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Objective: Anti-glutamic acid decarboxylase (anti-GAD) antibodies are a frequently used diagnostic marker for autoimmune forms of diabetes mellitus (DM), namely, type 1 diabetes mellitus (T1DM) and latent autoimmune diabetes in adults (LADA). We sought to provide insight into a unique diagnostic application of anti-GAD antibodies in patients potentially misdiagnosed with type 2 diabetes mellitus (T2DM)., Methods: We present a case series of patients who had a change in diagnosis from T2DM to autoimmune DM that was supported by positive anti-GAD antibodies. Patients were identified via a retrospective chart review of all anti-GAD antibodies tests ordered between 1 January 2020 and 31 December 2021 at a tertiary care academic hospital., Results: Of the 23 patients with previous diagnosis of T2DM, positive anti-GAD antibodies supported the clinician's decision to change the diagnosis to autoimmune DM. The prominent clinical reasons for ordering anti-GAD antibodies in patients previously diagnosed as T2DM were patient presentation with diabetic ketoacidosis, features of insulin insufficiency, inadequate effect of oral diabetes mellitus medications, young age at diagnosis, and a family history of autoimmune conditions., Conclusion: Anti-GAD antibodies' positivity can support a change in diagnosis from T2DM to autoimmune DM, which has substantial impact on patient care. Timely and reliable clinical laboratory reporting of anti-GAD antibodies is highly recommended., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.)

Competing Interests: Competing interests: None declared.

Introduction: Health professions education often includes teaching observation to inform faculty development (FD) and indirectly improve student performance. Although these FD approaches are well received by faculty, they remain underused and/or underreported, with limited opportunities to receive feedback in workplace contexts. The goal of our study was to map the depth and breadth of education literature on the use of observation of teaching as a tool of professional development in medical education., Methods: Following the methodology by Arksey and O'Malley, we conducted a scoping review and searched four databases for articles published in English (final searches in April 2022)., Results: Of 2080 articles identified, 45 met the inclusion criteria. All observation activities were associated with one of the following FD approaches: peer observation of teaching (23 articles, 51%), peer coaching (12, 27%), peer review (9, 20%), and the critical friends approach (1, 2%). Thirty-three articles (73%) concerned formative versions of the observation model that took place in clinical settings (21, 47%), and they tended to be a voluntary (27, 60%), one-off (18, 40%), in-person intervention (29, 65%), characterized by limited institutional support (13, 29%). Both barriers and challenges of teaching observation were identified., Discussion: This review identified several challenges and shortcomings associated with teaching observation, such as inadequate methodological quality of research articles, inconsistent terminology, and limited understanding of the factors that promote long-term sustainability within FD programs. Practical strategies to consider when designing an FD program that incorporates teaching observation are outlined., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 The Alliance for Continuing Education in the Health Professions, the Association for Hospital Medical Education, and the Society for Academic Continuing Medical Education.)

Role modelling is important in developing professionalism with a need for reliable, evidence-based tools to assess professionalism in the learning environment (LE). The Learning Environment for Professionalism (LEP) survey is brief, anonymous and balanced assessing medical trainees' and attendings' positive and negative professionalism behaviours that can be tracked longitudinally and identify problem areas in the LE. Seven training programs agreed to facilitate administration of the LEP survey at four hospitals in Ottawa, Canada. The survey was carried out iteratively between 2013 and 2020. A total of 3783 LE ratings of training programs and hospitals were assessed longitudinally using univariate linear regression. A Bonferroni corrected p -value of ≤.0045 was used to account for multiple comparisons. Positive professional behaviours were observed across time with some of the negative behaviors having improved. A negative signal was found, with attendings appearing to be treating patients unfairly because of their financial status, ethnic background, sexual or religious preferences. Applying LEP survey longitudinally across diverse training programs and institutions is feasible and may assist programs to identify areas requiring attention and acknowledging areas of exemplary professionalism. Continuous monitoring of LE to meet requirements of accrediting bodies can also be considered an important quality improvement metric., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.