053 Practising wisely: how a one-day workshop successfully reduces overmedicalization among family doctors and residents in Canada
Notice bibliographique
Résumé
In 2015, the Practising Wisely workshop emerged as a collaborative effort between the Ontario College of Family Physicians, physicians engaged with the Choosing Wisely Canada campaign, and other partners. The program focused on promoting wise clinical decision-making and enhancing patient care through evidence-based practices. Over the years, it garnered momentum and support, and the program underwent a comprehensive update in 2019, leveraging the expertise of a national scientific committee to ensure the program’s content remained aligned with the latest medical insights and recommendations. This interactive seven-hour workshop is divided into four modules that progressively cover different key topics: Judicious prescribing (with a focus on imaging) Shared decision-making (including examples related to cardiovascular and fracture risk) Cancer screening and overdiagnosis Polypharmacy and deprescribing The hands-on, case-based learning format ensures practical learning and collaboration. Delivered directly in clinics upon request, the workshop encourages team-based participation, fostering an environment where implementing change becomes more seamless and effective. Since 2021, sessions have also been offered to family medicine residents of the four Quebec faculties of medicine. Objectives Describe the Practising Wisely workshop format and its changes over the years Identify the impacts of the Practising Wisely program in tackling low-value care and overdiagnosis Identify challenges and future needs Method The workshop content is reviewed annually by a scientific committee. The facilitators are all family physicians. Before being able to deliver the workshop, all facilitators must attend at least two sessions and participate in an annual update training. All sessions are presented by two presenters, including at least one senior presenter. Participant feedback is collected after each session, and reflective practice questionnaires are also gathered after 3 months. The reflective practice questionnaires include sections on the changes participants have implemented in their practice, the progress made in their clinical skills, and the clinical tools that participants have integrated into their daily practice. The data is compiled annually. Logistical support is provided by the Quebec College of Family Physicians. Results Since 2017, over 70 sessions have brought together more than 1,300 participants, including over 400 family medicine residents. The sessions have also increasingly included nurse practitioners. 97% of participants reported a positive impact of the training on their practice, and 96% successfully implemented at least one change within 3 months, ranging from judicious management of lipid-lowering medications to more thoughtful periodic medical exams and screening. 73% of residents also reported a significant reduction in the number of unnecessary laboratory tests. Conclusions A hands-on workshop like Practising Wisely is an opportunity to foster interest in resource stewardship and can have a significant impact on the clinical practice of family doctors and residents.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,010 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,012 | 0,002 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,003 | 0,006 |
| Intégrité de la recherche | 0,001 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,012 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».