Search

The purpose of this study is to describe the demographics, training and practice characteristics of physicians performing thoracic surgery across Canada to better assess workforce needs.We developed a questionnaire using a modified Delphi process to generate questionnaire items. The questionnaire was administered to all Canadian thoracic surgeons via email (n = 102) or mail (n = 35).In all, 97 surgeons completed the survey (71% response rate). The mean age of respondents was 47.7 (standard deviation 9.1) years; 10.3% were older than 60. Ninety respondents (88.7%) were men, 95 (81.1%) practised in English and 93 (76%) were born in Canada. Most (90.4%) had a medical school affiliation, with an equal proportion practising in community or university teaching hospitals. Only 18% of respondents reported working fewer than 60 hours per week, and 34% were on call more than 1 in 3. Three-quarters of work hours were devoted to clinical care, with the remaining time split among research, administration and teaching. Malignant lung disease accounted for 61.2% of practice time, with the remaining time equally split between benign and malignant thoracic diseases. Preoperative testing (49.4%) and insufficient operating time (49.5%) were the most common factors delaying delivery of care. More than 80% of respondents reported being satisfied with their careers, with 62.1% planning on retiring after age 60.This survey characterizes Canadian thoracic surgeons by providing specific demographic, satisfaction and scope of practice information. Despite challenges in obtaining adequate resources for providing timely care, job satisfaction remains high, with a balanced workforce supply and demand anticipated for the foreseeable future.Cette étude a pour but de décrire les caractéristiques démographiques, de formation et de pratique des chirurgiens thoracique au Canada afin de mieux cerner les besoins en effectifs.Nous avons mis au point un questionnaire à l'aide d'une méthode Delphi modifiée pour générer les questions. Nous avons envoyé le questionnaire à tous les chirurgiens thoraciques canadiens par courriel (En tout, 97 chirurgiens ont répondu au sondage (taux de réponse de 71 %). L'âge moyen des répondants était de 47,7 (écart-type 9,1) ans; 10,3 % avaient plus de 60 ans. Quatre-vingt-dix répondants (88,7 %) étaient des hommes, 95 (81,1 %) exerçaient en anglais et 93 (76 %) étaient nés au Canada. La plupart (90,4 %) étaient rattachés à une faculté de médecine ou, en proportion égale, exerçaient dans des centres hospitaliers communautaires ou universitaires. Seulement 18 % des répondants ont déclaré travailler moins de 60 heures par semaine et 34 % étaient « sur appel » plus d'un jour sur 3. Les trois quarts des heures travaillées étaient consacrées aux soins cliniques et le temps restant se répartissait entre la recherche, les tâches administratives et l'enseignement. Le cancer du poumon a occupé 61,2 % du temps de pratique, le reste du temps se répartissant également entre diverses maladies thoraciques bénignes et malignes. Les épreuves préopératoires (49,4 %) et le manque de temps opératoire qui leur est accordé (49,5 %) figurent parmi les principaux facteurs qui retardent les chirurgies. Plus de 80 % des répondants se sont dits satisfaits de leur carrière et 62,1 % prévoient prendre leur retraite après l'âge de 60 ans.Ce sondage a permis de dégager les caractéristiques des chirurgiens thoraciques canadiens en fournissant des données démographiques spécifiques, leur taux de satisfaction et la portée de leur pratique. Même s'il leur est difficile d'obtenir toutes les ressources nécessaires pour prodiguer les traitements en temps opportun, leur satisfaction au travail demeure élevée et l'offre et la demande semblent équilibrées en regard des effectifs et des besoins prévus pour l'avenir prévisible.

Questioning the underutilization of ‘knowledge’ for the purpose of informing policy and decision-making is an area of historical and continued debate. In the last decade or so, there has been renewed interest in the health and health-care sectors in rapidly transforming knowledge into informed action. The term knowledge translation (KT) has been used to describe this process. Concomitant with this has been the rapid growth in the application of Information and Communications Technology (ICT) to capture data, transform data into information, share this information to generate knowledge, and to then apply that knowledge, giving rise to the term Technology-Enabled Knowledge Translation (TEKT). Many advantages are purported to exist for the use of ICTs in business, entertainment, health, education, and KT through linking people, objects, and information. Disadvantages are seldom addressed. Overlooked in this convergence of technology and KT has been the fact that application of any type of ICT solution has an environmental impact. Recent research into Environmental e-Health, another ICT-intensive field of health-related research and application, has revealed concern for three primary areas of environmental impact (resource depletion, energy use, and e-waste) and the need for thorough understanding of any specific circumstance through life cycle assessment. These findings are examined in the context of TEKT in order to raise awareness and encourage environmentally sensitive applications of TEKT solutions.

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.

The "Foundations in Global e-Health" is a capacity building initiative designed for providers, managers, and ICT professionals in the healthcare sector. Currently being trialled through PANACeA (a pan-Asian e-health research network) it is intended to offer the course in other developing regions from 2011. Using adult education principles, this on-line, self-paced course is offered in a modular fashion comprising 12 modules; the workload of each module is in the range of 20-24 hrs, with modules 2 to 12 requiring 1 month for completion. The evidence-based curriculum is designed to provide an introduction to e-Health such that graduates of the program have a solid and standardised baseline awareness and understanding--a common foundation--from which they are better able to collaboratively communicate and independently develop and assess e-Health initiatives within their respective settings and countries.

The Environmental e-Health Research and Training Program has completed its scoping study to understand the breadth of a new field of research: Environmental e-Health. Nearly every aspect of modern life is associated, directly or indirectly, with application of technology, from a cup of coffee, through transportation to and from work, to appliances in the home and industrial activities. In recent decades the rapidly increasing application of information and communications technologies (ICT) has added to the cacophony of technological 'noise' around us. Research has shown that technology use, including ICTs, has impact upon the environment. Studying environmental impact in such a complex global setting is daunting. e-Health is now being used as a convenient microcosm of ICT application within which to study these impacts, and is particularly poignant given that e-Health's environmental harms conflict with its noble goals of 'doing no harm'. The study has identified impacts, both benefits and harms in all three life-cycle phases for e-Health: up-stream (materials extraction, manufacturing, packaging, distribution), mid-stream (use period), and down-stream (end-of-life processes--disposal, recycling). In addition the literature shows that a holistic 'Life Cycle Assessment' approach is essential to understand the complexity of the setting, and determine the true balance between total harms and total benefits, and for whom.