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1. Web-based videoconferencing for rural palliative care consultation with elderly patients at home

Author

Aynharan Sinnarajah, Linda Read Paul, Charleen Salmon, and Ron Spice

Subjects
Male, Rural Population, business.product_category, Palliative care, Telehealth, Clinical nurse specialist, 03 medical and health sciences, 0302 clinical medicine, Nursing, Surveys and Questionnaires, Internet access, Humans, Medicine, 030212 general & internal medicine, Referral and Consultation, Aged, Internet, Travel, business.industry, Communication, Nursing research, Palliative Care, Home Care Services, Focus group, Oncology, 030220 oncology & carcinogenesis, Hospice and Palliative Care Nursing, Videoconferencing, Female, The Internet, Rural area, business
Abstract

Providing specialized palliative care support to elderly patients in rural areas can be challenging. The purpose of this study was to gain a preliminary understanding of the experience of using mobile web-based videoconferencing (WBVC) for conducting in-home palliative care consults with elderly rural patients with life-limiting illness. This was a descriptive, exploratory, proof-of-concept study with a convenience sample of 10 WBVC visits. A palliative care clinical nurse specialist (PC-CNS), in the home with the patient/family and home care nurse (HC-N), used a laptop computer with webcam and speakerphone to connect to a distant palliative care physician consultant (PC-MD) over a secure Internet connection. Data was collected using questionnaires, interviews, and focus groups. Analysis of qualitative data revealed four themes: communication, logistics, technical issues, and trust. Participants reported they were comfortable discussing concerns by WBVC and felt it was an acceptable and convenient way to address needs. Audiovisual quality was not ideal but was adequate for communication. Use of WBVC improved access and saved time and travel. Fears were expressed about lack of security of information transmitted over the Internet. Using WBVC for in-home palliative care consults could be an acceptable, effective, feasible, and efficient way to provide timely support to elderly rural patients and their families. Having a health care provider in the home during the WBVC is beneficial. WBVC visits have advantages over telephone calls, but limitations compared to in-person visits, suggesting they be an alternative but not replacement for in-person consultations.

Published
2019
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2. Rural Home Care Palliative Videoconsultation Project – Phase 2

Author

Maureen Wass, Linda Read Paul, Rauj Walia, Russell Loftus, Kathy Hutcheon, Ron Spice, Katie Woo, Nicole Porquet-Seitz, Natalia Csomor, Marie Webb, Janna Greir, and Gilian Ho

Subjects
Anesthesiology and Pain Medicine, Nursing, business.industry, Medicine, Neurology (clinical), business, Phase (combat), General Nursing
Published
2018
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3. P127 Web-Based Videoconferencing for Rural Palliative Care Consultation in the Home: A Pilot Project in the Calgary Zone of Alberta Health Services

Author

Rakib Mohammed, Jill Uniacke, Jason Kettle, Charleen Salmon, Ayn Sinnarajah, Marie Webb, Ron Spice, Gilian Ho, and Linda Read Paul

Subjects
Health services, Anesthesiology and Pain Medicine, Palliative care, Videoconferencing, Nursing, business.industry, Web application, Medicine, Neurology (clinical), computer.software_genre, business, computer, General Nursing
Published
2016
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4. Beyond bricks and mortar: a rural network approach to preclinical medical education

Author

Paul Adamiak, Wayne Woloschuk, Ron Spice, Nathan Turley, and Douglas L Myhre

Subjects
Clinical clerkship, Rural Population, Educational measurement, Teaching method, education, Pilot Projects, Education, Alberta, Pre-clinical medical education, Medicine, Humans, Curriculum, Distributed medical education, Schools, Medical, Accreditation, Medicine(all), Medical education, Education, Medical, business.industry, Social learning, Clinical Clerkship, General Medicine, Academic equivalence, Rural management, Educational Measurement, Rural Health Services, Rural medical education, business, Network approach, Research Article
Abstract

Background Countries with expansive rural regions often experience an unequal distribution of physicians between rural and urban communities. A growing body of evidence suggests that the exposure to positive rural learning experiences has an influence on a physician’s choice of practice location. Capitalizing on this observation, many medical schools have developed approaches that integrate rural exposure into their curricula during clerkship. It is postulated that a preclinical rural exposure may also be effective. However, to proceed further in development, accreditation requirements must be considered. In this investigation, academic equivalence between a preclinical rural community based teaching method and the established education model was assessed. Method Two separate preclinical courses from the University of Calgary’s three year Undergraduate Medical program were taught at two different rural sites in 2010 (11 students) and 2012 (12 students). The same academic content was delivered in the pilot sites as in the main teaching centre. To ensure consistency of teaching skills, faculty development was provided at each pilot site. Academic equivalence between the rural based learners and a matched cohort at the main University of Calgary site was determined using course examination scores, and the quality of the experience was evaluated through learner feedback. Results In both pilot courses there was no significant difference between examination scores of the rural distributed learners and the learners at the main University of Calgary site (p > 0.05). Feedback from the participating students demonstrated that the preceptors were very positively rated and, relative to the main site, the small group learning environment appeared to provide strengthened social support. Conclusion These results suggest that community distributed education in pre-clerkship may offer academically equivalent training to existing traditional medical school curricula while also providing learners with positive rural social learning environments. The approach described may offer the potential to increase exposure to rural practice without the cost of constructing additional physical learning sites.

Published
2014

5. Design and implementation of an online course on research methods in palliative care: lessons learned

Author

Moné Palacios, Patricia D. Biondo, Neil A. Hagen, and Ron Spice

Subjects
Research design, Canada, Internet, Palliative care, business.industry, Teaching, Palliative Care, Internship and Residency, General Medicine, Anesthesiology and Pain Medicine, Nursing, Research capacity, Research Design, Online course, Needs assessment, Medicine, Humans, The Internet, Curriculum, Program Development, business, Training program, General Nursing
Abstract

Research capacity in palliative and end-of-life care is less than some other fields of medicine where there is a longer track record of biomedical research. Palliative medicine clinicians often receive little or no formal research training during their postgraduate education; hence, education efforts may prove pivotal to increasing palliative care research capacity. To that end, our group established a national online training program on palliative care research methodologies, called Foundations of Palliative Care Research. This report describes the development and implementation of the course, and its evaluation. To inform decisions on the overall course objectives, length, design, and implementation, formal needs assessments were conducted through surveys of Canadian palliative medicine residency program directors and of Canadian palliative medicine residents.A 12-week, online, module-based course was designed. The first iteration of the course was offered to English-speaking palliative medicine residents from across Canada between October 2008 and March 2009. The course utilized Web-based communication methods, and was delivered using a combination of asynchronous and synchronous learning strategies and activities.Ten palliative care residents from different parts of the country registered and all completed the course with passing marks. Participants evaluated the course through a post course survey. The formal evaluation of the course, along with successes, challenges, and lessons applicable to future ventures, are discussed.

Published
2011

6. Development of a rural palliative care program in the Calgary Zone of Alberta Health Services

Author

Patricia D. Biondo, Ron Spice, and Linda Read Paul

Subjects
Adult, Male, Palliative care, Rural health care, Service delivery framework, Health Personnel, MEDLINE, Rural Health, Alberta, Health services, Nursing, Health care, Medicine, Humans, Program Development, General Nursing, Aged, Aged, 80 and over, Health Services Needs and Demand, business.industry, Rural health, Palliative Care, Middle Aged, Outreach, Anesthesiology and Pain Medicine, Female, Neurology (clinical), Rural Health Services, business
Abstract

Specialized rural models of palliative care are greatly needed to address the challenges rural communities face in providing palliative care services and to ensure that their unique strengths and needs are considered. In late 2005, a Rural Palliative Care Program was developed to support primary care providers in delivering palliative care to patients in rural communities outside of Calgary, Alberta, Canada. The program was grounded in the needs of individual communities, incorporated integral roles for local champions, and adopted pre-existing, accepted rural structures and processes. Needs and gaps in rural palliative care service delivery were identified and prioritized. The following actions were taken to address the top six priorities: 1) more accessible palliative care education opportunities with a rural focus were provided to health care professionals; 2) linkages with rural and urban resources were strengthened and access to specialists and procedures was improved; 3) strategies were implemented to improve psychosocial support for patients and families; 4) resources were developed to facilitate rural home deaths; 5) opportunities were expanded for education and utilization of volunteers; and 6) a mobile specialist consultation team was developed to support rural health care professionals and their patients in their rural communities. In its first four years, the team consulted on 640 patients, nearly three-quarters of whom died in their rural communities. Rather than imposing an urban outreach strategy, the development of a rural-based program through respectful engagement of local providers has proven to be crucial to the success of this rural palliative care program.

Published
2011

8. CONTRIBUTORS

Author

Judith A. Aberg, Amy P. Abernethy, Janet L. Abrahm, Michael Adolph, Michael Aherne, K. Allsopp, Rogelio Altisent, Carmen Fernandez Alvarez, Pablo Amigo, Wendy G. Anderson, Sik Kim Ang, Tiziana Antonelli, John Armstrong, Wendy S. Armstrong, Robert M. Arnold, Pilar Arranz, Koen Augustyns, Isabel Barreiro-Meiro Sáenz-Diez, Pilar Barreto, Debra Barton, Ursula Bates, Maria B. Fernandez-Creuchet Santos, Jacinto Bátiz, Costantino Benedetti, Nabila Bennani-Baiti, Michael I. Bennett, Kevin Berger, Mamta Bhatnagar, Lesley Bicanovsky, Lynda Blue, Barton Bobb, Jean-Jacques Body, Gian Domenico Borasio, Claudia Borreani, Federico Bozzetti, Valentina Bozzetti, Jason Braybrooke, William Breitbart, Barry Bresnihan, Bert Broeckaert, Eduardo Bruera, Kay Brune, Bradley Buckhout, Phyllis N. Butow, Ira Byock, Anthony Byrne, Clare Byrne, Beryl E. Cable-Williams, Sarah E. Callin, David Casarett, David Casper, Eric J. Cassell, Barrie Cassileth, Emanuele Castagno, Carlos Centeno, Walter Ceranski, Lucas Ceulemans, Meghna Chadha, Bruce H. Chamberlain, Eric L. Chang, Victor T. Chang, Harvey Max Chochinov, Edward Chow, Grace Christ, Katherine Clark, Stephen Clarke, Josephine M. Clayton, James F. Cleary, Lawrence J. Clein, Katri Elina Clemens, Libby Clemens, Robert Colebunders, Steven R. Connor, Viviane Conraads, Colm Cooney, Massimo Costantini, Azucena Couceiro, Holly Covington, John D. Cowan, Patrick Coyne, Garnet Crawford, Brian Creedon, Hilary Cronin, Garret Cullen, Jennifer E. Cummings, David C. Currow, Paul J. Daeninck, Pamela Dalinis, Prajnan Das, Mellar P. Davis, Sara N. Davison, Catherine Deamant, Liliana de Lima, Conor P. Delany, Peter Demeulenaere, Lena Dergham, Noël Derycke, Rajeev Dhupar, Mario Dicato, Edwin D. Dickerson, Andrew Dickman, Maria Dietrich, Pamela Dixon, Philip C. Dodd, James T. D'Olimpio, Per Dombernowsky, Michael Dooley, Deborah Dudgeon, Geoffrey P. Dunn, David Dunwoodie, Jane Eades, Badi El Osta, Katja Elbert-Avila, John Ellershaw, Bassam Estfan, Louise Exton, Alysa Fairchild, Matthew Farrelly, Konrad Fassbender, Jason Faulhaber, Kenneth C.H. Fearon, Lynda E. Fenelon, Peter F. Ferson, Petra Feyer, Marilene Filbet, Pam Firth, Susan F. FitzGerald, Hugh D. Flood, Francesca Crippa Floriani, Paul J. Ford, Barry Fortner, Darlene Foth, Bridget Fowler, Karen Frame, Thomas G. Fraser, Fred Frost, Michael J. Fulham, Pierre R. Gagnon, Lisa M. Gallagher, Maureen Gambles, Subhasis K. Giri, Paul Glare, Cynthia R. Goh, Xavier Gómez-Batiste, Leah Gramlich, Luigi Grassi, Phyllis A. Grauer, Claire Green, Gareth Griffiths, Yvona Griffo, Hunter Groninger, David A. Gruenewald, Jyothirmai Gubili, Terence L. Gutgsell, Elizabeth Gwyther, Paul S. Haber, Achiel Haemers, Mindi C. Haley, Mazen A. Hanna, Janet R. Hardy, Jodie Haselkorn, Katherine Hauser, Cathy Heaven, Michael Herman, Jørn Herrstedt, Stephen Higgins, Irene J. Higginson, Joanne M. Hilden, Kathryn L. Hillenbrand, Burkhard Hinz, Jade Homsi, Kerry Hood, Juliet Y. Hou, Guy Hubens, Peter Hudson, John G. Hughes, John Hunt, Craig A. Hurwitz, James Ibinson, Nora Janjan, Birgit Jaspers, Thomas Jehser, A. Mark Joffe, Laurence John, Jennie Johnstone, J. Stephen Jones, Javier R. Kane, Matthew T. Karafa, Andrew P. Keaveny, Dorothy M.K. Keefe, Catherine McVearry Kelso, Rose Anne Kenny, Martina Kern, Dilara Seyidova Khoshknabi, Jordanka Kirkova, Kenneth L. Kirsh, David W. Kissane, Eberhard Klaschik, Seref Komurcu, Kandice Kottke-Marchant, Kathryn M. Kozell, Sunil Krishnan, Deborah Kuban, Damian A. Laber, Ruth L. Lagman, Rajesh V. Lalla, Deforia Lane, Philip J. Larkin, Wael Lasheen, Peter Lawlor, Susan B. LeGrand, Vincent Lens, Dona Leskuski, Pamela Levack, Marcia Levetown, Jeanne G. Lewandowski, William R. Lewis, S. Lawrence Librach, Wendy G. Lichtenthal, J. Norelle Lickiss, Stefano Lijoi, Edward Lin, Arthur G. Lipman, Jean-Michel Livrozet, Mari Lloyd-Williams, Richard M. Logan, Francisco López-Lara Martín, Charles L. Loprinzi, John Loughnane, Michael Lucey, Laurie Lyckholm, Carol Macmillan, Frances Mair, Stephen N. Makoni, Bushra Malik, Kevin Malone, Marco Maltoni, Aruna Mani, Lucille R. Marchand, Darren P. Mareiniss, Anna L. Marsland, Joan Marston, Julia Romero Martinez, Isabel Martínez de Ubago, Lina M. Martins, Timothy S. Maughan, Catriona Mayland, Susan E. McClement, Ian McCutcheon, Michael F. McGee, Neil McGill, Stephen McNamara, Mary Lynn McPherson, Henry McQuay, Regina McQuillan, Robert E. McQuown, Michelle Meiring, Sebastiano Mercadante, Elaine C. Meyer, Randy D. Miller, Yvonne Millerick, Roberto Miniero, Armin Mohamed, Busi Mooka, Helen M. Morrison, J. Cameron Muir, Fiona Mulcahy, Hugh E. Mulcahy, Monica Muller, H. Christof Müller-Busch, Scott A. Murray, Friedemann Nauck, Katherine Neasham, Busisiwe Nkosi, Simon Noble, Antonio Noguera, Anna K. Nowak, Juan Nuñez-Olarte, Eugenie A.M.T. Obbens, Tony O'Brien, Megan Olden, Norma O'Leary, David Oliver, David Oliviere, Aurelius G. Omlin, Kaci Osenga, Diarmuid O'Shea, Christophe Ostgathe, Faith D. Ottery, Michel Ouellette, Edgar Turner Overton, Moné Palacios, Robert Palmer, Teresa Palmer, Carmen Paradis, Armida G. Parala, Antonio Pascual-López, Steven D. Passik, Timothy M. Pawlik, Malcolm Payne, Sheila Payne, Silvia Paz, José Pereira, George Perkins, Karin Peschardt, Hayley Pessin, Douglas E. Peterson, Vinod K. Podichetty, Robin Pollens, Eliza Pontifex, Susan Poole, Josep Porta-Sales, Graeme Poston, Ruth D. Powazki, William Powderly, Leopoldo Pozuelo, Eric Prommer, Christina M. Puchalski, Lukas Radbruch, David F.J. Raes, Jane Read, Anantha Reddy, Steven I. Reger, Susan J. Rehm, Stephen G. Reich, Javier Rocafort, Adam Rosenblatt, Cynda Hylton Rushton, K. Mitchell Russell, Karen Ryan, Lisa A. Rybicki, Paola Sacerdote, Vinod Sahgal, Mary Ann Sammon, Dirk Sandrock, Mark Sands, Denise L. Schilling, Valerie Nocent Schulz, Lisa N. Schum, Peter Selwyn, Joshua Shadd, Charles L. Shapiro, Aktham Sharif, Helen M. Sharp, Kirk V. Shepard, J. Timothy Sherwood, Nabin K. Shrestha, Richard J.E. Skipworth, Howard S. Smith, Mildred Z. Solomon, Diego Soto de Prado Otero, Denise Wells Spencer, Ron Spice, David Spiegel, Manish Srivastava, John N. Staffurth, Randall Starling, Grant D. Stewart, Jan Stjernswärd, Florian Strasser, Edna Strauss, Imke Strohscheer, Brett Taylor Summey, Graham Sutton, Nigel P. Sykes, Alan J. Taege, Marcello Tamburini, Yoko Tarumi, Davide Tassinari, Martin H.N. Tattersall, Karl S. Theil, Keri Thomas, Adrian Tookman, María P. Torrubia, Anna Towers, Daphne Tsoi, Rodney O. Tucker, James A. Tulsky, Rachel A. Tunick, Claire Turner, Martha L. Twaddle, Marie Twomey, Christina Ullrich, Catherine E. Urch, Mary L.S. Vachon, Bart Van den Eynden, Antonio Vigano, Erika Vlieghe, Angelo E. Volandes, Raymond Voltz, Paul W. Walker, Sharon Watanabe, Michael A. Weber, Elizabeth Weinstein, Sharon M. Weinstein, Kathryn L. Weise, Sherri Weisenfluh, John Welsh, Clare White, Donna M. Wilson, Joanne Wolfe, Tugba Yavuzsen, Albert J.M. Yee, Lisa M. Yerian, and Elena Zucchetti

Published
2009
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9. Capsaicin in Burning Mouth Syndrome: Titration Strategies

Author

Ron Spice and Neil A. Hagen

Subjects
business.industry, Burning Mouth Syndrome, General Medicine, Middle Aged, Burning mouth syndrome, Pharmacology, chemistry.chemical_compound, chemistry, Capsaicin, medicine, Humans, Female, Titration, medicine.symptom, business, Pain Measurement
Published
2004
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