 |
|
> Family Practice Home > Department > Department News & Events > Newsletters > Family Matters Spring 2011
|
History
MERG reading list
Spring 2011 issue | |
| | |
 | Department welcomes new Postgraduate Program Director, The Department of Family Practice is pleased to announce the appointment of Dr. Willa Henry, Clinical Associate Professor, to the position of Program Director, Postgraduate Program, Deparment of Family Practice from April 1, 2011 to March 31, 2014. >> more |
 | Message from the Chair, Dr. Martin Dawes If change is a marker for success then Family Practice in BC is very successful. It seems that barely a week goes by without some change to the way we diagnose, treat, bill, manage, or teach. Despite the number of changes and the demands made on family practice, the enthusiasm for practice was very evident in my visits around the province. >> more |
| | |
DEPARTMENT NEWS | |
| | Federal government provides funding to train IMG graduatesThe Government of Canada is providing approximately $5.9 million in funding to BC over five years through the Pan-Canadian Health Human Resources Strategy >> more |
 | Department hosts farewell celebration for Dr. Jill Kernahan, Postgraduate Program DirectorMembers of the Department, past and present, gathered together on Friday, January 7th to voice their appreciation for Dr. Jill Kernahan, Director, Family Practice Postgraduate Program. >> moreView a slideshow of the event |
| | DFP Faculty Research Day - save the date: Thursday, June 16, 2011Join the Department in celebrating the research of clinical and academic faculty, Clinician Scholars, community-based researchers, and midwives. >> more |
EDUCATION NEWS | |
Dr. Jatinder (Taj) Baidwan appointed Director, International Medical Graduates residency site, Postgraduate Residency ProgramThe Postgraduate program of the Department of Family Practice (DFP) is pleased to announce the appointment of Dr. Jatinder (Taj) Baidwan as Director, International Medical Graduates residency training site. >> more | |
 | Nanaimo Postgrad training site pilots simulation training labNew facility contains a range of advanced equipment that can provide detailed, multi-faceted and multimedia feedback to participants performing acute care procedures. >> more |
Southern Medical Program to receive first cohort of undergraduates in January, 2012Thirty two new students will begin their medical studies at Vancouver’s Point Grey campus in September 2011, and then migrate to their new home in Kelowna after the first semester of study is completed. >> more | |
| | SPECIAL INTEREST FOCUS GROUPS (SIFPS) AND UNIT UPDATES |
 | Teaching - and learning - about palliative care in Kerala, IndiaDr. Patricia Boston, Director, Palliative Care SIFP, observed that there are a growing number of physicians and nurses in India who have a strong sense that the chronically ill and the dying deserve a good quality of life and/or care. >> more |
| | |
 | Collaborating Centre for Prison Health Education publishes proceedings from June, 2010 workshop The proceedings from a workshop – “Building Prison Health Connections with Public Health and Communities to Address Gaps and Inequities” – hosted in June, 2010 were recently published and will soon be available from the CCPHE in both print and electronic formats. >> more |
| | |
UBC Palliative Care features Dr. Frank D. Ferris from San Diego Hospice for 2011 International Distinguished Speaker SeriesDr. Ferris is particularly interested in strategies for integrating palliative care into existing healthcare systems worldwide. He has published and spoken widely on multiple palliative care subjects and effective approaches to education and program implementation. >> more | |
| | FACULTY NEWS |
| | Dr. Janusz Kaczorowski co-develops local blood pressure program |
 | Drs. Patricia Boston, Trevor Corneil honoured at Faculty of Medicine's 2011 Academic Gowns CeremonyThe Faculty of Medicine hosted its annual Academic Gowns ceremony on April 12, 2011 to recognize individuals receiving promotions to the academic rank of Clinical Professor or Professor. >> more |
 | Dr. Garry Grams retires from Department of Family PracticeDr. Garry Grams, Assistant Professor, recently retired from his teaching and clinical duties at the Department of Family Practice after a career spanning 28 years. >> more |
| | |
| | RECENT AWARD WINNERS |
 | Dr. Michael Klein receives CFPC award for Lifetime Achievement in Family Medicine ResearchThe College of Family Physicians of Canada conferred its 2010 Lifetime Achievement in Family Medicine Research award on Dr. Michael Klein, Professor Emeritus and Director, Clinician Scholar Program. >> more |
| | |
| | Dr. Janusz Kaczorowski's paper selected for distinguished presentation honour at 2010 NAPCRAG annual meeting |
EDUCATION NEWS
Nanaimo Postgrad training site pilots simulation training lab
The simulation mannequin at the
Nanaimo Residency training site.
Dr. Steve Beerman, Director of the Department’s Nanaimo Postgraduate Family Medicine Residency site, is excited about the learning and research potential of the site’s new simulation lab. “I bagged the mannequin myself, and it’s exquisitely sensitive,” he replies when asked whether or not the simulator ‘felt like a real patient.’ “The lung pressure can be changed to mimics a patient with COPD, and the operator in the control room can alter the blood pressure to read from 0 to 250. The BP cuff actually reads off the mannequin’s arm.”
The mannequin Beerman is referring to is part of a simulation laboratory pilot project organized by the Vancouver Island Health Authority (VIHA). Nanaimo Regional General Hospital (NRGH) is home to the new facility. It contains a range of advanced equip-
ment that can provide detailed, multi-faceted and multimedia feedback to participants performing acute care procedures in the laboratory. It is a new and very powerful educational tool for Nanaimo residents – one that Beerman hopes will not only improve residency training but will shine a light on how physicians and other health care providers deal with occupational stress and perhaps improve interaction and communication between critical care team members.
Simulation training
The Nanaimo site is familiar with simulation exercises. Site faculty at NRGH have been running low-tech simulation exercises once a month for several years now. These ‘practice runs’ provide Nanaimo residents the opportunity to perform select acute care procedures
without the risk or stress of having to learn in-situ during a live critical incident. Dr. Andrew
McLaren, a member of NRGH’s ICU group, has been spearheading simulation training at NRGH and, together with Beerman, worked to bring the high tech lab to the site
“NRGH is ideal for the simulation lab,” says Beerman, “There is a focus on academic space here and we are interested in engaging all of our care staff to participate in the simulation training. We want the simulation laboratory facilities to be a centre for learning for everyone in the hospital – paramedics, nurses, residents, physicians.”
The new lab has an amazing capacity for learning and analysis and can create scenarios for many medical conditions and situations. The high tech mannequin is only one part of the facility – the lab also contains a control room, video conferencing centre, reading room, lounge, showers and beds. It is designed specifically to house groups of learners, for extended periods of time if need be.
The lab is set up to provide sophisticated feedback and interaction for learners. The mannequin is synched up to two laptop computers. One laptop operates the doll and sets it up for possible scenarios such as a cardiac infarction in an elderly patient with hypertension. The second computer collects data from the mannequin and from the participants during the simulation, logging such information as apparatus positioning for intubation, chest line and femoral line exercises, or compression depth, pressure and rate for CPR exercises. The data is streamed to a control room where a competency examiner can monitor the exercise, providing instructive feedback and/or cautionary advice to the practitioner. There is even a microphone function that allows an examiner to provide dialogue so that the mannequin can provide verbal feedback to the caregiver, allowing the participant to respond to ‘patient’ comments. Once the simulation ends, participant and examiner can review the scenario step-by-step through a combination of video playback (which includes slow- motion, freeze-frame and frame-by-frame review capability) and visual feedback from the computer’s data collection during the exercise.
Use of the simulator in research
Resident response to the simulation lab has been positive to date. Currently, all sessions on the new simulator are voluntary. Beerman plans to introduce mandatory sessions on the new simulator in the future, for all residents. He is also hoping to develop a residency curriculum that integrates the simulation lab. “The simulator is not a replacement for preceptor-led and patient-centered learning,” Beerman emphasizes, “it’s more of a tool that could help residents gain confidence in their knowledge and performance of certain procedures.”
Beerman noted that this simulator could benefit preceptors and other allied health professionals as well. “The simulation lab has the potential to allow preceptors and learners to more fully understand how residents and other caregivers manage their stress during a critical incident and perhaps afterwards as well. There isn’t much that is known about the effect of stress on medical caregivers and how it might impact the individual, the care team and the health system as a whole. The simulator could hopefully provide us with insights that could lead to a better understanding of how we can address those needs in the future.” Beerman can also see future applications of the simulator including the development of approaches to help health professionals learn how to deal with adverse care outcomes, and communication in challenging situations. “We currently have actors to help us train residents in the scenarios where they will have to deliver bad news to patients and/or their families,” Beerman noted, “but this simulation lab will allow us to more clearly focus on how we can best manage a wider range of difficult situations involving critical incidents. We could learn how we can best take care of our residents and our staff after a challenging incident.”
Province-wide training in the future?
The information gathered from this pilot project will be relayed to UBC’s Faculty of Medicine, who is considering the possibility of using mannequin-based simulators at different training sites across the province. “The mannequin can be adapted for travel – we’ve used it to run simulations with paramedics during our testing phase, so it could be a highly useful for training personnel in outlying areas who need to keep their critical care skills sharp,” says Beerman. When the current NRGH pilot project concludes, Beerman believes that simulators could easily become an essential element of future residency training. “It is cost-effective to operate and it provides some definite benefits, for all health professionals who want to engage with it, not just residents.”
Southern Medical Program to receive first cohort of undergraduates in January, 2012
 | |
| Artist's rendering of the Health Sciences building at UBC Okanagan, which will host the Southern Medicine Program. |
The Southern Medical Program (SMP) at UBC Okanagan will be receiving its first cohort of undergraduate medical students in January, 2012. Thirty two new students will begin their medical studies at Vancouver’s Point Grey campus in September 2011, and then migrate to their new home in Kelowna after the first semester of study is completed.
Excitement for the new program is high. SMP Course Director Dr. Gayle Klammer reported that during the Prototypical Week test of the readiness of the SMP, there was positive anecdotal feedback about the strong involvement from the [Okanagan] medical community, and that the recruitment potential for the SMP will support an MD program at UBC Okanagan.
“The Southern Medical Program [will] provide learning opportunities throughout the Southern Interior. In the first two years, virtually all studies are in Kelowna; in years 3 and 4, students may select rotations in Kamloops, Kelowna, Vernon, Penticton or Trail, “ says Klammer. ”[SMP students] will attend the same lectures as all otherUBC Faculty of Medicine students, via state-of-the-art video conferencing and interactive technologies.” Additionally, students will benefit from the smaller class sizes and greater one-on-one teaching by preceptors.
The Faculty of Medicine’s Evaluation Studies Unit is currently conducting a formal evaluation of the SMP. The team at UBC Okanagan anticipates that the report will show strong confidence in the SMP. “Time will tell, but I am confident that the Southern Medical Program will be highly sought after,” says Klammer.
SPECIAL INTEREST FOCUS GROUPS (SIFPs) AND UNIT UPDATES
Teaching – and learning – about palliative care in Kerala, India
Dr. Patricia Boston returned
to Kerala, India to teach
at the Trivandrum Institute
of Palliative Sciences
In February, 2010, Dr. Patricia Boston, Director of the Palliative Care Special Interest Focused Program and Clinical Professor, had a unique opportunity to ride along with a mobile palliative care team in Kerala, India. (Her observations were reported in the Fall 2010 issue of Family Matters.) This past November, Dr. Boston returned to Kerala as a visiting professor at the Trivandrum Institute of Palliative Sciences (TIPS). She was invited to teach doctors and nurses enrolled in a six-week Certificate in Pain and Palliative Care intensive about common communication issues that arise when providing palliative care to patients.
“I sometimes wonder how much I can really do [at an institute like TIPS] or what I can contribute,” Dr. Boston mused, “I find that I often learn more than I contribute.”
Although palliative care is a relatively new area of medicine in India, some Indian health care providers are quite advanced in their service provision. In addition to the mobile palliative care units which enable practitioners to provide treatment to some rural and remote patients, providers in Kerala are using their skills and knowledge to ease the pain of patients who may be chronically ill, parapalegic or suffering from terminal conditions other than cancer, such as congestive heart failure, degenerative diabetes or even untreated snakebite. Dr. Boston observed that there are a growing number of physicians and nurses in India who have a strong sense that the chronically ill and the dying deserve a good quality of life and/or care. “These patients have complex physical, mental, spiritual and/or existential, and emotional issues. Good palliative care can go a long way to alleviating multiple types of pain and suffering for many of these patients.”
Even though there are many challenges to the provision of palliative care in India (such as securing a stable supply of opioid pain management medications, accessing rural patients, and delivering treatment to patients who cannot afford health care services), interest in palliative care in India is strong. TIPS offers its Certificate course several times a year, and each intake – consisting of 10-12 care providers for the most part – is fully subscribed. The six-week course offers health care providers a theoretical grounding in palliative care combined with hands-on experience through home-care outreach at the patient’s bedside in both urban and rural areas of Kerala. Participants are taught not only how to administer to a patient’s physical needs, but to their mental and emotional needs as well. They learn how to recognize anxiety and depression in both the patient as well as live-in family members (who are often caregivers) and they are taught how to have difficult conversations with patients, families and other health care providers. “In many cases, these learners are not just acquiring skills and knowledge for themselves,” notes Dr. Boston. “Because they are often highly positioned as heads of departments in hospitals, they will be taking this knowledge back to their teams and training their people in these skills. Participants in this course are sowing seeds of knowledge and are establishing palliative care practices in their home communities.”
Although Dr. Boston has practiced palliative medicine for several years now, she notes that palliative care – in Western countries, at least – are only now beginning to “come of age” as care providers focus on more than “curing at all costs.” There is a growing awareness that palliative care could also benefit patients with chronic pain, not just those for whom further medical intervention is not possible. Her experiences in India have shown that palliative care has many applications and that good palliative care can go a long way to alleviate patient suffering. When asked to compare Western versus Keralan approaches to palliative medicine, Dr. Boston observed that Westerners still suffer greatly and do not always have access to adequate end-of-life-care. She would like to see Canadian providers develop more resources to allow people to die peaceful deaths, surrounded by their loved ones. “Although India’s population suffers so extremely from many health conditions, they are remarkably resilient and they have a strong, very beautiful way of handling the end of life. We could all definitely learn from India even as they are learning from us.”
Collaborating Centre for Prison Health Education publishes proceedings from June, 2010 workshop
 | |
| 2010 workshop proceedings published by the Collaborating Centre for Prison Health Education |
On June 8, 2010, the Collaborating Centre for Prison Health and Education held a workshop – “Building Prison Health Connections with Public Health and Communities to Address Gaps and Inequities” – in Vancouver, BC. The workshop – which involved 61 participants from 24 organizations – fostered networking and dialogue between stakeholders with an interest and/or role in understanding and improving health for incarcerated persons and those seeking to (re)integrate into the community.
The proceedings from the workshop were recently published and will soon be available from the CCPHE in both print and electronic formates. During the workshop, participants were asked to brainstorm what “one or two things [they] can do within their organizations to improve collaboration for health, inside and outside the gates?” Suggestions from the participants are collected in the proceedings and include such ideas as collaborating with incarcerated persons shortly before release, as well as collaborating between organizations to create community resources, improve public education and adocacy.
The CCPHE hopes that in the long term, the connections created during the workshop will continue to develop into collegial and working relationships across sectors and organizations.
To download a copy of the workshop proceedings, visit the CCPHE web site.