PM Workshops

Authors/Presenters: Kristina Powles, Nikki Bozinoff, Anthony Davies

Description:

Addiction Medicine training remains a critical gap for Family Medicine (FM) residents. One contributing factor is the discomfort some FM preceptors feel when teaching substance use-related topics, often stemming from their own limited knowledge of clinical content and available resources. However, it is crucial to recognize that mental health and substance use have profound impacts on patients, families, and communities. Evidence-based interventions provided by family physicians can be life-saving.

This interactive workshop will introduce participants to the 2024 update of the DFCM Competency-Based Curriculum in substance use and mental health, and identifies barriers and facilitators to resident learning of this content. Through a situation-based approach, we will examine opportunities for leveraging adaptive expertise, mentorship, and community resources to enhance resident education and promote accessible, patient-centered care.

Presenters: Ullanda Niel, Dara Abells

Description:

Adults with intellectual and developmental disabilities (IDD) are an equity deserving group that has a right to primary care that meets their specific health and developmental needs. Despite more complex health needs, they often experience challenges in accessing primary care. Family physicians need the skills and resources to support these patients in their busy practices and an understanding of how to mobilize team-based support to make this care possible.

The Developmental Disabilities Primary Care Program is a program of Surrey Place, Toronto that published the Canadian consensus guidelines on primary care for adults with IDD and offers clinical guidelines and tools.

This workshop will provide practical resources to help implement these guidelines. Community family physicians together with self-advocates with lived experience of IDD will guide participants through a case-based workshop highlighting how family physicians can best care for adults with IDD in the community.

Authors: Daphna Grossman, Shannon Poyntz, Diana Lo, Judy Katz, Maria Muraca

Description:

Advance care planning discussions are important to ensuring that people understand their illness, consider their values in health care decision making and choose their power of attorney. According to Advance Care Planning Canada (2021), 77% of respondents stated it is important to speak to their health care provider about ACP, however only 7% do so. Together, an Interprofessional health care team including primary care providers from the North York Family Health Team (NYFHT), palliative care providers and a patient experience partner from North York General Hospital (NYGH) have developed a workshop demystifying ACP conversation. This workshop, which takes place in community centres and libraries presented several times a year, includes ACP Canada’s didactic information, an interactive polling portion asking, “Who is the SDM in the scenario?” and role playing with 3 volunteer participants who must agree on answers for presented scenarios. Results from our feedback study showed a significant improvement in participants' understanding of the SDM’s role and the types of decisions an SDM can make. In the 3-month follow-up survey, 73% of respondents had considered their values and beliefs related to healthcare, while 33% had conversations with their HCPs, and 30% completed a POA document. Participant feedback highlighted satisfaction with the sessions and the informative content, along with suggestions for improvement, such as providing more detailed information on specific medical decisions. We will discuss our interactive presentation, the method of reaching out to the community, choosing locations and enhancing the participation in a hybrid model.

Authors/Presenters: Noor Ramji, Curtis Handford, Nassim Vahidi-Williams, Shikha Duggal

Description:

Introduction: In 2022, the Ontario Health Teams attachment report revealed that 19% of Downtown East Toronto residents lacked access to primary care, disproportionately affecting equity-deserving groups.

To address this, the St. Michael’s Hospital Academic Family Health Team (SMHAFHT) launched an initiative to improve equitable attachment to primary care. Using Quality Improvement methods, the team increased the number of newly rostered patients identified as equity-deserving and developed a toolkit for practitioners to enhance equitable attachment tailored to local populations. Key strategies included optimizing team-based care in patient onboarding, addressing social determinants of health, fostering community partnerships, and identifying measurement tools for monitoring and advocacy. The first PDSA cycle resulted in 19% of attached patients identifying as equity-deserving. PDSA #2 is ongoing to further enhance outcomes.

Methods: This interactive 60-minute workshop introduces a practical toolkit to help primary care clinics improve equitable attachment rates. Participants will explore strategies such as outreach to underserved populations, culturally responsive care, and patient-provider engagement.

Using real-world examples from SMHAFHT and a hands-on case study, attendees will learn how to apply equity-focused tools in their clinical contexts. By the end of the session, participants will gain actionable steps to improve attachment rates and reduce barriers for marginalized populations.

Results: Attendees will leave equipped with tools to enhance equitable access to primary care within their practice.

Conclusion: The NEWR pathway addresses primary care disparities in Downtown East Toronto through targeted interventions. SMHAFHT’s toolkit offers a replicable approach, empowering other teams to advance health equity.

Authors: David Kaplan, Gracia Mabaya

Description:

In this interactive session, participants will learn about important opportunities to improve care for people diagnosed with hypertension or who are at risk of developing hypertension, as described in Ontario Health’s new Hypertension: Care in the Community for Adults quality standard.

Hypertension is the most common modifiable risk factor for death or disability. In fiscal year 2022-2023, 66% of people aged 65 years and older in Ontario reported having received a diagnosis of hypertension; 33% of them are not reaching clinically established blood pressure targets. Between 2017 and 2022, the number of emergency department visits with a diagnosis of hypertension rose by 19%. High-quality hypertension management in primary care and home and community care settings is key to preventing avoidable emergency department visits, unplanned hospitalizations, and patient outcomes.

The quality standard outlines seven key opportunities to improve care, including: culturally responsive care; accurate measurement of blood pressure; out-of-office assessment to confirm diagnosis; health behaviour changes; care planning and self-management; monitoring and follow-up after a confirmed diagnosis; and improving adherence to medications. The quality standard is accompanied by useful resources for clinical use, such as a quick-reference placemat for clinicians, and a patient guide with hypertension self-management resources to share with patients and their care partners.

Through case studies, participants will explore the quality standard and reflect on opportunities to improve care for people diagnosed with hypertension or who are at risk of developing hypertension with the goal of improving patient outcomes and health care system utilization.

Authors/Presenters: Andrew Pinto, Nisanthini Ravichandiran, Gurnoor Brar, Tara Marie Watson, Christopher Meaney, Peter Selby

Description:

Work in primary care leads to numerous questions and ideas for research. These can be related to ways to improve clinical care or the healthcare system, or how to better train the primary care workforce. However, only a small fraction of primary care practitioners have had the support and mentorship to develop proposals for the funding necessary to conduct research. In this interactive workshop, we will provide an overview to how to take an idea and develop a research question. We will work through the key parts of a research proposal. We will discuss how to form a team to conduct research, and explore the different roles that team members play. We will discuss factors that lead to success, and review opportunities for funding. Finally, we will share insights from the Ideas to Proposal course that is organized by DFCM Research and UPLEARN.

Please visit the Oral Papers page for more information on the presentations during this session.

Adaptive expertise in family medicine: exploring how practice context enables and constrains expertise
Authors/Presenters: Nathan Cupido, Nicole N. Woods, Kulamakan Kulasegaram, Risa Freeman, Melissa Nutik, Azadeh Moaveni, Maria Mylopoulos

AI teaching assistants: Evaluating the impact of custom ChatGPTs within undergraduate medical education
Presenters: Chris Gilchrist, Alina Sami

Collaborative Medical Education: Benefits of joint early exposure to roles and scope of practice for physician assistants and physician learners in primary care settings  
Presenters: Sharona Kanofsky, Judith Peranson

Top Influences and Concerns of Residents Selecting a Career in Family Medicine: An Educational Lens
Presenters: Melissa Nutik, Mira Mitri, Risa Freeman, Stu Murdoch, Milena Forte

Trust in Transition: Family Medicine Residents Share Insights on Entrustment Scales in Maternity Care Assessment
Presenters: Natalie Morson, Milena Forte

Please visit the Oral Papers page for more information on the presentations during this session.

A Curriculum to Stimulate Medical Students’ Interest in Community Practice Careers
Presenters: Baraa Alghalyini, Abdul Rehman Zia Zaidi, Racha Khaled, Mohamed Ameen Alswes, Helen P. Batty

Co-Developing Muhimbili University of Health and Allied Sciences (MUHAS) Innovative Family Medicine Residency Curriculum
Presenter: Donatus Mutasingwa

Examining Anxiety and Depression visits to primary care in 8 International Consortium of Primary Care Big Data Researchers-INTRePID countries. 
Presenters: Aaron Orkin

Navigating Primary Health Care in Ontario: A Qualitative Study Investigating the Perceptions of Chinese Newcomers to Canada
Presenters: Karen Tu, Maria Carla Lapadula, Christine Hallinan, José Carlos Prado Jr, Amy Ng, Tokuharu Tanaka, Sofia Cuba, Javier Silva-Valencia, Lay-Hoon Goh, Zheng Jye Ling, Jo-Anne Manski-Nankervis, Jack Westfall, William Wong

Integrating Rehabilitation into Primary Care: A DFCM WHO Collaborating Centre and World Rehabilitation Alliance Collaboration
Presenters: Julia Alleyne, Katherine Rouleau

Authors: Tina Parassakis, Karen Lock, Carolyn Willson, Risa Bordman

Description:

Patients living with life-limiting illnesses often wish to receive palliative and end-of-life care at home. Challenges to providing high quality care in this setting includes complex symptom management, caregiver support and education, and the lack of around-the-clock home care support. There are 89% of Canadians with life-limiting illnesses that could benefit from palliative care (Health Canada, 2018). However, only 40% of Family Physician’s reported feeling equipped to fill this gap within our healthcare system (CIHI, 2023). Family Physicians play an essential role in providing continuity of care, managing medical issues and symptoms, and improving the quality of life for their homebound patients. However, evidence has shown that Family Physicians lack palliative care training and skills, and as a result they chose not to manage their patients at home and prefer a palliative care specialist to take over the care (Mahtani et al., 2015). This workshop will provide practical tips on collaboration with the home care team, discuss common symptoms at end-of-life, and review medications and associated supplies commonly used within the home setting. Participants will have an opportunity to observe demonstrations, participate in hands-on training in initiating subcutaneous lines for urgent symptom management and gain knowledge about the use of ambulatory infusion pumps for difficult to manage symptoms. Lastly, this workshop will highlight how palliative care teams can collaborate and support primary care practitioners in delivering high-quality palliative and end-of-life care in their community.

Authors/Presenters: Samantha Green, Lidia Ferreira, Susan Deering, KitShan Lee

Description:

Extreme heat is increasing as a result of climate change, with Toronto projected to see a 3-fold to 4-fold increase in days above 30 degrees celsius. Extreme heat poses a direct threat to health in the form of heat exhaustion, heat stroke, and increased mortality. Heat waves also worsen common chronic conditions, including asthma, heart disease, mental health disorders, diabetes, and renal insufficiency. Family physicians can protect our patients from the health impacts of extreme heat. We can identify patients who are at increased risk of heat-related illness and counsel these at-risk patients; we can advocate for resources for individual patients and communities; and we can advocate for policy change such as maximum temperature by-laws. Family physicians can also collaborate with community organizations to identify at-risk individuals and intervene during heat waves. CREW is an organization working in St. Jamestown to protect residents from heat through a neighbours-to-neighbours approach. http://www.crewresilience.ca/ They have developed a heat wave protocol with 5 focus areas to help residents during a heatwave: 1) notify residents in advance of a heatwave; 2) keep residents' homes as cool as possible; 3) support residents to reach cool areas and cooling stations if their home is too hot; 4) check-in with vulnerable residents; 5) provide additional support services for residents.