Evaluation of a tool to improve the quality of preceptor written feedback for family medicine residents: training and use of a CanMEDS-MF competency-based criterion guide.

Background: Written feedback is essential in resident teaching, but preceptors are not always well equipped to provide relevant feedback. The purpose of this study was to evaluate the effectiveness of multi-episodic training and the use of a criterion-referenced guide for written feedback for family medicine preceptors in a French-language academic hospital. Method: Twenty-three (23) preceptors participated in the training and used the criterion-referenced guide to guide them during the written evaluation in an evaluation sheet named "Field Notes." The content of these Field Notes was analyzed according to completion, the rate of specific feedback, and the rate of feedback by CanMEDS-MF role before and after the training over a three-month period. Results: Based on the analysis of the Field Notes (n = 70 pre-test; n = 138 post-test), an increase in the percentage of completion (50% vs. 92%, z = 2.97, p = 0.0030) and specific feedback (59% vs. 92%, z = 2.47, p=0.0137) was noted. There was no significant increase in feedback by CanMEDS-MF role. Conclusions: The development of multi-episodic training and a criterion-referenced guide, created according to the CanMEDS-MF repository, suggests an improvement in comprehensive and specific written feedback in family medicine education.

Contexte: La rétroaction écrite est primordiale dans l'enseignement aux résidents, mais les précepteurs ne sont pas toujours outillés pour offrir une rétroaction pertinente. Cette étude visait à évaluer l'efficacité de formations multiépisodiques et l'utilisation d'un guide critérié pour les rétroactions écrites des précepteurs en médecine familiale d'un centre hospitalier académique francophone. Méthode: Vingt-trois (23) précepteurs ont participé aux formations et ont utilisé le guide critérié pour les guider lors de l'évaluation écrite dans une fiche évaluative nommée «feuille de route¼. Le contenu de ces feuilles de route a été analysé selon la complétion, le taux de rétroactions spécifiques et le taux de rétroactions par rôle CanMEDS-MF avant et après les formations sur une période de trois mois. Résultats: Selon l'analyse des feuilles de route (n=70 prétest ; n=138 posttest), une augmentation du pourcentage de complétion (40% vs 92%, z=3.51, p=0.0005) et de rétroactions spécifiques (59% vs 92%, z=2.47, p=0.0137) fut notée. Il n'y avait aucune augmentation significative quant aux rétroactions par rôle CanMEDS-MF. Conclusions: L'élaboration de formations multiépisodiques et d'un guide critérié, créés selon le référentiel CanMEDS-MF, suggère une amélioration de rétroactions écrites complètes et spécifiques en éducation de la médecine familiale.

Effects of exercise intensity on food intake and appetite in women.

BACKGROUND: Increasing exercise intensity has been shown to reduce energy intake in men. OBJECTIVE: The main objective of this study was to investigate the effects of exercise intensity on energy intake in women. DESIGN: Thirteen moderately active (peak oxygen uptake: 44.0 +/- 4.7 mL . kg(-1) . min(-1)) women [body mass index (in kg/m(2)): 22.2 +/- 2.4; age: 22.2 +/- 2.0 y] were subjected to 3 experimental conditions: control with no exercise and 2 equicaloric (350 kcal) low- (LIE) and high- (HIE) intensity exercise sessions at 40% and 70% of peak oxygen uptake, respectively. After each session, the participants ate ad libitum from buffet-type meals at lunch and dinner and ate snacks during the afternoon and evening. Visual analogue scales were used to rate appetite. RESULTS: More energy was ingested at lunchtime after the HIE session than after the control session (878 +/- 309 and 751 +/- 230 kcal, respectively; P = 0.02). Relative energy intake (postexercise energy intake corrected for the energy cost of exercise above the resting level) at lunch was lower after the LIE session than after the control session (530 +/- 233 and 751 +/- 230 kcal, respectively; P < 0.001) and was lower after the HIE session than after the control session (565 +/- 301 and 751 +/- 230 kcal, respectively; P < 0.01). Similarly, daily energy intake tended to increase during the HIE session relative to that during the control session. No treatment effect was found for appetite scores throughout the experiment. CONCLUSION: The results suggest that HIE increases energy intake in women.

Fasting and postprandial total ghrelin remain unchanged after short-term energy restriction.

Adaptations that promote positive energy balance appear in response to dietary restriction. The aim of this study was to determine whether fasting and postprandial total ghrelin increase in response to short-term energy restriction. Fifteen adult male subjects were subjected to a 4-d energy restricted diet (-800 kcal/d). Body weight and composition, resting energy expenditure, respiratory quotient, fasting and postprandial appetite scores, and fasting and postprandial serum leptin and total ghrelin were determined before and after dietary intervention. Despite the fact that fat mass remained unchanged after the 4 d, fasting (-36%; P

Unchanged fasting and postprandial adiponectin levels following a 4-day caloric restriction in young healthy men.

OBJECTIVE: Adiponectin is an adipocyte-secreted protein that has been shown to promote fat oxidation and insulin sensitivity in animals. Whether acute energy restriction is associated with modulation of adiponectin in humans remains largely unknown. The purpose of this study was to examine the effects of a short-term caloric restriction on fasting and postprandial adiponectin levels in young healthy men. RESEARCH DESIGN AND METHODS: Fifteen young healthy men were subjected to a 4-day energy restricted diet (-800 kcal/day). Before and after the intervention, anthropometric measurements, fasting and postprandial glucose, insulin and adiponectin were measured at 0, 30 and 60 min after a fixed breakfast. RESULTS: While fat mass remained stable, minor but significant changes in weight were observed after the 4-day energy-restricted diet. Glucose and insulin levels increased postprandially, and patterns did not differ before and after the intervention. Fasting levels of adiponectin remained unchanged after the energy restriction, and postprandial levels were not significantly different from fasting levels either before, or after, the intervention. CONCLUSIONS: Fasting and postprandial adiponectin levels are not acutely modulated by a short-term energy restriction in young healthy men.