Survey of Interprofessional Collaboration Learning Needs and Training Interest in Health Professionals, Teachers, and Students: An Exploratory Study

AbstractBackground: Researchers and trainers from many professions and settings have emphasized the importance of explicit training in interprofessional collaboration (IPC), but interest in and best practice for training for IPC remains unknown.Methods and Findings: A 33-item Internet-based survey was completed by 486 practicing professionals and students from the sectors of health and education. The survey assessed experiences and knowledge of IPC as well as interest in and barriers to further training in IPC. Overall, there was agreement among respondents regarding the importance of IPC. Satisfaction with IPC was associated with higher self-ratings of knowledge and skills related to IPC. Interest in further IPC training was high, especially for one- or two-day workshops or web-based modules. Qualitative analysis of responses to an open-ended question about IPC skills and knowledge revealed seven networks of common themes that can serve as a framework for training and theory development.Conclusions: IPC training should provide knowledge about IPC models and research, leadership styles, team stages, and conflict management, while also ensuring that training applies to the workplace or practicum placement. Efforts should be made to promote awareness of the need for training in areas where trainees already feel competent

Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of aseptic meningitis

BACKGROUND: The seasonality, clinical and radiographic features and outcome of aseptic meningitis have been described for regional outbreaks but data from a wider geographic area is necessary to delineate the epidemiology of this condition. METHODS: A retrospective chart review was completed of children presenting with aseptic meningitis to eight Canadian pediatric hospitals over a two-year period. RESULTS: There were 233 cases of proven enteroviral (EV) meningitis, 495 cases of clinical aseptic meningitis and 74 cases of possible aseptic meningitis with most cases occurring July to October. Headache, vomiting, meningismus and photophobia were more common in children ≥ 5 years of age, while rash, diarrhea and cough were more common in children < 5 years of age. Pleocytosis was absent in 22.3% of children < 30 days of age with proven EV meningitis. Enterovirus was isolated in cerebrospinal fluid (CSF) from 154 of 389 patients (39.6%) who had viral culture performed, and a nucleic acid amplification test for enterovirus was positive in CSF from 81 of 149 patients (54.3%). Imaging of the head by computerized tomography or magnetic resonance imaging was completed in 96 cases (19.7%) and 24 had abnormal findings that were possibly related to meningitis while none had changes that were definitely related to meningitis. There was minimal morbidity and there were no deaths. CONCLUSION: The clinical presentation of aseptic meningitis varies with the age of the child. Absence of CSF pleocytosis is common in infants < 30 days of age. Enterovirus is the predominant isolate, but no etiologic agent is identified in the majority of cases of aseptic meningitis in Canadian children

Six ways to get a grip on patient and family centered care during the undergraduate medical years

Patient and family-centered care and patient engagement practices have strong evidence-based links with quality and safety for both patients and health care providers. Expectations for patient and family-centered care have advanced beyond hearing the patient perspective and taking patient wishes into account. A participatory approach including patients as partners in their care journey is expected, but attitudes toward patient and family-centered care remain barriers in practice. As health service organizations shift from a system-centered approach to a patient and family-centered care delivery model, black ice occurs. In this Black Ice article, we present some practical tips for medical educators to improve opportunities for medical students to develop knowledge, attitudes, and skills that support patient and family-centered care

Patient and family engagement: Bridging together interprofessional practice and patient- and family-centred care

Patient and family engagement as part of the health care team is increasingly recommended to meet the objective of providing safer and more coordinated care, as well as enhancing patient satisfaction. This project explores both health care professionals’ and patients and families’ experiences with patient- and family-centred care (PFCC) and interprofessional practice (IPP). Data were collected through individual interviews with 29 health care professionals and 17 patients and families on medicine and pediatrics at a tertiary care teaching hospital. Inductive coding and thematic analysis outcomes are presented using qualitative description. We used communicative action theory to interpret the gap that emerges in our findings between the ideals and practice of IPP and PFCC. Our findings reveal that strategic action takes place far more often than communicative action. The domination of communication by health care professionals, among other systemic factors in health care, contributes to the marginalized status of patients and families in the health care team instead of being at the centre, and them being informed instead of being truly engaged. The lived experiences of patients and families are overshadowed by the needs of the health care system. Patient and family engagement has the potential to support the implementation of PFCC and IPP in health care delivery. Communicative action theory could be used as a theoretical framework for further research and evaluation of patient and family engagement. Experience Framework This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens

Learning needs of family physicians, pediatricians and obstetricians to support breastfeeding and inform physician education

Background: Physicians require breastfeeding education appropriate to their roles. The aim of this survey was to determine physician learning needs and to inform development of breastfeeding education for physicians.Methods: A cross sectional survey was distributed to family physicians, pediatricians and obstetricians in a tertiary institution. Importance of knowledge to practice and confidence to manage was assessed for 18 learning topics proposed by a multi-specialty physician working group. Descriptive statistics, ANOVA and tests for equality of variances were calculated. Mean values of importance to practice and confidence to manage for each topic suggested learning priorities.Results: The study group included 75 physicians. The most important topics were “informed choice when supporting newborn feeding,” “analgesics, antidepressants and other medications while breastfeeding” and “community resources for breastfeeding support.”  Confidence to manage was lowest for “latch assessment,” “what mom can do during pregnancy to promote milk production,” and “risk factors for delayed lactogenesis.” Preferred learning formats were 15-minute online modules and grand rounds.Conclusions: Physicians acknowledged the importance of all topics but report lowest confidence to manage latch assessment, prenatal interventions to support lactogenesis and management of delayed lactogenesis.  Participants placed relatively low importance on learning about latch assessment despite the central nature of this skill in supporting early breastfeeding.Contexte : Les médecins ont besoin d’une formation sur l’allaitement adaptée à leur rôle. L’objectif de cette enquête était de contribuer à l’élaboration d’une telle formation en déterminant les besoins d’apprentissage des médecins dans ce domaine.Méthodes : Une enquête transversale a été réalisée auprès des médecins de famille, des pédiatres et des obstétriciens dans un établissement tertiaire. L’importance des connaissances pour la pratique et de la confiance envers la prise en charge a été évaluée pour 18 sujets d’apprentissage proposés par un groupe de travail de médecins de diverses spécialités. On a effectué des statistiques descriptives, une analyse de la variance et des tests de l’égalité des variances. Les valeurs moyennes de l’importance pour la pratique et de la confiance dans la prise en charge pour chaque sujet indiquent les priorités d’apprentissage.Résultats : Le groupe d’étude comprenait 75 médecins. Les sujets les plus importants étaient « le choix éclairé concernant l’alimentation du nouveau-né », « la prise d’analgésiques, d’antidépresseurs et d’autres médicaments pendant l’allaitement » et « les ressources communautaires de soutien à l’allaitement ». La confiance dans la prise en charge était la plus faible en ce qui concerne « l’évaluation de la prise du sein », « ce que la mère peut faire pendant la grossesse pour favoriser la production de lait » et « les facteurs de risque associés au retard de la lactogenèse ». Les formats d’apprentissage préférés étaient les modules en ligne de 15 minutes et les séances plénières.Conclusions : Les médecins reconnaissent l’importance de tous les sujets mais ils se disent moins confiants dans leur capacité d’évaluer la prise du sein, de faire les interventions prénatales pour favoriser la lactogenèse et de prendre en charge la lactogenèse retardée. Les participants ont accordé relativement peu d’importance à l’apprentissage de l’évaluation de la prise du sein, malgré l’importance de cette compétence pour soutenir le démarrage précoce de l’allaitement

Besoins d’apprentissage des médecins de famille, des pédiatres et des obstétriciens pour les outiller à soutenir l’allaitement et pour mieux orienter leur formation

Background: Physicians require breastfeeding education appropriate to their roles. The aim of this survey was to determine physician learning needs and to inform development of breastfeeding education for physicians. Methods: A cross sectional survey was distributed to family physicians, pediatricians and obstetricians in a tertiary institution. Importance of knowledge to practice and confidence to manage was assessed for 18 learning topics proposed by a multi-specialty physician working group. Descriptive statistics, ANOVA and tests for equality of variances were calculated. Mean values of importance to practice and confidence to manage for each topic suggested learning priorities. Results: The study group included 75 physicians. The most important topics were “informed choice when supporting newborn feeding,” “analgesics, antidepressants and other medications while breastfeeding” and “community resources for breastfeeding support.”  Confidence to manage was lowest for “latch assessment,” “what mom can do during pregnancy to promote milk production,” and “risk factors for delayed lactogenesis.” Preferred learning formats were 15-minute online modules and grand rounds. Conclusions: Physicians acknowledged the importance of all topics but report lowest confidence to manage latch assessment, prenatal interventions to support lactogenesis and management of delayed lactogenesis.  Participants placed relatively low importance on learning about latch assessment despite the central nature of this skill in supporting early breastfeeding.Contexte : Les médecins ont besoin d’une formation sur l’allaitement adaptée à leur rôle. L’objectif de cette enquête était de contribuer à l’élaboration d’une telle formation en déterminant les besoins d’apprentissage des médecins dans ce domaine. Méthodes : Une enquête transversale a été réalisée auprès des médecins de famille, des pédiatres et des obstétriciens dans un établissement tertiaire. L’importance des connaissances pour la pratique et de la confiance envers la prise en charge a été évaluée pour 18 sujets d’apprentissage proposés par un groupe de travail de médecins de diverses spécialités. On a effectué des statistiques descriptives, une analyse de la variance et des tests de l’égalité des variances. Les valeurs moyennes de l’importance pour la pratique et de la confiance dans la prise en charge pour chaque sujet indiquent les priorités d’apprentissage. Résultats : Le groupe d’étude comprenait 75 médecins. Les sujets les plus importants étaient « le choix éclairé concernant l’alimentation du nouveau-né », « la prise d’analgésiques, d’antidépresseurs et d’autres médicaments pendant l’allaitement » et « les ressources communautaires de soutien à l’allaitement ». La confiance dans la prise en charge était la plus faible en ce qui concerne « l’évaluation de la prise du sein », « ce que la mère peut faire pendant la grossesse pour favoriser la production de lait » et « les facteurs de risque associés au retard de la lactogenèse ». Les formats d’apprentissage préférés étaient les modules en ligne de 15 minutes et les séances plénières. Conclusions : Les médecins reconnaissent l’importance de tous les sujets mais ils se disent moins confiants dans leur capacité d’évaluer la prise du sein, de faire les interventions prénatales pour favoriser la lactogenèse et de prendre en charge la lactogenèse retardée. Les participants ont accordé relativement peu d’importance à l’apprentissage de l’évaluation de la prise du sein, malgré l’importance de cette compétence pour soutenir le démarrage précoce de l’allaitement

Paediatric Investigators Collaborative Network on Infections in Canada (PICNIC) study of aseptic meningitis

Abstract Background The seasonality, clinical and radiographic features and outcome of aseptic meningitis have been described for regional outbreaks but data from a wider geographic area is necessary to delineate the epidemiology of this condition. Methods A retrospective chart review was completed of children presenting with aseptic meningitis to eight Canadian pediatric hospitals over a two-year period. Results There were 233 cases of proven enteroviral (EV) meningitis, 495 cases of clinical aseptic meningitis and 74 cases of possible aseptic meningitis with most cases occurring July to October. Headache, vomiting, meningismus and photophobia were more common in children ≥ 5 years of age, while rash, diarrhea and cough were more common in children < 5 years of age. Pleocytosis was absent in 22.3% of children < 30 days of age with proven EV meningitis. Enterovirus was isolated in cerebrospinal fluid (CSF) from 154 of 389 patients (39.6%) who had viral culture performed, and a nucleic acid amplification test for enterovirus was positive in CSF from 81 of 149 patients (54.3%). Imaging of the head by computerized tomography or magnetic resonance imaging was completed in 96 cases (19.7%) and 24 had abnormal findings that were possibly related to meningitis while none had changes that were definitely related to meningitis. There was minimal morbidity and there were no deaths. Conclusion The clinical presentation of aseptic meningitis varies with the age of the child. Absence of CSF pleocytosis is common in infants < 30 days of age. Enterovirus is the predominant isolate, but no etiologic agent is identified in the majority of cases of aseptic meningitis in Canadian children

“We survived the pandemic together”: The impact of the COVID-19 pandemic on Canadian families living with chronic pain

ABSTRACTIntroduction Pediatric chronic pain is a significant problem in Canada, affecting one in five youth. This study describes the impact of the pandemic on the experiences of Canadian families living with chronic pain through interviews with youth living with chronic pain, parents, and siblings.Methods Employing a qualitative descriptive design, in-depth semistructured interviews were completed with Canadian youth living with pain, as well as parents and siblings. Participants were not required to be related. Interviews were analyzed using a reflexive thematic analysis approach.Results Forty-four interviews were completed with 14 parents, 19 youth with chronic pain, and 11 siblings from across the country. Three key themes were developed: (1) absorbing and shifting: the toll of the pandemic on the family system (e.g., loss of coping mechanisms, shifting roles to respond to the pandemic), (2) social ambiguity and abandonment (e.g., social sacrifice and abandonment by the health care system), and (3) building community resilience: familial adaptation to the pandemic (e.g., family cohesion, confidence, and self-management).Discussion/Conclusions Youth, parents, and siblings reported that the pandemic impacted coping strategies across the family system. These results outline the challenges youth experienced managing their pain and overall health throughout the pandemic and the resilience built within families during this time. Going forward, it would be relevant to examine how racialized and structurally marginalized youth with chronic pain and their families experienced the pandemic. Future research should examine how unexpected benefits of the pandemic (e.g., increased confidence and self-management) may be sustained into the future

Experiences of Pediatric Pain Professionals Providing Care during the COVID-19 Pandemic: A Qualitative Study

Chronic pain affects 1 in 5 youth, many of whom manage their pain using a biopsychosocial approach. The COVID-19 pandemic has impacted the way that healthcare is delivered. As part of a larger program of research, this study aimed to understand the impact of the pandemic on pediatric chronic pain care delivery including impact on patients’ outcomes, from the perspective of pediatric healthcare providers. A qualitative descriptive study design was used and 21 healthcare providers from various professional roles, clinical settings, and geographic locations across Canada were interviewed. Using a reflexive thematic analysis approach 3 themes were developed: (1) duality of pandemic impact on youth with chronic pain (i.e., how the pandemic influenced self-management while also exacerbating existing socioeconomic inequalities); (2) changes to the healthcare system and clinical practices (i.e., triaging and access to care); (3) shift to virtual care (i.e., role of institutions and hybrid models of care). These findings outline provider perspectives on the positive and negative impacts of the pandemic on youth with chronic pain and highlight the role of socioeconomic status and access to care in relation to chronic pain management during the pandemic in a high-income country with a publicly funded healthcare system