Author: UBC Abbotsford-Mission Family Practice Residency Program

“As hospitals and health care systems turn to artificial intelligence to help summarize doctors’ notes and analyze health records, a new study led by Stanford School of Medicine researchers cautions that popular chatbots are perpetuating racist, debunked medical ideas, prompting concerns that the tools could worsen health disparities for Black patients.

Powered by AI models trained on troves of text pulled from the internet, chatbots such as ChatGPT and Google’s Bard responded to the researchers’ questions with a range of misconceptions and falsehoods about Black patients, sometimes including fabricated, race-based equations, according to the study published Friday in the academic journal Digital Medicine and obtained exclusively by The Associated Press.”

Read more on AI chatbots are supposed to improve health care. But research says some are perpetuating racism via CBC News.

Do you have an idea for how to improve practice, health care delivery or any aspect of community-based primary health care? Then the UBC Clinician Scholar Program (CSP) may be for you! We are accepting applications until November 30, 2023 for program start date of July 1, 2024, so please help us spread the word.

The CSP will help you to develop your ideas into scholarship. Our program supports:

• Developing and conducting research
• Community engagement
• Contributions to education and to the family medicine knowledge base
• Knowledge translation

The Clinician Scholar Program offers two-year, half-time positions in family medicine research. These enhanced skills residency positions are open to practicing BC family physicians as part of the Postgraduate Program of the UBC Faculty of Medicine. The CSP is an accredited program with the College of Family Physicians in Canada.

For more information, please see our CSP Brochure attached, write to brian.ng@ubc.ca and evelyn.cornelissen@ubc.ca or visit our website: http://research.familymed.ubc.ca/clinician-scholar-program-2/

Please consider forwarding this information to any colleagues who might be interested in and/or considering research in their field of practice. 

Sincerely,

Evelyn Cornelissen, RD, PhD & Brian E. Ng, MD, MPH, CCFP, FCFP
Co-Director, Clinician Scholar Program
Dept of Family Practice 

“Under the circumstances, I feel compelled to speak out. As health professionals, we are committed to humanity and must condemn and fight these crimes against humanity.” ~ Aron Troen, Director of Hebrew University’s Nutrition and Brain Health Laboratory.

Read more on Israeli and Palestinian Doctors Speak Out: Medics and health workers describe how they have been affected by Hamas’ attacks on Israel and the response in Gaza via The Lancet.

“Canadian mothers face a high rate of severe, long-term injuries from the use of forceps or vacuum in childbirth, and urgent action is needed to reduce it, the authors of a new analysis paper say.

Operative vaginal delivery (OVD) refers to using forceps or vacuum in the second stage of labour when the cervix is fully dilated. Health-care professionals may need to use the instruments if labour stalls or if the fetus is at risk.

In an article published Thursday by medical journal BMJ, epidemiologist Giulia Muraca, an assistant professor in obstetrics and gynecology at McMaster University, and her co-authors note that Canada has the highest rate of maternal trauma during forceps- and vacuum-assisted deliveries out of 24 high-income countries. Canada’s injury rate was 16 per cent, compared to an average rate of 5 per cent for the group.

The paper says that of the more than 35,000 single infants born after OVD in Canada, one in four attempted forceps deliveries and one in eight attempted vacuum deliveries resulted in obstetric trauma — most commonly, obstetric anal sphincter injury, which involves severe tearing to the perineum.”

Read more on Severe childbirth injuries from forceps, vacuum ‘unacceptably high’ in Canada, research shows via CBC.

Question  What is the reliability of chatbot-generated responses to physician-generated medical queries?

Findings  In this cross-sectional study of 33 physicians across 17 specialties who generated 284 medical questions, chatbot generated predominantly accurate information in response to these diverse medical queries as judged by these academic physician specialists. The median accuracy score was 5.5 (between almost completely and completely correct), and the median completeness score was 3.0 (complete and comprehensive).

Meaning  Chatbot shows promise as a tool for providing accurate medical information in clinical settings.

Read more here on Accuracy and Reliability of Chatbot Responses to Physician Questions via JAMA Network.

Background: To train physicians who will respond to patients’ evolving needs and expectations, medical schools must seek educational strategies to foster the development of non-technical competencies in students. This article aims to synthetize studies that focus on patient engagement in medical training as a promising strategy to foster the development of those competencies.

Methods: We conducted a rapid review of the literature to synthetize primary quantitative, qualitative and mixed studies (January 2000-January 2022) describing patient engagement interventions in medical education and reporting non-technical learning outcomes. Studies were extracted from Medline and ERIC. Two independent reviewers were involved in study selection and data extraction. A narrative synthesis of results was performed.

Results: Of the 3875 identified, 24 met the inclusion criteria and were retained. We found evidence of a range of non-technical educational outcomes (e. g. attitudinal changes, new knowledge and understanding). Studies also described various approaches regarding patient recruitment, preparation, and support and participation design (e.g., contact duration, learning environment, patient autonomy, and format). Some emerging practical suggestions are proposed.

Conclusion: Our results suggest that patient engagement in medical education can be a valuable means to foster a range of non-technical competencies, as well as formative and critical reflexivity. They also suggest conditions under which patient engagement practices can be more efficient in fostering non-instrumental patient roles in different educational contexts. This supports a plea for sensible and responsive interventional approaches.

Read more on Fostering the development of non-technical competencies in medical learners through patient engagement: a rapid review via CMEJ.

“The overall objective of World Mental Health Day is to raise awareness of mental health issues around the world and to mobilize efforts in support of mental health.

The Day provides an opportunity for all stakeholders working on mental health issues to talk about their work, and what more needs to be done to make mental health care a reality for people worldwide.”

Learn more via WHO.

An Ottawa walk-in clinic already under scrutiny is now being accused of falsely posting the biographies of at least two doctors who have never worked for the clinic on its website.

Dr. Sonam Maghera shared screenshots with CBC of the South Keys Health Center’s (SKHC) website section of team members, which displayed her name and a description matching the bio posted on her practice’s website word for word. 

According to Maghera, she has never had any contact whatsoever with the South Keys clinic.

“I was deeply concerned because I didn’t work there … and they could have potentially been seeing patients under my licence,” she said.

The physician, who specializes in sports medicine, became aware of the problem last week after a patient contacted her clinic concerned that Maghera had left her existing practice with the Ottawa Orthopedic Centre.

Read more on Doctors discover their bios being used by clinic despite never working there via CBC News.

Abstract:
Background: Breast cancer-related lymphedema (BCRL) after primary therapy is a common condition, causing physical and psychological distress. Decongestive lymphedema therapy (DLT) using multi-layered compression bandages is an effective treatment. We conducted a randomized controlled trial evaluating the use of a specific mobilizing bandage (Mobiderm^®) on lymphedema volume reduction during the intensive phase of DLT.

Methods and Results: Fifty female BCRL patients were randomized to receive either conventional multi-layered bandages or mobilizing bandaging by using Mobiderm. Affected limb volume and excess volume were evaluated at baseline (D0) and after 15 days. The primary outcome was change in affected limb volume after adjustment for baseline. Symptom scores were evaluated by visual analogue scale (VAS); safety and tolerability were also assessed. Baseline characteristics were comparable. Affected limb volume reduction was observed in both study groups after 15 days: by 19.0% in the Mobiderm arm and 8.6% in controls (adjusted values). The between-group mean difference in adjusted volume reduction at day 15 was 256 mL (95% confidence interval [CI], 92.5 to 421.3 mL; p = 0.003) favoring Mobiderm. Reductions in excess volume of 57.3% (Mobiderm) and 25.1% (controls) were observed (adjusted values); with between-group mean difference in adjusted excess volume of 220.2 mL (95% CI, 69.3 to 371.3 mL; p = 0.006) favoring Mobiderm. Pain/heaviness VAS scores fell significantly in both groups, with mean reductions of 1.84 (Mobiderm) versus 0.83 (control; p = 0.001). Both regimens were well tolerated.

Conclusion: The use of Mobiderm in multilayer compression bandaging shows benefit in lymphedema reduction and in alleviating functional symptoms/pain in patients with BRCL.

Read more on Safety and Efficacy of a Mobiderm Compression Bandage During Intensive Phase of Decongestive Therapy in Patients with Breast Cancer-Related Lymphedema: A Randomized Controlled Trial via Lymphatic Research and Biology.

As our department co-lead for Assessment & Evaluation, I often receive questions as to the differences between field notes and in-training assessment reports. The infographic above attempts to easily explain how these two instruments are used in our program. If you have any further questions, please feel free to reach out to me at jacqueline.ashby@ubc.ca or visit our A & E website here.