'Change talk' among physicians in small group learning communities: An ethnographic study.

Introduction: Physicians face uncertainties in complex clinical environments. Small group learning initiatives allow physicians to decipher new evidence and address challenges. This study aimed to understand how physicians in small learning groups discuss, interpret and assess new evidence-based information to make decisions for practice.

Assessing Unperceived Learning Needs in Continuing Medical Education for Primary Care Physicians: A Scoping Review.

Introduction: Assessing needs before developing continuing medical education/continuing professional development (CME/CPD) programs is a crucial step in the education process. A previous systematic literature review described a lack of objective evaluation for learning needs assessments in primary care physicians. This scoping review updates the literature on uses of objective evaluations to assess physicians' unperceived learning needs in CME/CPD.

Toward Practice-Based Continuing Education Protocols: Using Testing to Help Physicians Update Their Knowledge.

Introduction: Using assessment to facilitate learning is a well-established priority in education but has been associated with variable effectiveness for continuing professional development. What factors modulate the impact of testing in practitioners are unclear. We aimed to improve capacity to support maintenance of competence by exploring variables that influence the value of web-based pretesting.

Academic Half-Days: Facilitated Small Groups to Promote Interactive Learning.

Background And Objectives: Medical educators have expressed interest in using less didactic and more interactive formats for academic half-days (AHDs) in postgraduate residency training. We assessed the feasibility and effectiveness of implementing a practice-based small-group learning (PBSGL) process as one part of AHDs.

Methods: A mixed-methods approach was used.

How do clinicians use implementation tools to apply breast cancer screening guidelines to practice?

Background: Implementation tools (iTools) may enhance uptake of guidelines. However, little evidence exists on their use by primary care clinicians. This study explored which iTools clinicians used and how often; how satisfied clinicians were with the tools; whether tool use was associated with practice changes; and identified mediators for practice change(s) related to breast cancer screening (BCS).

Encouraging Reflection and Change in Clinical Practice: Evolution of a Tool.

This article describes the systematic development and gradual transformation of a tool to guide participants in a continuing medical education program to reflect on their current practices and to make commitments to change. The continuous improvement of this tool was influenced by evolving needs of the program, reviews of relevant educational literature, feedback from periodic program surveys, interviews with group facilitators, and results from educational research studies. As an integral component of the educational process used in the Practice Based Small Group Learning Program, the current tool is designed to help family physicians think about what has been learned during each educational session and examine issues related to the implementation of evidence-based changes into their clinical practice.

Is the Cognitive Complexity of Commitment-to-Change Statements Associated With Change in Clinical Practice? An Application of Bloom's Taxonomy.

Introduction: This study categorizes 4 practice change options, including commitment-to-change (CTC) statements using Bloom's taxonomy to explore the relationship between a hierarchy of CTC statements and implementation of changes in practice. Our hypothesis was that deeper learning would be positively associated with implementation of planned practice changes.

Methods: Thirty-five family physicians were recruited from existing practice-based small learning groups.

17β-Estradiol alters the response of subfornical organ neurons that project to supraoptic nucleus to plasma angiotensin II and hypernatremia.

This study was done in urethane anesthetized, ovariectomized (OVX) female rats that were either implanted or not implanted with silastic capsules containing17β-estradiol (E2) to investigate the effect of systemic changes in E2 on the discharge rate of subfornical organ (SFO) neurons that projected to supraoptic nucleus (SON) and responded to changes in plasma levels of angiotensin II (ANG II) or hypernatremia. Extracellular single unit recordings were made from 146 histologically verified single units in SFO. Intra-carotid infusions of ANG II excited ~57% of these neurons, whereas ~23% were excited by hypertonic NaCl.

Women's views on reminder letters for screening mammography: Mixed methods study of women from 23 family health networks.

Objective: To explore women's perspectives on the acceptability and content of reminder letters for screening mammography from their family physicians, as well as such letters' effect on screening intentions.

Design: Cross-sectional mailed survey followed by focus groups with a subgroup of respondents.

Setting: Ontario.

Using a novel small-group approach to enhance feedback skills for community-based teachers.

Background: As medical education expands into distant settings, challenges in providing faculty development to busy clinical teachers increase-especially for those who have difficulty accessing sessions offered at academic centers.

Description: Sixty-five clinical teachers participated in six small-group workshops, using a printed module on the topic of delivering feedback. The modules included teaching-learning "cases," tools, and a summary of medical literature.

Acceptability of reminder letters for Papanicolaou tests: a survey of women from 23 Family Health Networks in Ontario.

Objective: To explore women's perspectives on the acceptability and content of reminder letters from the family physician for Papanicolaou (Pap) test screening and the effect of reminder letters on compliance with screening recommendations.

Methods: A population-based survey was conducted in 23 Family Health Networks and Primary Care Networks participating in a demonstration project to increase the delivery of preventive services in Ontario. Questionnaires were mailed to randomly selected women aged 35 to 69 years who had received a reminder letter for a Pap test from their family physician within the previous six months.

Translating learning into practice: lessons from the practice-based small group learning program.

Unlabelled: PROBLEM ADDRESSED The need for effective and accessible educational approaches by which family physicians can maintain practice competence in the face of an overwhelming amount of medical information.

Objective Of Program: The practice-based small group (PBSG) learning program encourages practice changes through a process of small-group peer discussion-identifying practice gaps and reviewing clinical approaches in light of evidence.

Program Description: The PBSG uses an interactive educational approach to continuing professional development.

Direct projections from caudal ventrolateral medullary depressor sites to the subfornical organ.

Experiments were performed in the male Wistar rat to investigate the projections from cardiovascular responsive sites in the ventrolateral medulla (VLM) to the subfornical organ (SFO). Unilateral iontophoretic injections of Phaseolus vulgaris leucoagglutinin (PHA-L) were made into either caudal VLM (CVLM) sites at which microinjection of l-glutamate (10 nl; 0.25 M) elicited decreases in mean arterial pressure or into rostral VLM (RVLM) sites at which l-glutamate microinjection elicited increases in arterial pressure.