Yves Talbot

Genetics education in medical school: a qualitative study exploring educational experiences and needs

Background: Genetic discoveries increasingly have an impact on clinical medicine. Primary care providers (PCPs) need to be prepared to address patients’ concerns about their genetic risks. Aims: To explore family medicine residents’ experiences with genetics in medical school and residency training and to understand their educational needs in genetics. Methods: Four focus groups were held with 33 family medicine residents at the University of Toronto, which represented graduates of 9 different Canadian medical schools. Groups were audio-taped, transcribed and analysed independently by 4 reviewers using content analysis. Recurrent themes were identified. Results: Participants described their experiences with genetics in medical school as almost entirely related to rare disorders, so genetics was not perceived to be clinically relevant. There was little awareness of the complex ethical and psychosocial issues that accompany genetics. However, participants felt that genetics would become significant in medical care in the future and PCPs would play an important role. They expressed a need for more knowledge of genetics to fulfill this role and practical teaching in genetics by clinicians. Conclusions: Medical school educational experiences may not be preparing future PCPs to address genetic issues with patients. A change and a broadening of the teaching of genetics are required to fulfill this need.

Conocimientos, Actitudes y Prácticas sobre Dengue en Dos Barrios de Bucaramanga, Colombia

Objetivo Identificar conocimientos, actitudes y practicas sobre dengue para orientar medidas de prevencion y control. Metodologia Encuesta realizada, en dos barrios de alta incidencia de dengue en Bucaramanga, mayo de 2007, mediante visita domiciliaria. Se identificaron criaderos y se brindo educacion sobre prevencion y control. La informacion fue analizada en EPI-INFO. Resultados En 643 de las 780 viviendas (82,4 %) se logro respuesta. La mayoria de los entrevistadas eran mujeres, 518 (80,6 %), con edad promedio 39,6 anos, desviacion estandar (DE) 16,8, escolaridad 6,2 anos (DE 3.5) y 5 habitantes por vivienda. En cuanto al dengue, 433 (67,3%) lo describieron como una enfermedad: muy grave 545 (84,8 %), transmitida por zancudo 242 (37,6 %) y producida por virus 59 (9,2 %). Sintomas reconocidos: fiebre 570 (88,6 %), vomito 352 (54,7 %), diarrea 275 (43,0 %), cefalea 243 (37,8 %), dolor oseo 196 (30,5 %) y muscular 109 (17,0 %). Para prevenirlo: evitan agua estancada 288 (44,7 %), lavan la pila 174 (27,2 %), limpian la casa 101 (15,8 %) y fumigan 91 (14,2 %). Cuando alguien tiene dengue: lo llevan al medico 410 (63,8 %), al hospital 129 (20,1 %) o automedica 78 (12,0 %). El indice larvario fue de 26,1 % y en 8,4 % de las viviendas hubo casos de dengue el mes anterior a la encuesta. Discusion Los conocimientos sobre dengue son escasos, las actitudes favorables al control, pero las practicas son insuficientes. Se requiere educar y empoderar la comunidad para que participe activamente en los programas de prevencion y control.

Effectiveness of community health agents' actions in situations of social vulnerability

Evaluation is purposeful activity examining multiple, diverse realities [1] that affect the implementation of social interventions and their management [2]. As political activity, evaluation involves partnerships among managers, stakeholders and internal and external evaluators. These partners review common interests and concerns to modify policies and modi operandi, and ultimately, to influence human life [3]. Evaluation is particularly sensitive to social problems and expectations; it documents their features, incidence and prevalence [2]. This article reports the quanti-qualitative results of an in-service effectiveness evaluation of interventions to reduce health risks for socially vulnerable people by community health agents (CHAs) (Agentes Comunitarios de Saude) in Brazil. CHAs are key personnel within the nationwide community health agent program (CHAP), created in 1991, that operates within Brazil’s Family Health Strategy (FHS). CHAP considers social inclusion through health education and promotion, a cornerstone of collective health. Most CHAs are from the communities they serve. This article documents some crucial features of CHAs’ work in dangerous neighborhoods previously inaccessible to health professionals (HPs). Knowledge about these residents’ health needs, challenges and difficulties due to their social vulnerability may not have reached health care providers.

Enhancing prevention in primary care: are interventions targeted towards consumers’ and providers’ perceived needs?

To explore perceived barriers to the implementation of prevention guidelines, with a particular interest to perceived information needs from the point of view of health professionals and consumers.

Learning globally to enhance local practice: an international programme in primary care & family health

Abstract Purpose: In a global context of growing health inequities, international learning experiences have become a popular strategy for equipping health professionals with skills, knowledge, and competencies required to work with the populations they serve. This study sought to analyse the Chilean Interprofessional Programme in Primary Health Care (CIPPHC), a 5 week international learning experience funded by the Ministry of Health in Chile targeted at Chilean primary care providers and delivered in Toronto by the Department of Family and Community Medicine at the University of Toronto. Method: The study focused on three cohorts of students (2010–2012). Anonymous programme evaluations were analysed and semi-structured interviews conducted with programme alumni. Simple descriptive statistics were gathered from the evaluations and the interviews were analysed via thematic content analysis. Results: The majority of participants reported high levels of satisfaction with the training programme, knowledge gain, particularly in the areas of the Canadian model of primary care, and found the materials delivered to be applicable to their local context. Conclusions: The CIPPHC has proven to be a successful educational initiative and provides valuable lessons for other academic centres in developing international interprofessional training programmes for primary care health care providers.