On Humane Experimental Technique

(@joseluislopezgalvan | 2011, Oil on Canvas) 
A paraphrasing of #Rembrandt’s “The Anatomy Lesson Of Dr. Nicolaes Tulp”

“The first principle is that you can only use animals if they’re the most ethically acceptable way to address the question. It goes beyond the “replacement” part of the three Rs in that scientists must not just consider alternatives to using animals, they must prove that there are no viable alternatives. An IACUC [Institutional Animal Care and Use Committee], for example, might ask an investigator to detail the science showing that animal alternatives like organ on a chip or microdosing humans aren’t viable. It puts more teeth into replacement.

Another principle would ask scientists to detail how much humans and society are likely to benefit from the research, and contrast that with how much animals are likely to suffer. Even if the benefits of using animals outweigh the costs, we want researchers to think about how they can mitigate—and even eliminate—any harms caused to animals during their experiments. Are they drawing blood more than they need to? Are they handling rodents more often than necessary?

Scientists also should be thinking about how to give these creatures the best life possible in the lab. That could include making sure they have companions, exercise, and other stimulating activity.”

More on Is it time to replace one of the cornerstones of animal research? via Science.

On Defunding the Police

“According to the Canadian Medical Health Association BC Division, nearly a third of people with serious mental illness have contact with police when trying to access mental health care for the first time. They are also more likely than other Canadians to be arrested or die in those interactions.

Yet, most mental health crises don’t require a police response, says Dr. Vicky Stergiopoulos, physician-in-Chief and Clinician Scientist at the Centre for Addiction and Mental Health in Toronto. She wants to see increased public funding for non-police emergency mental health responses. ‘The presence of police escalates the agitation, as opposed to providing the safe holding environment that someone needs to regain control of themselves,’ she says. ‘There is expertise in the mental health field on how to allow others to regain control of themselves.’

She points to the Crisis Assistance Helping Out on the Streets (CAHOOTS) service in Eugene, Oregon, where health professionals respond to mental health calls instead of police. Last year, the service responded to 17% of the local 911 calls and called for police backup less than 1% of the time. According to the CAHOOTS program, the service saves an estimated $8.5 million in public safety spending annually. Similar services exist in Sweden and the United Kingdom.”

More on Why some doctors want to defund the police via CMAJ.

Additional 2020 articles on the issue:

What we know about the last 100 people shot and killed by police in Canada via CTV News.
UBC nursing student suing RCMP officer for alleged assault after health check via The Star.
Indigenous woman killed by Edmundston, N.B., police during wellness check via CBC.
London, Ont. police officer convicted in death of Indigenous woman via CP24.
Funerals held for Toronto woman who fell from balcony and Indigenous woman shot by police via National Post.
Police kill Canadian man during mental health check via BBC News.

UFV-UBC Interprofessional Virtual Simulation

This past week we conducted our first University of the Fraser Valley (UFV) and University of British Columbia (UBC) interprofessional virtual simulation. Our UFV-UBC faculty have worked over the past year to design this unique opportunity that bridges Nursing and Family Practice programs in order to support team-based communication and patient-centred care. During the course of three hours, we facilitated four simulations that involved two teams comprised of one nursing student and one resident. Each team participated in two simulations that addressed caring for a critically ill patient followed by breaking bad news to the patient’s caregiver. Our learning objectives focused on:

  1. Demonstrating effective, collaborative, and respectful interprofessional communication
  2. Developing knowledge of health care team members roles
  3. Demonstrating collaborative leadership skills when caring for a critically ill patient
  4. Managing the care of a deteriorating/changing patient

We want to thank our simulation participants including Claire Wilcox, Megan Schmidt, Dr. Sophia Park, and Dr. Casey Hicks, in addition to our learners that joined us from home. We would also like to acknowledge the UFV-UBC faculty that were instrumental in developing and facilitating the simulation including Lee-Anne Stephen, Sarah Johanson, Janelle Baerg, Dr. Thanh Luu, and Dr. Jacqueline Ashby. Lastly, we thank UFV for allowing our team to use their facilities.

I want to conclude by saying that COVID-19 has challenged our program’s ability to both protect our learners’ health and offer them the experiences that are instrumental in their growth and development as healthcare practitioners. As a community, it’s imperative that we all do our part in taking the necessary measures to stop the spread of this virus. Please review the new regional orders that pertain to social gatherings, travel, indoor group physical activities, and workplace safety.

We are in this together.

Thank you,


The CFPC underscores the unique considerations for Indigenous health in medical education

The College of Family Physicians of Canada (CFPC) is pleased to release the CanMEDS–Family Medicine Indigenous Health Supplement. It outlines Indigenous-specific considerations relevant to all areas of physicians’ professional activity, from medical expertise to advocacy and academic pursuits. This important resource, developed by the CFPC’s Indigenous Health Committee, complements CanMEDS–Family Medicine 2017—a competency framework that outlines the skills and abilities required for Canadian family physicians—and aims to optimize positive Indigenous health outcomes through a commitment to lifelong learning.

The document elaborates on the seven key CanMEDS-FM roles—the Family Medicine Expert, Communicator, Collaborator, Leader, Health Advocate, Scholar, and Professional—and defines each role in the context of Indigenous tradition. It focuses on supporting therapeutic relationships and creating a culturally safe patient experience that considers the unique needs, circumstances, and strengths of First Nations, Inuit, and Métis patients and their communities.

“This resource provides medical educators and academic leaders with a framework to prepare learners on how to engage in care that authentically respects the cultural, historical, political, and social contexts of Indigenous peoples,” says Dr. Sarah Funnell, CFPC Board Director and Co-chair of the CFPC’s Indigenous Health Committee. “Family doctors are often the first point of care and it is imperative that they have the critical knowledge and skills needed to support effective therapeutic interactions that are culturally safe, informed, and free of racism and discrimination.”

Learn more here.

Online supports for COVID-19 stress are there—but Canadians aren’t accessing them

“Sixty-five per cent of the 3,000 survey participants reported adverse mental health impacts related to COVID-19 in May, yet only two per cent reported accessing online mental health resources such as apps, websites, digital tools or other supports not involving direct contact with a mental health care provider.

‘Even among people who were experiencing mental distress of various types, and in groups who would likely benefit from these resources, the uptake was quite low,’ said lead researcher Emily Jenkins, a professor of nursing at UBC. ‘These programs are ideally positioned for the types of difficult experiences and emotions that we’re seeing during the pandemic. They are well suited for people who are having trouble coping and need some support to manage their mental health. They’re also easily accessed, and many are available in different languages.’

Among the online mental health resources available free to Canadians are:

  • CMHA’s BounceBack, currently available in B.C., Manitoba and Ontario and expanding to the rest of the country soon through a gift from Bell Let’s Talk
  • Wellness Together Canada, a federally funded program
  • WellCan, a resource developed and funded by corporate, community and public sector partners
  • Ontarians also have free access to the for-profit cognitive behavioural therapy program MindBeacon during the COVID-19 pandemic

Jenkins and Richardson are conducting further research to understand why use of these resources is so low, but early indications are that a lack of awareness is a major contributing factor. ‘We see a lot of messaging out there about physical distancing, face masks and hand washing. We really need to get more messages out to people about how they can support their mental health in a positive way as well,’ said Richardson.”

Learn more here on Online supports for COVID-19 stress are there—but Canadians aren’t accessing them via UBC Faculty of Medicine.