BackgroundEnsuring access to timely and appropriate primary healthcare for people living in poverty is an issue facing all countries, even those with universal healthcare systems. The transformation of healthcare practices and organization could be improved by involving key stakeholders from the community and the healthcare system in the development of research interventions. The aim of this project is to stimulate changes in healthcare organizations and practices by encouraging collaboration between care teams and people living in poverty. Our objectives are twofold: 1) to identify actions required to promote the adoption of professional practices oriented toward social competence in primary care teams; and 2) to examine factors that would encourage the inclusion of people living in poverty in the process of developing social competence in healthcare organizations.Methods/designThis study will use a participatory action research design applied in healthcare organizations. Participatory research is an increasingly recognized approach that is helpful for involving the people for whom the research results are intended. Our research team consists of 19 non-academic researchers, 11 academic researchers and six partners. A steering committee composed of academic researchers and stakeholders will have a decision-making role at each step, including knowledge dissemination and recommendations for new interventions. In this project we will adopt a multiphase approach and will use a variety of methods, including photovoice, group discussions and interviews.DiscussionThe proposed study will be one of only a few using participatory research in primary care to foster changes aimed at enhancing quality and access to care for people living in poverty. To our knowledge this will be the first study to use photovoice in healthcare organizations to promote new interventions. Our project includes partners who are targeted for practice changes and improvements in delivering primary care to persons living in poverty. By involving knowledge users, including service recipients, our study is more likely to produce a transformation of professional practices and encourage healthcare organizations to take into account the needs of persons living in poverty.

Following the massacre of fourteen women at Ecole Polytechnique, in December 1989, the content (affective, social, religious, feminist, and anti-masculinist) of 690 condolence messages written by the public at two French universities (Université de Montréal and Université du Québec à Montréal) were compared. The results show that this event did not trigger a homogeneous social reaction, but rather different ones, according to sex and university, suggesting that social investment factors play a role in the codification of events related to public deaths.

We assessed clinicians' continuing professional development (CPD) needs at family practice teaching clinics in the province of Quebec. Our mixed methodology design comprised an environmental scan of training programs at four family medicine departments, an expert panel to determine priority clinical situations for senior care, a supervisors survey to assess their perceived CPD needs, and interviews to help understand the rationale behind their needs. From the environmental scan, the expert panel selected 13 priority situations. Key needs expressed by the 352 survey respondents (36% response rate) included behavioral and psychological symptoms of dementia, polypharmacy, depression, and cognitive disorders. Supervisors explained that these situations were sometimes complex to diagnose and manage because of psychosocial aspects, challenges of communicating with patients and families, and coordination of interprofessional teams. Supervisors also reported more CPD needs in long-term and home care, given the presence of caregivers and complexity of senior care in these settings.

Introduction : La pandémie de COVID-19 est de l’ordre de l’évènement. Il y a un temps de passage pandémique qui impacte profondément nos vies personnelles, professionnelles et collectives. Or, comment enseignons-nous dans ces temps de grand bouleversement ? Quels sont les principaux changements survenus ? Méthode : Suivant une logique de Cartel, quatre professeures et un chercheur qualitatif ont réalisé une recherche autoethnographique visant à documenter les principaux changements survenus dans l’enseignement de la médecine de famille dans leurs pratiques respectives situées dans quatre groupes de médecine familiale universitaire différents de l’Université de Sherbrooke. Résultats : Cinq moments clefs de l’enseignement survenus en temps de pandémie ont été identifiés: a) la déclaration de pandémie, b) l’approche avec la cohorte finissante/avancée de résidents, c) l’anticipation et la préparation de l’arrivée des nouveaux résidents, d) l’arrivée des résidents de première année et e) l’adaptation à la deuxième vague. Pour chacun, nous présentons les enjeux rencontrés dans nos pratiques de soins et d’enseignement sous trois axes relationnels transversaux : la relation de l’humain à son contexte culturel, la relation patient-médecin et la relation enseignant-résident.  Conclusion : Notre analyse montre que la transmission du savoir médical et de l’art de la médecine ne peut se faire sans une attention spécifique au contexte culturel global, à la relation contextuelle de soins cliniques et à la relation d’enseignement. Notre étude permet aussi de recommander l’ouverture d’espaces de réflexion et de dialogue dans nos milieux d’enseignement.

Background and Objectives: Many clinical supervisors in family medicine feel ill-equipped to teach senior care to their family medicine residents (trainees). We therefore sought to explore their preferred learning strategies for improving their clinical and teaching skills with regard to senior care. Methods: In this qualitative study, we conducted focus groups and interviews with supervisors from four family medicine clinics, to explore their preferred educational strategies. We selected four clinics using a maximum-variation strategy, based on a survey assessing continuing professional development (CPD) needs. The qualitative thematic analysis followed an inductive/deductive approach based on McGuire’s attributes of persuasive communication. Results: The four focus groups and nine interviews with 53 supervisors (37 physicians, 9 nurses, 4 psychologists, 1 social worker, 1 nutritionist, 1 sexologist) revealed that supervisors preferred being trained by experienced trainers specialized in senior care, from various professional backgrounds, and knowledgeable about local community resources. They valued practical training the most, such as clinical case discussions based on real cases, clinical tools, and mentoring. The findings also suggest that training in senior care should be adapted to the supervisors’ experience, profession, workload, and scope of intervention. Supervisors valued repeated CPD with longitudinal follow-up and easy access to trainers and to up-to-date training content. Conclusions: The findings of this project will allow those who design CPD activities to adapt such activities to the preferences of supervisors, so as to improve their clinical and teaching skills in senior care. This, in turn, may help supervisors to embody an appealing professional role model for learners.