Navigating long wait times for rheumatological health issues and suggestions for further investigations

Canada continues to struggle with wait times for patients transitioning from primary to specialized care. Since 2019, wait times for speciality consultation and time to specialty treatment have increased significantly throughout Canada, with Ontario ranking third overall among the provinces for the longest wait times. In addition to Ontario having the largest population among the provinces, musculoskeletal (MSK) based issues make up approximately 30% of all primary care reasons for visits and ranks among the longest wait times by specialty. Thus, a large proportion of patients seeking MSK based health care in Ontario are experiencing significant delays. This commentary discusses the burden of wait times for MSK patients requiring specialized care and offers a guide on how to assess, interpret, and possibly challenge the current care model. Essentially, this commentary suggests further studies be conducted through a qualitative lens to gather and assess information about patients’ perspectives on access, feasibility, and patient-provider alignment of care. Through this subjective lens, a better understanding may be gained regarding how patients interact with the current model of care for MSK health, and this knowledge can be applied in creating patient-education resources, guiding continuing medical education, and most importantly, increasing awareness for prominent systemic impacts such as wait times

Effective dementia care: what matters most to people living with dementia and five key components for delivery in primary care

Primary care providers play an integral role in providing access to dementia care to Canadians; they are often the first point of discussion and support for people with dementia-related concerns and their care partners. Thus, it is important to identify models and strategies to ensure that the medical community can provide effective care to people living with dementia and support their care partners. When receiving care, the most important outcome for many people living with dementia and their care partners is improved quality of life. An environmental scan of academic and grey literature was conducted to identify models of care for dementia that improve quality of life of people living with dementia and their care partners. Eighteen models were identified, but only one, the Dementia Care Management (DCM) model, demonstrated an impact on quality of life. Examining the models, five key components that improve delivery and implementation of dementia care in primary care settings were found across all models. These five core components (team-based care, centralized care/case coordination, individual care plans, a stepped-care approach, and incorporation of care partner needs) can be implemented in primary care settings to improve care for people living with dementia and their care partners. These findings are of relevance to medical trainees and practicing clinicians who may implement these approaches in their own practices, as well as policy makers seeking to improve dementia care delivery and outcomes

Natural Language Processing to Identify Digital Learning Tools in Postgraduate Family Medicine: Protocol for a Scoping Review

BackgroundThe COVID-19 pandemic has highlighted the growing need for digital learning tools in postgraduate family medicine training. Family medicine departments must understand and recognize the use and effectiveness of digital tools in order to integrate them into curricula and develop effective learning tools that fill gaps and meet the learning needs of trainees. ObjectiveThis scoping review will aim to explore and organize the breadth of knowledge regarding digital learning tools in family medicine training. MethodsThis scoping review follows the 6 stages of the methodological framework outlined first by Arksey and O’Malley, then refined by Levac et al, including a search of published academic literature in 6 databases (MEDLINE, ERIC, Education Source, Embase, Scopus, and Web of Science) and gray literature. Following title and abstract and full text screening, characteristics and main findings of the included studies and resources will be tabulated and summarized. Thematic analysis and natural language processing (NLP) will be conducted in parallel using a 9-step approach to identify common themes and synthesize the literature. Additionally, NLP will be employed for bibliometric and scientometric analysis of the identified literature. ResultsThe search strategy has been developed and launched. As of October 2021, we have completed stages 1, 2, and 3 of the scoping review. We identified 132 studies for inclusion through the academic literature search and 127 relevant studies in the gray literature search. Further refinement of the eligibility criteria and data extraction has been ongoing since September 2021. ConclusionsIn this scoping review, we will identify and consolidate information and evidence related to the use and effectiveness of existing digital learning tools in postgraduate family medicine training. Our findings will improve the understanding of the current landscape of digital learning tools, which will be of great value to educators and trainees interested in using existing tools, innovators looking to design digital learning tools that meet current needs, and researchers involved in the study of digital tools. Trial RegistrationOSF Registries osf.io/wju4k; https://osf.io/wju4k International Registered Report Identifier (IRRID)DERR1-10.2196/3457