moved to a new community.

Methods: A semistructured interview format was used to explore transitional experiences, including reasons for moving; the role of colleagues, learning, and organizational structures; how various mediating factors affected perceptions; and how the experience affected the physicians personally.

Helping Babies Breathe: global neonatal resuscitation program development and formative educational evaluation.

Objectives: To develop an educational program designed to train health care providers in resource limited settings to carry out neonatal resuscitation. We analyzed facilitator and learner perceptions about the course, examined skill performance, and assessed the quality of instruments used for learner evaluation as part of the formative evaluation of the educational program Helping Babies Breathe.

Methods: Multiple stakeholders and a Delphi panel contributed to program development.

The development of an instrument to assess clinical teaching with linkage to CanMEDS roles: A psychometric analysis.

Background: Assessment of clinical teaching by learners is of value to teachers, department heads, and program directors, and must be comprehensive and feasible.

Aims: To review published evaluation instruments with psychometric evaluations and to develop and psychometrically evaluate an instrument for assessing clinical teaching with linkages to the CanMEDS roles.

Method: We developed a 19-item questionnaire to reflect 10 domains relevant to teaching and the CanMEDS roles.

Mentorship for the physician recruited from abroad to Canada for rural practice.

Background: Mentoring is one way to help physicians new to a country assimilate.

Aim: This study examined the feasibility and focus of a mentoring program from the perspective of medical leaders (leaders) and physicians new to Canada (physicians).

Methods: Focus groups with 23 physicians were held in six regional centers.

Learning to practice in Canada: the hidden curriculum of international medical graduates.

Introduction: There is movement of physicians internationally. In some cases, physicians are recruited from low-income countries to wealthier countries like Canada to provide medical services in underresourced communities. This needs assessment examined the clinical medicine learning challenges faced by international medical graduates (IMGs) from the perspective of both the IMGs and medical leaders (eg, Vice President-Medical for a Health Region).

An analysis of long-term outcomes of the impact of curriculum: a comparison of the three- and four-year medical school curricula.

Purpose: To determine the long-term effects of curriculum length on physician competence, the authors compared the performance of graduates from the University of Calgary (U of C; a school with a three-year curriculum) with matched samples from the University of Alberta (U of A) and from other Canadian schools with a four-year curriculum.

Method: The authors used data from the College of Physicians and Surgeons of Alberta, Physician Achievement Review (PAR) program to determine curricular outcomes. The authors analyzed PAR program data, comprising reviews from medical colleagues, nonphysician coworkers (e.

The assessment of pathologists/laboratory medicine physicians through a multisource feedback tool.

Context: There is increasing interest in ensuring that physicians demonstrate the full range of Accreditation Council for Graduate Medical Education competencies.

Objective: To determine whether it is possible to develop a feasible and reliable multisource feedback instrument for pathologists and laboratory medicine physicians.

Design: Surveys with 39, 30, and 22 items were developed to assess individual physicians by 8 peers, 8 referring physicians, and 8 coworkers (eg, technologists, secretaries), respectively, using 5-point scales and an unable-to-assess category.

Push, pull, and plant: the personal side of physician immigration to alberta, Canada.

Background And Objectives: The global migration of physicians has led many international physicians to enter practice in Alberta, Canada. The study was designed to explore the personal side of migration and transition experiences of these international medical graduates (IMGs).

Methods: A qualitative study using telephone interviews and a semi-structured interview guide was used to interview 19 IMGs who are currently practicing and have held Part V, restricted or temporary practice licenses for less than 7 years.

Changes in performance: a 5-year longitudinal study of participants in a multi-source feedback programme.

Objectives: Multi-source feedback (MSF) enables performance data to be provided to doctors from patients, co-workers and medical colleagues. This study examined the evidence for the validity of MSF instruments for general practice, investigated changes in performance for doctors who participated twice, 5 years apart, and determined the association between change in performance and initial assessment and socio-demographic characteristics.

Methods: Data for 250 doctors included three datasets per doctor from, respectively, 25 patients, eight co-workers and eight medical colleagues, collected on two occasions.

Assessment of psychiatrists in practice through multisource feedback.

Objective: To assess the feasibility and evidence for the reliability and validity of a set of questionnaires for psychiatrists, given that multisource feedback (MSF) or 360 degrees evaluation allows medical colleagues, coworkers, and patients to provide feedback about competencies to enhance physician improvement in intended directions.

Method: Surveys with 40, 22, 38, and 37 items were developed to assess psychiatrists by 25 patients, 8 coworkers, 8 psychiatrist colleagues, and self, respectively, using a 5-point agreement scale with an unable-to-assess category. Items addressed key competencies related to communication skills, professionalism, collegiality, and self-management.

Assessment of radiology physicians by a regulatory authority.

Purpose: To determine whether it is possible to develop a feasible, valid, and reliable multisource feedback program for radiologists.

Materials And Methods: Surveys with 38, 29, and 20 items were developed to assess individual radiologists by eight radiologic colleagues (peers), eight referring physicians, and eight co-workers (eg, technicians), respectively, by using five-point scales along with an "unable to assess" category. Radiologists completed a self-assessment on the basis of the peer questionnaire.

Roles and responsibilities of family physicians on geriatric health care teams: Health care team members' perspectives.

Objective: To examine the beliefs and attitudes of FPs and health care professionals (HCPs) regarding FPs' roles and responsibilities on interdisciplinary geriatric health care teams.

Design: Qualitative study using focus groups.

Setting: Calgary Health Region.

What multisource feedback factors influence physician self-assessments? A five-year longitudinal study.

Background: Multisource feedback, in which medical colleagues, patients, coworkers, and the physician involved provide data, is a tool to inform physician practice. Its impact on physicians' self-assessment through two iterations is unknown.

Method: Data from 250 family physicians in Alberta who participated in two iterations, five years apart-1999 and 2006--allowed the authors to determine the change in self-assessment scores, using a t test.

International medical graduates: learning for practice in Alberta, Canada.

Introduction: There is little known about the learning that is undertaken by physicians who graduate from a World Health Organization-listed medical school outside Canada and who migrate to Canada to practice. What do physicians learn and what resources do they access in adapting to practice in Alberta, a province of Canada?

Methods: Telephone interviews with a theoretical sample of 19 IMG physicians were analyzed using a grounded theory constant comparative approach to develop categories, central themes, and a descriptive model.

Results: The physicians described two types of learning: learning associated with studying for Canadian examinations required to remain and practice in the province and learning that was required to succeed at clinical work in a new setting.