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Purpose: This study aimed to examine how different learner arrangements affect the number of patients seen per hour by staff emergency physicians in ambulatory and non-ambulatory zones of two tertiary teaching hospitals in Ottawa, Canada., Methods: This was a retrospective cohort study analyzing all emergency department (ED) shifts at the Civic and General Campus EDs of The Ottawa Hospital from April 2022 to March 2023. Data collected included shift type (ambulatory or non-ambulatory), learner arrangement, and number of patients seen per hour. Descriptive statistics and two-sample, two-tailed t tests to analyze the relationship between patients seen per hour and learner arrangements., Results: We analyzed 8161 shifts over the study period, including 5233 in ambulatory care and 2928 in non-ambulatory care areas. Among ambulatory care shifts, the average number of patients seen per hour was 2.1 (95% CI 2.1-2.1) when working alone, 1.9 (1.9-2.0, p < 0.001) with a medical student, 2.1 (2.1-2.2, p = 0.20) with a junior resident, 2.6 (2.5-2.6, p < 0.001) with a senior resident, 2.1 (2.1-2.2, p = 0.33) with a junior resident and a medical student, and 2.6 (2.5-2.7, p < 0.001) with a senior resident and a medical student. In non-ambulatory care shifts, the average number of patients seen per hour was 1.4 (95% CI 1.3-1.5) when working alone (122 shifts, 4%), 1.4 (1.4-1.5, p = 0.63) with a medical student (85 shifts, 3%), 1.5 (1.5-1.5, p = 0.02) with a junior resident (1,013 shifts, 35%), 1.8 (1.7-1.8, p < 0.001) with a senior resident (682 shifts, 23%), 1.6 (1.5-1.6, p < 0.001) with a junior resident and a medical student (683 shifts, 23%), and 1.8 (1.7-1.8, p < 0.001) with a senior resident and a medical student (343 shifts, 12%)., Conclusion: This study highlights the significant impact that learner arrangements have on staff physician productivity in the ED. These findings underscore the importance of strategic scheduling to optimize patient throughput., Competing Interests: Declarations. Conflict of interest: On behalf of all authors, the corresponding author states that there is no conflict of interest. Ethical approval: This study received research ethics board exemption for quality improvement initiatives., (© 2024. The Author(s), under exclusive licence to the Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU).)

Inspired by Photovoice, a participatory research methodology, I WAS HERE was a photoblogging workshop in Toronto, Canada, for young mothers who, when they joined, were either homeless or had past experience of homelessness. A participatory qualitative analysis process was developed to support workshop participants in collectively conducting qualitative analysis on a selection of their photoblogs exploring how they view their lives. Five mothers engaged in the participatory qualitative analysis process to categorize their photoblogs into themes. Participants selected over 70 of their personal photoblogs, discussed the meaning of their photoblogs, and categorized them into qualitative themes. One of the mothers continued work on the research by contributing to the write-up of the themes for publication. Participants, through the reflective dialogue, developed nine themes from the photoblogs that describe how they experience motherhood. The resulting nine themes were as follows: 'Family', 'Reality Check', 'Sacrifice for Positive Change', 'Support', 'Guidance', 'Growth and Transition', 'Proud of Becoming/Being a Mother', 'Passing on/Teaching Values' and 'Cherished Moments/Reward for Being a Mother'. These themes illustrate the satisfaction that comes from motherhood, strengths and goals for the future, and the desire for support and guidance. The themes developed from this participatory analysis illustrate that young mothers have a positive view of themselves and their ability to be mothers. This constructive view of young mothers provides an alternative to the negative stereotypes commonly attributed to them. This paper also discusses the strengths and challenges of using a participatory analysis approach. As a research methodology, incorporating procedures for participatory qualitative analysis into the Photovoice process provides an effective mechanism to meaningfully engage participants in qualitative analysis. From a health promotion perspective, using the participatory analysis process expanded the Photovoice methodology to facilitate self-reflection and an empowering collective dialogue among a group of women whose strengths and assets are rarely showcased., (© The Author(s) 2014.)

Background: Countries around the world are experiencing a current and projected ongoing shortage of nurses. Internationally educated nurses are an underused, valuable human resource that could reduce the nursing shortage. A bridge program, with several innovations bundled into one program, was developed specifically to meet the needs of internationally educated nurses., Methods: A qualitative study using interviews was conducted with internationally educated nurses. Data were collected in the first semester, at the end of the program, and after nurses started work., Results: Although knowledge of the health care system is critical, an understanding of the adopted country's educational philosophy is also important. Occupation-specific language training and ample clinical time are essential for program success and for helping participants to secure employment., Conclusion: "One-stop shopping" bridge programs that provide a range of curricular supports for internationally educated nurses are essential to support this pool of highly skilled nurses in preparing for practice in their new home., (Copyright 2012, SLACK Incorporated.)

Objectives: To date, most patient safety studies have been conducted in relation to the hospital rather than the prehospital setting and data regarding emergency medical services (EMS)-related errors are limited. To address this gap, a study was conducted to gain an in-depth understanding of the views of highly experienced EMS practitioners, educators, administrators, and physicians on major issues pertaining to EMS patient safety. The intent of the study was to identify key issues to give direction to the development of best practices in education, policy, and fieldwork., Methods: A qualitative study was conducted using processes described by Lincoln and Guba (1985) to enhance the quality and credibility of data and analysis. Purposive sampling was used to identify informants with knowledge and expertise regarding policy, practice, and research who could speak to the issue of patient safety. Sixteen participants, the majority of whom were Canadian, participated in in-depth interviews., Results: Two major themes were identified under the category of key issues: clinical decision making and EMS's focus and relationship with health care. An education gap has developed in EMS, and there is tension between the traditional stabilize-and-transport role and the increasingly complex role that has come about through "scope creep." If, as expected, EMS aligns increasingly with the health sector, then change is needed in the EMS educational structure and process to develop stronger clinical decision-making skills., Conclusion: The results of this study indicate that many individual organizations and health regions are addressing issues related to patient safety in EMS, and there are important lessons to be learned from these groups. The broader issues identified, however, are system-wide and best addressed through policy change from health regions and government.

A recent national assessment of emergency planning in Canada suggests that health care professionals are not properly prepared for disasters. In response to this gap, an interprofessional course in disaster management was developed, implemented and evaluated in Toronto, Canada from 2007 to 2008. Undergraduate students from five educational institutions in nursing, medicine, paramedicine, police, media and health administration programs took an eight-week online course. The course was highly interactive and included video, a discussion forum, an online board game and opportunity to participate in a high fidelity disaster simulation with professional staff. Curriculum developers set interprofessional competency as a major course outcome and this concept guided every aspect of content and activity development. A study was conducted to examine change in students' perceptions of disaster management competency and interprofessional attitudes after the course was completed. Results indicate that the course helped students master basic disaster management content and raised their awareness of, and appreciation for, other members of the interdisciplinary team. The undergraduate curriculum must support the development of collaborative competencies and ensure learners are prepared to work in collaborative practice.