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What Do Clinical Supervisors Require to Teach Residents in Family Medicine How to Care for Seniors?

Published online by Cambridge University Press:  09 January 2018

Anik M. C. Giguere
Affiliation:
Laval University
Paule Lebel
Affiliation:
University of Montreal
Michèle Morin
Affiliation:
Laval University Quebec Excellence Centre on Aging
Françoise Proust
Affiliation:
Research Centre of the CHU de Quebec
Charo Rodríguez
Affiliation:
McGill University
Valerie Carnovale
Affiliation:
Laval University
Louise Champagne
Affiliation:
Sherbrooke University
France Légaré
Affiliation:
Laval University Laval University Research Centre in Primary Care and Services Research Centre of the CHU de Quebec
Pierre-Hugues Carmichael
Affiliation:
Quebec Excellence Centre on Aging
Bernard Martineau
Affiliation:
Sherbrooke University
Philippe Karazivan
Affiliation:
University of Montreal
Pierre J. Durand
Affiliation:
Laval University
Corresponding

Abstract

We assessed clinicians’ continuing professional development (CPD) needs at family practice teaching clinics in the province of Quebec. Our mixed methodology design comprised an environmental scan of training programs at four family medicine departments, an expert panel to determine priority clinical situations for senior care, a supervisors survey to assess their perceived CPD needs, and interviews to help understand the rationale behind their needs. From the environmental scan, the expert panel selected 13 priority situations. Key needs expressed by the 352 survey respondents (36% response rate) included behavioral and psychological symptoms of dementia, polypharmacy, depression, and cognitive disorders. Supervisors explained that these situations were sometimes complex to diagnose and manage because of psychosocial aspects, challenges of communicating with patients and families, and coordination of interprofessional teams. Supervisors also reported more CPD needs in long-term and home care, given the presence of caregivers and complexity of senior care in these settings.

Résumé

Nous avons évalué les besoins de formation des cliniciens qui supervisent les résidents dans les cliniques d’enseignement de médecine familiale au Québec. Nous avons utilisé une méthodologie mixte comprenant: un balayage environnemental des programmes de formation des Départements de médecine familiale, un consensus d’experts pour sélectionner des situations cliniques prioritaires pour les soins aux aînés, un questionnaire pour connaître la perception des superviseurs de leurs besoins de formation, et des entrevues pour comprendre les raisons des besoins. Partant du balayage, les experts ont identifié 13 situations cliniques prioritaires. Les 352 participants au sondage (taux de réponse : 36 %) ont rapporté des besoins plus importants pour gérer les symptômes comportementaux et psychologiques de la démence, la polymédication, la dépression, et les troubles cognitifs. Les entrevues ont révélé que ces situations cliniques étaient parfois complexes à diagnostiquer et à gérer en raison de leurs aspects psychosociaux, de la communication avec les patients et les familles, et de la coordination des équipes interprofessionnelles. Les superviseurs ont également rapporté des besoins plus important en milieu soins de longue durée et à domicile par rapport aux soins ambulatoires, dû à la complexité des soins aux aînés dans ces milieux et à la présence de proches aidants.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2018 

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Footnotes

*

This project was funded by the Ministère de la Santé et des Services Sociaux du Québec, by the Research Chair in Aging at Laval University, by the three Departments of Family and Emergency Medicine of the Province of Quebec (Laval University, University of Montreal, University of Sherbrooke) and by McGill University’s Department of Family Medicine. We wish to thank the staff of the participating clinic; the members of the Comité Interuniversitaire et interprofessionnel de développement professoral continu en enseignement et en soins aux personnes âgées who acted as experts to select the priority clinical situations for senior care; Marie Meudec for conducting the interviews and Katherine Hastings for her writing assistance. AMCG is funded by a Research Scholar Junior 2 Career Development Award by the Fonds de Recherche du Québec-Santé.

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