Plain language communication as a priority competency for medical professionals in a globalized world

This brief report aims to highlight the impact of globalization – the international movement of goods, people, and ideas – on patient-provider communication in medical training and practice, and how the implementation of plain language communication training as a core competency for care providers can mitigate this impact. Globalization influences both patient and provider population diversity, which presents challenges with regard to patient-provider communication, particularly in cases of limited health literacy. Plain language communication - the delivery of information in a simple, succinct, and accurate manner - can help address these challenges. Training in plain language communication, however, is not a part of standard education for health care providers. Based on a synthesis of relevant literature pertaining to globalization, plain language communication, and medical education curricula, it is hoped that the information presented establishes the need for plain language communication as a core competency in medical education to enable providers to better meet the needs of an increasingly globalized health system

CASE 10: Lost in Translation: Developing Strategies for Indigenous People who have Cancer, Limited English Proficiency, and Limited Health Literacy

Studies have documented that people who have limited health literacy and limited English proficiency often have challenges with all aspects of health care, including difficulties accessing health care, understanding medical information, making treatment decisions, taking prescriptions properly, and communicating with health care workers. People who have limited health literacy often have an overall negative outlook about health care, and they are less likely to seek help from health care providers or health programs, which can negatively affect their overall long-term health and lead to poorer health outcomes than those with high health literacy. The main goals of this case are for the reader to understand limited English proficiency and health literacy in the context of health care for Indigenous populations, and to define and apply strategies to effectively communicate with these populations in a health care setting. This case provides the reader with an array of information regarding Indigenous health issues and perspectives. It gives the reader the opportunity to assess a health care problem and identify the social and cultural determinants of health within it. Through the use of concept mapping, the reader will be pushed to explore the relationships between limited English proficiency, health literacy, and Indigenous knowledge and beliefs in a healthcare setting. It will challenge the reader to think critically about the situation and propose strategic interventions to break down communication barriers

Avantages et inconvénients de la formation médicale continue virtuelle : une étude de la portée

Introduction: With the COVID-19 pandemic, most continuing medical education activities became virtual (VCME). The authors conducted a scoping review to synthesize the advantages and disadvantages of VCME to establish the impact of this approach on inequities that physicians face along the intersections of gender, race, and location of practice. Methods: Guided by the methodological framework of Arksey and O’Malley, the search included six databases and was limited to studies published between January 1991 to April 2021. Eligible studies included those related to accredited/non-accredited post-certification medical education, conferences, or meetings in a virtual setting focused on physicians. Numeric and inductive thematic analyses were performed.   Results: 282 studies were included in the review. Salient advantages identified were convenience, favourable learning formats, collaboration opportunities, effectiveness at improving knowledge and clinical practices, and cost-effectiveness. Prominent disadvantages included technological barriers, poor design, cost, lack of sufficient technological skill, and time. Analysis of the studies showed that VCME was most common in the general/family practice specialty, in suburban settings, and held by countries in the Global North. A minority of studies reported on gender (35%) and race (4%).  Discussion: Most studies report advantages of VCME, but disadvantages and barriers exist that are contextual to the location of practice and medical subspecialty. VCME events are largely organized by Global North countries with suboptimized accessibility for Global South attendees. A lack of reported data on gender and race reveals a limited understanding of how VCME affects vulnerable populations, prompting potential future considerations as it evolves. Introduction : Par suite de la pandémie de la COVID-19, la plupart des activités de formation médicale continue ont été offertes en ligne. Les auteurs ont effectué une revue de la portée visant à synthétiser les avantages et les inconvénients de la formation médicale continue en mode virtuel (FMCV) et à examiner les effets de cette approche sur les inégalités qui affectent les médecins en fonction du sexe, de la race et du lieu d’exercice. Méthodes : Suivant le cadre méthodologique d’Arksey et O’Malley, nous avons effectué une recherche dans six banques de données, que nous avons limitée aux études publiées entre janvier 1991 et avril 2021. Les études incluses étaient celles relatives à la formation médicale post-certification, accréditée ou non, aux conférences et aux réunions destinées aux médecins qui se sont déroulées dans un cadre virtuel. Une analyse numérique et une analyse thématique inductive ont été réalisées. Résultats : Au total, 282 articles ont été inclus dans l’étude. Les principaux avantages identifiés sont la commodité, les formats favorables à l’apprentissage, les possibilités de collaboration, l’efficacité pour l’amélioration des connaissances et des pratiques cliniques et le rapport coût-efficacité. Les principaux inconvénients sont les obstacles technologiques, les défauts de conception, le coût, les compétences technologiques insuffisantes et le manque de temps. L’analyse des études a montré que la FMCV était la plus courante dans la spécialité de la médecine générale/familiale, dans les banlieues et dans les pays du Nord. Quelques études considèrent les facteurs sexe (35 %) et race (4 %). Discussion : La plupart des études évoquent les avantages de la FMCV, mais il existe des inconvénients et des obstacles liés au lieu d’exercice et à la sous-spécialité médicale. La plupart des activités de FMCV sont organisées dans les pays du Nord et leur accessibilité n’est pas optimale pour les participants provenant des pays du Sud. Le manque de données sur le sexe et la race pose une limite à notre compréhension de la façon dont la FMCV affecte les populations vulnérables. Ces facteurs seraient à prendre en considération dans les recherches futures sur le sujet et au fur et à mesure que la FMCV évolue.

The Association of Health Literacy and Self-Efficacy to Cancer Chemotherapy Self-Management Behaviours and Health Service Utilization

Abstract Background Increasing demands on Canadaâ s healthcare system require patients to take on more active roles in their health [1]. Effective self-management has been linked to improved health outcomes; and there is evidence that effective behaviours are linked to health literacy, however, this link has had minimal testing in the cancer context [2, 3]. Firmly establishing this link is important because those aged 65 years and older comprise the majority of the users of the cancer care system, and these individuals are most at risk for inadequate health literacy [4]. As such, the cancer care system may require increased self-management by patients least able to do so and, in doing so, fail to provide adequate care and incur substantial cost [5-7]. Objectives To examine the association between health literacy and cancer chemotherapy self-management behaviours (CSMB) and health service utilization (HSU) and test the hypothesized relationship between self-efficacy and these outcomes. Design Cross-sectional survey. Methods Participants completed a questionnaire package with socio-demographic information and validated measures of health literacy, cancer coping self-efficacy, symptom severity, symptom interference, CSMB score, and HSU. Multivariate modeling using hierarchical linear regression was used to examine the association of health literacy to CSMB health services utilization. Results Education and language spoken at home explained a significant amount of variance (22.5%) in health literacy score. Health literacy was not significantly associated with any of the dependent variables in multivariate analysis. The analyses conducted to explore the association of self-efficacy to CSMB score and HSU showed that self-efficacy contributed to explaining variation in CSMB score but did not contribute significantly to explaining HSU. Conclusion This study provides new knowledge that advances understanding of the association of health literacy and self-efficacy on CSMBs and HSU in the context of cancer care.Ph.D

Pivoting the Provision of Smoking Cessation Education in a Virtual Clinical World: The Princess Margaret Cancer Centre Experience

Continued smoking after a cancer diagnosis may be attributed to misbeliefs by both patients and healthcare providers on the value and benefit of quitting smoking on treatment outcomes. The perceived myths and misconceptions about the relationship between smoking and cancer may be readily dispelled with the provision of practical and pertinent education. However, busy clinics as well as the rapid move to virtual care due to the COVID-19 pandemic present several challenges with the provision of smoking cessation education. Here, we describe how the Princess Margaret Cancer Centre implemented innovative solutions to improve the delivery of education during the COVID-19 pandemic to better support patients and healthcare providers

Autonomiser les patients et les soignants grâce au savoir : Élaboration d’une formation sur la chimiothérapie en gynécologie oncologique dirigée par le personnel infirmier

L’augmentation du nombre de patients vus en clinique dans un centre de cancérologie du Canada est venue nuire à l’offre d’un enseignement de qualité sur la chimiothérapie pour les patients et leur famille. Le département de gynéco-oncologie a cerné plusieurs obstacles à la transmission d’un enseignement complet et opportun. Une fois le diagnostic de cancer tombé, l’accès à l’enseignement, l’efficacité de l’information transmise par écrit, les contraintes de temps des infirmières et l’absence d’uniformité dans la prise en charge des effets secondaires figurent parmi les obstacles relevés. Une équipe interdisciplinaire s’est donc rassemblée pour revoir les pratiques d’enseignement actuelles et se pencher sur le programme d’enseignement aux patients afin de développer, conjointement, des stratégies pour régler ces problèmes. Cet article décrit les étapes ayant mené à l’élaboration, par le personnel infirmier, d’une formation sur la chimiothérapie (protocoles courants) destinée aux patients atteints de cancers gynécologiques et visant à aider les patients et les soignants à mieux se préparer aux séances de chimiothérapie, à calmer l’anxiété et à savoir comment gérer les effets secondaires liés au traitement

Empowering patients and caregivers with knowledge: The development of a nurse-led gynecologic oncology chemotherapy education class

At a Canadian cancer centre, rising patient volumes made it difficult to provide quality chemotherapy education to patients and families in the clinical setting. The gynecology oncology site identified several barriers to the provision of timely and comprehensive teaching. These barriers included receiving education after learning of a cancer diagnosis, the efficacy of written information, time constraints nurses experienced, and absence of standardized side effect management. This prompted an interdisciplinary team to review current teaching practices and engage the Patient Education Program to collaboratively develop strategies to overcome these challenges. This paper describes the development of a nurse-led chemotherapy education class tailored to patients with gynecologic cancers and focused on common chemotherapy treatment protocols. The purpose of the class was to help patients and caregivers know what to expect during their chemotherapy routine, lower anxiety, and to equip them with knowledge and skills to manage side effects of treatment

COVID-19 and Cancer Patients in the Second Year of the Pandemic: Investigating Treatment Impact, Information Sources, and COVID-19-Related Knowledge, Attitudes and Practices

Background: The novel coronavirus that has triggered the present COVID-19 pandemic continues to spread globally, resulting in widespread morbidity and mortality. Patients with cancer remain one of the most vulnerable subsets of the population to the disease. This study examined the effects of the pandemic on cancer patients’ treatment, psychology, knowledge, attitudes, and practices. Methods: A survey was emailed to 9861 patients at a cancer centre in Toronto, Canada. Descriptive results were summarized. Qualitative feedback was coded and summarized. Regression modelling was used to explore factors associated with patient psychological well-being, knowledge, attitudes, and practices. Results: A total of 1760 surveys were completed, with a response rate of 17.8%. Most participants did not experience any pandemic-related treatment delays, and vaccination rates were high. Participants who identified themselves as non-white (OR 3.30, CI: 1.30–5.30; p ≤ 0.001), and those who referred to journal articles for information (p = 0.002) reported higher psychological impact scores. There were no significant predictors of whether participants would use personal protective equipment when leaving their homes or whether they would go to crowded places. Discussion: This study provides another snapshot of cancer patients perceptions and needs during the COVID-19 pandemic