Abstract: Countless hours and dollars are frittered away during teleconferences. This situation is greatly magnified when spread across international boundaries. Some simple steps can reduce this waste. Careful attention should be paid to such issues as time zones, appropriate telephone etiquette and equipment, sensible meeting management, careful use of additional data files and restrained use of new technology in some areas. Based on our group's extensive experience, we have collected some useful tips and resources on how to reduce your costs and frustrations.
Abstract: BACKGROUND AND OBJECTIVES: Little is known about where family physicians learn procedural skills. In this study, we examine where Canadian family medicine graduates learned to do the procedures they perform. METHODS: In 2001, a cross-sectional postal survey was conducted of the 369 family medicine graduates from the University of Alberta and the University of Calgary between 1996 - 2000. From a list of 31 procedures, respondents identified procedures regularly performed over the past 2 years and indicated which procedures they had stopped performing. Respondents indicated whether the procedures performed were learned primarily during medical school and residency, through formal skills training following residency, or in the practice setting. RESULTS: The 282 (76.4% response rate) respondents reported performing a mean of 10.5 (SD=5.3) procedures. The vast majority reported learning procedural skills in medical school or during family medicine residency training (91.1%), followed by the clinical practice setting (12.6%), then formal skills training (6.4%). Those in rural practice learned a relatively greater proportion of procedural skills through formal skills training. CONCLUSIONS: For Canadian family physicians, procedural skill acquisition occurs across the learning continuum. Medical schools and residency training programs play a role in facilitating the learning of procedural skills and supporting self-directed learning.
Abstract: BACKGROUND AND OBJECTIVES: In our previous projects, students and residents have readily adopted personal digital assistants (PDAs), but faculty have generally been reluctant. The objective of the project reported here was to maximize adoption of PDAs by our faculty, using a combination of strategies. METHODS: Through cost-shared funding, we provided full-time and community teachers with PocketPCs or Handspring Visors, along with preinstalled medical software. Use patterns and satisfaction were assessed by structured questionnaire and focus group discussions. RESULTS: For the calendar, address book, and pharmacopoeia, we found that 83% of faculty use these two to three times per day. Cost sharing and software preinstallation were popular. Device synchronization and e-mail showed potential but caused problems. Easy access to technical support from peers and a variety of information-sharing structures eased maintenance issues. Point-of-care data access was important to faculty. CONCLUSIONS: With the right support structures, faculty adopt PDAs in clinical and teaching settings.
Abstract: To address the increasing need for rural health practitioners, Canada is trying various methods of medical education, including community based residency streams, additional skills training and teamwork models. This paper discusses some of the factors that may affect the effectiveness of these methods.
Abstract: OBJECTIVE: To create an electronic procedural logbook with enhanced user interactivity and usefulness as an educational resource. DESCRIPTION: From our own work on electronic student logbooks and other studies, it is clear that compliance with complete and valid data entry remains a challenge. Without direct and visible benefit, students are reluctant to spend time logging all their cases. We developed an interactive procedural logbook using Microsoft Embedded Visual Basic and Metrowerks CodeWarrior. Interface design focused on rapid data entry with minimum requirement for text, and field-level automation where possible. We loaded it onto a mixed platform of personal digital assistants (PDAs)--Compaq iPaq Pocket PCs and HandEra 330 PalmOS devices. Our rural residents were supplied with the devices of their choice. Various built-in educational reference resources included: (1) contextual help options about each procedure, which contained diagrams and pictures; (2) diagnostic and fee coding so they could see how poorly some procedures pay; and (3) Quick Tips relevant to each procedure, which can be easily modified by the preceptor. Preceptor evaluations and comments can be entered rapidly. Using built-in database conduits, data are automatically collected from each device on every HotSync with the desktop. Data can then be collated and analyzed using Microsoft Access or via secure Web access. DISCUSSION: Improved compliance has been dramatic-one resident logged 250 procedures in just two months. However, not all residents have been successful in establishing seamless synchronization, and the resulting data loss has caused frustration. The evidence indicates the need to implement central data collection and backup right from the outset. Central data collection provides many advantages. The program director has better information for future applications. Preceptor evaluations are now spread over many interactions and yet can be collated and analyzed. Quick Tips have been very popular-we have been able to collect the tips and redistribute them. Focus-group feedback from the residents has shown that the rich data in the logbook's reference component improved its usefulness and popularity as an educational tool. Choice of device type is important for user acceptance because devotees of one platform are reluctant to switch to another. Cross-platform development does slow the process but is increasingly easy with the latest software design tools, such as AppForge. These new tools have enabled us to explore further improvements in data entry. Digital ink provides the ability to capture annotated diagrams and preceptor signatures. Voice input is built in with these devices, and our software now allows for voice annotation for more detailed commentary by preceptors or student. The compressed digital sound file is collected along with the data and transcribed centrally (on-device voice recognition is not feasible yet). Point-of-care accessibility has been the key attraction of using these devices for logging encounter data. This project demonstrates that it is important to explore all multimodal interactive capabilities to provide a truly rich educational tool.
