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Objectives: The purpose of this evaluation study was to identify the feasibility of repurposing specific online modules developed by the Public Health Agency of Canada as continuing education modules for front-line practitioners, in teaching clinical epidemiology to undergraduate medical students. Specifically, relevancy of the content, quality of online material, time-effectiveness of using the online component, required resources, and student satisfaction were investigated., Method: Both qualitative and quantitative data were collected. Semi-structured interviews were conducted with stakeholders from the Skills Enhancement Program, technical support personnel, instructors, a web administrator and an assignment marker. Surveys measuring student satisfaction were administered to students in the middle of the online component and at the end of the course. Two student focus groups were conducted. As well, other documents (e.g., online materials, course packages) were reviewed., Results: Instructors felt that the content of the modules was appropriate and would enhance learning, although making changes was time consuming. Medical students reported that the content was relevant and they enjoyed the flexibility allowed by the online components. However, students reported that there were too many assignments and too much content for the allotted time frame., Conclusion: The Public Health Agency's online content seems to be relevant to medical students, but needs to be fine-tuned further to cater to their specific needs. Instructors required a lot of time to review and revise the content. The time allocated for online content in this course was too little compared to the volume of information. It is feasible to repurpose the online modules in undergraduate medical education.

Background: While the benefits of physical activity are generally recognized, over half of adult Canadians are not active enough to receive those benefits. Physicians may influence patient activity through counselling; however, research is inconsistent regarding their effectiveness in doing so. Increasing patients' use of self-regulatory skills in managing their activity and additional telephone support are suggested as two means of improving physician counselling. When assessing the effectiveness of physician counselling, it may be important to measure both outcome and treatment adherence. We compared physician-directed activity counselling (modified PACE protocol) with a modified PACE protocol augmented with telephone-based counselling for patient support for both outcome and treatment adherence., Methods: Physicians counselled 90 patients using a modified PACE protocol that included self-regulatory skills. Physical activity was assessed by questionnaire at baseline (prior to counselling) and one month later. Participants were divided into two groups: counselling (modified PACE counselling) and enhanced counselling (modified PACE counselling plus telephone support)., Results: The main outcome (mean energy expenditure) and secondary outcomes of treatment adherence (frequency, frequency of moderate activity, and duration) significantly increased over time (p < 0.05). No significant interactions between group and time were found., Interpretation: Our results support the effectiveness of physician counselling for activity that included the use of self-regulation skills. The effectiveness of telephone support over and above that of physician counselling was not supported. Our results demonstrate that assessing treatment adherence provides a means of discerning whether the counselling intervention was delivered as intended.

Background and Purpose: The purpose of this study was to estimate rates of hospitalization and in-hospital case-fatality for cerebral infarction and intracerebral hemorrhage in Canada and to describe variation in rates by age, sex, and calendar period., Methods: Data were obtained from hospitalization databases for each of Canada's 10 provinces for the 10 fiscal years of 1982 through 1991. All hospitalizations of persons 15 years of age or older with a primary diagnosis at discharge coded 431, 434, or 436 according to the International Classification of Disease, 9th Revision, were included. Rates per 100,000 population were calculated for intracerebral hemorrhage and cerebral infarction, for men and women, and for five age groups. Annual age- and sex-specific, 30-day, in-hospital case-fatality rates were also calculated., Results: A total of 335,283 discharges for stroke were enumerated over the 10-year period (309,631 cerebral infarctions and 25 652 intracerebral hemorrhages). A significant decline of approximately 1% per year was observed for the rate of cerebral infarctions. For hemorrhages, the reverse was seen. For men there was a 44% increase over the 10-year period, and for women there was a 34% increase. In-hospital case-fatality rates for cerebral infarctions increased with age but did not differ by sex when age was considered. For the five age groups of 15 to 54, 55 to 64, 65 to 74, 75 to 84 and > or = 85 years, rates were 6%, 8%, 12%, 18% and 27%, respectively. For intracerebral hemorrhage, the in-hospital case-fatality rates declined significantly over time from approximately 36% to 29%, 55% to 37%, 49% to 41%, 66% to 45%, and 72% to 59% for the five age groups, respectively., Conclusions: The possibility that these changes are artifactual could not be ruled out, but because there is no obvious risk in assuming that they are not, it would be prudent to investigate their causes further.