Self-documentary in the emergency department: Perspectives on patients recording their own procedures.

OBJECTIVES: Patients often bring their smartphones to the emergency department (ED) and want to record their procedures. There was no clear ED recording policy in the Saskatoon Health Region nor is there in the new Saskatchewan Health Authority. With limited literature on the subject, clinicians currently make the decision to allow/deny the request to record independently. The purpose of this study was to examine and compare patient and clinician perspectives concerning patients recording, in general, and recording their own procedures in the ED. METHODS: Surveys were developed for patients and clinicians with respect to history and opinions about recording/being recorded. ED physicians and nurses, and patients>17 years old who entered the ED with a laceration requiring stitches were recruited to participate; 110 patients and 156 staff responded. RESULTS: There was a significant difference between the proportion of patients (61.7% [66/107]) and clinicians (28.1% [41/146]) who believed that patients should be allowed to video record their procedure. There was also a significant difference between clinicians and patients with regard to audio recording, but not "selfies" (pictures). However, with no current policy, 47.8% (66/138) of clinicians said that they would allow videos if asked, with caveats about staff and patient privacy, prior consent, and procedure/patient care. CONCLUSION: Contrary to patients' views, clinicians were not in favour of allowing audio or video recordings in the ED. Concerns around consent, staff and patient privacy, and legal issues warrant the development of a detailed policy if the decision is made in favour of recording.

Rural family medicine training site: Proposed framework.

OBJECTIVE: To develop a framework for a successful rural family medicine training program and to assess the potential for a rural family medicine residency training program using the Weyburn and Estevan areas of Saskatchewan as test sites. DESIGN: A mixed-method design was used; however, the focus of this article was on the qualitative data collected. Questions formulated for the semistructured interviews evolved from the literature. SETTING: Rural Saskatchewan. PARTICIPANTS: Community physicians and representatives from the Sun Country Regional Health Authority, the Saskatchewan Ministry of Health, and the University of Saskatchewan. METHODS: The data were documented during the interviews using a laptop computer, and the responses were reviewed with participants at the end of their interviews to ensure accuracy. The qualitative data collected were analyzed using inductive thematic analysis. MAIN FINDINGS: Through the analysis of the data several themes emerged related to implementing a rural family medicine residency training program. Key predictors of success were physical resources, physician champions, physician teachers, educational support, administrative support, and other specialist support. Barriers to the development of a rural family medicine training site were differing priorities, lack of human resources, and lack of physical resources. CONCLUSION: A project of this magnitude requires many people at different levels collaborating to be successful.

Participatory health research: celebrating smoke-free homes.

For community engagement to be successful, the interests of the community must be taken into account and researchers must become facilitators. Patience is required. Meaningful and sustainable relationships that have been developed over time promote mutual learning and capacity building among the partners (Elders, community members, health care providers, and researchers). In addition, community engagement leads to the sharing of available resources (eg, human, time, and financial) and to a sustained commitment by the partners. This mutual commitment makes future projects easier to develop and complete. Thus, authentic transformative health development, informed by participatory health research, becomes an ongoing process.

Implementing an evidence-informed faculty development program.

OBJECTIVE: To establish an evidence-informed faculty development program. DESIGN: Survey derived from a needs-assessment tool. SETTING: Department of Academic Family Medicine at the University of Saskatchewan, which is geographically dispersed across the province. PARTICIPANTS: Full-time faculty members in the Department of Academic Family Medicine at the University of Saskatchewan. MAIN OUTCOME MEASURES: Creation of an evidence-informed faculty development program. RESULTS: The response rate was 77.3% (17 of 22). The data were stratified by 2 groups: faculty members with less than 5 years of experience and those with 5 or more years of experience. Those with less than 5 years of experience rated the following as their top priorities: teaching, developing scholarly activities, and career development. Those with 5 or more years of experience rated the following as their top priorities: administration and leadership, teaching, and information technology. Although there were differences in overall priorities, the 2 groups identified 17 out of 54 skills as important to faculty development. CONCLUSION: The results of the needs-assessment tool were used to shape a dynamic, evidence-informed faculty development program with full-time faculty in the Department of Academic Family Medicine at the University of Saskatchewan. Future programs will continue to be dynamic, faculty-centred, and evidence-informed.

The pursuit of excellence: engaging the community in participatory health research.

Community-based participatory research approaches are designed to improve health and well-being in communities and to minimize health disparities in general. It is this partnership approach to research that equitably involves community members, organizational representatives and researchers in all aspects of the research process and in which all partners contribute expertise, decision-making and ownership. Further to this, community-based participatory research is utilized to study and address community-identified issues through a collaborative and empowering action-oriented process that builds on the strengths of the community. The results of this research endeavour highlight the need for integrating community-based participatory research, primary health care and social accountability in the pursuit of excellence. The process and the results/findings provide ways that the community are able to enhance their health and wellness, increase capacity and be empowered to direct their education, research and service activities towards addressing and meeting the health priorities of the community.

Collaboration between family physicians and community pharmacists to enhance adherence to chronic medications: opinions of Saskatchewan family physicians.

OBJECTIVE: To ascertain the opinions of family physicians about medication adherence in patients with chronic diseases and the role of community pharmacists in improving adherence to chronic medications, as well as their opinions on increased collaboration with pharmacists to enhance medication adherence. DESIGN: A self-administered postal survey of 19 questions, with opinions collected by ordinal (5-point Likert scale) and open responses. SETTING: Saskatchewan. PARTICIPANTS: Two hundred and eighty-six family physicians working in Saskatchewan in January 2008. MAIN OUTCOME MEASURES: Descriptive statistics of physicians' opinions on the following: medication adherence in patients with chronic diseases; their current interaction with community pharmacists; and potential collaborative strategies to promote medication adherence. RESULTS: The response rate was 39.4%. Approximately 75% of the physicians acknowledged that nonadherence to chronic medications was a problem among their patients. Medication costs and side effects were identified as the 2 most common reasons for medication nonadherence. Only one-quarter of physicians communicated regularly with community pharmacists about adherence issues; most of these physicians were rural physicians. Most physicians agreed that increased collaboration with pharmacists would improve adherence, although support for potential interactions with pharmacists varied. Concerns were expressed about time required by physicians and financial reimbursement. Physicians in practice for less than 10 years and those practising in rural areas were more willing to share clinical information and communicate with pharmacists to promote medication adherence. CONCLUSION: Saskatchewan family physicians appreciate the importance of medication nonadherence but currently seldom interact with community pharmacists on this issue. They believe that pharmacists have a role in supporting patients with medication adherence and indicate a willingness to work more collaboratively with them to promote adherence. For this type of collaboration to be effective, it appears that increased adherence-related communication between the 2 health care providers and additional health care funding are required.