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Farrell B, Grant RE, Dilliott D, Granikov V, Sen HE, Grad R, Vuong V, Smith S, Pluye P. Lessons learned from using whiteboard videos and YouTube for deprescribing guidelines knowledge mobilization. Int J Pharm Pract 2022; 30:441-448. [PMID: 35849347 DOI: 10.1093/ijpp/riac054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/27/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Deprescribing is the planned and supervised process of dose reduction or stopping medication. Few clinical guidelines exist to help health care professionals in making decisions about deprescribing. The Bruyère Deprescribing Guidelines Team developed a series of evidence-based medication-class specific deprescribing guidelines and, to extend reach and uptake, disseminated them as whiteboard videos published on YouTube. This paper reports on the creation, sharing and evaluation of videos on proton pump inhibitor (PPI), antihyperglycemic (AHG), antipsychotic (AP) and benzodiazepine receptor agonist (BZRA) deprescribing guidelines. METHODS Whiteboard videos depict an animator drawing on a whiteboard, while the narrator reads the script. In each video, the deprescribing algorithm is applied to mock patient cases. The videos were shared on YouTube and promoted via Twitter and other web-based tools. Evaluation methods included YouTube analytics and the validated Information Assessment Method (IAM) questionnaire. KEY FINDINGS The four videos have a combined total of 26 387 views over the approximately 50 months since publishing, with viewers watching 34-40% of the videos' runtimes on average. The PPI and AHG deprescribing videos were viewed 4318 times in 97 countries during the first year. IAM respondents perceived the PPI, AHG and AP video content to be relevant, useful to learning and applicable to patient care. CONCLUSIONS Using whiteboard videos on YouTube to explain deprescribing guidelines was a successful approach to knowledge mobilization. The evaluation approach is innovative as it combines typical success factors for online learning videos (e.g. views, estimated minutes watched) with responses to a validated information assessment tool.
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Affiliation(s)
- Barbara Farrell
- Bruyère Research Institute, Ottawa, ON, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Rachel E Grant
- Bruyère Research Institute, Ottawa, ON, Canada
- Faculty of Education, University of Ottawa, Ottawa, ON, Canada
| | - Daniel Dilliott
- Bruyère Research Institute, Ottawa, ON, Canada
- Queen's University School of Medicine, Kingston, ON, Canada
| | - Vera Granikov
- School of Information Studies, McGill University, Montréal, QC, Canada
| | - Heera Elize Sen
- Bruyère Research Institute, Ottawa, ON, Canada
- Peter A. Allard School of Law, University of British Columbia, Vancouver, BC, Canada
| | - Roland Grad
- Department of Family Medicine, Faculty of Medicine, McGill University, Montréal, QC, Canada
| | | | | | - Pierre Pluye
- Department of Family Medicine, Faculty of Medicine, McGill University, Montréal, QC, Canada
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Archibald D, Stratton J, Liddy C, Grant RE, Green D, Keely EJ. Evaluation of an electronic consultation service in psychiatry for primary care providers. BMC Psychiatry 2018; 18:119. [PMID: 29720133 PMCID: PMC5932827 DOI: 10.1186/s12888-018-1701-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 04/23/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND This study explores the effectiveness of an electronic consultation (eConsult) service between primary care providers and psychiatry, and the types and content of the clinical questions that were asked. METHODS This is a retrospective eConsult review study. All eConsults directed to Psychiatry from July 2011 to January 2015 by Primary care providers were reviewed. Response time and the amount of time reported by the specialist to answer each eConsult was analyzed. Each eConsult was also categorized by clinical topic and question type in predetermined categories. Mandatory post-eConsult surveys for primary care providers were analyzed to determine the number of traditional consults avoided and to gain insight into the perceived value of eConsults. RESULTS Of the 5597 eConsults, 169 psychiatry eConsults were completed during the study period. The average response time for a specialist to a primary care provider was 2.3 days. Eighty-seven percent of clinical responses were completed by the psychiatrist in less than 15 min. The primary care providers most commonly asked clinical questions were about depressive and anxiety disorders. 88.7% of PCPs rated the eConsult service a 5 (excellent value) or 4. CONCLUSIONS This study indicates that an eConsult psychiatry service has tremendous potential to improve access to psychiatric advice and expand the capacity to treat mental illness in primary care. Future research may include follow-up with PCPs regarding the implementation of specialist advice.
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Affiliation(s)
- Douglas Archibald
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada. .,Bruyère Research Institute, 85 Primrose Avenue, Ottawa, ON, K1R 6M1, Canada.
| | - Julia Stratton
- 0000 0001 2182 2255grid.28046.38Department of Psychiatry, University of Ottawa, Ottawa, ON Canada
| | - Clare Liddy
- 0000 0001 2182 2255grid.28046.38Department of Family Medicine, University of Ottawa, Ottawa, ON Canada ,0000 0000 9064 3333grid.418792.1Bruyère Research Institute, 85 Primrose Avenue, Ottawa, ON K1R 6M1 Canada
| | - Rachel E. Grant
- 0000 0001 2182 2255grid.28046.38Faculty of Education, University of Ottawa, Ottawa, ON Canada
| | - Douglas Green
- 0000 0001 2182 2255grid.28046.38Department of Psychiatry, University of Ottawa, Ottawa, ON Canada
| | - Erin J. Keely
- 0000 0001 2182 2255grid.28046.38Department of Medicine, University of Ottawa, Ottawa, ON Canada ,0000 0000 9606 5108grid.412687.eOttawa Hospital Research Institute, Ottawa, ON Canada
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Abstract
The Surgical Safety Checklist (SSC) has been adopted in operating rooms (OR) worldwide to reduce medical errors, increase patient safety and improve interprofessional communication. Despite often high compliance rates, recent studies suggested the SSC has not been associated with significant reductions in operative mortality or complications. This ethnographic study sought to understand this disconnection through approximately 50 hours of observation in the OR and 10 in-depth semi-structured interviews with surgeons, nurses, and anaesthesiologists in orthopaedic surgery. Inductive thematic analysis was used to analyse the data. By spending time in the OR and listening to the staff, this study was able to look beyond what "ought" to be happening in the OR and garner a deep understanding of the realities of OR work that acknowledges the complexities of surgical culture in which the SSC is being implemented. This study found SSC compliance was influenced by the perceived (un)importance of individual checklist items within the orthopaedic setting. Additionally, there remains a need to further explore patients' involvement in their operative experience.
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Affiliation(s)
- Roxanne Ziman
- a Daphne Cockwell School of Nursing, Faculty of Community Services , Ryerson University , Toronto , Ontario , Canada
| | - Sherry Espin
- a Daphne Cockwell School of Nursing, Faculty of Community Services , Ryerson University , Toronto , Ontario , Canada
| | - Rachel E Grant
- b Faculty of Education , University of Ottawa , Ottawa , Ontario , Canada
| | - Simon Kitto
- c Department of Innovation in Medical Education , University of Ottawa , Ottawa , Ontario , Canada.,d Office of Continuing Professional Development, Faculty of Medicine , University of Ottawa , Ottawa , Ontario , Canada
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Kitto SC, Grant RE, Peller J, Moulton CA, Gallinger S. What's in a name? Tensions between formal and informal communities of practice among regional subspecialty cancer surgeons. Adv Health Sci Educ Theory Pract 2018; 23:95-113. [PMID: 28600711 DOI: 10.1007/s10459-017-9776-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 04/24/2017] [Indexed: 06/07/2023]
Abstract
In 2007 the Cancer Care Ontario Hepatobiliary-Pancreatic (HPB) Community of Practice was formed during the wake of provincial regionalization of HPB services in Ontario, Canada. Despite being conceptualized within the literature as an educational intervention, communities of practice (CoP) are increasingly being adopted in healthcare as quality improvement initiatives. A qualitative case study approach using in-depth interviews and document analysis was employed to gain insight into the perceptions and attitudes of the HPB surgeons in the CoP. This study demonstrates how an engineered formal or idealized structure of a CoP was created in tension with the natural CoPs that HPB surgeons identified with during and after their training. This tension contributed to the inactive and/or marginal participation by some of the surgeons in the CoP. The findings of this study represent a cautionary tale for such future engineering attempts in two distinct ways: (1) a CoP in surgery cannot simply be created by regulatory agencies, rather they need to be supported in a way to evolve naturally, and (2) when the concept of CoPs is co-opted by governing bodies, it does not necessarily capture the power and potential of situated learning. To ensure CoP sustainability and effectiveness, we suggest that both core and peripheral members need to be more directly involved at the inception of the COP in terms of design, organization, implementation and ongoing management.
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Affiliation(s)
- Simon C Kitto
- Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, 451 Smyth Rd, RGN Building, Rm 3231, Ottawa, ON, K1H 8M5, Canada.
| | - Rachel E Grant
- Faculty of Education, University of Ottawa, Ottawa, ON, Canada
| | - Jennifer Peller
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Carol-Anne Moulton
- Division of General Surgery, University Health Network, Toronto, ON, Canada
- Department of Surgery, University of Toronto, Toronto, ON, Canada
- The Wilson Centre, Toronto, ON, Canada
| | - Steven Gallinger
- Division of General Surgery, University Health Network, Toronto, ON, Canada
- Department of Surgery, University of Toronto, Toronto, ON, Canada
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Grant RE, Van Hoof TJ, Sajdlowska J, Miller NE, Kitto S. Terminology in Continuing Education: A Hybrid Methodology for Improving the Use and Reporting of Interventions in Continuing Education. J Contin Educ Health Prof 2015; 35 Suppl 2:S45-S50. [PMID: 26954001 DOI: 10.1097/ceh.0000000000000014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Researchers and leaders working in quality improvement and continuing education have a variety of interventions available to change clinician behavior and to improve patient outcomes. Evidence from systematic reviews and meta-analyses of such interventions is often mixed, with methodological weaknesses contributing to challenges in summarizing and interpreting evidence. Confusion and inconsistency surrounding many of the terms contributes to this challenge. This international study was commissioned by the Society for Academic Continuing Medical Education to use expert opinion to improve the consistency of important educational terminology by describing the essential components of a set of educational interventions, such as educational meetings. This article will describe how this project uses the literature and an expert consensus process to improve precision around the conceptualization and implementation of educational interventions. This article will offer an in-depth description of a hybrid methodology that blends the Chaffee framework for concept explication with a modified Delphi technique that constitutes a novel expert consensus process. This article concludes with recommendations for other scholars replicating this process.
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Affiliation(s)
- Rachel E Grant
- Ms. Grant: Project Manager, Department of Surgery, and Research Associate, Continuing Professional Development, Faculty of Medicine, University of Toronto, Toronto, Canada. Dr. Van Hoof: Associate Professor, University of Connecticut School of Nursing, Storrs, CT, and Associate Professor, Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, CT. Ms. Sajdlowska: Research Assistant, School of Nursing, University of Connecticut, Storrs, CT. Ms. Miller: Research Assistant, School of Nursing, University of Connecticut, Storrs, CT. Dr. Kitto: Associate Professor, Department of Innovation in Medical Education, and Director of Research, Office of Continuing Professional Development, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Van Hoof TJ, Grant RE, Campbell C, Colburn L, Davis D, Dorman T, Fischer M, Horsley T, Jacobs-Halsey V, Kane G, LeBlanc C, Moore DE, Morrow R, Olson CA, Silver I, Thomas DC, Turco M, Kitto S. Society for Academic Continuing Medical Education Intervention Guideline Series: Guideline 2, Practice Facilitation. J Contin Educ Health Prof 2015; 35 Suppl 2:S55-S59. [PMID: 26954003 DOI: 10.1097/ceh.0000000000000012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The Society for Academic Continuing Medical Education commissioned a study to clarify and, if possible, standardize the terminology for a set of important educational interventions. In the form of a guideline, this article describes one such intervention, practice facilitation, which is a common strategy in primary care to help practices develop capacity and infrastructure to support their ability to improve patient care. Based on a review of recent evidence and a facilitated discussion with US and Canadian experts, we describe practice facilitation, its terminology, and other important information about the intervention. We encourage leaders and researchers to consider and build on this guideline as they plan, implement, evaluate, and report practice facilitation efforts. Clear and consistent use of terminology is imperative, along with complete and accurate descriptions of interventions, to improve the use and study of practice facilitation.
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Affiliation(s)
- Thomas J Van Hoof
- Dr. Van Hoof: Associate Professor, University of Connecticut School of Nursing, Storrs, and Associate Professor and Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, CT. Ms. Grant: Research Associate, Continuing Professional Development, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Dr. Campbell: Associate Professor of Medicine, University of Ottawa, and Director, Continuing Professional Development, Royal College of Physicians and Surgeons of Canada, Ottawa, Canada. Ms. Colburn: Executive Director, Center for Continuing Education, University of Nebraska Medical Center, Omaha, NB. Dr. Davis: Senior Director, Continuing Education and Performance, Association of American Medical Colleges, Washington, DC. Dr. Dorman: Professor, Johns Hopkins University School of Medicine, Baltimore, MD. Dr. Fischer: Director, National Resource Center for Academic Detailing, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, MA and Associate Professor, Harvard Medical School, Boston, MA. Dr. Horsley: Associate Director, Research Unit, Royal College of Physicians and Surgeons of Canada and Adjunct Faculty, Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada. Dr. Jacobs-Halsey: Director, Office of Continuing Professional Development, Medical School, University of Minnesota, Minneapolis, MN. Dr. Kane: Associate Professor, Department of Biomedical Informatics and Medical Education and Associate Professor, Department of Radiation Oncology, University of Washington, Seattle, WA. Dr. LeBlanc: Associate Dean for Continuing Medical Education, and Professor, Department of Emergency Medicine, Dalhousie University, Halifax, NS. Dr. Moore: Professor of Medical Education and Administration, Director, Office for Continuing Professional Development, and Director of Evaluation, Medical Student Curriculum, Vanderbilt Universi
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Grant RE, Sajdlowska J, Van Hoof TJ, Kitto S. Conceptualization and Reporting of Context in the North American Continuing Medical Education Literature: A Scoping Review Protocol. J Contin Educ Health Prof 2015; 35 Suppl 2:S70-S74. [PMID: 26954006 DOI: 10.1097/ceh.0000000000000010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Within continuing medication education (CME), it has been argued that an "authentic" clinical context should be built into CME activities for knowledge to be effectively translated into clinical practice. However, although context is considered significant in the success (or lack thereof) of an intervention, there is a lack of consensus on what exactly context is. This scoping review arises from concerns surrounding the opaque, complex, and potentially problematic relationship between context and the effective design and implementation of CME interventions. In this article, we present a protocol for examining how context is discussed within the CME literature. The specific purpose of this scoping review is to summarize the breadth of existing evidence on context within the North American CME literature. The scoping review methodology will also highlight gaps in the current literature, which can inform future research endeavors.
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Affiliation(s)
- Rachel E Grant
- Ms. Grant: Research Associate, Continuing Professional Development, Faculty of Medicine, University of Toronto, Toronto. Ms. Sajdlowska: Research Assistant, School of Nursing, University of Connecticut, Storrs. Dr. Van Hoof: Associate Professor, University of Connecticut School of Nursing, Storrs, and Associate Professor, Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington. Dr. Kitto: Director of Research, Continuing Professional Development and Associate Professor, Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, Canada
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Sajdlowska J, Grant RE, Van Hoof TJ, Kitto S. Context and terminology in continuing education: improving the use of interventions in quality improvement and research. J Contin Educ Health Prof 2015; 35 Suppl 1:S27-S28. [PMID: 26115239 DOI: 10.1002/chp.21278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Van Hoof TJ, Grant RE, Sajdlowska J, Bell M, Campbell C, Colburn L, Dorman T, Fischer M, Horsley T, LeBlanc C, Lockyer J, Moore DE, Morrow R, Olson CA, Silver I, Thomas DC, Turco M, Kitto S. Society for Academic Continuing Medical Education Intervention Guideline Series: Guideline 3, Educational Meetings. J Contin Educ Health Prof 2015; 35 Suppl 2:S60-S64. [PMID: 26954004 DOI: 10.1097/ceh.0000000000000011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The Society for Academic Continuing Medical Education commissioned a study to clarify and, if possible, to standardize the terminology for a set of important educational interventions. In the form of a guideline, this article describes one such intervention, educational meetings, which is a common intervention in health professions' education. An educational meeting is an opportunity for clinicians to assemble to discuss and apply important information relevant to patient care. Based on a review of recent evidence and a facilitated discussion with US and Canadian experts, we describe proper educational meeting terminology and other important information about the intervention. We encourage leaders and researchers to consider and to build on this guideline as they plan, implement, evaluate, and report educational meeting efforts. Clear and consistent use of terminology is imperative, along with complete and accurate descriptions of interventions, to improve the use and study of educational meetings.
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Affiliation(s)
- Thomas J Van Hoof
- Dr. Van Hoof: Associate Professor, University of Connecticut School of Nursing, Storrs, CT, and Associate Professor, Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, CT. Ms. Grant: Research Associate, Continuing Professional Development, Faculty of Medicine, University of Toronto, Toronto, ON, Canada. Ms. Sajdlowska: Research Assistant, School of Nursing, University of Connecticut, Storrs, CT. Dr. Bell: Associate Professor, Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada. Dr. Campbell: Associate Professor of Medicine, University of Ottawa, Ottawa, ON, Canada, and Director, Continuing Professional Development, Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada. Ms. Colburn: Executive Director, Center for Continuing Education, University of Nebraska Medical Center, Omaha, NE. Dr. Dorman: Professor, Johns Hopkins University School of Medicine, Baltimore, MD. Dr. Fischer: Director, National Resource Center for Academic Detailing, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, MA, and Associate Professor, Harvard Medical School, Boston, MA. Dr. Horsley: Associate Director, Research Unit, Royal College of Physicians and Surgeons of Canada, and Adjunct Faculty, Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada. Dr. LeBlanc: Associate Dean, Continuing Professional Development, and Professor, Department of Emergency Medicine, Dalhousie University, Halifax, NS, Canada. Dr. Lockyer: Professor, Department of Community Health Sciences, and Senior Associate Dean, Education, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. Dr. Moore: Professor of Medical Education and Administration, Director, Office for Continuing Professional Development, and Director of Evaluation, Medical Student Curriculum, Vanderbilt University School of Medici
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Van Hoof TJ, Grant RE, Sajdlowska J, Bell M, Campbell C, Colburn L, Davis D, Dorman T, Fischer M, Horsley T, Jacobs-Halsey V, Kane G, LeBlanc C, Lockyer J, Moore DE, Morrow R, Olson CA, Reeves S, Sargeant J, Silver I, Thomas DC, Turco M, Kitto S. Society for Academic Continuing Medical Education Intervention Guideline Series: Guideline 4, Interprofessional Education. J Contin Educ Health Prof 2015; 35 Suppl 2:S65-S69. [PMID: 26954005 DOI: 10.1097/ceh.0000000000000015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The Society for Academic Continuing Medical Education commissioned a study to clarify and, if possible, to standardize the terminology for a set of important educational interventions. In the form of a guideline, this article describes one such intervention, interprofessional education (IPE), which is a common intervention in health professions education. IPE is an opportunity for individuals of multiple professions to interact to learn together, to break down professional silos, and to achieve interprofessional learning outcomes in the service of high-value patient care. Based on a review of recent evidence and a facilitated discussion with US and Canadian experts, we describe IPE, its terminology, and other important information about the intervention. We encourage leaders and researchers to consider and to build on this guideline as they plan, implement, evaluate, and report IPE efforts. Clear and consistent use of terminology is imperative, along with complete and accurate descriptions of interventions, to improve the use and study of IPE.
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Affiliation(s)
- Thomas J Van Hoof
- Dr. Van Hoof: Associate Professor, University of Connecticut School of Nursing, Storrs, and Associate Professor, Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington. Ms. Grant: Research Associate, Continuing Professional Development, Faculty of Medicine, University of Toronto, Toronto. Ms. Sajdlowska: Research Assistant, School of Nursing, University of Connecticut, Storrs. Dr. Bell: Associate Scientist, Sunnybrook Research Institute; Associate Professor, Faculty of Medicine, Department of Medicine, University of Toronto, Toronto. Dr. Campbell: Director of Continuing Professional Development, Royal College of Physicians and Surgeons of Canada, Ottawa. Ms. Colburn: Executive Director, Center for Continuing Education, University of Nebraska Medical Center, Omaha. Dr. Davis: Senior Director, Continuing Education and Performance Improvement, Association of American Medical Colleges, Washington DC. Dr. Dorman: Professor, Johns Hopkins University School of Medicine, Baltimore, MD. Dr. Fischer: Director, National Resource Center for Academic Detailing, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, Boston, and Associate Professor, Harvard Medical School, Boston. Dr. Horsley: Associate Director, Research Unit, Royal College of Physicians and Surgeons of Canada and Adjunct Faculty, Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa. Dr. Jacobs-Halsey: Director, Office of Continuing Professional Development, Medical School, University of Minnesota Medical School, Minneapolis. Dr. Kane: Associate Professor, Department of Biomedical Informatics and Medical Education, and Associate Professor, Department of Radiation Oncology, University of Washington, Seattle. Dr. LeBlanc: Professor of Emergency Medicine, and Associate Dean for Continuing Professional Development, Dalhousie University, Halifax. Dr. Lockyer: Professor, Department of Commu
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Van Hoof TJ, Grant RE, Miller NE, Bell M, Campbell C, Colburn L, Davis D, Dorman T, Horsley T, Jacobs-Halsey V, Kane G, LeBlanc C, Lockyer J, Moore DE, Morrow R, Olson CA, Silver I, Thomas DC, Kitto S. Society for Academic Continuing Medical Education Intervention Guideline Series: Guideline 1, Performance Measurement and Feedback. J Contin Educ Health Prof 2015; 35 Suppl 2:S51-S54. [PMID: 26954002 DOI: 10.1097/ceh.0000000000000013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The Society for Academic Continuing Medical Education commissioned a study to clarify and, if possible, to standardize the terminology for a set of important educational interventions. In the form of a guideline, this article describes one such intervention, performance measurement and feedback, which is a common intervention in health professions education. In the form of a summary report, performance measurement and feedback is an opportunity for clinicians to view data about the care they provide compared with some standard and often with peer and benchmark comparisons. Based on a review of recent evidence and a facilitated discussion with the US and Canadian experts, we describe proper terminology for performance measurement and feedback and other important information about the intervention. We encourage leaders and researchers to consider and build on this guideline as they plan, implement, evaluate, and report efforts with performance measurement and feedback. Clear and consistent use of terminology is imperative, along with complete and accurate descriptions of interventions, to improve the use and study of performance measurement and feedback.
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Affiliation(s)
- Thomas J Van Hoof
- Dr. Van Hoof: Associate Professor, University of Connecticut School of Nursing, Storrs, and Associate Professor, Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, CT. Ms. Grant: Research Associate, Continuing Professional Development, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Ms. Miller: Research Assistant, School of Nursing, University of Connecticut, Storrs, CT. Dr. Bell: Associate Scientist, Sunnybrook Research Institute, and Associate Professor, Faculty of Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Dr. Campbell: Director of Continuing Professional Development, Royal College of Physicians and Surgeons of Canada, Ottawa, Canada. Ms. Colburn: Executive Director, Center for Continuing Education, University of Nebraska Medical Center, Omaha, NE. Dr. Davis: Senior Director, Continuing Education and Performance Improvement, Association of American Medical Colleges, Washington, DC. Dr. Dorman: Professor, Johns Hopkins University School of Medicine, Baltimore, MD. Dr. Horsley: Associate Director, Research Unit, Royal College of Physicians and Surgeons of Canada and Adjunct Faculty, Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada. Dr. Jacobs-Halsey: Director, Office of Continuing Professional Development, Medical School, University of Minnesota, Minneapolis, MN. Dr. Kane: Associate Professor, Department of Biomedical Informatics and Medical Education, and Associate Professor, Department of Radiation Oncology, University of Washington, Seattle, WA. Dr. LeBlanc: Professor of Emergency Medicine, and Associate Dean for Continuing Professional Development, Dalhousie University, Halifax, NS. Dr. Lockyer: Professor, Department of Community Health Sciences, and Senior Associate Dean, Education, University of Calgary, Calgary, Alberta, Canada. Dr. Moore: Professor of Medical Education and Administ
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Grant RE. Tuuhikya: the Hopi healer. Am Indian Q 2001; 6:291-304. [PMID: 11614178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Grant RE, Banks WJ, Alleyne KR. A survey of the ethnic and racial distribution in orthopedic residency programs in the United States. J Natl Med Assoc 1999; 91:509-12. [PMID: 10517071 PMCID: PMC2608541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
This study examined the racial and ethnic composition of orthopedic training programs in the United States. A questionnaire was mailed in January 1995 to chairpersons at 159 orthopedic programs in the United States. Eighty-nine (56%) responses were received. The distribution of orthopedic residents and fellows was as follows: white non-Hispanic, 84.2%; Asian, 6.6%; African American, 3.6%; Native American, 2.2%; Puerto Rican, 1.2%; Mexican American, 0.8%; and other Hispanic, 1%. African Americans and Hispanics were under-represented in orthopedic training programs compared with their numbers in the general population. The percentage of residents in these two minority groups also were below goals established by the Council on Graduate Medical Education and the US Government's Healthy People 2000 report. In contrast, Native Americans and Asians were overrepresented. If racial balance is to be achieved in orthopedics, new incentives must be created to encourage more African Americans and Hispanics to enter orthopedic residency training programs.
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Affiliation(s)
- R E Grant
- Division of Orthopaedic Surgery, Howard University Hospital, Washington, DC 20060, USA
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Saunders ME, Grant RE. Cost effectiveness of low-molecular weight heparin versus warfarin following hip replacement surgery. J Natl Med Assoc 1998; 90:677-80. [PMID: 9828582 PMCID: PMC2608386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Little information is available on the efficacy of low-molecular-weight heparin (enoxaparin) versus warfarin for treatment of deep vein thrombosis and pulmonary embolism following hip replacement surgery. Still less is known of the comparative cost effectiveness of these two therapies. A retrospective study was done on 56 patients who underwent elective hip surgery at an urban medical center between 1991 and 1996. All patients received enoxaparin or warfarin for purposes of thromboprophylaxis. An analysis of medication cost, therapy, laboratory monitoring, and bleeding events of the two antithrombolytic agents was undertaken. Total savings with enoxaparin averaged $1253 per patient, or $137,886 over the study period. The incidence of deep vein thrombosis or pulmonary embolism was 0% with enoxaparin and 3% with warfarin. These data indicate that enoxaparin is a more cost-effective and efficacious regimen for thromboprophylaxis following hip replacement surgery than warfarin.
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Affiliation(s)
- M E Saunders
- Division of Orthopaedic Surgery, Howard University Hospital, Washington, DC 20060, USA
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15
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Grant RE, Schneider JA, Ferguson EJ, Cummings PB. Total hip reconstruction in a woman with Cornelia de Lange syndrome: a case report. J Natl Med Assoc 1997; 89:530-2. [PMID: 9264220 PMCID: PMC2568114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
More than 250 cases of Cornelia de Lange syndrome have been reported in the medical literature, but not have described the use of hip reconstruction to correct the congenital dysplasia that may be associated with this condition. This article reports the application of a bipolar hemiarthroplasty and acetabular allograft reconstruction for a 32-year old woman with congenital dysplasia and degenerative joint disease of the hip secondary to de Lange's syndrome. On admission, she was in considerable pain and unable to bear weight on the affected extremity. Her Harris hip score was 25. Following surgical intervention and a well-designed plan of rehabilitation, the patient's functional status improved markedly. Her Harris hip score was 72, and her pain was alleviated.
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Affiliation(s)
- R E Grant
- Howard University Hospital, Div of Orthopaedic Surgery, Washington, D.C. 20060, USA
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16
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Garden MS, Grant RE, Jebraili S. Perioperative complications in patients with sickle cell disease. An orthopedic perspective. Am J Orthop (Belle Mead NJ) 1996; 25:353-6. [PMID: 8727085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Osteonecrosis of the femoral head has been reported to occur in 19% to 31% of patients with sickle cell disease, with the condition often being bilateral. Current surgical options for these patients include various forms of arthrodesis, resection arthroplasty, osteotomy, and uncemented hip arthroplasty. Poor surgical outcome, coupled with frequent perioperative medical complications, makes the treatment of these patients very challenging. A case report of a 33-year-old black woman with a 21-year history of sickle cell disease who underwent hip arthroplasty and developed sickle chest syndrome is presented.
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Affiliation(s)
- M S Garden
- Howard University Hospital, Washington, DC, USA
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17
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Fink G, Grant RE. Justifying reasonable compensation. Trustee 1992; 45:21. [PMID: 10122637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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18
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Bryant DD, Grant RE, Tang D. Fibular strut grafting for fibrous dysplasia of the femoral neck. J Natl Med Assoc 1992; 84:893-7. [PMID: 1404469 PMCID: PMC2571794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
When fibrous dysplasia affects the femoral neck, normal bone is replaced by fibro-osseous dysplastic bone that is both mechanically weakened and biomechanically abnormal. Surgical management is recommended for persistent pain, progressive deformity, or impending fracture. Surgical options include curettage and cancellous bone grafting, osteotomy and nail-plate fixation, intramedullary rodding, and cortical bone grafting. We present the case of a patient with a painful, dysplastic lesion of the femoral neck who underwent cortical bone grafting using dual fibular strut grafts. To ensure long-term graft incorporation, the fibular cortical grafts bridged the lesion in the femoral neck and were securely anchored to the normal bone of the lateral femoral cortex and a head of the femur. No supplemental internal fixation was required. The biological basis for success of the fibular strut grafting procedure is that creeping substitution of the cortical graft necrotic bone does not replace the interstitial lamellae, which persist to lend structural support. Fibular strut grafting is an excellent procedure for fibrous dysplasia of the femoral neck.
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Affiliation(s)
- D D Bryant
- Division of Orthopaedic Surgery, Howard University Hospital, Washington, DC
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19
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Eady JL, Lundquist JE, Grant RE, Nagel A, Kim DD. Congenital bowing of the ulna and aggressive fibromatosis. J Natl Med Assoc 1991; 83:978-82. [PMID: 1766021 PMCID: PMC2571611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The association of skeletal anomalies and aggressive fibromatosis has been documented. Isolated bowing of the ulna is rare, yet its occurrence, particularly in conjunction with congenital dislocation of the radial head, has been documented. This article presents two cases of ulnar bowing in which the patients subsequently developed aggressive fibromatosis. We feel that aggressive fibromatosis may be a latent manifestation of congenital bowing of the ulna. The course of the disease appears to be of an aggressive nature, and patients who present with bowing of the ulna should be followed for the potential development of this disease.
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Affiliation(s)
- J L Eady
- Division of Orthopaedic Surgery, Howard University Hospital, Washington, DC
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20
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Grant RE. Theoretic orientation and body of knowledge. Heart Lung 1991; 20:427. [PMID: 2071438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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21
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Grant RE. Predicting academic success. NLN Publ 1986:93-105. [PMID: 3642440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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22
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Grant RE. The disordered world of the patient with schizophrenia. Jamaican Nurse 1976; 16:29, 37. [PMID: 1051901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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23
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Craig C, Grant RE. The visualisation of the lower ureter with the image intensifier. Australas Radiol 1973; 17:53-5. [PMID: 4732240 DOI: 10.1111/j.1440-1673.1973.tb01411.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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24
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Abstract
Spine arrangements on silicified specimens of Waagenoconcha abichi (Waagen) from the Khisor Range of West Pakistan suggest that the juvenile shell attached itself to a foreign object, and that the adult shell lay on its ventral valve in the substrate, anchored and stabilized by a dense corona of long slender spines around the ventral visceral disc.
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Brickner RM, Grant RE. Treatment of the R
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Rat Sarcoma. Science 1937; 86:450. [PMID: 17838965 DOI: 10.1126/science.86.2237.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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