PubMed Health⌕ Search

Biomedical subjects

Dave Davis

Publications and source records attributed to Dave Davis.

14 recordsLinked to original sources
PubMed2006

Continuing education, guideline implementation, and the emerging transdisciplinary field of knowledge translation.

This article discusses continuing education and the implementation of clinical practice guidelines or best evidence, quality improvement, and patient safety. Continuing education focuses on the perspective of the adult learner and is guided by well-established educational principles. In contrast, guideline implementation and related concepts borrow from the fields of quality improvement and patient safety and from health services research. Relative to the question of improved clinical outcomes, both to some extent afford only partial understanding of a complex issue. Knowledge translation (KT) is a transformative concept that links the best elements of both broad fields and, in particular, adds educational elements to the work of health services researchers and others. Interdisciplinary in the extreme, KT is explored in some detail: its major elements (information, facilitation, context, the clinician-learner, among others) considered as variables in an equation leading to knowledge uptake and improved health care outcomes and an improved functioning health care system.

Education, Medical, Continuing↗
PubMed2006

Pay-for-performance = pay for quality?

While we agree with most of what the authors report in this brief paper, we note that the process is already under way in Canada, challenge a few of the paper's assumptions and provide a few suggestions for and cautions in undertaking next steps. At the same time, we highlight the significant potential pay-for-performance may have in being part of the solution to the great concerns over the sustainability of our much-loved healthcare system.

Canada↗
PubMed2005

Building bridges of understanding through continuing education and professional development of Arabs and Israelis.

In this article, we present an educational approach uniquely linked to humanitarian and peace-building goals in conflicted regions of the world. We examine the Canada International Scientific Exchange Program and its lead program, the Middle East Association for Managing Hearing Loss, as a case study. Under a Canadian umbrella, continuing medical education and continuous professional development are used to gather academics from regions in conflict for mutually beneficial professional activities. Larger scale international prospects for educational programming, extending beyond the health sector, are ways of addressing the primary determinants of health and creating social capital.

Altruism↗
PubMed2004

Severe acute respiratory syndrome and the delivery of continuing medical education: case study from Toronto.

INTRODUCTION: Severe acute respiratory syndrome (SARS) struck Toronto in the spring of 2003, causing many deaths, serious morbidity, forced quarantine of thousands of individuals, and the closure of all provincial hospitals for several weeks. Given the direction by public health authorities to cancel or postpone all continuing medical education (CME) courses, including those sponsored by the University of Toronto Faculty of Medicine, SARS has had a profound effect on the delivery of CME in Toronto and beyond. METHOD: Case study design using existing documents and self-report. RESULTS: The immediate, specific response of the University of Toronto CME program to SARS is described for the period from March 2003 to September 2003. DISCUSSION: During major outbreaks of infectious disease, continuing education providers should maintain regular contact with public health authorities and learners, enact a rational process for postponing or canceling courses, and implement a disaster plan flexible enough to ensure the deliver, of education using technological advances.

Education, Medical, Continuing↗
PubMed2003

Information needs in the management of osteoporosis in family practice: an illustration of the failure of the current guideline implementation process.

The objectives of this study were to determine information needs of family physicians around issues in the management of osteoporosis and preferences for dissemination of this information. A mailed survey was sent to a stratified random sample of 1000 family physicians in Ontario in May 2001. Female physicians and those practicing in rural communities were over-sampled from the College of Family Physicians' database. Among the 505 respondents, 364 were still practicing (182 males and 182 females) and completed the full questionnaire. There were no statistically significant differences in responses by sex or region of practice. Over 80% of family physicians wanted to be more informed about bone density testing and the pharmacological and non-pharmacological management of osteoporosis. The presence of risk factors was one of the most influential factors (72%) for ordering bone density testing. Information in peer-reviewed journals was thought to be the most credible, with 80% rating the CMAJ as very credible compared to 47% for the Osteoporosis Society of Canada (OSC). Sixty-two percent found the OSC guidelines (1996) to be useful even though much of that information is now out of date. Almost 70% had not read the more recently published treatment guidelines from the Ontario Program for Optimal Therapeutics (2000). Over 80% were interested in a decision aid, which incorporates information on risk factors, fracture risk and a treatment algorithm. The perceived need and the lack of availability of clinically useful information on osteoporosis for the family practice setting highlights the failure of the current guideline implementation process and provides insight into where the process has to be improved.

Adult↗
PubMed2003

The use of the opinion leader in continuing medical education.

This paper describes a process evaluation of an opinion leader (OL) project for a geriatric medical education program in dementia. Structured interviews with OLs were conducted to understand their experience as formal OLs from their initial training to the project's completion. Thirteen of 15 physicians involved in an OL project were interviewed. The adoption of a formal educational OL role was not an easy transition for most identified OLs. Some physicians struggled with the role and would have preferred more specific guidance. For this subject some content expertise was felt to be essential. Strong project leadership and some measures of success are important to sustain the OL commitment to a project. More attention needs to be devoted to the appropriate selection and training of OLs for educational projects to ensure that they have the relevant clinical expertise and skills to be effective and feel comfortable adopting a formal OL role.

Aged↗
PubMed2003

How are family physicians managing osteoporosis? Qualitative study of their experiences and educational needs.

OBJECTIVE: To explore family physicians' experiences and perceptions of osteoporosis and to identify their educational needs in this area. DESIGN: Qualitative study using focus groups. SETTING: Four Ontario sites: one each in Thunder Bay and Timmins, and two in Toronto, chosen to represent a range of practice sizes, populations, locations, and use of bone densitometry. PARTICIPANTS: Thirty-two FPs participated in four focus groups. Physicians were identified by investigators or local contacts to provide maximum variation sampling. METHOD: Focus groups using a semistructured interview guide were audiotaped and transcribed. The constant comparative method of data analysis was used to identify key words and concepts until saturation of themes was reached. MAIN FINDINGS: Family physicians order bone densitometry and try to manage osteoporosis appropriately, but lack a rationale for testing and are confused about management. Participants' main concern was clinical management, followed by disease prevention and their educational needs. CONCLUSION: Family physicians are confused about how to manage osteoporosis. To reduce the burden of illness due to osteoporosis, educational interventions should be tailored to family physicians' needs.

Adult↗
PubMed2002

Can we alter physician behavior by educational methods? Lessons learned from studies of the management and follow-up of hypertension.

INTRODUCTION: As expectations for effective continuing medical education (CME) grow, so, too, does the need to identify relationships among educational methods, physician performance, and patient outcomes associated with specific disease entities. Thus, we set out to review the literature on the effectiveness of physician educational interventions in the management and follow-up of hypertension. METHOD: We searched PubMed and the Research and Development Resource Base in Continuing Medical Education for randomized controlled trials of physician educational interventions. We included only those studies that (a) used replicable educational interventions with > 50% physician involvement and that employed objective methods to measure physician behavior change or patient outcomes, (b) indicated a physician or patient dropout rate of < 30%, and (c) followed outcome measurement for > 30 days. Studies were designated "positive" if one or more of the primary outcome measures demonstrated a statistically significant change in physician performance or health care outcome. RESULTS: We found 12 studies in which 7 different physician educational interventions were employed, alone or in combination, including reminders (computer or chart), formal CME, computerized decision support systems/risk stratification, printed educational materials, academic detailing, continuous quality improvement projects, and disease management aids in patient charts. Of the 12, 7 were positive and 4 were negative. One had mixed results. DISCUSSION: Although physician educational interventions, especially reminders, improved the follow-up of hypertension, they were ineffective in changing blood pressure levels. However, they may have some utility in improving compliance with guideline recommendations.

Decision Support Systems, Clinical↗
PubMedDate not supplied

The contingencies of organizational learning in long-term care: factors that affect innovation adoption.

We apply the theoretical frameworks of knowledge transfer and organizational learning, and findings from studies of clinical practice guideline (CPG) implementation in health care, to develop a contingency model of innovation adoption in long-term care (LTC) facilities. Our focus is on a particular type of innovation, CPGs designed to improve the quality of LTC. Our interest in this area is founded on the premise that the ability of LTC organizations to adopt and sustain the use of innovations like CPGs is contingent on the initial capacity these institutions have to learn about them, and on the presence of factors that contribute to capacity building at each stage of innovation adoption. Based on our review of relevant theory, we develop a set of fifteen testable propositions that relate factors operating at the guideline, individual, organizational, and environmental levels in LTC institutions to stages of guideline adoption/transfer. Our model offers insights into the complexities of adopting and sustaining innovations in LTC facilities particularly, in health care organizations specifically, and in service organizations generally.

Diffusion of Innovation↗