053 Practising wisely: how a one-day workshop successfully reduces overmedicalization among family doctors and residents in Canada
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.010 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.012 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.003 | 0.006 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.012 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".