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Context: The CanMEDS framework promotes the development of competencies required to be an effective physician. However, it is still not well understood how to apply such frameworks to CPD contexts, particularly with respect to intrinsic competencies. Objective: This study explores whether physician narratives around challenging cases would provide information regarding learning needs that could help guide the development of CPD activities for intrinsic CanMEDS competencies. Methods: We surveyed medical and surgical specialists from Southern Ontario using an online survey. To assess perceived needs, participants were asked, ‘Describe three CPD topic you would like to learn about in the next 12 months’. To identify learning needs that may have arisen from problems encountered in practice, participants were asked, ‘Describe three challenging situations encountered in the past 12 months.’ Responses to the two open-ended questions were analyzed using thematic content analysis. Results: Responses were received from 411 physicians, resulting in 226 intrinsic CanMEDS codes for perceived learning needs and 210 intrinsic codes for challenges encountered in practices. Discrepancies in the frequency of intrinsic roles were observed between the two questions. Specifically, Leader (28%), Scholar (43%), and Professional (16%) roles were frequently described perceived learning needs, as opposed to challenges in practice (Leader: 3%; Scholar: 2%; and Professional: 8%. Conversely, Communicator 39%, Health Advocate 39%, and to a lesser extent Collaborator 11%) roles were frequently described in narratives surrounding challenges in practice, but appeared in

Studies have noted that close relationships with individuals with posttraumatic stress disorder can lead to traumatic stress among their caregivers. This study intended to understand the prevalence of secondary trauma stress among spouses of veterans and the association of the degrees of posttraumatic stress disorder in veterans with the severity of symptoms in their spouses. One hundred veterans and their spouses were studied and data were gathered using measures and questionnaires. The severity of posttraumatic stress disorder in the veterans group predicted the degree of traumatic stress in the spouses group (p = .0001). Among the demographic factors, only the duration of posttraumatic stress disorder symptoms in veterans predicted the severity of secondary trauma stress in spouses (p = .01).

Background: Impaired marital adjustment has been introduced as one major complication of PTSD. There are controversial results about the role of Cognitive Behavioral Couple' s Therapy (CBCT) on improvement of marital adjustment of PTSD veterans; the efficacy of CBCT on marital adjustment improvement is questioned in some studies and also there are no similar researches about the affect of CBCT on marital adjustment, conducted among Middle Eastern PTSD veterans. These factors motivated us to perform and evaluate our CBCT protocol among Iranian combat veterans. Methods: we enrolled 60 PTSD veterans with low degrees of marital adjustment. They were randomly distributed into intervention and control groups. Both groups have been evaluated for marital adjustment by means of ENRICH scale before and after intervention and the results were analyzed by MANOVA test. Results: The analysis was based on difference of T2 and T1 (T2-T1) where the mean of T2-T1 was -2.63 for control group and 44.9 for intervention group, sum of squares 69552.7, f=95.4 and sig. �000.1. Conclusion: this shows that the prevalence of marital maladjustment is high among PTSD veterans (43%) and the efficacy of CBCT was significant both for veterans themselves and their spouses.