Assessing commitment to reflection: perceptions of medical students.

Background: While developing reflection skills is considered important by educators, the assessment of these skills is often associated with unintended negative consequences. In the context of a mandatory longitudinal course that aims to promote the development of reflection on professional identity, we assessed students' commitment to reflection. This study explores students' perception of this assessment by their mentor.

Quality of Narratives in Assessment: Piloting a List of Evidence-Based Quality Indicators.

Background & Need For Innovation: Appraising the quality of narratives used in assessment is challenging for educators and administrators. Although some quality indicators for writing narratives exist in the literature, they remain context specific and not always sufficiently operational to be easily used. Creating a tool that gathers applicable quality indicators and ensuring its standardized use would equip assessors to appraise the quality of narratives.

Narrative Assessments in Higher Education: A Scoping Review to Identify Evidence-Based Quality Indicators.

Purpose: Narrative comments are increasingly used in assessment to document trainees' performance and to make important decisions about academic progress. However, little is known about how to document the quality of narrative comments, since traditional psychometric analysis cannot be applied. The authors aimed to generate a list of quality indicators for narrative comments, to identify recommendations for writing high-quality narrative comments, and to document factors that influence the quality of narrative comments used in assessments in higher education.

Reflecting on professional identity in undergraduate medical education: implementation of a novel longitudinal course.

Background: Today's healthcare professionals face numerous challenges. Improving reflection skills has the potential to contribute to the better management of complex patients and healthcare systems, as well as to improve professional practice. However, the question of how reflection skills can inform professional identity development at the undergraduate medical education level remains unanswered.

Impact of an educational intervention combining clinical obesity preceptorship with electronic networking tools on primary care professionals: a prospective study.

Background: Primary care providers' (PCPs) attitude toward obesity is often negative, and their confidence level for helping patients manage their weight is low. Continuing professional development (CPD) on the subject of obesity is often based on a single activity using a traditional passive approach such as lectures known to have little effect on performance or patient outcomes. The aim of this study was to evaluate the impact of an educational intervention for obesity management on PCPs' attitude, self-efficacy, practice changes and patient-related outcomes.

Teaching and learning clinical reasoning: a teacher's toolbox to meet different learning needs.

Clinical reasoning is an essential part of medical practice and therefore should be an important part of clinical teaching. However, it has been and is still a challenge for clinical teachers to support learners in the development of their clinical reasoning skills. As learners progress in clerkship, so do their learning needs.

Assessment of the Efficacy of An Osteopathic Treatment in Infants with Biomechanical Impairments to Suckling.

Breastfeeding can be challenging for mother-infant dyads experiencing biomechanical suckling difficulties. Although lactation consultants (LCs) all over the world have increased their skills in this field and can provide support to help position the infant at the breast, the impact of their intervention might be limited in the presence of stiff structures in the infants. Here we present a protocol for a randomized controlled trial to assess the efficacy of osteopathic treatment, coupled with lactation consultation, for infants' biomechanical suckling difficulties.

Strategies identified by program directors to improve adoption of the CanMEDS framework.

Background: Challenges associated with the use of the CanMEDS physician competency framework (CanMEDS) have been the subject of several studies. Most of these have focused on the adoption of specific roles in an Anglophone context. This study aims to investigate how Francophone postgraduate medical education (PGME) program directors have integrated the CanMEDS framework into their programs.

Efficacy of an Osteopathic Treatment Coupled With Lactation Consultations for Infants' Biomechanical Sucking Difficulties.

Background: Despite well-known recommendations from national and international bodies including the World Health Organization, few mothers achieve the goal of breastfeeding exclusively for 6 months. Half of mothers stop breastfeeding due to biomechanical issues in the first month, despite increasing support from lactation consultants. Osteopaths worldwide work with these babies, but there is little empirical evidence for this type of treatment.

Complementary and alternative medicine: Do physicians believe they can meet the requirements of the Collège des médecins du Québec?

Objective: To determine whether medical training prepares FPs to meet the requirements of the Collège des médecins du Québec for their role in advising patients on the use of complementary and alternative medicine (CAM).

Design: Secondary analysis of survey results.

Setting: Quebec.

Erratum to: Impact of an integrated obesity management system on patient's care - research protocol.

[This corrects the article DOI: 10.1186/s40608-014-0019-z.].

Age-related decline and diagnostic performance of more and less prevalent clinical cases.

Since cognitive abilities have been shown to decrease with age, it is expected that older physicians would not perform as well as their younger counterparts on clinical cases unless their expertise can counteract the cognitive effects of aging. However, studies on the topic have shown contradictory results. This study aimed to further investigate the effect of aging on physicians' diagnostic accuracy when diagnosing prevalent and less prevalent cases based on clinical vignettes.

Impact of an integrated obesity management system on patient's care - research protocol.

Background: The majority of obese subjects are treated by primary care physicians (PCPs) who often feel uncomfortable with the management of obesity. In a previous study, we successfully developed, implemented and evaluated an obesity management system based on training and coaching of health professionals of family medicine groups (FMGs) by a team of experts in obesity management. Using a pre/post design, this study suggested a positive impact on health professionals' perceptions and reported obesity care.

[Episodes of care: a concept in public health].

This paper presents a revision of the literature on the definition of episodes of care, which emerged as a concept in health services research during the 1960s. Episodes of care have been described from three different perspectives: that of the patient (episode of indisposition); the care provider (episode of illness); and the financial sponsor (episode of care). The main scope of this study is to present a review of the literature on the operational definition of episode of care.

[The ambulatory care of the acute myocardial infarction in Quebec: description, classification and typology].

Objective: Description of ambulatory care of AMI, in Quebec population.

Design: A retrospective cohort study was designed to classify and propose a typology of ambulatory care.

Methods: The studied population was included in all 25 years and older inpatients residing in Quebec, whose admission were from January to December 2000.

Severe injury mechanisms in two paediatric trauma centres: Determination of prevention priorities.

Background: To meet community needs, injury prevention programs for children should be targeted to trends in objective data on mechanisms of injury. The aim of the present study was to identify the most important severe injury mechanisms.

Methods: The present study retrospectively reviewed severe paediatric trauma patients in two regional trauma centres.

Empowerment interventions, knowledge translation and exchange: perspectives of home care professionals, clients and caregivers.

Background: Few studies have examined empowerment interventions as they actually unfold in home care in the context of chronic health problems. This study aims to document the empowerment process as it plays out in interventions with adults receiving home care services.

Methods/design: The qualitative design chosen is a fourth generation evaluation combined with case studies.

[Management of thyroid dysfunction by primary care physicians of the Province of Quebec: a transversal study].

Objectives: This study aims to evaluate clinical practice of primary care physicians regarding common thyroid disorders.

Materials And Methods: A sample of 210 primary care physicians was randomly selected in three Quebec's administrative regions. Four clinical vignettes (V1 to V4) were presented by mail: two cases of subclinical hypothyroidism (women of 25 years - V1 - and 70 - V2 - years of age) for which physicians had to choose to either treat or not with thyroid replacement and two cases of hyperthyroidism (women of 30 - V3 - and 66 - V4- years of age) for which they had to choose a course of action (observation, treatment or referral to a specialist).

Evaluation of clinical innovation: a gray zone in the ethics of modern clinical practice?

Background: Various stakeholders can have differing opinions regarding ethical review when introducing new procedures with patients.

Objective: This pilot study examines the way in which Research Ethics Boards (REBs; Institutional Review Boards) and clinical biochemists (CBs; laboratory medicine specialists) differ in their interpretation of what is research and what should be considered common practice versus innovation versus experimentation when introducing new procedures with patients. It also explores whether these groups agree on who is responsible for the ethical review of new procedures.

Prevalence of pneumonia in children under 12 years of age who undergo abdominal radiography in the emergency department.

Objective: Pneumonia is a well-known cause of acute abdominal pain in children. However, the utility of chest radiography in this setting is controversial. We sought to determine the prevalence of pneumonia in children under 12 years of age who had abdominal pain and underwent abdominal radiography when visiting an emergency department (ED).

Integrated obesity care management system -implementation and research protocol.

Background: Nearly 50% of Canadians are overweight and their number is increasing rapidly. The majority of obese subjects are treated by primary care physicians (PCPs) who often feel uncomfortable with the management of obesity. The current research proposal is aimed at the development and implementation of an innovative, integrated, interdisciplinary obesity care management system involving both primary and secondary care professionals.

Re-engineering cardiac rehabilitation programmes: considering the patient's point of view.

Aims: The aim of this paper is to report a study to describe how cardiac patients experience the first 3 months following a cardiac event requiring hospitalization, identify differences between the needs expressed by patients and the support they received during their recuperation and produce a preliminary model for the development of cardiac rehabilitation programmes, taking into account the patient perspective.

Background: Although cardiac rehabilitation should be standard care for patients with cardiovascular disease, less than 20% begin and maintain a rehabilitation programme. Cited barriers include inadequate rehabilitation services, sub-optimal referral, low participation rates of women and older adults and travel considerations.

Training fourth-year medical students in critical invasive skills improves subsequent patient safety.

Complications after procedures performed by residents are thought to occur most often early in the first postgraduate year (PGY-1). We evaluated the number of pneumothoraces (PTXs) caused by central venous line insertion (CVLI) by two groups of PGY-1 residents in both the first 3 months of residency and the entire year from 1996 through 2000 to determine the impact of CVLI training on PTX. From 1996 through 1998 fourth-year medical students had no specific training in CVLI and learned on the job as residents.

Antibiotics in primary prevention of myocardial infarction among elderly patients with hypertension.

Background: Given the premise that certain bacteria (such as Chlamydia pneumoniae) may play a role in the etiology of atherosclerosis, subjects treated with antibiotics that have antibacterial activity against C pneumoniae may be at lower risk for the development of an acute myocardial infarction (MI) than untreated subjects.

Methods: A case-control design, nested within a cohort of 29,937 elderly subjects in whom antihypertensive therapy was initiated (1982-1995) was used, in which each subject who was hospitalized with a primary discharge diagnosis of MI between 1987 and 1995 (n = 1047) was matched on calendar time to 5 randomly selected control subjects for exposure contrasts. Conditional logistic regression analyses were conducted to adjust for predisposing factors for MI.