Our strength for tomorrow: valuing our children.
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Biomedical subjects
Publications and source records attributed to C Levitt.
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OBJECTIVE: To evaluate a new storage system for patient education materials. DESIGN: Anonymous surveys before and after implementation of new storage system. SETTING: Family medicine residency teaching centre. PARTICIPANTS: All nurses, staff doctors, and first- and second-year residents in the unit. INTERVENTIONS: Implementation of a new storage system for patient education materials, orientation of all health professionals in the unit to the new system, and periodic distribution of patient education newsletters. MAIN OUTCOME MEASURES: Self-reported use of patient education materials. RESULTS: Response rates were 73% (30 of 41 health professionals) in 1990 and 86% (36 of 42) in 1992. Responses to the first survey on use of 20 categories of patient education materials showed materials were seldom used by most respondents. Back Care, Nutrition, Diabetes, VD/Birth Control, and Pregnancy categories were the most frequently used. In the second survey, more respondents reported using these five categories of pamphlets. Rates of use varied only slightly for the remaining 15 categories. CONCLUSIONS: Health professionals reported more frequent use of certain patient education materials following implementation of a new storage system.
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BACKGROUND: This study evaluated the knowledge gained and retained by family practice residents who participated in the Neonatal Resuscitation Program (NRP) course. METHODS: Knowledge attainment and its retention was assessed by the administration of pre-, post-, and 6-month follow-up tests using the standard NRP written examination. Twenty-nine residents from the Department of Family Medicine at McGill University completed the pretests and posttests, and 10 of these completed the follow-up tests. The data were analyzed using repeated measures analysis of variance and Student's t tests. RESULTS: The average score was 60.6% (n = 29) for pretest, 90.7% (n = 29) for posttest, and 75.4% (n = 10) for the follow-up test. A significant improvement was shown in posttest examination scores when compared to pretest scores and in the follow-up test scores when compared to pretest scores. No significant difference existed between the posttest and follow-up test scores. However, small sample size may have prevented detection of significant differences. Further, follow-up scores for some subjects had fallen to below the level required to pass the course. CONCLUSIONS: The results suggest that participation in an NRP course significantly increased knowledge of neonatal resuscitation by family practice residents, but that knowledge may decrease over time.
OBJECTIVE: To determine the referral practices, perceived usefulness, knowledge, prior training and desire for training of general practitioners (GPs) in Quebec with regard to complementary health care services such as acupuncture, chiropractic and hypnosis. DESIGN: Cross-sectional mail survey. SETTING: Province of Quebec. PARTICIPANTS: Random sample of 200 GPs. Of the 146 who responded, 25 were excluded because they were no longer in practice; this left 121 (83%). OUTCOME MEASURES: Self-reported referral practices for complementary health care services, perceived usefulness and self-assessed knowledge of such services, and prior training and desire for training in these services. RESULTS: Sixty percent (72/121) of the GPs knew at least one practitioner of a complementary health care service for referral; 59% (70/119) reported referring patients to physicians who practise such services and 68% (80/118) to nonmedical practitioners. At least one of the three services studied were regarded as having some use by 83% (101/121). Overall, self-reported knowledge was poor: the proportions of GPs who reported knowing a lot about acupuncture, chiropractic and hypnosis were 11% (13/121), 10% (12/121) and 8% (10/121) respectively. Prior training was also lacking: only 8% (9/118) of the GPs had received previous training in acupuncture, 2% (2/111) in chiropractic and 3% (3/103) in hypnosis. In all, 48% (57/118) indicated that they would like further training in at least one of the services studied, and 13% (16/121) indicated that they currently provided one service. CONCLUSIONS: Referral of patients by GPs to practitioners of complementary health care services is common in Quebec. Although self-assessed knowledge about such services is relatively poor, interest in learning more about them is high. These findings identify a demand for future educational initiatives.
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Since 1987, McGill University's Department of Family Medicine has invited new faculty to an orientation workshop. Workshop topics cover learning agreements and principles of adult learning, effective teaching methods, and feedback and evaluation. Workshop methods aim to promote active participation and experiential learning.
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PURPOSE: To develop a curriculum in ethics in family practice by studying which ethical issues physicians believe to be important based on frequency of encounter, difficulty in managing the problem, and helpfulness of discussion; to examine whether there are any important differences between faculty and residents and between genders; and to determine the preferred format(s) for teaching these issues. METHOD: Between November 1991 and June 1992 a total of 475 questionnaires were mailed to all the family practice residents (first- and second-year), graduates in their first two years of practice, and the physician faculty of the Department of Family Medicine at the McGill University Faculty of Medicine. Overall, 319 usable questionnaires were returned, for a final response rate of 67%. The questionnaire asked respondents to evaluate 14 ethical dilemmas in order to determine the importance of teaching specific ethical issues as well as to determine the preferred format for teaching. Chi-square tests, analyses of variance, and Student's t-tests were used to test the significance of differences in responses. RESULTS: No consistent pattern of interrelationship was found among frequency of encounter and difficulty and helpfulness of discussion for most items. Overall, there was little difference in how faculty and residents, men and women, perceived the importance of these ethical issues. Women reported encountering ethical issues less frequently than men [F (14,285) = 1.82, p < .04], while at the same time finding them somewhat more difficult and more deserving of discussion. Small-group, case-oriented discussion appears to have been the favored teaching format regardless of the ethical dilemma. CONCLUSION: It is difficult to narrow down the content to be included in a curriculum in ethics in family practice. Frequency of encounter, difficulty in management, and helpfulness of discussion can all be argued to be important factors for consideration; they should all be considered separately or in combination for each teaching situation if time restrictions force a choice between topics.
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All residents of McGill University's Department of Family Medicine were surveyed by mail about their family practice clinic experience. Residents were generally satisfied with their training site and their supervision, but noted problems with volume and diversity of patients, learning certain procedures, and knowledge of community resources. They did not want more family medicine clinic time.
An approach to preconception health promotion by obtaining a history and through physical examination and laboratory investigation is outlined. The controversies are explained, and the current programs that have been developed in the United Kingdom, Canada, and the United States are described. All women of childbearing age should have access to prepregnancy intervention; however, presently, barriers to its comprehensive implementation exist.