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BACKGROUND: This project aims to characterize the extent and nature of impostor phenomenon (IP) among women surgeons in Canada. IP is well documented among medical professionals and trainees. It is known to have significant impacts on mental health and career trajectory. STUDY DESIGN: We conducted a cross-sectional survey of self-identifying women who have completed a surgical residency and currently or most recently practiced in Canada. RESULTS: Among 387 respondents, 98.7% have experienced IP. Median IP score corresponded to frequent impostor feelings or high impostorism. Self-doubt affects most women surgeons for the first time during training. It tends to be most intense in the first 5 years of practice and lessens over time. One hundred twelve (31.5%) surgeons experience self-doubt in the operating room (OR). Due to self-doubt, 110 (28.4%) respondents preferred to work with a more experienced assistant in the OR, whereas 40 (10.4%) stated that they would only operate with an experienced assistant. Few surgeons take on less OR time due to self-doubt (29 [7.5%]), but 60 (16.5%) take on fewer complex cases due to self-doubt. A small but important number of surgeons (11 [2.8%]) had given up operating altogether due to self-doubt. Due to feelings of self-doubt, 107 (21.4%) respondents were hesitant to take on a leadership role in the workplace. CONCLUSIONS: IP is a nearly universal experience among women surgeons and is influential in their professional lives. This study contributes to scientific knowledge that can advance gender equity in medicine and leadership. [ABSTRACT FROM AUTHOR]

Background The current literature provides heterogeneous recommendation regarding the investigation of older delirious patients, which may lead to over-testing. Our study aims to describe Canadian physicians' current practice for the investigation of older patients with delirium. Our secondary objective is to define specific indications for performing a CT head scan in this population. Methods Design: cross-sectional online survey. Participants: physicians who conduct their clinical practice in Canada and who care for older patients with delirium. Potential study participants were reached through Canadian associations: Canadian Geriatrics Society, the Canadian Association of Emergency Physicians, the Association des Médecins d'Urgence du Québec, and members of Choosing Wisely Canada. Results We received 296 survey responses. More than 80% of respondents always order complete blood count, urea, and creatinine and electrolytes. Extended electrolytes, TSH, chest X-ray, electrocardiogram, urinalysis and urinary culture tests tend to be ordered somewhat frequently. Physicians mostly agreed to order a head CT scan for loss of consciousness, altered mental status, fall, and anticoagulation. Conclusions Physicians' investigations for older patients with delirium are highly variable, even with the lack of evidence supporting a broad workup. Also, respondents mostly align with current recommendations of indications for CT head scans. [ABSTRACT FROM AUTHOR]

Background The Canadian province of Alberta released the ABTraceTogether smartphone app in May 2020 to assist in contact tracing during the SARS-CoV-2 pandemic. Public engagement with this public health tool has been low, limiting the effectiveness of the intervention. This study examines physician knowledge of the app and practice patterns in relation to the app. Methods We conducted a cross-sectional self-administered online English language survey of physicians and medical students in Alberta, Canada. The survey link was sent to all registered members of the College of Physicians and Surgeons of Alberta and was distributed by other provincial physician organizations and health zone leaders. Results The survey received 317 responses. 96% of participants were aware of the app but only 27% had recommended the app to patients. The most common reason provided for not downloading or recommending the app was that participants had security concerns about the app. 23% of participants indicated they did not believe they had a responsibility to recommend the app to others. Conclusions Our study provides insights into participants' knowledge and beliefs about the ABTraceTogether app. This information may be valuable to public health officials who wish to engage physicians in future public health campaigns. [ABSTRACT FROM AUTHOR]

Objective: Early mobilization is safe, feasible, and associated with better outcomes in patients with critical illness. However, barriers to mobilization in clinical practice still exist. The objective of this study was to assess the knowledge and practice patterns of intensive care unit (ICU) clinicians, as well as the barriers and facilitators to early mobilization. Design: Cross-sectional survey. Setting: Intensive care units of 3 university-affiliated hospitals in Montreal, Canada. Participants: One hundred and thirty-eight ICU clinicians, including nurses, physicians, respiratory therapists, and physiotherapists. Interventions: None. Measurements: Perceived barriers, facilitators, knowledge, and practice patterns of early mobilization were assessed using a previously validated mobility survey tool. Main Results: The overall response rate was 50.0% (138 of 274). Early mobilization was not perceived as a top priority in 49% of respondents. Results showed that clinicians were not fully aware of the benefits of early mobilization as per the current literature. About 58% of clinicians did not feel well trained and informed to mobilize mechanically ventilated patients. Perceptions on patient-level barriers varied with clinicians' professional training, but there was a high degree of interprofessional and intraprofessional disagreement on the permissible maximal level activity in different scenarios of critically ill patients. Conclusions: Our survey shows limited awareness, among our respondents, of the clinical benefits of early mobilization and high level of disagreement on the permissible maximal level of activity in the critically ill patients. Future studies should evaluate the role of knowledge translation in modifying these barriers and improving early mobilization. [ABSTRACT FROM AUTHOR]

The diagnostic process for patients presenting with cognitive decline and suspected dementia is complex. Physicians face challenges distinguishing between normal aging, mild cognitive impairment, Alzheimer's disease, and other dementias. Although there is some evidence for improving attitudes towards the importance of prompt diagnosis, there is limited information describing how physicians approach this diagnostic challenge in practice. This was explored in the present study. Across-sectional survey of primary care and specialist physicians, in 5 European countries, Canada, and the United States, was conducted. Participants were asked about their use of cognitive screening tools and diagnostic technologies, as well as the rationales and barriers for use. In total, 1365 physicians participated in the survey, 63% of whom were specialists. Most physicians stated they use objective cognitive tools to aid the early detection of suspected mild cognitive impairment or Alzheimer's disease in patients. The Mini-Mental State Examination was the most common tool used for initial screening; respondents cited speed and ease of use but noted its lack of specificity. Cerebrospinal fluid biomarker and amyloid positron emission tomography tests, respectively, had been used by only 26% and 32% of physicians in the preceding 6 months, although patterns of use varied across countries. The most commonly cited reasons for not ordering such tests were invasiveness (for cerebrospinal fluid biomarker testing) and cost (for amyloid positron emission tomography imaging). Data reported by physicians reveal differences in the approaches to the diagnostics process in Alzheimer's. A higher proportion of primary care physicians in the United States are routinely incorporating cognitive assessment tools into annual visits, but this is due to country differences in clinical practice. The value of screening tools and regular use could be discussed further with physicians; however, lack of specificity associated with cognitive tools and the investment required from patients and the healthcare system are limiting factors. [ABSTRACT FROM AUTHOR]

• The impact of COVID-19 pandemic on child maltreatment investigators was examined. • The changes in work practices during the pandemic were investigated through a survey. • Child maltreatment investigators experienced greater stress levels during the pandemic. • Workers perceived higher stress levels among children and families receiving services. As cases of child maltreatment become an increasing concern during the COVID-19 pandemic, the perspectives of those charged with protecting and supporting children and families is an important area of inquiry. We sought to examine the experiences of child maltreatment workers during the first wave of the pandemic (i.e., May-July 2020). We specifically aimed to examine child maltreatment experiences related to the following: (1) their work practices during the pandemic, (2) their perceived safety during the pandemic, and (3) their perceptions on the safety of the children and families with whom they work. A total of 106 child maltreatment investigators and forensic interviewers provided responses to a national survey disseminated across Canada. Using a cross-sectional design, data were collected through a survey management program. The survey combined both open-ended and forced choice questions to gather perspectives on respondents' experiences. More than half (67%) reported a reduction in their caseloads during the pandemic (May-July 2020) and continued in-person interviews, with the use of preventative health measures (i.e., PPE, physical distancing, gloves). Most respondents reported elevated stress levels and similarly high stress levels amongst the children and families to whom they provide services. Overall, our findings highlight both how child maltreatment investigators have adapted to preventative measures and the continuing areas of weakness where further supports are required. [ABSTRACT FROM AUTHOR]

Background: Cocaine has traditionally been the topical decongestant most frequently used for visualization of the surgical field in Endoscopic Sinus Surgery (ESS). Alternatives include xylometazoline, oxymetazoline, and epinephrine. The understanding of the safety profile of each agent is changing, as are the practices of Otolaryngologists-Head & Neck Surgeons. The objective of this study is to determine decongestant use practices in ESS across Canada, which has not previously been studied. Methods: A cross-sectional survey design using a 24-item electronic questionnaire was distributed to actively practicing members of the Canadian Society of Otolaryngology-Head and Neck Surgery via email. A French translated version of the survey was also available. Questions explored the respondents' demographics and decongestion practices for ESS. Results: Ninety-six surveys from otolaryngologists practicing in Canada were completed (19% response rate). The average time in practice was 16.5 years (range 1–50 years, SD 12.0 years). Twenty-six (27%) of respondents use some form of cocaine solution for topical decongestion in ESS. Over a total of over 1500 combined practice-years, eight respondents (8%) personally experienced an adverse event that could be attributed to cocaine, including two mortalities. One cardiac even was directly attributable to the patients' use of recreational cocaine in the immediate pre-operative period. Conclusion: The popularity of cocaine for topical decongestion in ESS in present-day Canada is less than in surveys from other countries. However, there are few reported adverse events with long-term consequences that are attributable to intraoperative cocaine. Considering the beneficial effects of cocaine for visualization and pain control, this change in practice warrants further investigation. [ABSTRACT FROM AUTHOR]