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Diabetes is increasingly prevalent in Indigenous women and increases their risk of developing diabetic retinopathy, an eye complication of diabetes and a common cause of vision loss in Canada, especially among adults. Early detection is the most effective approach to prevent vision loss and reduce the impact of diabetic retinopathy.This study examined enablers and barriers that influence the diabetes eye care behaviour of First Nations and Métis women with diabetes and at risk of diabetes.We conducted a descriptive qualitative study with 35 First Nations and Métis women with diabetes or at risk of diabetes in Saskatoon, Canada. Data were collected via four sharing circle discussions and were analysed using thematic analysis.The study findings showed that understanding of diabetes eye care access and cost, and unsupportive interactions with health care practitioners, were barriers to diabetic retinopathy care behaviour. Conversely, the presence of eye complications, participants' resolve to manage diabetes, self-efficacy and fear due to experiences of family members with diabetes enabled diabetes eye care.Our study advances knowledge in socio-cultural factors influencing diabetic retinopathy care behaviour among First Nations and Métis women living with and at risk of diabetes. The study shows the need for further public health and health system interventions to address barriers and support Indigenous peoples with or at risk of diabetes to make informed health decisions.

Family practice anesthesia (FPA) providers are family physicians trained to deliver anesthesia care; they often practice in rural hospitals to facilitate surgical care. FPA providers in rural hospitals face challenges including professional isolation and limited opportunities for formal continuing education. To address needs identified by FPA providers, we piloted mobile medical simulation in rural Saskatchewan.Using a logic model framework, we evaluated feasibility of a one-day interdisciplinary mobile simulation workshop for healthcare providers in a rural Saskatchewan hospital. As part of this mixed methods pilot study, we interviewed stakeholders to explore their perceptions of human and financial resources associated with delivering medical simulations in rural locations. Multiple simulation scenarios were utilized to train participants in clinical and professional skills. Participants completed pre- and post-workshop surveys to evaluate their experience.Financial and human resources included cost of renting, transportation of mannequins, and the time required to create the scenarios. Participants (Mobile medical simulation brought continuing medical education (CME) to health professionals in a rural location, but the program was expensive. Our logic model may inform educators and administrators considering mobile medical simulation for physicians in rural areas when balancing resource allocation and the organization's commitment to CME for rural physicians.Les anesthésistes en pratique familiale (APF) sont des médecins de famille formés pour offrir des soins d’anesthésie. Ils pratiquent souvent dans des hôpitaux ruraux pour faciliter les soins chirurgicaux. Les APF dans les hôpitaux ruraux sont confrontés à divers défis, tels l’isolement professionnel et un nombre limité d’occasions de formation continue formelle. Pour répondre aux besoins identifiés par les APF, nous avons mené une simulation médicale mobile dans une région rurale de la Saskatchewan.En utilisant un cadre de modèle logique, nous avons évalué la faisabilité d’un atelier sur une simulation mobile interdisciplinaire d’un jour pour les professionnels de la santé dans un hôpital rural de la Saskatchewan. Dans le cadre de cette étude pilote basée sur des méthodes mixtes, nous avons interviewé les parties prenantes pour explorer leurs perceptions en matière de ressources humaines et financières associées à la prestation de simulations médicales dans des zones rurales. Nous avons eu recours à de multiples scénarios de simulation pour former les participants dans des compétences cliniques et professionnelles. Les participants ont rempli un questionnaire avant et après l’atelier pour évaluer leur expérience.Les ressources financières et humaines comprenaient le coût de location, le transport de mannequins et le temps requis pour créer les scénarios. Les participants (La simulation médicale mobile rapproche l’éducation médicale continue des professionnels de la santé dans une zone rurale, mais le programme a coûté cher. Notre modèle logique peut informer les éducateurs et les administrateurs qui envisagent la simulation médicale mobile pour les médecins dans les zones rurales lorsqu’ils équilibrent les ressources et l’engagement de l’organisation à la formation médicale continue pour les médecins en zones rurales.

ePosters (electronic Posters), a modification of traditional paper-based posters have gained popularity in medical education conferences since 2011. ePoster in educational settings differs from the traditional poster in that it allows the ePoster creator to focus on the learning process rather than reporting scientific outcomes. However, there is limited literature comparing ePosters to traditional paper-based posters and their impact on the student learning experience. ePosters as an assessment tool are well suited for online learning. This article presents twelve tips for using ePosters as an active learning strategy in classrooms and describes how to incorporate ePosters as a formative and summative assessment tool in health professions education, at all levels.

Diabetes is a public health challenge in Canada with a disproportionate number of Indigenous people, especially women, living with diabetes. Diabetic retinopathy is a diabetes ocular complication and a common cause of blindness in Canadian adults. Many individuals living with diabetes do not have regular diabetic eye screening. This study sought to determine the diabetic retinopathy awareness and eye care behaviour of Indigenous women with diabetes or at risk of diabetes. This was a quantitative study among 78 Indigenous women (First Nations and Métis) in Saskatoon, Canada. Data on diabetic retinopathy awareness and eye care behaviour were collected via a knowledge, attitude, and practice survey. Participants had high diabetic retinopathy practice mean scores (32.16) than knowledge (30.16) and attitude scores (22.56). Sub-group analysis showed a significant difference in knowledge scores between age, education, and diabetes status, and differences in practice scores between age and education. Although our regression analysis indicated an association between education and knowledge scores (p = 0.024), and diabetes status and attitude scores (p = 0.044), the associations are not conclusive. Indigenous peoples with or at risk of diabetes may benefit from targeted interventions on diabetes and eye care, which could improve eye care awareness and behaviour.

We found that actively engaging students in our introductory microbiology course was a challenge given our large class sizes and many non-majors taking the course as a program requirement. Therefore, we introduced a novel active learning strategy to our course. Students grouped into teams of three had to create PowerPoint virtual posters on one of three themes: (a) a report on a microbe or immunology story in the news, b) interview a research scientist, or c) research a microbiological topic of their choice. To assess the intervention’s effectiveness, a pre- and post-course assessment was done. Pre-posttest analysis revealed a significant drop in surface learning and rise in deep learning. Also, there was a drop in the extrinsic (grade-dependent) goal orientation and affective (test anxiety) components. We found a decline in task value, self-efficacy for learning and performance, organization, critical thinking, time and study environment, and help seeking in students’ post-test scores. Qualitative findings also indicated the importance of group activity, gaining extra knowledge outside the curriculum, and long-term course content retention. In conclusion, we propose that the creation of digital posters in teams is an effective strategy to increase student engagement in large classes. Nous avons constaté qu’il était difficile de faire participer les étudiants dans notre cours d’introduction à la microbiologie, du fait de nos grandes classes et du grand nombre d’étudiants inscrits dans le cours qui n’avaient pas l’intention de faire une majeure dans ce domaine et pour qui le cours n’était pas une exigence de leur programme. Par conséquent, nous avons introduit dans notre cours une nouvelle stratégie d’apprentissage actif. Les étudiants ont été divisés en groupes de trois et chaque groupe devait créer une affiche virtuelle avec PowerPoint sur l’un des trois thèmes suivants : (a) présenter un rapport sur un microbe ou sur une histoire liée à l’immunologie présentée aux nouvelles, (b) interviewer un chercheur ou une chercheuse, ou (c) faire une recherche sur un sujet de leur choix lié à la microbiologie. Afin d’évaluer l’efficacité de l’intervention, une évaluation a été menée avant et après le cours. L’analyse des évaluations menées avant et après le cours a révélé que l’apprentissage de surface avait considérablement diminué et que l’apprentissage profond avait augmenté. Également, les composantes relatives à l’orientation des objectifs extrinsèques (liée aux notes obtenues) et affectifs (anxiété face aux tests) avaient diminué. Nous avons constaté une baisse dans la valeur des tâches, l’efficacité personnelle pour l’apprentissage et la performance, l’organisation, la pensée critique, le temps et l’environnement d’étude, ainsi que l’aide recherchée dans les résultats après le test des étudiants. Les résultats qualitatifs indiquent également l’importance de l’activité de groupe, l’acquisition de connaissances supplémentaires hors du programme de cours et la rétention à long terme du contenu du cours. En conclusion, nous proposons que la création d’affiches numériques par groupes est une stratégie efficace pour augmenter la participation des étudiants dans les grandes classes.

BackgroundRehabilitation therapies are still in the early stages of development in Honduras. At the present time there are no formal training opportunities in Honduras to support the learning needs of health professionals and healthcare workers who specialize in neurological rehabilitation. Support and development of those delivering rehabilitation services from community engaged academic collaborations outside of Honduras can enhance the learning and knowledge of healthcare workers. The purpose of this study was to evaluate reaction and learning linked to two continuing educational workshops for rehabilitation workers in northern Honduras. MethodsThe study design was a pretest-posttest design. The workshops were conducted in a rehabilitation center and a family support organization located in northern Honduras in September 2017.Faculty from Canada and Colombia, together with health professionals from Honduras, facilitated two workshops. Seventeen participants attended the ‘Acquired brain injury/spinal cord injury workshop’ (adult workshop); 15 attended the ‘Rehabilitation for children with impaired neuromotor development workshop’ (pediatric workshop). Participants completed three questionnaires: sociodemographic, knowledge, and Modified Stages of Learning Questionnaires (MSLQ), and three after: Modified Kirkpatrick, knowledge, MSLQ. ResultsWorkshop participants were physiotherapists, physicians, nurses, educational professionals and other non-physiotherapists. Most agreed that the workshops had positive effects in reaction (engagement, relevance, satisfaction), and learning (skills, attitude, confidence and commitment). Stages of Learning changed from scanning/evaluation to learning/experience (pConclusionsWorkshops offered to the neurological rehabilitation healthcare workers in Honduras through an international collaboration resulted in enhanced learning and knowledge of participants. This has the potential to improve quality of care for people with neurological conditions in the region.

Introduction Indigenous peoples in Canada face numerous health needs and challenges and often have poor health status due to inequitable access to care. Providing culturally appropriate support for health conditions, particularly chronic conditions that require self-management, can assist in averting complications and morbidity. Mobile health is a useful medium for delivering health education across different populations. However, meaningful user involvement is necessary because mobile health interventions suitable for one population may not be appropriate for another. Indigenous people’s views will inform the use of mobile health interventions in Indigenous communities. Objective The study explored the perception of Indigenous women on using mobile health as a tool for receiving health information. Methods This was a qualitative study, and participants comprised of 22 Indigenous women (First Nations and Métis) with or at risk of diabetes, aged 18–69 years in Saskatoon, Canada. After 12 weeks of disseminating diabetic eye care information via text messaging, data were collected via sharing circle discussions and analyzed using thematic analysis. Results Participants indicated that the nature of messages such as the use of Indigenous languages, the message content, frequency of messages, group activities, and delivery formats such as voice messages, mobile applications, Internet, two-way messaging, and text messages were essential considerations in using mobile health as a tool for receiving health information. Conclusion Different factors need to be considered in using mobile health as a tool for health education among Indigenous peoples. These factors could be applicable in implementing mobile health solutions in other populations for the management of health conditions.

Student Response Systems (Clickers) have been adopted by a number of instructors to increase interactions, student engagement and/or formative assessment and feedback especially in large group sessions. Clickers are well known as tools for active learning strategy particularly in formative assessments. However, they are rarely used in assessments that count. With the advent of clickers with a display screen, attempts are being made to use clickers in summative exams. We examined the feasibility of their use in high stakes summative assessment by piloting such an assessment in a simulated setting. Utilizing the lessons learned in the pilot study, clickers were used in formative and summative assessments in various iterations of a computer course taught by one of the authors (CC). At the end of the course, perceptions of students on the use of clickers for high-stake examinations were obtained using an online survey. The instructor was interviewed to identify factors that facilitated clicker use and the challenges faced. In general, students were accepting of the use of this technology in high stakes exams and found it engaging and satisfying, primarily because of instant feedback. The instructor found the process less time consuming and efficient, and more secure compared to scan sheets. Clickers are best used for examinations of short duration, with multiple-choice questions or questions with minimal text or mathematical entry.

Background Self-directed learning (SDL) is defined as learning on one’s own initiative, with the learner having primary responsibility for planning, implementing, and evaluating the effort. Medical education institutions promote SDL, since physicians need to be self-directed learners to maintain lifelong learning in the ever-changing world of medicine and to obtain essential knowledge for professional growth. The purpose of the study was to measure the self-directed learning readiness of medical students across the training years, to determine the perceptions of students and faculty on factors that promote and deter SDL and to identify the role of culture and curriculum on SDL at the Christian Medical College, Vellore, India. Methods Guglielmino’s SDL Readiness Scale (SDLRS) was administered in 2015 to six student cohorts (452 students) at admission, end of 1st, 2nd, 3rd and 4th year of training, and at the beginning of internship in the undergraduate medicine (MBBS) program. Analysis of variance (ANOVA) was used to compare SDL scores between years of training. 5 student focus groups and 7 interviews with instructors captured perceptions of self-direction. Transcripts were coded and analyzed thematically. Results The overall mean SDLRS score was 212.91. There was no significant effect of gender and age on SDLR scores. There was a significant drop in SDLRS scores on comparing students at admission with students at subsequent years of training. Qualitative analysis showed the prominent role of culture and curriculum on SDL readiness. Conclusions Given the importance of SDL in medicine, the current curriculum may require an increase in learning activities that promote SDL. Strategies to change the learning environment that facilitates SDL have to be considered.

Background: Diabetes is increasingly prevalent in Indigenous people along with associated ocular complications such as diabetic retinopathy, which is the most common cause of blindness in Canadian adults. Though the risk of diabetic retinopathy is higher particularly among Indigenous women, there is limited utilization of diabetic eye care services. Hence there is the need for studies and interventions that pursue an innovative and culturally appropriate way of providing relevant information to promote diabetes-eye knowledge and prompt eye care behavior among Indigenous women living with and at-risk of diabetes.

Medicine and medical education are changing, as rapid changes in technology occur. In Canada, two organizations—the Association of Faculties of Medicine of Canada (AFMC) and Canada Health Infoway (Infoway) recognized a need to prepare the next generation of physicians to practice in a digitally enabled practice setting. In response to recommendations from a national academic eHealth leadership committee, these organizations partnered on an initiative to “train the trainers” by providing medical educators with tools for teaching eHealth concepts to physician trainees. This chapter presents the eHealth content that was initially delivered through live accredited educational webinar workshops, and was later published in an online eHealth Workshop Toolkit Collection, available on the AFMC website. The AFMC-Infoway partnership succeeded in producing an openly accessible collection of online eHealth educational resources. However, considerable work is required going forward in the domains of advocacy, curriculum development, assessment, training, and the ongoing engagement of key stakeholder groups.

Many factors contribute to errors that occur during emergency Cesarean birth under general anesthesia. The Joint Commission of Accreditation of Health Care Organizations (JACO) reports that 70% of sentinel events in obstetric practice are attributable to errors in communication and teamwork. Our objective was to develop a video training module to address these deficiencies, and measure its effectiveness. A webbased learning resource was created using professionally made videos that depicted effective and non-effective communication/teamwork techniques in an obstetrical event. This resource could be accessed by a facilitator of small group sessions or by self directed learners. Obstetrical nurses watched this learning resource and were then debriefed by a facilitator to highlight examples of how human factors contribute to the evolution of adverse events. The knowledge and skills, as well as, perceptions of their own behaviors and of other health professionals in the team, were evaluated preand post intervention. The performance of a subgroup of participants in a high-fidelity simulation of an emergency Cesarean birth was assessed to measure the outcome of intervention. Ninety-five obstetrical nurses were given the pre-intervention questionnaires, and 52 completed the post-intervention questionnaires one year later. Participants had significantly higher scores post-intervention (M = 0.78, SD = 0.09) as compared to pre-intervention (M = 0.73, SD = 0.12; t(53) = ?3.07, p

The School of Medicine, University of Saskatchewan curriculum promotes self-direction as one of its learning philosophies. The authors sought to identify changes in self-directed learning (SDL) readiness during training.Guglielmino's SDL Readiness Scale (SDLRS) was administered to five student cohorts (N = 375) at admission and the end of every year of training, 2006 to 2010. Scores were analyzed using repeated-measurement analysis. A focus group and interviews captured students' and instructors' perceptions of self-direction.Overall, the mean SDLRS score was 230.6; men (n = 168) 229.5; women (n = 197) 232.3, higher than in the average adult population. However, the authors were able to follow only 275 students through later years of medical education. There were no significant effects of gender, years of premedical training, and Medical College Admission Test scores on SDLRS scores. Older students were more self-directed. There was a significant drop in scores at the end of year one for each of the cohorts (P.001), and no significant change to these SDLRS scores as students progressed through medical school. Students and faculty defined SDL narrowly and had similar perceptions of curricular factors affecting SDL.The initial scores indicate high self-direction. The drop in scores one year after admission, and the lack of change with increased training, show that the current educational interventions may require reexamination and alteration to ones that promote SDL. Comparison with schools using a different curricular approach may bring to light the impact of curriculum on SDL.

In many areas of study—especially health professions, visual demonstration of concepts, processes and procedures form an important strategy for teaching and learning. Video recordings can be invaluable in capturing visual components. Annotations add another all-important dimension to the learning value of the video. Our Annotated Video Software is an innovative e-learning tool in support of experiential and self-directed learning. Annotations are independent of the video and the separation of annotation and video provides a robust learning environment that supports content. The tool is user-friendly and instructors can add annotations, without the need for intervention by programmers. Annotations can consist of notes of explanation, complementary videos, links to additional information and questions to engage critical thinking. Students’ answers to questions may also be collected and collated. Upon submission of answers feedback can be displayed, thus transforming evaluation into an immediate learning opportunity. We have already created educational resources for health professionals. Next steps include dissemination of the software to educators, provision of software access by mobile devices and better strategies to incorporate the annotated videos into existing learning management systems.

This study explored the effectiveness of using clickers in remote locations and investigated the impact of using clickers on the teaching and learning techniques that must be employed within a distributed multi-classroom setting. Participants (N=24) synchronously participated in a clicker incorporated seminar either face-to-face, remotely in a group or in remote individual offices. Post-seminar surveys, interviews, and focus groups were conducted to examine student, instructor, and information technology (IT) perspectives. Students perceived clickers to be easy to use and reported that clickers helped them feel more engaged. The instructor reported that preparation time was increased due to the use of clickers, and that her awareness of remote students increased delivery time. IT personnel indicated that using clickers was feasible and estimated that it would take more time initially, but having dedicated technical support would decrease the ongoing time involved. Clickers can serve as a tool for engaging students in remote sites. Although clickers are easy to use by students, the effective use of this technology in remote educational settings is more complex and time-consuming. It is vital to remember that the technology utilized is only a tool, and that learning that occurs and learners should be in the forefront.

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. Key words: Community health education; undergraduate medical education; online learning

ObjectivesWe sought to compare two ultrasound simulation interventions used during critical care simulation. The primary outcome was trainee and instructor preference for either intervention. Secondary outcomes included the identification of strengths and weaknesses of each intervention as well as overall merits of ultrasound simulation during high-fidelity, critical care simulation. The populations of interest included emergency medicine trainees and physicians.MethodsThis was a randomized crossover study with two ultrasound simulation interventions. 25 trainees and eight emergency physician instructors participated in critical-care simulation sessions. Instructors were involved in session debriefing and feedback. Pre- and post-intervention responses were analyzed for statistically significant differences usingttest analyses. Qualitative data underwent thematic analysis and triangulation.ResultsBoth trainees and instructors deemed ultrasound simulation valuable by allowing trainees to demonstrate knowledge of indications, correct image interpretation, and clinical integration (pConclusionsThese findings support the use of ultrasound simulation during critical care simulations. The increased functional fidelity associated with edus2 suggests that it is the preferred intervention. Further study of the impact on clinical performance is warranted.

The purpose of this study was to identify changes in dental students' self-directed learning (SDL) readiness during their education. Guglielmino's SDL readiness scale (SDLRS) was completed at admission by dental students at the University of Saskatchewan and at the end of each year of training. The response rates varied from year to year. Between twenty-seven and thirty students completed the questionnaire each year at admission (93-100 percent of the entering class). The numbers of participants were lower in succeeding years: numbers used for analysis ranged from eleven to twenty-six; years in which fewer than eleven students participated were not included in the analysis. At admission, the students' mean SDLRS score was 228.98 (on a scale from 58 to 290, with 290 the highest); this score was higher than that of the average adult population (214±25.59). There was no significant effect of years of predental education, prior unsuccessful applications to dental school, interview scores, age, or admission test scores. There was a significant drop in SDLRS scores at the end of the first year for most of the cohorts (p

Background. Massage therapy is a noninvasive treatment that many individuals with multiple sclerosis (MS) use to supplement their conventional treatment.Objective. We hypothesize that massage therapy will improve the leg function and overall quality of life (QoL) of MS patients.Design. A two-period (rest, massage) crossover design was used. Twenty-four individuals with MS ranging from 3.0 to 7.0 on the Expanded Disability Status Scale (EDSS) received Swedish massage treatments for four weeks. Exercise capacity and leg function as well as QoL were assessed using the Six-Minute Walk Test (6MWT) and the Hamburg Quality of Life in Multiple Sclerosis (HAQUAMS) instrument, respectively. Assessments were measured before and after a massage period and a rest period where no massages were employed.Results. The results displayed no significant changes in 6MWT distances or HAQUAMS scores. However, the participants perceived improvement in overall health as expressed in written comments.Conclusions. Massage is a safe, noninvasive treatment that may assist MS patients in managing the stress of their symptoms. Future studies with larger sample size and cortisol measures are warranted.

The last decade saw a rapid increase in the use of multimedia in health education. Easy availability, accessibility, low cost of technological resources and the expanding body of research on the role of multimedia in student learning, among others, have all contributed to this increase in usage. Since one of the roles of educators is to assess and select learning resources based on curriculum goals and student needs, the development of standardized methods for multimedia evaluation becomes vital. To the learner, it is important for reviews of the quality of the resource to be readily available. An evaluation too was developed based on the recognition of this need. The validity of the tool was tested using experts in technology and education. Reliability was determined using faculty and students who reviewed the same software, using the tool. In addition, graduate students reviewed two versions of a nursing program, of varying quality. The results indicate that the tool is reliable and valid. It is envisaged that this tool can be utilized by health educators for evaluating multimedia resources and setting up a much needed clearinghouse for health education resources.

This module is a collection of 40 video vignettes developed for use by faculty developers in a variety of settings. The vignettes depict effective and ineffective teaching methods. There is an accompanying resource manual with guiding questions and suggestions for how the vignettes may be used in training. While many of the video vignettes target those who train medical faculty, others may be used by those involved in training the learners at all educational levels. Each video has been kept deliberately short so that it can be used to quickly demonstrate a technique, or as a starter for discussions. Using these, participants may be asked to critically analyze good and not-so-good ways of teaching. This DVD is divided into four major categories: presentation skills, active learning strategies, small-group teaching, and clinical teaching. Each category has been further divided into specific teaching methods. Questions added under each of the categories, may be used to actively engage participants watching the videos. This resource has been used as part of the 2-day Teaching Improvement Project Systems (TIPS) workshops to train faculty and residents at the College of Medicine, University of Saskatchewan, Canada. TIPS is mandatory for all new faculty. All residents take TIPS in their first and second year of training. During TIPS, these videos are used to trigger discussions, as well as identify effective and ineffective teaching methods.

While massage therapy (MT) is an increasingly used health care service with a growing evidence base, there is insufficient information about the extent to which MT practice is evidence-based. The purpose of this study was to provide a comprehensive view of Saskatchewan MT's research utilization to inform the development of evidence-based massage therapy practice. The main objectives of the study were to describe MT's perceptions of research, their appraised self-efficacy in research literacy and to identify the characteristic of practitioners who use research. Using a survey design all 815 registered members of the Massage Therapist Association of Saskatchewan were invited to complete a mail-out questionnaire. A total of 333 questionnaires were completed and returned for a 41% response rate. Univariate and logistic regression analysis was conducted using SPSS 17.0. While overall perceptions of research were positive, self-efficacy in research literacy was low and research utilization was limited. Characteristics associated with research use included referring to online research databases and peer-reviewed journals, belief that practice should be based on research, and 20 or greater hours per week of practice. Provincial regulatory status may be the first step to quality service delivery and research literacy training and support is needed for practitioners.

Innovations in medical education have led to the increasing use of problem-based learning techniques, a committee system organization, and more time for independent study in many undergraduate programmes. There has been an increase in availability of alternative methods for presentation of information. To encourage self-directed learning, resources such as computers, videos and models, among others, should be readily available to students. The University of Calgary Faculty of Medicine has provided various resources contained in one area, called the Bacs Learning Resource Centre (BLRC). Since the maintenance and further development of such a centre requires significant resources, it is important to determine student utilization of the various components used in their learning. For those who are about to set up such a learning resource centre this information gives guidance on which materials are most useful. The utilization of the centre by 69 first year medical students was studied using questionnaires. The utilization during a specific course was determined by analysing the entries in the individual log books given to the students at the beginning of the Integrative Course. With the exception of one student, all those who responded to the questionnaire used the Centre, with 20% or less of their total study time being spent there. The BLRC was most used for the Musculoskeletal, Cardiovascular and Reticulo-Endothelial courses. All categories of resources were found to be useful, with the tape/slides least utilized. Utilization was most influenced by the quality of resources available and recommendations by peers. The development of a centre such as the BLRC, with a variety of resources concentrated in one area, suitable for individual or group study and accessible 24 hours a day, should be considered by all medical schools to enhance self-directed learning in medical students.

Methods Twenty-four MS patients with scores ranging from 3.0 to 7.0 on the Expanded Disability Status Scale (EDSS) received four weeks of Swedish massage treatments. The Six-Minute-Walk-Test (6MWT) was used to assess their exercise capacity and leg function and the Hamburg Quality of Life in MS (HAQUAMS) instrument was used to assess changes in client QoL. These assessments were measured before and after a massage period and a rest period where no massages were employed.

The need for cesarean birth is sometimes so urgent that regional anesthesia techniques such as spinal or epidural cannot be done quickly enough to safely deliver the baby. Primary general anesthesia for surgery is a rare event on the labor and birth unit, but is the only way in which cesarean birth can occur without jeopardizing the health and safety of the baby and/or mother. While this represents a small number of patients overall (10–12 per year in the authors' unit), the outcome can be devastating for both mother and baby when this procedure is not well managed. The purpose of this resource is to improve patient safety and quality of care for patients who must have an emergency cesarean birth under primary general anesthesia. This quality improvement resource emphasizes teamwork and communication in the labor and birth unit during these critical and emergent times through a series of videos depicting a pregnant woman requiring emergency cesarean birth under general anesthesia. This web-based and interactive video format is used as a clinical example that emphasizes the importance of teamwork and communication in an interdisciplinary acute care setting. Further, it is the authors hope that engagement with these videos will provoke an emotional involvement that will prime the learner to more actively participate in other medical education exercises such as debriefings after medical simulations.

This chapter describes the medical context and characteristics of medical students, residents, and medical professionals and implications for m-learning. Some technologies used and examples of usage, benefits, outcomes, and barriers at the undergraduate, postgraduate and continuing medical education are explored.

Student response system or clickers is an electronic application where a receiver in the instructor's computer captures responses to questions from student keypads. Used effectively, clickers can promote learner engagement and serve to improve learning. It can be used in a variety of ways such as to provide feedback to learners and instructor, to start discussions, for peer evaluation, for formative and summative assessment, to build a learning community, and to experiment on human responses.Using our experience in the use of this technology and literature review, we provide twelve tips for successful use of the student response system.We have found these strategies useful and envisage that the application of these tips can help maximize learner engagement and learning.