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This article documents a collaborative effort between university teacher educators and an urban school district in Wisconsin to address acute teacher shortages in bilingual education. The effort took shape as a Grow-Your-Own program based on the teacher residency model. Several innovations were required in program design and implementation to satisfy state licensure requirements, including how uncredentialed teachers working as teachers of record would meet clinical stipulations. The COVID-19 pandemic posed obstacles to the program in the very first year; however, due to the pressing teacher shortage, all parties decided to push on rather than suspend the program. The authors discuss bilingual teacher shortages, program design and implementation, challenges associated with the pandemic, and conclude with recommendations for teacher educators interested in creating a similar pipeline.

Introduction: Health system disruptions, caused by unexpected emergencies such as disease outbreaks, natural disasters, and cybercrimes, impact the delivery of routine preventative care. As comprehensive care providers, family physicians (FPs) devote significant time to prevention. However, without emergency and pandemic plans in place in primary care, FPs face added barriers to prioritizing and sustaining preventative care when health systems are strained, which was evident during the COVID-19 pandemic. This study aims to describe FPs' experiences providing preventative care during the COVID-19 pandemic and their perceptions of the impacts of disrupted preventative care in primary care settings.Methods: Using a qualitative descriptive approach, we conducted semistructured interviews with FPs across 4 provinces in Canada (i.e. Newfoundland and Labrador, Nova Scotia, Ontario, British Columbia) between October 2020 and June 2021 as part of a larger multiple case study. These interviews broadly explored the roles and responsibilities of FPs during the COVID-19 pandemic. Interviews were coded thematically and codes from the larger study were analysed further using an iterative, phased process of thematic analysis.Results: Interviews averaged 58 min in length (range 17-97 min) and FPs had a mean of 16.9 years of experience. We identified 4 major themes from interviews with FPs (n = 68): (i) lack of capacity and coordination across health systems, (ii) patient fear, (iii) impacts on patient care, and (iv) negative impacts on FPs. Physicians voiced concerns with managing patients' prevention needs when testing availability and coordination of services was limited. Early in the pandemic, patients were also missing or postponing their own primary care appointments. Change in the provision and coordination of routine preventative care had negative impacts on both patients and physicians, affecting disease incidence/progression, physician workload, and psychological wellbeing.Conclusion: During the COVID-19 pandemic, upstream care efforts were impacted, and FPs were forced to reduce their provision of preventative care. FPs contribute direct insight to primary care delivery that can support pandemic planning to ensure preventative care is sustained during future emergencies. [ABSTRACT FROM AUTHOR]

Introduction: Throughout the COVID-19 pandemic, primary care nurses were often redeployed to areas outside of primary care to mitigate staffing shortages. Despite this, there is a scarcity of literature describing their perceptions of and experiences with redeployment during the pandemic. Objectives: This paper aims to: 1) describe the perspectives of primary care nurses with respect to redeployment, 2) discuss the opportunities/challenges associated with redeployment of primary care nurses, and 3) examine the nature (e.g., settings, activities) of redeployment by primary care nurses during the COVID-19 pandemic. Methods: In this qualitative study, semi-structured interviews were conducted with primary care nurses (i.e., Nurse Practitioners, Registered Nurses, and Licensed/Registered Practical Nurses), from four regions in Canada. These include the Interior, Island, and Vancouver Coastal Health regions in British Columbia; Ontario Health West region in Ontario; the province of Nova Scotia; and the province of Newfoundland and Labrador. Data related to redeployment were analyzed thematically. Results: Three overarching themes related to redeployment during the COVID-19 pandemic were identified: (1) Call to redeployment, (2) Redeployment as an opportunity/challenge, and (3) Scope of practice during redeployment. Primary care nurses across all regulatory designations reported variation in the process of redeployment within their jurisdiction (e.g., communication, policies/legislation), different opportunities and challenges that resulted from redeployment (e.g., scheduling flexibility, workload implications), and scope of practice implications (e.g., perceived threat to nursing license). The majority of nurses discussed experiences with redeployment being voluntary in nature, rather than mandated. Conclusions: Redeployment is a useful workforce strategy during public health emergencies; however, it requires a structured process and a decision-making approach that explicitly involves healthcare providers affected by redeployment. Primary care nurses ought only to be redeployed after other options are considered and arrangements made for the care of patients in their original practice area. [ABSTRACT FROM AUTHOR]

Background: As the first point of contact in health care, primary care providers play an integral role in pandemic response. Despite this, primary care has been overlooked in previous pandemic plans, with a lack of emphasis on ways in which the unique characteristics of family practice could be leveraged to create a more effective response. Aim: To explore family physicians' perceptions of the integration of primary care in the COVID-19 pandemic response. Design and setting: Descriptive qualitative approach examining family physician roles during the COVID-19 pandemic across four regions in Canada. Method: Semi-structured qualitative interviews were conducted with family physicians and participants were asked about their roles during each pandemic stage, as well as facilitators and barriers they experienced in performing these roles. Interviews were transcribed and a thematic analysis approach was employed to develop a unified coding template across the four regions and identify recurring themes. Results: In total, 68 family physicians completed interviews. Four priorities for integrating primary care in future pandemic planning were identified: 1) improve communication with family physicians; 2) prioritise community-based primary care; 3) leverage the longitudinal relationship between patients and family physicians; and 4) preserve primary care workforce capacity. Across all regions, family physicians felt that primary care was not well incorporated into the COVID-19 pandemic response. Conclusion: Future pandemic plans require greater integration of primary care to ensure the delivery of an effective and coordinated pandemic response. Strengthening pandemic preparedness requires a broader reconsideration and better understanding of the central role of primary care in health system functioning. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusion Implications for the Profession and Patient Care Impact Reporting Method Patient or Public Contribution What does this Paper Contribute to the Wider Global Clinical Community? To describe vaccination roles of primary care nurses during the COVID‐19 pandemic in Canada.This analysis was part of a larger mixed‐methods case study.We conducted semi‐structured qualitative interviews from May 2022 to January 2023 with primary care nurses across four provinces: British Columbia, Ontario, Newfoundland and Labrador, and Nova Scotia. We asked participants to describe their roles during various stages of the pandemic, facilitators and challenges encountered and possible roles that nurses could have played. We used thematic analysis and analysed codes relevant to vaccination.We interviewed a total of 76 nurses and identified four key functions of primary care nurses' roles in COVID‐19 vaccination: (1) education, (2) vaccine administration, (3) outreach and (4) advocacy. Themes outlined nurses' roles with respect to patient education, addressing vaccine hesitancy, partaking in vaccination roles outside of regular primary care practice and supporting accessibility in COVID‐19 vaccination. Specific tasks varied by nursing professions.Primary care nurses fostered trust through existing patient–provider relationships to enhance roles and activities related to education, outreach and advocacy in COVID‐19 vaccination. Some COVID‐19 vaccine‐related roles were more easily integrated into primary care, whereas others competed with routine primary care roles.Findings highlight the vital contributions of primary care nurses towards COVID‐19 vaccination efforts in Canada. Leveraging nursing expertise can enhance future pandemic response efforts and improve patient care by addressing barriers to vaccination and promoting equitable access to vaccination services.This study addresses a knowledge gap by describing the vaccination‐related roles of primary care nurses during the pandemic. Findings illustrate that nurses demonstrated adaptability through their engagement in vaccine education, administration, outreach and advocacy. This research informs resource allocation, policy development and workforce planning for future vaccination efforts during a pandemic response.The authors have adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines included in the Empirical Research Qualitative reporting method.No patient or public contribution. Provides insight into the pivotal roles of primary care nurses during the COVID‐19 vaccination efforts in Canada, highlighting their diverse contributions towards education, vaccine administration, outreach and advocacy. Offers implications for future pandemic planning by informing resource allocation, policy development and workforce planning for vaccination efforts. [ABSTRACT FROM AUTHOR]

Objective: To understand how lack of attachment to a regular primary care provider influences patients' outlooks on primary care, ability to address their health care needs, and confidence in the health care system., Design: Qualitative descriptive study using semistructured interviews., Setting: Canadian provinces of Nova Scotia, Ontario, and Quebec., Participants: Patients aged 18 years or older who were unattached or had become attached within 1 year of being interviewed and who resided in the province in which they were interviewed., Methods: Forty-one semistructured interviews were conducted, during which participants were asked to describe how they had become unattached, their searches to find new primary care providers, their perceptions of and experiences with the centralized waiting list in their province, their experiences seeking care while unattached, and the impact of being unattached on their health and on their perceptions of the health care system. Interviews were transcribed and analyzed using a thematic approach., Main Findings: Two main themes were identified in interviews with unattached or recently attached patients: unmet needs of unattached patients and the impact of being unattached. Patients' perceived benefits of attachment included access to care, longitudinal relationships with health care providers, health history familiarity, and follow-up monitoring and care coordination. Being unattached was associated with negative effects on mental health, poor health outcomes, decreased confidence in the health care system, and greater pre-existing health inequities., Conclusion: Having a regular primary care provider is essential to having access to high-quality care and other health care services. Attachment also promotes health equity and confidence in the public health care system and has broader system-level, social, and policy implications., (Copyright © 2024 the College of Family Physicians of Canada.)

Background: Medical professionals experienced high rates of burnout and moral distress during the COVID-19 pandemic. In Canada, burnout has been linked to a growing number of family physicians (FPs) leaving the workforce, increasing the number of patients without access to a regular doctor. This study explores the different factors that impacted FPs' experience with burnout and moral distress during the pandemic, with the goal of identifying system-based interventions aimed at supporting FP well-being and improving retention., Methods: We conducted semi-structured qualitative interviews with FPs across four health regions in Canada. Participants were asked about the roles they assumed during different stages of the pandemic, and they were also encouraged to describe their well-being, including relevant supports and barriers. We used thematic analysis to examine themes relating to FP mental health and well-being., Results: We interviewed 68 FPs across the four health regions. We identified two overarching themes related to moral distress and burnout: (1) inability to provide appropriate care, and (2) system-related stressors and buffers of burnout. FPs expressed concern about the quality of care their patients were able to receive during the pandemic, citing instances where pandemic restrictions limited their ability to access critical preventative and diagnostic services. Participants also described four factors that alleviated or exacerbated feelings of burnout, including: (1) workload, (2) payment model, (3) locum coverage, and (4) team and peer support., Conclusion: The COVID-19 pandemic limited FPs' ability to provide quality care to patients, and contributed to increased moral distress and burnout. These findings highlight the importance of implementing system-wide interventions to improve FP well-being during public health emergencies. These could include the expansion of interprofessional team-based models of care, alternate remuneration models for primary care (ie, non-fee-for-service), organized locum programs, and the availability of short-term insurance programs to cover fixed practice operating costs., (© 2024 The Author(s); Published by Kerman University of Medical Sciences This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Using qualitative interviews with 68 family physicians (FPs) in Canada, we describe practice- and system-based approaches that were used to mitigate COVID-19 exposure in primary care settings across Canada to ensure the continuation of primary care delivery. Participants described how they applied infection prevention and control procedures (risk assessment, hand hygiene, control of environment, administrative control, personal protective equipment) and relied on centralized services that directed patients with COVID-19 to settings outside of primary care, such as testing centres. The multi-layered approach mitigated the risk of COVID-19 exposure while also conserving resources, preserving capacity and supporting supply chains., (Copyright © 2023 Longwoods Publishing.)

Background: In Canada, international medical graduates (IMG) consist of immigrant-IMG and previous Canadian citizens/permanent residents who attended medical school abroad (CSA). CSA are more likely to obtain a post-graduate residency position than immigrant-IMG and previous studies have suggested that the residency selection process favours CSA over immigrant-IMG. This study explored potential sources of bias in the residency program selection process., Methods: We conducted semi-structured interviews with senior administrators of clinical assessment and post-graduate programs across Canada. We asked about perceptions of the background and preparation of CSA and immigrant-IMG, methods applicants use to improve likelihood of obtaining residency positions, and practices that may favour/discourage applicants. Interviews were transcribed and a constant comparative method was employed to identify recurring themes., Results: Of a potential 22 administrators, 12 (54.5%) completed interviews. Five key factors that may provide CSA with an advantage were: reputation of the applicant's medical school, recency of graduation, ability to complete undergraduate clinical placement in Canada, familiarity with Canadian culture, and interview performance., Conclusions: Although residency programs prioritize equitable selection, they may be constrained by policies designed to promote efficiencies and mitigate medico-legal risks that inadvertently advantage CSA. Identifying the factors behind these potential biases is needed to promote an equitable selection process., Competing Interests: None to declare., (© 2023 Mathews, Bourgeault, Ryan; licensee Synergies Partners.)

Family physicians play important roles throughout all stages of a pandemic response; however, actionable descriptions outlining these roles are absent from current pandemic plans. Using a multiple case study design, we conducted a document analysis and interviewed 68 family physicians in four Canadian regions. We identified roles performed by family physicians in five distinct stages of pandemic response: pre-pandemic, phased closure and re-opening, acute care crisis, vaccination, and pandemic recovery. In addition to adopting public health guidance to ensure continued access to primary care services, family physicians were often expected to operationalize public health roles (eg, staffing assessment centres), modulate access to secondary/tertiary services, help provide surge capacity in acute care facilities, and enhance supports and outreach to vulnerable populations. Future pandemic plans should include family physicians in planning, explicitly incorporate family physician roles, and ensure needed resources are available to allow for an effective primary care response.