Merlin Njoya

Training family physicians in shared decision making for the use of antibiotics for acute respiratory infections: a pilot clustered randomized controlled trial.

Background  Experts estimate that the prevalence of antibiotics use exceeds the prevalence of bacterial acute respiratory infections (ARIs).

Prenatal screening for Down syndrome: a survey of willingness in women and family physicians to engage in shared decision‐making

To assess the willingness of women and their family physicians (FPs) to engage in shared decision‐making (SDM) as regards prenatal Down‐syndrome screening and the factors that might influence their willingness to do so.

The impact of blended teaching on knowledge, satisfaction, and self-directed learning in nursing undergraduates: a randomized, controlled trial.

AIM This study aimed to assess the effectiveness of a blended‐teaching intervention using Internet‐based tutorials coupled with traditional lectures in an introduction to research undergraduate nursing course. Effects of the intervention were compared with conventional, face‐to‐face classroom teaching on three outcomes: knowledge, satisfaction, and self‐learning readiness. METHOD A two‐group, randomized, controlled design was used, involving 112 participants. Descriptive statistics and analysis of covariance (ANCOVA) were performed. RESULTS The teaching method was found to have no direct impact on knowledge acquisition, satisfaction, and self‐learning readiness. However, motivation and teaching method had an interaction effect on knowledge acquisition by students. Among less motivated students, those in the intervention group performed better than those who received traditional training. CONCLUSION These findings suggest that this blended‐teaching method could better suit some students, depending on their degree of motivation and level of self‐directed learning readiness.

A systematic review of interventions promoting clinical information retrieval technology (CIRT) adoption by healthcare professionals

PURPOSE This paper presents the evidence on the effectiveness of interventions promoting the use of clinical information retrieval technologies (CIRTs) by healthcare professionals. METHODS We electronically searched articles published between January 1990 and March 2008 using following inclusion criteria: (1) participants were healthcare professionals; (2) specific intervention promoted CIRT adoption; (3) studies were randomised controlled trials, controlled clinical trials, controlled before and after studies or interrupted time series analyses; and (4) they objectively reporting measured outcomes on CIRT use. RESULTS We found nine studies focusing on CIRT use. Main outcomes measured were searching skills and/or frequency of use of electronic databases by healthcare professionals. Three studies reported a positive effect of the intervention on CIRT use, one showed a positive impact post-intervention, and four studies failed to demonstrate significant intervention effect. The ninth study examined financial disincentives, and found a significant negative effect of introducing user fees for searching MEDLINE in clinical settings. A meta-analysis showed that educational meetings were the only type of interventions reporting consistent positive effects on CIRT adoption. CONCLUSION CIRT is an information and communication technology commonly used in healthcare settings. Interventions promoting CIRT adoption by healthcare professionals have shown some success in improving searching skills and use of electronic databases. However, the effectiveness of these interventions remains uncertain and more rigorous studies are needed.

Minimizing Pain During Vasectomy: The Mini-Needle Anesthetic Technique

PURPOSE We describe pain scores for a modified anesthesia technique for no-scalpel vasectomy using a 1-inch 30 gauge mini-needle. MATERIALS AND METHODS A prospective study was performed in 277 patients who received anesthesia using a 3 cc syringe filled with approximately 2 cc 2% lidocaine without epinephrine and a 1-inch 30 gauge needle. Local anesthesia was given directly to the vas at the expected surgical site on each side. RESULTS Mean +/- SD pain intensity score on the 10 cm visual analog scale was 1.5 +/- 1.6 (95% CI 1.3-1.7) during the anesthesia and 0.6 +/- 1.0 (95% CI 0.5-0.7) during the procedure. Patients experienced less pain during anesthesia and the procedure than they expected before vasectomy (average 3.1 +/- 1.8, 95% CI 2.8-3.3). CONCLUSIONS The mini-needle technique provides excellent anesthesia for no-scalpel vasectomy. It compares favorably to the standard vasal block and other anesthetic alternatives with the additional benefit of minimal equipment and less anesthesia.