FAMILY MEDICINE ANNUAL REPORT

Transcription

1 FAMILY MEDICINE ANNUAL REPORT

2 MISSION STATEMENT MISSION STATEMENT OF MEMORIAL UNIVERSITY Memorial University is an inclusive community dedicated to innovation and excellence in teaching and learning, research, scholarship, creative activity, service and public engagement. MISSION STATEMENT OF THE FACULTY OF MEDICINE The mission of the Faculty of Medicine is to enhance the health of the people of Newfoundland and Labrador by educating physicians and health researchers; promoting lifelong learning; conducting research in the biomedical, clinical, applied health sciences, community health and medical humanities; engaging communities and decision makers; and collaborating to apply the best available evidence in the formulation of policy and the organization and delivery of care. MISSION STATEMENT DISCIPLINE OF FAMILY MEDICINE The mission of the Memorial University Discipline of Family Medicine is to guide the next generation of family physicians into practice. Upholding the principles of family medicine as well as evidence based medicine, our work reflects valuing rural skills, inter-professional collaboration and leadership.

3 TABLE OF CONTENTS MESSAGE FROM THE CHAIR 2 DISCIPLINE ACCOMPLISHMENTS Faculty Activities 4 Faculty Awards 6 Discipline Organizational Chart 9 Discipline Committees 10 EDUCATION Undergraduate Program 12 Postgraduate Program 18 Enhanced Skills - Care of the Elderly 25 Enhanced Skills - Emergency Medicine 26 NorFam 27 NunaFam 28 PERRT 29 Resident Research Projects 30 CPD/Faculty Development 31 CLINICAL SERVICE AND COMMUNITY ENGAGEMENT 34 Family Medicine Unit (HSC) 36 Torbay Road Family Medicine Clinic 38 Ross Family Medicine Clinic 39 Shea Heights Community Health Centre 41 Low Risk Obstetrics Group 42 RESEARCH, DISCOVERY AND SCHOLARSHIP Primary Healthcare Research Unit (PHRU) 43 Publications 47 Presentations and Posters 50 Research Projects 56 FACULTY APPOINTMENTS 58 ACRONYMS 63 CONTACT INFORMATION 64

4 MESSAGE FROM THE CHAIR We are very pleased and excited to share this 2014/15 discipline of family medicine annual report. The discipline has been very active and has successfully met several strategic objectives as well as launching new initiatives this past year. Despite many changes and external pressures, we continue to remain focused on key areas we Senior Secretary Jennifer Rideout Intermediate Clerk Stenographer Jill Colbourne have identified to determine our collective success in family medicine at Memorial University. This can only be done with the dedication of our staff and faculty and the excellent work that is done in the community. It continues to be an immense pleasure to meet community based teachers from St. John s to Iqaluit. We are an incredibly diverse and rich program with many strengths and a fabulous amount of collective energy, enthusiasm and wisdom. Many of the individual program reports for this year will highlight the wonderful work that is being done for learners across the education continuum from UG to CPD. Our preceptor evaluations are often glowing, and show for many learners, that their family medicine experiences are the best! One of our courageous steps this year was to move to four separate CaRMS match sites for 2015 for the first time at Memorial. In August 2014, this was submitted to CaRMS and in March 2015, this paid off with us fully matching all our PG positions in the first iteration of CaRMS in Well done to Dr. Danielle O Keefe, the PG staff, the admissions committee and all those who participated in the interviews. We interviewed 175 candidates! It was a great group effort and we are very excited about these changes which continue to unfold. We owe a special thank you to all those who submitted streams proposals and to the Faculty of Medicine for negotiating successfully for the implementation budget for streams. Much of the attention in PG for the past year has been on the upcoming accreditation. We had an internal review completed and are working hard for a smooth transition as the PERRT project winds down in Thanks to the diligence and creativity of Dr. Roger Butler and Susan Mercer, we now also have a new Care of the Elderly program. Emergency was expanded to six positions. Both of these programs reflect our dedication to meeting the needs of the province. Our undergraduate programs also flourished this year under Norah Duggan s leadership. Family medicine continues to have many successes in the new curriculum including the most highly rated rotation in clerkship. We had a Celebrating Family Medicine Day for the first time in 2014 and will continue to explore ways to attract more medical students at Memorial to family medicine as a career choice which will only help with better recruitment of family physicians throughout the province. This is one of our key strategic goals. CPD was a new role for Dr. Vina Broderick and we were pleased she has taken this on. The annual Fall Medical Education Forum continues to grow and provide relevant faculty development for our community based faculty who are distributed throughout Newfoundland and Labrador, Nunavut, New Brunswick, Prince Edward Island and the Yukon. In the past year, many of our staff and faculty have done the Crucial Conversations course.

5 We had new faculty join us this year with retirements as well as new positions. We interviewed several candidates and were so impressed by the caliber of applicants. In particular, this year we were pleased to have Dr. Steve Darcy and Dr. Amanda Pendergast join us. Both are now GFT at the Shea Heights clinic and both bring wonderful new assets to the discipline. The Primary Healthcare Research Unit (PHRU) also had an amazing year with not one successful PriFor conference, but two! June s meeting was the biggest yet and an amazing event for showcasing research done in the discipline, but also internationally. We have an impressive list of publications, presentations and initiatives with an excellent national and international profile for the research done by our faculty. Our family medicine faculty continues to expand their scholarship productivity and we will continue to increase our efforts particularly during this period of primary care reform in Newfoundland and Labrador. Several part time faculty also had publications this year. I have also been impressed with the advancement we have made on the Patients Medical Home model clinically. We have undertaking several new initiatives that improved access, use of EMR beyond our clinics, new services and several new inter-professional team members have joined us. We were the first program in Canada to offer Point of Care Ultrasound certification to our residents and this year was the first time an ultrasound machine was being used as a teaching tool in one of our clinical settings. This holds much promise for clinical research and teaching in the future and we have great potential to be leaders in this area in Canada. I hope you enjoy reading through the report. I think you will find we are working hard, pushing for new and better ways to do things in all we do, creating wonderful new collaborations, including with patients, while aiming for excellence. We have a lot to be proud of, as demonstrated by the many stories we have to share from our 2014/2015 year. Respectfully submitted, Cathy MacLean, MD, FCFP, MClSc, MBA Professor & Chair

6 DISCIPLINE ACCOMPLISHMENTS FACULTY ACTIVITIES - LEADERSHIP Several of our faculty members hold major leadership positions within the Faculty of Medicine: DR. JAMES ROURKE, dean of the Faculty of Medicine DR. SCOTT MOFFATT, assistant dean for Student Affairs DR. MOHAMED RAVALIA, assistant dean for Rural Medical Education Network (RMEN) DR. WANDA PARSONS, assistant dean for Admissions DR. PAMELA SNOW, academic director (family medicine), Professional Development and Conferencing Services DR. MARSHALL GODWIN, director of the Primary Healthcare Research Unit (PHRU) DR. GERARD FARRELL, director of e-health Research Unit Our faculty members are involved in a variety of boards and committees, including as chair, both within the region and nationally, some of which include: Locally: Provincially: Newfoundland and Labrador Medical Association Newfoundland and Labrador Chapter of College of Family Physicians of Canada Newfoundland and Labrador Centre for Applied Health Research Nationally: Association of Faculties of Medicine of Canada Committees Canadian Pediatric Society College of Family Physicians of Canada Committees including: Accreditation committee Examination committee Medical Council of Canada Examination committee Advanced Life Support in Obstetrics National Advisory Committee Atlantic representative Collaborative Committee on Rural Education SAMP Committee & Task Force Working Group on Maintenance of Certification & Fellowship Governance Advisory committee CPCSSN committee Advisory committee on Family Practice (AdComFMP) Patient Education committee Faculty of Medicine Admissions committee Curriculum committees including chair of the Faculty of Medicine Clerkship committee Medical Practice Associates Faculty of Medicine Promotion and Tenure committee

7 CFPC NL CHAPTER REPRESENTATION: DR. JACQUELINE ELLIOTT DR. CHARLENE FITZGERALD DR. DAVE THOMAS DR. SONYA BROWN-BRAKE DR. KAREN HORWOOD DR. ELIZABETH MATE DR. LISA KIELEY DR. ANNA MELEEVA-KARAIVANOVA DR. CATHY MACLEAN DR. DANIKA KUNG KEAN DR. CHARLES WANG DR. STACIE CONNORS DR. MIMI PUKULAKATT President Past President President Elect Honorary Treasurer Honorary Secretary Member at Large Member at Large Member at Large Family Medicine Academic Representative MUN Resident Representative MUN Resident Representative MUN Medical Student Representative MUN Medical Student Representative PROMOTIONS: We were very pleased that both of these full-time faculty were successful in their application for promotion: DR. NORAH DUGGAN Associate Professor DR. KATH STRINGER Associate Professor NEW FULL-TIME FACULTY: We welcome two new faculty members: DR. AMANDA PENDERGAST who practices at the Shea Heights Community Health Centre DR. STEVE DARCY who practices at the Shea Heights Community Health Centre

8 FACULTY AWARDS The following faculty members have received distinguished honors and awards in : DR. JODY WOOLFREY DR. LESLIE ROURKE DR. WENDY GRAHAM DR. GEORGE HURLEY DR. PATRICK O SHEA DR. BILL EATON DR. MARSHALL GODWIN DR. ETIENNE VAN DER LINDE DR. GABE WOOLLAM DR. STEPHEN DARCY DR. KRISTIAN GREEN DR. RAIE LENE KIRBY DR. JOSHUA O HAGAN DR. NICOLE STOCKLEY DR. MOHAMED RAVALIA Family Physician of the Year Researcher of the Year Award (PHRU) Community Physician Teaching Award 2014 The George Hurley Award in Family Medicine Education 2014 Dr. Yong Kee Jeon Award Bill Eaton Family Medicine Humanities Award Award of Excellence from the NL College of Family Physicians 2014 Dr. Craig Loveys Award The Gus Rowe Teaching Award Janus Research Grant Norlien Foundation Grant for Addiction Leadership Award for Family Medicine Residents Family Medicine Resident Award for Scholarly Achievement Leadership Award for Medical Student (MUN) Order of Canada Dr. Jody Woolfrey was presented with Family Physician of the Year Award by Dr. Jackie Elliott, president of the NL College of Family Physicians of Canada. Dr. Bill Eaton entertaining guests at the Family Medicine Awards. Dr. Cheri Bethune presented Dr George Hurley with the inaugural George Hurley Award in Family Medicine Education. Dr. Marshall Godwin was awarded an Award of Excellence by Dr. Chalene Fitzgerald.

9 STUDENT & RESIDENT AWARDS DR. DAVID KWINTER - Best Poster Recipient & Resident s Choice Award Title: Compendium: Free Open - Access Clinical Reference Platform DRS. DANIKA KUNG KEAN, DR. STEPHANIE HYNES, and DR. JEFF POWER - The Thomas Gleason Award for Social Accountability in Research. Danika & Stephanie s Title: Sexual health and Safety Education Program in Rural Haiti. Jeff s Title: Giving a Damn - Community Engagement, Health Education and Promotion DR. KELLY MONAGHAN - The Best Oral Presentation Award Title: Women s Experiences of Homebirth of NL MARI-LYNNE SINNOTT - CFPC Family Medicine Resident Leadership Award for Memorial OTHER NOTEWORTHY ACTIVITY & ACCOMPLISHMENTS LUANNE AGRIESTI-CLEARY moved to a new role at Memorial. Luanne played a huge role in the discipline for over 30 years. The discipline is very grateful to her for her dedication and hard work on behalf of family medicine. WENDY GRAHAM was President of the NLMA. She had an excellent term and served the province well. STEPHANIE HARLICK archived family medicine materials as we prepared for our move. It was a big job! DR. MICHAEL JONG continued role as VP Medical Services, Labrador-Grenfell Regional Health. DR. DENNIS RASHLEIGH continued role as VP Medical Services for Western Region. DR. EMILY MARSHALL came as a visiting researcher from Dalhousie and shared her work with us. SONYA MCLEOD finished with the discipline and started a new role in Professional Development and Conference Services. TRISH POTTY, from Strongest Families, joined us as our keynote for our Resident Research Day 2014.

10 DEPARTURES DRS. CHERI BETHUNE and BOB MILLER we said goodbye to two of our faculty who were so involved and passionate about our educational endeavors within family medicine and left a wonderful legacy for the discipline after so many years of dedicated work in NL. DR. GREG BROWN retired and is taking a lead in the occupational medicine training being offered now at Memorial from University of Alberta. HIGHLIGHTS FOR THE DFM IN 2014 L-R: Dr. George Hurley, Dr. Peter Cornish STEVE LAWLOR joined us in August 2014 as our first Operations Manager in the history of family medicine at Memorial. We developed the first Strategic Planning document and the Executive Committee was in place to implement and track progress on the priority strategic directions including development and implementation of Streams, increased matches to family medicine, increased research and scholarship productivity with supportive CPD for faculty and the adoption of the Patient s Medical Home model in the FM academic teaching units. PhD folklorist ANN LAFFERTY worked on our Archive Project in Memorial University family medicine jackets were available and can still be purchased. Point of Care Ultrasound was trialed with residents at the FPU with GORDON STOCKWELL and KEON HUGHES taking the lead. DEAN KLEMOLA is working for our PG program in HSIMS and our e-portfolio for residents including the on line field notes. This is a major advance for the PG program and will be an asset for us at Accreditation. New DFM policies adopted in 2014/15 include: improved clinic access during Memorial University closures with a new contingency planning document, DFM guidelines for interaction with industry and implementation of a new policy/procedure for faculty in difficulty. We are working on a communications plan and have worked to standardize our approach to printing and marketing to ensure a more consistent brand for DFM. SABBATICALS DR. WANDA PARSONS DR. DAVE MORGAN DR. BILL EATON

11 2015 DISCIPLINE ORGANIZATIONAL CHART DISCIPLINE CHAIR Dr. Cathy MacLean DFM MANAGER Steve Lawlor HR Finance Strategic Planning/KPI s Operations Recruitment CLINICAL MANAGER Barbara Morrissey FPU Director Dr. Leslie Rourke Ross Clinic Director Dr. Gary Tarrant Miller Centre Veteran s Rehab Shea Heights Director Dr. Norah Duggan Torbay Road Director Dr. Stephen Lee Low Risk Maternity Academic Palliative Care ADMINISTRATION MANAGER (Chair s Office) Jennifer Rideout Support to the Chair Appointments Promotion & Tenure Strategic Planning Policies Family Medicine Education Forum RESEARCH/DISCOVERY DIRECTOR Dr. Marshall Godwin Primary Healthcare Research Unit APBRN CPCSSN Centre for Rural Health Studies Director Dr. Kris Aubrey Scholarship UNDERGRADUATE DIRECTOR Dr. Norah Duggan PROGRAM COORDINATOR Patricia Penton Pre-Clerkship Community Engagements II & II Dr. Kath Stringer Dr. Scott Moffatt Clerkship Dr. Lyn Power Electives/Selectives Dr. Kris Aubrey Family Medicine Interest Group Dr. Stephen Lee Education POSTGRADUATE DIRECTOR Dr. Danielle O Keefe FM PROGRAM COORDINATOR Susan Carter NorFam NunaFam NLFam Enhanced Skills Eastern Central Western Emergency Medicine EM Postgraduate Director Dr. Peter Rogers EM Program Coordinator Dr. Michael Parsons EM Program Coordinator Patricia Penton Care of the Elderly Lead: Dr. Roger Butler CPD DIRECTOR Dr. Vina Broderick Program Support Jacqueline Ryan Faculty Development CME PDCS Director Dr. Pam Snow Leadership Back to Table 9 of Contents

12 DISCIPLINE COMMITTEES CPD COMMITTEE Dr. Vina Broderick Dr. Pam Snow Dr. Heather Flynn Dr. Kath Stringer Dr. Peter Rogers Dr. Steve Shorlin Support: Ms. Jacqueline Ryan EM PROGRAM COMMITTEE Dr. Kris Aubrey Dr. Steven Combden Dr. Adam Dubrowski Dr. Brian Metcalfe Dr. Cliona O Brien Dr. Danielle O Keefe Dr. Michael Parsons Dr. Peter Rogers Support: Ms. Patricia Penton UG EXECUTIVE Dr. Kris Aubrey Dr. Norah Duggan Dr. Stephen Lee Dr. Scott Moffatt Dr. Lyn Power Dr. Kath Stringer Support: Ms. Patricia Penton RESIDENCY TRAINING COMMITTEE Dr. Kris Aubrey Dr. Susan Avery Dr. Roger Butler Ms. Susan Carter Dr. Sonny Collis Dr. Wendy Graham Dr. Holly Delaney Dr. Carla Dillon Dr. Cathy MacLean Dr. Danielle O Keefe Dr. Ean Parsons Dr. Peter Rogers Dr. Mo Ravalia CURRICULUM COMMITTEE Dr. Susan Avery Ms. Susan Carter Dr. Karen Horwood Ms. Patricia McCarthy Dr. Danielle O Keefe Dr. Lyn Power Dr. Dennis Rashleigh Dr. Erin Smallwood Dr. Ean Parsons Dr. Kathryn Veersteeg Support: Ms. Shenoa White EVALUATIONS AND PROMOTIONS COMMITTEE Dr. Amanda Pendergast Ms. Susan Carter Dr. Lynette Powell Ms. Patti McCarthy Dr. Nicole Stockley Dr. Danielle O Keefe Dr. Ean Parsons Dr. Robert Forsey Dr. Sarah Lesperance Dr. Stacey Saunders Support: Ms. Chantal Froude CARE OF THE ELDERLY COMMITTEE Dr. Roger Butler Ms. Denise Cahill, NP Dr. Cathy Hickey Dr. Bruce Hollett Dr. Susan Mercer Dr. Ean Parsons Dr. Dave Thomas Dr. Jody Woolfrey EMR COMMITTEE Dr. Leslie Rourke Dr. Cathy McLean Dr. Roger Butler Dr. Lisa Bishop Dr. Gerard Farrell Dr. Susan Avery Dr. Neil Niak Ms. Rhonda Hooper Ms. Barb Morrissey Mr. Mike Foley

13 FULL FACULTY EDUCATIONAL (UG/PG) All GFT Support by Ms. Shenoa White and Ms. Trish Penton ADMISSIONS COMMITTEE Dr. Susan Avery Dr. Danielle O Keefe Dr. Ean Parsons Dr. Heather Flynn Dr. Roger Butler Dr. Pam Snow Ms. Susan Carter Support: Ms. Shenoa White FULL FACULTY CLINICAL All St. John s Clinical GFT s Inter-professional representatives PT Faculty from Academic Clinic representative Support: Ms. Barbara Morrissey PG EXECUTIVE COMMITTEE Dr. Danielle O Keefe Dr. Holly Delaney Dr. Ean Parsons Dr. Nicole Stockley Ms. Susan Carter Dr. Kathryn Veersteeg Support: Ms. Chantal Froude CHAIR S EXECUTIVE Dr. Cathy MacLean (Chair) Mr. Steve Lawlor, Operations Manager Ms. Barbara Morrissey, Clinic Operations Manager Dr. Danielle O Keefe, PG Director Dr. Norah Duggan, UG Director Dr. Vina Broderick, CPD Director Dr. Marshall Godwin, Research Director Support: Ms. Jennifer Rideout FULL FACULTY BUSINESS Dr. Cathy MacLean (Chair) Mr. Steve Lawlor Ms. Barbara Morrissey Ms. Susan Carter Ms. Patricia Penton All GFT Support: Ms. Jennifer Rideout FAMILY MEDICINE INTEREST GROUP Amanda Cranford Christopher Earle Erin Fitzpatrick Gloria Lin Mahmud Hasan Michelle MacDougald Mimi Pukulakatt Richa Parihar Sara Dalley Sarah Small Stacie Connors Support: Ms. Sarah Eustace PLANNING COMMITTEE PRECEPTORS MEETING Dr. Cathy MacLean Ms. Cecilia Mesh Ms. Fran Kirby Ms. Jennifer Rideout Ms. Sheri Coombs Mr. Steve Lawlor Dr. Vina Broderick Dr. Wendy Graham Dr. Mo Ravalia PHRU COMMITTEES PRIFOR COMMITTEE AND PHRU CORE MANAGEMENT TEAM: Dr. Shabnam Asghari Dr. Kris Aubrey Mr. Ricky Cullen Dr. Marshall Godwin (Chair) Ms. Karen Griffiths Mr. Adam Pike Ms. Andrea Pike

14 EDUCATION UNDERGRADUATE PROGRAM DR. NORAH DUGGAN PATRICIA PENTON SARAH EUSTACE MICHELLE HOLLOWAY Director Academic Program Administrator Academic Program Assistant Secretary GENERAL OVERVIEW Undergraduate medical education is an exciting place to be these days with the introduction of the new curriculum and the increased opportunities for students to be taught and mentored by family physicians, both in the academic setting and in the community. We are working hard with our colleagues at every level to ensure that the curriculum focuses on preparing our graduates to be knowledgeable generalist MDs. Many of you responded to our survey last year and we are utilizing this information to provide students with access to as many varied experiences in family medicine as possible. Deepest gratitude for their hard work and dedication goes to Dr. Scott Moffatt and Dr. Kath Stringer, who have handed over the Community Engagement Course co-ordination as both have major roles in the UGME realm of the medical school. We had an opportunity to showcase our innovative approach to teaching in the undergraduate curriculum when Dr. Duggan gave two talks at WONCA Rural in Dubrovnik, Croatia in April 2015, showcasing our approach to providing students opportunities and mandatory rotations in the community, particularly rural sites and on the web based academic half day teaching, both of which were received with much interest from an international audience. FAMILY MEDICINE UNDERGRADUATE EXECUTIVE DR. NORAH DUGGAN Undergraduate Director DR. LYN POWER Clerkship Coordinator DR. KRIS AUBREY Electives/Selectives Coordinator DR. NORAH DUGGAN and DR. AMANDA PENDERGAST Course Co-Chairs for Community Engagement 2 and 3 DR. STEPHEN LEE Family Medicine Interest Group Faculty Liaison PRE-CLERKSHIP Community Engagement 2 (The Housecall) was implemented in August/September of With this additional two week community/family physician placement, Memorial medical students now have exposure to family medicine in all four phases of the curriculum. The class size has increased to 80 students per year, so the demand for clinical teachers is higher as well. Student Feedback Housecall (Community Engagement 2) I attained valuable experience that will assist me in becoming a competent physician. Before beginning this placement, I had my heart set on pursuing family medicine, and this past week has done nothing but solidify this decision. I had a very enjoyable and informative experience and I learned an extraordinary amount in 2 weeks. Overall, fantastic learning experience in family medicine. Overall, this experience has been nothing short of extraordinary. This placement has put a new perspective on family medicine for me. I have found a new found love for family medicine.

15 Student Feedback The Black Bag (Community Engagement 3) I would consider my one week placement to have been a very valuable learning experience. I feel confident being able to practice my clinical skills and interviewing skills. This was a good educational experience. I was exposed to inpatients, outpatients and emergency services. This was the most educational placement to date. I really liked the opportunity to do the placement in town to see how family doctors can integrate the resources of a tertiary care centre into their treatment. This was a fantastic learning experience. I learned so much from the great clinicians there. CLERKSHIP Family medicine coordinated 66 student placements for the Rural Family Medicine eight-week rotation in Forty-nine remained in Newfoundland and Labrador, 12 went to New Brunswick, four went to Prince Edward Island and one to the Yukon. With the new Memorial/Yukon agreement, plans are underway to enable the Yukon student to return home for all community/family medicine rotations. Our GFT faculty continue to facilitate the weekly academic half-day sessions. Due to the need for increased capacity, one site visit was held and more are planned for Student Feedback An incredibly enjoyable experience. The approach and teamwork at the clinic is second to none. Greatly enhanced my interest in practicing family medicine. CURRICULUM Phase 1 Management Team Phase 2 Management Team Phase 3 Management Team ILS Facilitators Clinical Skills Community Visit/Black Bag Adaptation Independent Projects (P2P) Working Group & P2P Geriatric Session Rourke Baby Record FACULTY Greg Sherman, Amanda Pendergast, Vina Broderick Lyn Power, Kath Stringer, Maria Goodridge Susan Mercer Scott Moffatt, Roger Butler, Stephen Lee, Susan Avery, Norah Duggan, Cathy MacLean Heather Flynn, Vina Broderick Kath Stringer/Scott Moffatt Many faculty in FM Lynn Power Susan Mercer, Roger Butler Leslie Rourke

16 FMIG Fridays with Family continued to be well received by medical students with 24 scheduled sessions in Attendance increased significantly with the larger class size. These informal talks by family physicians and other health care professionals highlight experiences in both rural and urban practices, explore career options and provide a resident s perspective on family medicine. Family Medicine Information Night was held on October 23, Presenters were available at eight tables covering topics such as Care of the Elderly and making Relationships Work in family medicine. Our FMIG won the national prize for the most money raised in the Walk for the Docs of Tomorrow 2014, for the second year in a row! Erin Fitzpatrick and Dr. Nicole Stockley recieving a cheque from Dr. Marie-Dominiqu Beaullieu and Dr. Ralph Masi. PROCEDURES DAY Procedures Day is an annual event that gives pre-clerkship students the opportunity to practice basic procedures of interest. It is especially useful for second year students as they prepare to enter clerkship. Stations have included casting, phlebotomy, suturing, joint injections, IV insertion, intubation, ophthalmoscope exams, EpiPen administration, blood drawing, breast cyst aspiration and endometrial biopsy. Procedures Day 2015 was held on March 14th, Special thanks to NL Chapter of CFPC for funding and supporting Procedures Day 2015.

17 FMIG FRIDAYS WITH FAMILY PRESENTER TOPIC October 3 Dr. Sean Doherty and friends Medicine North of Sixty An adventurous full-scope practice awaits you! October 17 Dr. Bridget Picco Eating Disorders October 24 Dr. Daniel Hewitt Arsenic in Well Water in my Practice Communities November 7 NL Medical Association-Robert Thompson Primary Care Renewal in NL & Jonathan Carpenter November 14 Drs. Avery and Pendergast Obstetrics in Family Medicine November 21 Dr. Stephen Lee Practice Management November 28 Dr. Ean Parsons Sports Medicine December 5 Dr. Roger Butler FM geriatrics-the Future 2015 PRESENTER TOPIC January 16 Dr. Stephen Lee Family Medicine in the NWT February 13 Dr. Gordon Stockwell Ultrasound in Family Medicne February 20 Dr. Susan MacDonald Palliative Care February 27 Dr. Pat O Shea The Pros and Cons of Fee for Service vs. Salaried Positions March 6 Heather Pitcher (Cancelled) Interprofessional Care in Family Practice March 13 Dr. Andrew Hunt Balancing Work and Leisure: Tales from a Hometown Rural Family Doc. March 20 Dr. Leslie Rourke Of Babies, Bicycles, and Boundaries: Stories of Practical Practice-based Research March 27 Dr. Peter Rogers X-ray Rapid Fire April 17 Dr. Gary Tarrant What s in a name? The Family in Family Medicine May 1 Dr. Julie Temple Newhook, CIHR-RPP Transgender Children: Beyond the Myths Post-Doctoral Fellow May 8 Dr. Ean Parsons The Places you can go! Where Family Medicine has taken me May 15 Dr. Karen Downton Family Medicine at Memorial May 22 Dr. Heather O Dea Locums May 29 Dr. Roger Butler (Cancelled) Why geriatrics is Core to Family Medicine

18 UG STUDENT RESEARCH PROJECTS STUDENTS TOPIC FACULTY ADVISOR Amanda Brett Alana Rumbolt Raman Sohi Lauren Jones Developing videos of the physical examination of 18 month old children Developing videos of the physical examination of 6 month old children Leslie Rourke Leslie Rourke Lisa Burke Cervical Cancer Screening Services on Fogo Island Norah Duggan Pauline Duke Michael Curran Diabetes in the Innu of Labrador: a Lifestyle Analysis Michael Jong Mark McKelvie Community Engagement to Address Diabetes Amongst the Innu in Labrador Michael Jong Katherine Clark Sarah Howse Music Therapy in Dementia Patients Susan Mercer Karla Finn Low Risk Family Medicine Patient Education Project Norah Duggan Katherine Holland Low Risk Family Medicine Obstetrics Patient Education Project Norah Duggan Susan Avery Braderick King Making Medicine a Career Choice Norah Duggan Kayla McNally Clinical Skills Training: an Updated Review Heather Flynn Amelia Moffatt Chelsea Harris Cecily Stockley The Use of Statin Drug Therapy for Primary Prevention of Cardiovascular Disease in Primary Care: A retrospective Cohort Study Telegerontology: A Novel Approach to Optimize Health and Safety and to Age in Place Among People with Dementia in NL Marshall Godwin Roger Butler Andrew O Brien Acute Care Needs in an office Environment: A Family Medicine Case Study Heather Flynn Jennifer Smith Assessing the awareness of Elder Abuse with NL Family Physicians Katherine Stringer Tracey Roche Obstetrical Care Handbook for Family Physicians Norah Duggan Susan Avery Alecia Rideout Christine Rideout Recruiting Rural Physicians: Influencing Factors from a Student Perspective Mohamed Ravalia Danielle Wentzell Sociological Study of Medical Students at Memorial University Wanda Parsons Alex States Giving Patients a Voice Cathy MacLean Des Whalen Holly Black ATV Related Injuries and Deaths in NL Cathy MacLean Elizabeth Faour Development of a MVC Clinical Reporting Tool Cathy MacLean Elliott Chard Use of Injectable B12 and Impact on Health Care Costs Cathy MacLean Jesse Church IV Drug Use Patterns in St. John s Cathy MacLean Jessica Dwyer Family Medicine Patient Education Project Cathy MacLean

19 STUDENTS TOPIC FACULTY ADVISOR Marcus Byrne Joys and Challenges of Practicing Family Medicine - Video Project Cathy MacLean Stacie Connors Referrals Cathy MacLean Alison Coleman Diet and Exercise Current State in NL Cathy MacLean Carson Marcoux SIFP s / Communities of Practice in NL Cathy MacLean Ian Gallant Developmental Disabilities Clinic Implementation and Evaluation Framework Cathy MacLean Janine Flaherty- Woodland Michelle Anderson Advanced Directives (Living Wills) and Their Use in NL Cathy MacLean Jeff MacDonald PA s in NL Cathy MacLean Kaitlyn Stanford Obesity and Diet in NL Cathy MacLean Samantha Dodge NL Diet Role of Grocery Store Dietitians Report Cathy MacLean Sean Dillon ATV Learning Module for age 16 and Over Cathy MacLean Erin Fitzpatrick Family Medicine Wellness Committee Cathy MacLean Jennifer Stuckless Walking Trails of the HSC Cathy MacLean Meaghan Coady Wellness for physicians, staff and learners in Family Medicine Cathy MacLean Reegan Anstey Health Literacy Cathy MacLean Victoria Ralph Inner City Family Practice Network Cathy MacLean UNDERGRADUATE FAMILY MEDICINE GOALS FOR 2015 As we start a new academic year this August, we are planning to develop more opportunities for students in the pre-clerkship to shadow family physicians in the metro St. John s area to demonstrate the broad scope of family medicine practice. We will continue to develop teaching sites for pre-clerkship and clerkship rotations. We are working to develop a database of elective and selective opportunities for Memorial and other students to ensure that any qualified applicant seeking an opportunity to study here is successful in obtaining that experience. We are working with the Postgraduate Executive to develop and offer the concept of layers of learners so that pre-clerkship and clerkship level learners are placed in sites with family medicine residents, who can develop their teaching as well as their practice skills. Dining with the Docs.

20 POSTGRADUATE PROGRAM DR. DANIELLE O KEEFE SUSAN CARTER CHANTAL FROUDE STACY HICKS SHENOA WHITE JACQUELINE RYAN Program Director Academic Program Administrator Intermediate Secretary (Scheduling) Secretary (Core Content) Secretary (Program) Receptionist The Family Medicine residency program at Memorial trains residents for urban, rural and remote practice. Over the two-year residency, residents train at sites throughout Newfoundland and Labrador, New Brunswick and Nunavut. At the start of the academic year, there were a total of 73 residents in our program. Training sites across Newfoundland and Labrador include: St. John s and surrounding areas: Airport Heights Medical Clinic Bay Bulls Family Practice Cabot Square Medical Clinic Churchill Square Medical Clinic Complete Medical Clinic Eleven Elizabeth Family Practice Health Sciences Centre Health Sciences Family Practice Janeway Child Health Centre L. A. Miller Centre Major s Path Family Practice Paradise Health Complex Ross Family Medicine Clinic Torbay Medical Clinic Family Medicine Clinic, Torbay Road Mall Shea Heights Community Health Centre St. Clare s Mercy Hospital Waterford Hospital Rural: St. Anthony Baie Verte Bonne Bay Botwood Burin Carbonear Clarenville Corner Brook Deer Lake Gander Goose Bay Grand Falls-Winsor Harbour Grace Port aux Basques Port Blandford Twillingate Our New Brunswick and Nunavut training sites include: Fredericton, New Brunswick Miramichi, New Brunswick Saint John, New Brunswick Waterville, New Brunswick Iqaluit, Nunavut (including visits to satellite communities)

21 STREAMS The past year has been focused on Program Streams and separate Stream matches in CaRMS. PROGRAM STREAMS Strategic Plan, Action Plan # 1: Development and Implementation of Streams In the fall of 2014 a proposal was submitted to the dean of medicine for consideration of our rationale for moving to a decentralized stream based family medicine postgraduate training program. The proposal was based on the expansion of the medical school with consideration for primary care reform, improved recruitment and retention and meeting the healthcare needs of the population of NL. The proposal was heavily informed by what family physician leaders, clinicians and educators in the health regions submitted in response to a call for proposals early in They indicated what was needed regionally to make training for family medicine more effective in meeting local needs and contributed greatly to the model proposed a cabinet model for each stream which would in turn enhance connectedness with the central postgraduate program for governance while meeting accreditation expectations. Included in the proposal was the plan for regions that offered a hub and spoke training model that built on the successes we trialed in our PERRT program in Burin and Grand Falls-Windsor. A description of the Streams for each region was included in the proposal. Much of the detail for the Streams description built on what was submitted by the regions. There was good agreement and some regional variation, depending on strengths, gaps, resources and interests across the province. STREAMS DESCRIPTION The Family Medicine Postgraduate Residency Training program proposed a significant change in the structure of the residency training program. The proposed streams would create the ability for residents to complete the vast majority, if not all, of their training within the stream. The proposed model would include four training streams (Eastern, Central, Western and Northern) that would be overseen by the central family medicine residency program and governed by the Residency Training Committee. We also worked with the Government of Nunavut to secure similar training opportunities in Nunavut. The Government of Nunavut recently approved funding for residency training beyond MUN DISCIPLINE OF FAMILY MEDICINE PG TRAINING PROGRAM ADMINISTRATION Under the direction of the Residency Training Committee, the family medicine PG program administration would be responsible for the oversight and delivery of the residency training program across all training streams. This central program would consist of the residency training Program Director, Program Coordinator and Program Secretary and the Coordinators for Curriculum, Evaluation and Promotions, Faculty Development and Research. STREAM CABINETS The individual stream would be governed by a local program cabinet. The cabinet members would include the Stream Director, leads for Curriculum, Faculty Development and Research and stream administrative support. Under the direction of the central program, the stream cabinet would be responsible for running the residency program in the stream. The Residency Training Committee and all standing committees of the Residency Training committee would be comprised of representatives from all of the training streams (e.g. the curriculum committee would consist of the curriculum leads from each of the streams. One of the curriculum leads would function as the curriculum chair. This curriculum chair would represent the curriculum committee on the Residency Training committee.)

22 Table 1: Residency Training Committee Structure with Streams Stream Training Model

23 STREAM TRAINING MODEL The proposed model for each stream was of a hub and spoke. We proposed that streams would consist of a main hub (E.g. Corner Brook ) with training opportunities in multiple teaching sites (E.g. Deer Lake, Bonne Bay, Stephenville and St. Anthony) while offering medical services and training opportunities to residents in more isolated communities (E.g. La Poile, Woody Point). Diagram 1: Streams Model Hub, Sites and Satellite In May 2015 we received approval to move forward with a number of initiatives from the proposal. SITE SATELLITE SATELLITE SITE SATELLITE HUB SITE SATELLITE SATELLITE SITE HUB central teaching location administrative support RHA link SATELLITE Underserved area SITE peripheral teaching location some admin support locally

24 Working with an incremental budget, we advertised for the Stream Director positions in June, CARMS STREAMS Strategic Plan, Action Item #3: Resident Templates This year we offered CaRMS candidates the opportunity to apply directly to training streams: Eastern, Rural (Central and Western), Northern Goose Bay and Northern Nunavut. In doing so, candidates were able to rank their preferences of training stream. All resident templates were organized around training opportunities within the stream. Residents were only scheduled for rotations outside of the training site if a training opportunity was not available locally. Preceptors from across the training streams were involved with the development of the templates. CARMS RESIDENCY POSITIONS Thirty-three residency positions were offered in CaRMS: 30 Canadian Medical Graduates (CMG), 2 International Medical Graduates (IMG) and 1 Department of National Defense sponsored family medicine (MOTP) positions. These thirty-three positions were distributed throughout the training streams: 13 Eastern, 10 Rural (Central/Western), 6 Northern-Goose Bay and 4 Northern-Nunavut. We reviewed 246 CMG applications and interviewed 175 candidates. There were 584 eligible IMG candidates and 18 interviews were offered for the two positions. Family medicine representatives from all of the training streams were involved with CaRMS from candidate interviews, to lunch time presentations to the final candidate rank lists. It was great to have everyone involved! For the first time since , our program filled in the first round of CaRMS! RESIDENCY NUMBERS With the addition of a resident who is transferring into the program, 34 residents will commence training on July 1st. We are working towards being able to offer 40 first year residency seats by First Year Residents Second Year Residents

25 CURRICULUM Strategic Plan, Action Plan #2: Academic Teaching in a Distributed Program STREAM CURRICULUM Currently there are portions of the curriculum that are delivered within the streams, namely the Counselling Centre curriculum in Port aux Basques for the first year residents and the Behavioural Medicine curriculum for the second year residents in Grand Falls-Windsor. During this upcoming academic year, the Northern Goose Bay stream will take on responsibility for the Behavioural Medicine, Practice Management, Evidence Based Medicine and Academic Half Day curriculum. As we build further capacity within the streams, we will be able to determine where there are opportunities to offer additional teaching within the streams. In efforts to determine alternative teaching options given our distributed program, we piloted online learning groups with twelve residents and four faculty this year. The online learning groups certainly proved to be interactive as residents worked through the curriculum over the course of a week as opposed to solely on one afternoon. We will review the results of the pilot to determine if this is a viable option for delivering the academic half day curriculum. Point of Care Ultrasound Training (PoCUS) We introduced Point of Care Ultrasound training (PoCUS) for all of the residents this year. A number of faculty and preceptors were also fortunate to participate. The course was a huge success and we plan to offer residents this training opportunity again in the academic year. EVALUATION We have been working on new electronic field notes that are embedded within a resident s electronic portfolio. The main purpose of this new field note is to enable residents to review their completed field notes in real time. We will be ready to roll out the new field notes as of the first of July. All residents and faculty will be sent usernames and passwords to access the system. Our next steps will involve the further development of the resident s electronic portfolio. With the start of a new academic year we will also be using new ITERs. The ITERs have been changed to reflect competency based education. The new Objectives Document will also be sent out to all residents and preceptors. Winter Camping Northern-Goose Bay (NorFam)

26 PROGRAM GRADUATES A total of 30 residents will complete training by the end of this academic year. Of the residents planning to practice in Newfoundland and Labrador, 6 residents plan to go into rural practice, 9 into urban practice and 2 will go into rural/remote practice (Goose Bay). Four of the graduates plan to go into rural/remote practice in either Goose Bay or Nunavut. Six of the residents have chosen to complete an Enhanced Skills Year: 5 in Family Medicine- Emergency Medicine and one in Palliative Care. Four additional residents will complete the program in the fall of Three plan to work in Newfoundland and Labrador: one in rural practice and two in urban practice. The other resident will start practice in Nunavut.

27 ENHANCED SKILLS PROGRAMS - CARE OF ELDERLY DR. ROGER BUTLER PATRICIA PENTON Program Director Program Coordinator We are now ready to offer two six-month positions of enhanced skills training in Care of the Elderly. Under the leadership of Dr. Butler, a new program was developed to provide enhanced training to those with an interest in geriatric medicine. Training is directed towards the care of the elderly in the context of care of seniors and towards preventing frailty. The resident in the PGY3 COE sixmonth program will learn the specific knowledge, skills and attitudes to support their future practice in the COE that may include primary care and consultative work which has a primary focus on the frail elderly. The program consists of training in geriatric assessments and consults, geriatric rehabilitation, geriatric psychiatry, family medicine geriatrics, ambulatory care, outreach and longitudinal geriatric clinics with opportunities in research, house calls, community visits and work with the Alzheimer s Society. Enhanced Skills in Care of the Elderly brochure 2015 The COE program has been approved by the CFPC to start on July 1, 2015, and we can accept applications for the program from July 1 to Dec. 31 for two positions, each six months in duration. Upon completion of the training, the candidate will receive a COE diploma. Candidates may come directly from the 2nd year of a completed residency program or be practicing physicians with a CCFP. Dr. Butler with an elderly patient.

28 ENHANCED SKILLS PROGRAMS - EMERGENCY MEDICINE DR. PETER ROGERS DR. MICHAEL PARSONS PATRICIA PENTON Program Director Assistant Program Director Program Coordinator Our family medicine program offers the opportunity to complete a third year of enhanced Emergency Medicine training to six applicants. These have been highly competitive positions. This training is completed over one year and it is designed to provide physicians with the complex skill set necessary to practice Emergency Medicine. Applicants must be enrolled in an accredited Family Medicine Residency Training Program in Canada or be in practice and hold certification with the College of Family Physicians of Canada or be eligible to sit the CCFP exam in order to apply for one of the four positions. Emergency residents: (L to R) Lyndsay Woods, Cliona O Brien, Brooke Saunders and Gregory (Kenzo) Saito. The objectives of the emergency medicine enhanced skills program are to: Train physicians to the high level of competence and confidence necessary for practice in urban, rural or remote communities. Provide trainees with a broadly developed skill set appropriate to their chosen practice. Enable the emergency physician to take a leading role in the administration of emergency services in the community. Provide a formal teaching setting to prepare trainees to successfully sit the CCFP examination in Emergency Medicine. The FM-EM program was fortunate to receive approval for two additional residency positions for the academic year. This will bring the total number of trainees to six. During the year, residents complete rotations in Adult Emergency Medicine, Pediatric Emergency Medicine, Coronary Care, Intensive Care, Plastic Surgery, Anesthesia, Rural Emergency Medicine and there is protected elective time. Traditionally residents have completed the Pediatric Emergency Medicine rotation in London, Ontario. We will be offering the opportunity for two residents to complete their Pediatric rotation at the Janeway this year. Our hope is that the rotation will fully transition to the Janeway within a couple of years. ENHANCED SKILLS PROGRAM - GLOBAL HEALTH/HEALTH EQUITY Under construction! Work is ongoing towards offering a Global Health/Health Equity Enhanced Skills program by A great deal of work has been underway in the DFM to get the programs and services in place for this enhanced skills program. Work in on going for a Refugee Clinic, Adult Developmental Disability Consult Service, Inner City Family Practice Network for marginalized and underserved populations downtown as well as other initiatives around Health Equity in NL. Stay tuned for more information on this promising program as it develops!

29 NORFAM DR. MICHAEL JONG Streams Director The academic year saw an increase of learners. We had up to two MUN medical students for their two months family medicine core rotation. In addition we have one to two medical students for their electives. We increased our 2nd year family medicine residency intake from four to six. The 2nd year family medicine residents were here for the traditional 28 NorFam block or for the one-year longitudinal family medicine, palliative care, psychiatry, pediatric and geriatric training. In addition we had four first year family medicine residents for their 4-month family medicine training. Number of medical students: 16 Number of family medicine residents: four 1st year and six 2nd year residents We continue to supervise seven 3rd year pediatric residents for their mandatory one-month northern rotation. This offers interdisciplinary learning and shared care experience for family medicine and pediatric residents. This is also the first year we had doctorate psychology students for their two-month rural training. This was a positive experience for the students and a great potential for using this opportunity to enhance interdisciplinary training. INNOVATION IN TRAINING: Learning indigenous health through immersion. Learners fly to indigenous communities to provide care. This is supplemented by a workshop on local Indigenous cultures and the impact of integration and development. Point of care ultrasound from the whole body systems is part of the regular practice. High fidelity simulation for rural critical care and training promising residents how to teach. Learning to provide care for remote population via telehealth. It includes robotic telepresence and leading resuscitation remotely via telehealth. Premed summer institute, a one-month training program for Indigenous students to prepare them for application and admission to a medical school. RESEARCH: Two of the faculty were involved in the six for six learning program learning to do research. One of the faculty members is involved in two CIHR funded projects: The nominated decision maker and a principal investigator for the project Transforming Primary Health Care in Remote Northern Communities: Proposal for a Circumpolar Health Systems Innovation Team [CircHSIT) A co-investigator in the CIHR funded project Mental well-being and suicide prevention in circumpolar regions: developing the evidence base and identifying promising practices. PAPERS PUBLISHED BY NORFAM FACULTY IN : A scoping review of indigenous suicide prevention in circumpolar regions in International Journal of Circumpolar Health. Prevalence of childhood eczema and food sensitization in the First Nations reserve of Natuashish, Labrador, Canada in BMC Pediatrics. Aeromedevac Medicine Workshop High-fidelity critical care simulation

30 NUNAFAM DR. MADELEINE COLE REBECCA IRWIN Director of Medical Education Onsite Administrator To date, the NunaFam initiative of the Project for Enhanced Rural & Remote Training (PERRT) has seen eleven first-year residents and twelve second-year residents spend anywhere from two to four months training in Nunavut during their residency. Residents training in Nunavut continue to develop excellent skills in the clinic, inpatient, emergency, air transport and obstetrical care settings. In addition, there is an emphasis on health advocacy, public health and preventative medicine. This successful collaboration between Memorial and the Government of Nunavut has had an impact on the number of long term family physicians practicing in Nunavut. Three of our family medicine residents are planning to live and practice in Nunavut after completing training, with two having already signed long-term contracts. The relationship continues to expand and has also led to discussions with the Government of Nunavut regarding plans for Nunavut to purchase of a seat in the medical school. The program will continue past the original end date of June 2016 with the recent approval of an additional four years of funding by the Government of Nunavut. This will ensure that training in Nunavut will remain as an option of the family medicine northern stream of training, and that academic and practice supports will be provided on an ongoing basis to add to the solid foundation put in place for a family practice teaching center in Iqaluit.

31 PG PROGRAM PROJECT FOR ENHANCED RURAL AND REMOTE TRAINING (PERRT) DR. BOB MILLER LISA GRANT GFW - SHERRI CHIPPETT BURIN - JACKIE SPENCER DR. LYN POWER DR. JOHN CAMPBELL DR. MADELEINE COLE REBECCA IRWIN PATTI MCCARTHY Program Lead Project Manager Academic Program Administrators Site Lead, Burin Site Lead, Grand Falls-Windsor Site Lead, Nunavut Site Administrator, Nunavut Curriculum Development Assistant The Family Medicine Residency program in partnership with the Government of Newfoundland has availed of Health Canada federal funding secured in 2010 for the Project for Enhanced Rural and Remote Training (PERRT) to support an additional intake of 16 family medicine residents over a four-year period. The funding provides support for increased focus on rural and remote training while ultimately enhancing recruitment and retention of family doctors in rural and remote communities in Canada. The project is divided into two initiatives: the Newfoundland and Labrador project which focuses on two communities currently utilized in the family medicine program, Burin and Grand Falls-Windsor; and the NunaFam program in partnership with the Territorial Government of Nunavut. Total funding for both initiatives is $9.4 million. Burin and Grand Falls-Windsor, sites which were identified based on their different populations and health care resources, have funds allocated to provide dedicated administrative support, an office/learning center space, two professional accommodations per site suitable for trainees completing a longitudinal rotation who may also have families, as well as videoconferencing and IT resources. Funds for curriculum support and enhancements and faculty development are also included. The plan being that these supports would enhance the learning and living experience of the resident while training in these communities with the hope that a longer rotation and positive exposure to living and practicing in a rural community will lead to a desire to practice rurally once graduated. At this point we are happy to report that the project outcomes have been met and residents who have been supported through the project and trained at the Burin and Grand Falls-Windsor sites have signed on to practice in these communities. Two recent graduates of the Family Medicine program who trained in Burin for the full PGY2 year and were supported by the project have decided to remain in Burin to practice. One physician who completed the program this June has moved to the community with his family and has now set up a new family practice clinic which opened as of July 1st, Another physician is also living on the Burin peninsula and providing service to Burin as a family practitioner. Grand Falls-Windsor has also seen one of our Family Medicine graduates who completed training as of this June sign on to practice in the community. Another is providing service to the nearby rural community of Botwood. Access to primary healthcare will likely improve for these rural communities with the addition of these new family medicine practitioners.

32 RESIDENT RESEARCH PROJECTS: Dr. Charles Ball Dr. Andrew Collins Dr. Naila Debbache Dr. Holly Delaney Dr. Karen Downton Dr. Kristian Green Dr. Marcus Hancock Dr. Ellen Henry Dr. Aimee Holla Drs. Stephanie Hynes & Danika Kung Kean Dr. Anil Imbulgoda Dr. Marc Kawaja Dr. Michelle Kennedy Dr. David Kwinter Dr. Theresa Lee Dr. Heather Maxwell Dr. Jamison Mercer Dr. Tyler Mercer Dr. Kelly Monaghan Dr. Angela Rees Dr. Jeff Power Dr. Janelle Schneider Dr. Joseph Scanlon Dr. Megan Sherman Dr. Mari-Lynne Sinnott Dr. Shahil Sood Dr. Jordan Stone-McLean Dr. Cory Veldman Drs. Everett & Kathryn Versteeg Dr. Brendan Webber Does Kinesio tape provide a benefit for common musculoskeletal injuries The MV Christmas Seal and the battle against TB in Newfoundland Open Mind Missed Orthopedic Fractures in the Emergency Department and the Utility of the ER Discrepancy Folder A New Approach for New Candidates: A Review of the CaRMS Interview Process for Memorial University Family Medicine 2014/2015 with a Comparison of Resident and Faculty Interview Scoring Effects of High Protein Diets vs Low Protein Diets on Weight Loss: A Systematic Review of the Literature A Review of Competency Based Medical Education in Canada An Assessment of Memorial University of Newfoundland Family Medicine Residency Perceived Level of Skills and Comfort in Identifying and Managing Addictions Issues Evaluating the Usefulness to Parents and Healthcare Providers of the Rourke Baby Record Parent Information Sheets Sexual Health and Safety Education Program for Rural Haiti Spirituality in Palliative Care Chronic Abdominal Discomfort Incidentally Improved with Antibiotics. A Case Report and Discussion of Suspected Small Intestinal Bacterial Overgrowth Syndrome Did You Feel Prepared To Teach Medical Students When You Entered Residency? Compendium: Free Open-Access Clinical Reference Platform Remote Monitoring of Patients with COPD Use of Natural Health Products and Supplements for Weight Loss Among Adolescents and Young Adults Access to Care and Predictors of Pathologic Complete Response in Patients with Rectal Cancer Triage and Follow-Up of the Family Medicine After-Hours Call System in St. John s, NL Women s Experiences of Homebirth in NL Internet Based Cognitive Behaviour Therapy: Can internet based cognitive behavioural therapy replace face to face cognitive behavioural therapy in patients with suicidal ideation? Giving a Damn Community Engagement, Health Education and Promotion Cervical Cancer Screening In Low Income Countries: A Feasibility Study of HPV Self-Sampling In Rural Haiti Planning for Driving Cessation in the St. John s Area A Systematic Review of Advanced Life Support (ALS) Skill Acquisition and Maintenance: Evidence for a Novel Postgraduate Teaching Methodology How Medical Abortion Can Improve Access for Canadian Women: A Health Policy Review of Mifepristone Cryptococcus Gatti Pneumonia - Case Report Ultrasound in the MUN Undergraduate Medicine Curriculum: A Needs Assessment The Development of a Multidisciplinary CME/CPD Accredited Ultrasound Course: Point of Care Ultrasound (PoCUS) for Physicians in Practice Alcohol Use In Pregnancy in Communities of Northern Labrador: A Retrospective Chart Review Diabetes under Review: Micro-details, Macro-outcomes

33 CONTINUING PROFESSIONAL DEVELOPMENT Faculty Development DR. VINA BRODERICK JACQUELINE RYAN CPD Director CPD Support 2014 BRINGS NEW CPD COMMITTEE: The Continuing Professional Development (CPD) Committee was established to oversee all CPD activities in the discipline of Family Medicine according to the CANMED Roles. Members of our committee are Dr. Kath Stringer (undergraduate representative), Dr. Heather Flynn (postgraduate representative), Dr. Pam Snow (PDCS representative), Dr. Peter Reddy (Enhanced Skills Representative), Dr. Stephen Shorlin (MESC representative), Ms. Patti McCarthy (Education Specialist) and Dr. Vina Broderick (Committee Chair). The CPD committee meets monthly to plan, accredit and deliver ongoing CPD to our family medicine teachers. In the near future, we are looking forward to having representation on our committee from the various stream faculty development leads to help facilitate the development of teaching sessions for our community preceptors in our streams. On behalf of the discipline of family medicine and our committee, we would like to thank Dr. Cheri Bethune for all her hard work and dedication to organizing and facilitating high quality Faculty Development over the many years that she was the Director of Faculty Development. Needs Assessment: A needs assessment was developed along with PDCS and distributed to family medicine preceptors in April This is to help us provide topics that best meet the needs of all preceptors, and to plan for our 2015 preceptor s meeting. 6 FOR 6 PROGRAM 6 for 6 is a faculty development program in research skills for doctors from rural and remote Newfoundland and Labrador, New Brunswick and Nunavut. Implemented in late 2014, 6 for 6 provides participants with the skills, support and expert mentorship needed to be an effective rural researcher. By catalyzing their first research project, 6 for 6 empowers participants to pursue research relevant to their community and practice. The most recent project under the Centre for Rural Health Studies, 6 for 6 also supports research to improve the accessibility and quality of primary healthcare. In April 2015, 6 for 6 celebrated its first alumni, who received certificates in research skills and presented their research in-progress to an enthusiastic audience. Two of these participants, Dr. Margo Wilson and Dr. Gabe Woollam of Happy Valley-Goose Bay, disseminated their first research posters on Aeromedical Evacuation in Labrador and Tuberculosis Care in Labrador respectively at the Primary Healthcare Research Unit s Primary Healthcare Partnership Forum this June. The program team welcomed the second cohort in summer These participants are nearly halfway through the program, and are busy conceptualizing their research projects with topics including arsenic in community well water; strategies to improving the quality of medical databases; and perspective differences between caesarean-section and vaginal birth after caesarean-section mothers. The research team will start selecting third year candidates in October has also been a successful year for dissemination. The research team presented at Northern Constellations conference at NOSM, Society of Rural Physicians of Canada (SRPC) 2015 in Montreal and WONCA 2015 in Dubrovnik, Croatia.

34 NEW FRAMEWORK FOR FACULTY DEVELOPMENT (FTA FRAMEWORK) DEVELOPED BY THE COLLEGE OF FAMILY PHYSICIANS OF CANADA: The Fundamental Teaching Activities in family medicine was designed to support all teachers (family physicians and other health care providers) involved in providing quality family medicine education in Canada. Intuitive in its language and practical in its approach, the FTA Framework describes what teachers actually do and helps them to consider creative ways to expand and enhance their teaching activities. With the implementation of the Triple C Competency-based Curriculum and other undergraduate, postgraduate, and continuing professional development educational initiatives, the CFPC recognizes that supporting clinical teachers is a priority for the organization. - See more at: Our committee looks forward to assisting our family medicine teachers in the use of the framework for their personal faculty development and enhancing their teaching of learners. FACULTY DEVELOPMENT PROGRAM: CPD sessions with full-time faculty: are held one to two times per month. Topics and speakers are chosen by our CPD committee with input from full time faculty. Faculty development scholarship: Our fifth and final faculty member has enrolled in our Evidence Based Medicine Scholarship Program which is awarded annually. This scholarship supports the individual to attend two EBM courses at Oxford University, plan and undertake a research project with mentorship and travel to present this project at NAPCRG. This scholarship has been offered to increase the research capacity of our discipline. Site visits for community based option sites: Visits to community based option teaching sites in and near St. John s occur to offer a faculty development agenda. Site visits for distributed sites: Visits to distributed sites throughout the province occurs at least once per year and includes a faculty development agenda. National involvement: Dr. Vina Broderick has joined the Faculty Development Interest Group at the College of Family Physicians of Canada. Residents as teachers TIPS workshop: This is offered to all residents annually. Certificate in Medical Teaching and Masters of Family Medicine: Several faculty members have enrolled in formal medical education courses which include Certificate in Medical Teaching and Programs. FAMILY MEDICINE EDUCATION FORUM (ANNUAL FAMILY MEDICINE COMMUNITY PRECEPTORS MEETING): Our Annual Family Medicine Community Preceptors meeting was held at the new Memorial University Medical Education Centre and the Capital Hotel in St. John s October 1-4, The Community Preceptors meeting is an opportunity for networking between program administration and distributed teachers, as well as program updates and workshops for our family medicine teachers. Those preceptors who were able to attend this meeting were treated to a reception in the main atrium of the new building, along with guided tours of the facility which includes a simulation laboratory and state of the art teaching facilities.

35 Here are the list of the workshops that were offered: Competency-Based Assessment & Triple C Evolution: What it Means for Me as a Preceptor Coaching Skills for the Effective Preceptor Using Technology at Point of Care to Enhance Teaching and Patient Care Continuous Quality Improvement of Clinical Teaching: The Teaching Community of Practice The Brand New Preceptor: Teaching Skills for Novice Preceptors Giving effective feedback The Challenging Learner: When Do I Call for Help Community Engagement From Day One Learner session- Active Learning: Getting the Most From Your Preceptor Crucial Conversations training: A two-part Crucial Conversations course for St. John s based GFT s and FM staff was held March 3-4 and June 2-3, Crucial Conversations is a course that teaches skills for creating alignment and agreement by fostering open dialogue around high-stakes, emotional, or risky topics - at all levels within an organization. By learning how to speak and be heard (and encouraging others to do the same), you ll surface the best ideas, make the highest-quality decisions, and then act on your decisions with unity and commitment. The sessions were facilitated by Wayne Weston M.D., C.C.F.P., F.C.F.P., a Professor Emeritus of family medicine at the Schulich School of Medicine and Dentistry at Western University. Faculty Development Seminar Series DATE TOPIC PRESENTER 2014 Sept. The New MUN Medical School Curriculum Dr. Vina Broderick and Dr. Scott Moffatt 2015 Jan. 27 SAMPS 101 Dr. Pam Snow Feb. 24 Preparing for Your Annual Review Dr. Cathy MacLean and Ms. Paula Corbett Mar. 17 Research Ethics and the Residents Projects Sandra Reid, Ethics Director, Health Research Ethics Authority Mar. 24 Online Learning Groups Pilot Drs. Susan Avery, Kath Stringer, Amanda Pendergast April 21 Mainpro + Guidelines Dr. Scott MacDonald April 28 Promotions and Sabbatical Leave Paula Corbett & Sonya MacLeod May 26 Respectful Workplace Policy Dr. Scott Moffatt June 16 Scholarly Writing Sessions Dr. Cheri Bethune June 23 Small Group Teaching Stephen Shorlin (MESC)

36 CLINICAL SERVICES AND COMMUNITY ENGAGEMENT GFT FACULTY CLINICAL ACTIVITY IN 2014 We have seen many changes this past year as we continue to strive to develop our Patients Medical Home Model (PMH) in our four academic teaching units. Our inter-professional team has expanded. We were pleased to welcome Heather Pitcher who is a Nurse Practitioner providing health coaching services. Heather has a part time appointment in family medicine and has become a regular in the Family Medicine band! Gerard Farrell, one of our full time faculty has been developing a Cancer Care follow up clinic and hopes to evolve this using a Cancer Care Rehab model that has been successful elsewhere. We continue to work closely with psychiatry and have psychiatry residents doing a variation of shared care with consult services through our Torbay Road and Ross Clinic locations providing access for patients of all four sites. Our first kinesiology graduate student in the spring of 2015, Thomas Dymond, paved the way for more kinesiology involvement in our family practice unit. We continue to provide support for nurse practitioner students at the Ross clinic and we have had pharmacy students in clinical placements at all four teaching clinics in St. John s. We have improved access to our clinics through a number of initiatives. We consolidated our discipline meetings to Tuesday afternoons when residents were in their academic half day. We created a contingency plan for Memorial University closures this past year so we would have more access for our patients, which was brought to the test a few times this year successfully. Other initiatives include the work Roger Butler has been spear-heading with the Emergency Department in the HSC and nurse practitioners providing a Rapid Response Team for frail elderly in the community. One of our largest undertakings was to take on the Ferryland site as a rural satellite of our HSC site. This is an exciting initiative that models the hub and spoke approach we have been advocating in our PG program Streams design. In this case we worked with Eastern Health and government to find a solution for a rural community that lost both of its physicians. Eastern Health now has a nurse practitioner working in the clinic Monday to Friday and she has been supported collaboratively by Dr. Marshall Godwin who goes to Ferryland weekly for a full day clinic. Several faculty in the DFM have also gone to the Shamrock Clinic to offer clinics covering for Dr. Godwin when needed. The feedback has been very positive and we are now operating with our EMR in this location! We have also expanded services within our clinics now offering 24-hour BP monitoring services internally and we are gradually working our way towards Point of Care Ultrasound capacity. Our residents and key faculty are obtaining training in this area and we have been using a PoCUS machine in our FPU setting this past year. The residents have been the drivers but with faculty also developing skills and certification, this will become an integral part of our service and teaching in the future. We also expanded our FM obstetrics team and continue to provide prenatal referral services and intra partum care through an ever growing and very dedicated group within the DFM. Work continues to support underserved and marginalized populations for our planned enhanced skills program in Global Health and Health Equity. We have worked throughout 2014/15 to create a model of primary care for the downtown area of St. John s. This work is on-going and has been engaging recent graduates, which has been exciting. Dr. Kath Stringer has been working on an Adult Developmental Disability Consult Clinic which started in 2015 at the Ross Clinic with the help of our Nurse Practitioner, Denise Cahill and collaborations with the Waterford through Dr. Bruce Hollett. Dr. Pauline Duke and her team have been planning for the implementation of a refugee clinic at the FPU for the fall of Also as a part of our PMH work, we have a new Patient Advisory Council, thanks to one of the medical students, Alex States, who did the leg work to get this off the ground this year. Jessica Dwyer s student

37 project was on Patient Education and her work has spurred us to clear out industry sponsored literature from our waiting areas and to provide more electronic options as well as those from local health related agencies. New TV screens in two of our clinics have very current and engaging messaging including screened patient education videos from YouTube as well as practice specific messaging for our patients. Quality Improvement (QI) continues primarily through resident audits. Our approach this past year has been evolving as we look at closing the loop on previous audits to determine if we are improving care and outcomes. Dr. Godwin and Barb Morrissey, our clinical operations manager have also been looking at approach to QI including meeting with Dr. Cheryl Levitt this past year regarding the family practice QI tool kit and how we can further implement QI into our day to day practice. As part of our strategic plan, our clinics are working hard to strengthen our implementation of the PMH and we will continue to develop the above initiatives and other exciting projects in the upcoming year. Many thanks to our clinic medical directors at each site and to Barb Morrissey thanks for all you did in 2014/15! PATIENT-CENTRED PERSONAL FAMILY PHYSICIAN TEAM-BASED CARE TIMELY ACCESS COMPREHENSIVE CARE CONTINUITY ELECTRONIC RECORDS AND HEALTH INFORMATION EDUCATION AND TRAINING SYSTEM SUPPORTS EVALUATION

38 FAMILY MEDICINE UNIT - HEALTH SCIENCES CENTRE DR. LESLIE ROURKE AGNES WHELAN SARAH ROSE BERNICE MULLETT JODIE BENNETT DOROTHY GRANT PENNEY RUSSELL Unit Director Clinical Practice Clerk Clinical Practice Clerk Clinical Practice Clerk Clinical Practice Clerk Licensed Practical Nurse Licensed Practical Nurse There are currently eleven GFT faculty members attached to this unit: Drs. Leslie Rourke, Pauline Duke, Vina Broderick, Scott Moffatt, Heather Flynn, Pamela Snow, Marshall Godwin, Ean Parsons, Wanda Parsons, Gerard Farrell and Cathy MacLean. Dr. Gerard Farrell joined the team in September and provides cancer care follow up services for our patients and for those referred from physicians in the community. Dr. Petra Joller continued as a clinical associate; and Dr. Russell Dawe as a locum physician with us since This site has two group practices (Team 1 and Team 2), and cares for over 4,000 patients ranging from birth to over 100 years of age. In the past academic year, 37 resident months of supervision and teaching occurred at this site. New initiatives in this unit in during the past year include: 1. New equipment including a cryo dispenser which is used for better precision when administering cryotherapy to patients, 2. Pilot training program using point of care ultrasound, 3. Establishment of a Patient Advisory Council for the academic FM clinics in St. John s, 4. Optimization of LPN role within their scope of practice including administration of injections, 5. Addition in early 2015 of Erin Davis, a second cross-appointed School of Pharmacy clinical pharmacist faculty member (now one on each of the two teams), 6. Updating of resources including recent acquisition of waiting room screen to display patient education/information resources, 7. Creation of a patient brochure outlining services available to patients, 8. Implementation of a quality initiatives project to ensure we have accurate demographic information on file for patients as well as linking patients in the same household together in our electronic medical records system, 9. Quality initiatives project to look at ways to improve access for our patients by reducing the number of no-show patients, 10. Expansion of team to include the services of a Heather Pitcher, a certified Health Coach, 11. Implementation of a pilot project with Memorial University s Department. of Kinesiology to have a master of kinesiology student working with patients in the clinic, 12. Addition of pharmacy student learners to the clinic, 13. Work with health authority to care for patients under a Nurse Practitioner Model in Ferryland clinic. There are several initiatives that are unique to the Family Practice Unit/Family Medicine Clinic at the Health Sciences Centre (HSC) site: MUN Med Gateway Project - The MUN Med Gateway Project which began in , continues to thrive. Dr. Pauline Duke is the lead physician involved. The project partners with the Association for New Canadians (ANC), the settlement agency for the Province and Eastern Health (through the ANC public health nurse). The main goals of the project are to train medical students in cross-cultural medicine and engage them in community action while improving access to healthcare for refugees in Newfoundland. This program has expanded from history taking to evidence-based screening (e.g. dental, hearing, vision, etc.).

39 Refugee well woman clinics In working with the Association For New Canadians (ANC), it became apparent that many refugee women were not having well woman exams and care due to cultural barriers, knowledge about the preventive care and gender issues. Two family medicine residents, along with faculty member Dr. Pauline Duke developed a program to encourage and provide care to these women in Well woman refugee clinics have continued since then. Prenatal group clinics This site provides space for the weekly prenatal clinics run by the family physicians in St. John s that are involved in intra-partum care. The clinic gives the patients the opportunity to meet all the involved physicians at their prenatal visits in the last month of their pregnancy prior to their delivery. The physicians are Susan Avery, Norah Duggan, Amanda Pendergast, and Russell Dawe and they were involved with intrapartum care for nearly 140 women. These physicians also covered Case Room call for the Obstetrics Department during the OB/GYN resident half day on Friday afternoons. Family medicine residents are involved in all aspects of the GP obstetrics program. Care for specific out of town populations This site provides family medicine care to families of: 1) children hospitalized at the Janeway Hospital (e.g. NICU); and 2) Bliss Murphy Cancer Centre patients if they are from elsewhere in the Province outside St. John s. Care during specific events This site provides family medicine care on an informal basis to visiting out of province musicians during special events such as the Festival 500 choral gathering. Family Medicine consultations on the in-patient HSC Psychiatry Unit This site provides family medicine consultations to patients on the in-patient psychiatry ward in the HSC. Participation in in-patient care at the Miller Centre Dr. Russell Dawe participates in the Palliative Care consultation service. Sports medicine referrals Dr. Ean Parsons is a certified sports medicine physician who provides sports medicine consultations. Acupuncture Dr. Marshall Godwin and Dr. Heather Flynn are certified to perform acupuncture, and provide acupuncture consultations and therapy. 24-hour ambulatory blood pressure monitoring This site provides 24-hour ambulatory blood pressure monitoring for patients at this site and also at the other three academic teaching sites (Ross Family Medical Centre, Shea Heights Community Health Centre, and Torbay Road Mall Family Medical Clinic).

40 TORBAY ROAD FAMILY MEDICINE CLINIC DR. STEPHEN LEE KRISTEN PARROTT ASHLEY SQUIRES Unit Director Clinical Practice Clerk Clinical Practice Clerk The Torbay Road Medical Clinic is now almost four years old having opened to accept residents in August of There are currently two GFT faculty members, Dr. Danielle O Keefe and Dr. Stephen Lee, as well as two part-time fee-forservice physicians, Dr. Rosann Seviour and Dr. Christine Aubrey-Bassler. We were fortunate to have Dr. Danielle Braidwood work with us to provide clinical coverage and resident supervision for several months this year but sadly for us she returned to Ottawa at the end of May The Torbay Road Clinic has almost 2,500 patients registered. We have a diverse patient population and a good spectrum of patients with all age groups represented in similar proportions to our other teaching sites in St. John s. Our residents have a busy comprehensive experience at Torbay Road. They consistently see six to eight patients per half day which allows for excellent clinical exposure and a taste of real-life family medicine. This year the Torbay Road site was scheduled to have four residents, but we also accepted two residents who transferred from Royal College programs so our total was six residents. Our site also welcomed undergraduate learners from the Faculty of Medicine, the School of Pharmacy, and the School of Nursing. The clinic is utilized on Thursday mornings by Dr. Bill Eaton and Dr. Russell Dawe to do practice videos for medical students and residents completing palliative care rotations. The Standardized Patient Program is integral to the success of this endeavour. Dr. Lee had the opportunity to supervise a Nurse Practitioner student, Kari Brown, during her pathophysiology and clinical practicum from January to April This was a positive experience for our clinic and patients and we look forward to working with the School of Nursing on similar projects in the future. We look forward to working with new learners from the Faculty of Medicine and allied faculties in the academic year!

41 ROSS FAMILY MEDICINE CENTRE DR. GARY TARRANT FRONIE SQUIBB MARILYN POLLARD JUANITA PEACH MAUREEN PIKE Unit Director Intermediate Secretary Clinical Practice Clerk Clinical Practice Clerk Licensed Practical Nurse There are currently four GFT faculty members working in this unit including Dr. Roger Butler, Dr. Katherine Stringer, Dr. Greg Sherman and Dr. Gary Tarrant. Dr. Lisa Barnes joined the unit as a locum family physician last year and will be finishing up at the end of July, 2015 when you moves to our Shea Heights clinic. Dr. Erin Bennett is returning as one of our part time physicians in August Denise Cahill is a Nurse Practitioner who works full-time in the unit and Dr. Carla Dillon is a Pharmacist from the School of Pharmacy who spends one-half day a week in the unit. In addition, Dr. Susan Mercer, a family physician with certification in geriatrics, works part-time in our clinic and does consultation work with Eastern Health for geriatric patients. This is an academic teaching unit and there are PGY1 and PGY2 Family Medicine residents that do rotations at the Ross Centre. For the past year, this cohort includes PGY1s doing longitudinal rotations and PGY2s for their Care of Elderly rotations. There are also a variety of other learners such as 1st and 2nd medical students, clerkship students and elective students from Memorial University, from outside the province and from outside the country. The Nurse Practitioner, Denise Cahill, works in conjunction with the GFT faculty members and the PT physicians in teaching the Family Medicine residents as well as Nurse Practitioner students that do rotations at our clinic. Dr. Carla Dillon also supervises pharmacy students from the School of Pharmacy that do their clinical training at the unit. The residents and other medical learners benefit greatly from this exposure to inter-professional education. This unit also participates in a number of ongoing research projects. There are several initiatives that are unique to the Ross Family Medicine Centre: Care of in-patients at the Dr. L. A. Miller Centre - Drs. Butler, Stringer and Sherman contribute to the care of in-patients at the Dr. L. A. Miller Centre where they manage a medical ward in the Caribou Memorial Veteran s Pavilion as well as providing on-call coverage for the centre. Care of Personal Care Homes - Dr. Tarrant currently supervises the care of residents of three personal care homes in the Goulds. Nurse Practitioner - NP Cahill plays a major role in house call visitation and currently has over fifty home visits on her regular rota. She also takes the lead in chronic disease management and has clinics which focus especially on the chronic care for patients with diabetes mellitus. Geriatric Assessments - Dr. Butler is involved in geriatric assessments including patients referred from outside the practice and in the past year has been involved in the development of an emergency response team for elderly patients in the ER who do not have a family doctor.

42 Psychotherapy - Dr. Tarrant is involved with psychotherapy treatment and takes referrals from all the teaching units in St. John s. McMorran Centre - This unit also has an association with the Nurse Practitioner at the McMorran Centre and at Buckmaster Circle. The physicians at the Ross Centre provide supportive back-up for the Nurse Practitioner with any patients who need family medicine advice. Care for Emmanuel House - This unit is a resource for Emmanuel House which has clients coming to St. John s from outside the city. Ross clinic provides care for these patients that do not have a family doctor in the city. Care of nursing students - The unit also has an association with the Centre for Nursing Studies and provides medical care for nursing students from outside St. John s who do not have a family doctor in the city. In addition, the unit provides Pap smear clinics for any of the nursing students. Action plans and goals in education are to maintain the high level of activity that the Ross Clinic currently is engaged in and to continue to accommodate as many learners as possible for the Family Medicine program. This unit currently trains PGY1s in six month blocks that include family medicine, care of elderly care and palliative care. Currently, Dr. Stringer and Denise Cahill NP are working toward developing a clinic for adults with developmental disabilities. The Ross Centre would also like to continue its community engagement as stated above and look for further opportunities in our area to be a resource for the eastern part of the city.

43 SHEA HEIGHTS COMMUNITY HEALTH CENTRE DR. CHERI BETHUNE RHONDA HOOPER SHELLEY YETMAN Unit Director Medical Secretary Medical Secretary has been a year of comings and goings. In July 2014, after 30 years of service to the community, we bid farewell to Dr. Cheri Bethune, who also served as the unit director, as she retired from practice and moved to the next exciting chapter in her life. In 2015 Dr. Stephen Darcy and Dr. Amanda Pendergast were appointed as full-time faculty with the discipline of family medicine. Dr. Susan Avery rounds out our complement of physician faculty. Dr. Lisa Bishop is cross-appointed from the School of Pharmacy and adds to the faculty team. We were also extremely saddened by the passing of one of Shea Heights community leaders and a staunch friend and supporter of our Health Centre and Community Alliance, Mr. Harold Druken. Shea Heights Folk Festival Shea Heights Community Health Centre offers a unique clinical experience, including acupuncture, with a multi-disciplinary and inter-professional approach to health care in a rural atmosphere. Family physicians work with a public health nurse, a community health nurse, a social worker and a pharmacist, offering residents and medical students a real experience of teamwork and service to a community. Three of the team members (Drs. Duggan, Avery and Pendergast) also comprise three-quarters of the Family Medicine Obstetrics group, so prenatal, post-partum and well-baby care are an important part of our practice. It is notable that three of the four faculty members also spent part of their residency training in Shea Heights! Important newsworthy items include our Participatory Action Research Project on youth and mental health that continues with major events such as participation in the CU (Community University) Expo in Ottawa, Ont. in May 2015 and PriFor in June Our research team includes a part-time graduate student and this summer we have an undergraduate psychology student and two medical students with SURA grants to develop various projects. The Shea Heights Community Alliance also received through a Community Development Fund from Eastern Health for a drama project at the junior high school (See Research, Discovery and Scholarship section under Community Engagement later in this report for more details.). As a clinic team we also participated in the Shea Heights Folk Festival and annual Christmas Parade.

44 LOW RISK OBSTETRICS GROUP DR. NORAH DUGGAN DR. SUSAN AVERY DR. AMANDA PENDERGAST DR. RUSSELL DAWE Clinical Lead Team The Low Risk Obstetrics Group was formed in July 2011 by Drs. Norah Duggan, Susan Avery and Monica Kidd to address the decreasing rate of Family Physicians participating in low risk obstetrics and to build a team based approach that would demonstrate to medical students and residents that this skill set is a viable and exciting part of the family physicians scope of practice. Since 2011, we have had several team members come and go as life circumstances dictate, including Dr. Bob Miller, Dr. Megan Hayes and Dr. Joanne Bishop. Dr. Raie Lene Kirby, a recent Memorial graduate, joined our team last August, but her heart was in Botwood, where she moved to practice in December Her term with us was short but enjoyable! We are anticipating new team members in the coming year as well. The Family Medicine Obstetrics group provides family-centered prenatal, intrapartum and postpartum/newborn care. There are multiple points of entry for the patient and their family into the care group. Patients are cared for by their own family doctor or by one of the group physicians until 36 weeks gestation. They then attend a weekly shared prenatal clinic, where they have the opportunity to meet all of the physicians in the group and discuss their care plan in the context of their own health, needs and values. The physicians in the group share call and care for the mother and baby through labour, delivery and postpartum up to six weeks, depending on preference of the parents. Residents are currently incorporated into the group by seeing prenatal patients in their home clinic, attending the group prenatal clinic when on the call schedule and providing supported labour, delivery and postpartum care under the supervision of the attending family doctor. We also provide Labour and Delivery room coverage for OB patients when there is no OB House staff. We have a defined call schedule which demonstrates a positive work-life balance. Currently, R1 Residents on their academic family medicine rotation attend prenatal clinic, take part in call, and spend time in Labour and Delivery with a member of the team always present for supervision. We are looking for opportunities to offer this to R2 s on their CBO as well. In June 2014, we were invited to present our new care model at a National Forum on Teaching Competency in Family Medicine Maternity Care. We also presented at Prifor In September 2014 the Group, as well as Claire Bessell from the Provincial Perinatal Program, offered an Obstetrical Skills Workshop to Memorial medical students. Using low-fidelity simulation, students were taught fetal heart tracing interpretation, cervical assessment, determining position and station, artificial rupture of membranes (with meconium occasionally for good measure!), cord prolapse and steps in a normal vaginal delivery. The 24 participants really enjoyed the experience. This workshop will now be modified and offered to first year family medicine residents as well. Our group is supervising two medical students with SURA funding who are developing research projects on the impact of our new model of training. We have published one paper (2013) on our new model of care.

45 RESEARCH, DISCOVERY AND SCHOLARSHIP THE PRIMARY HEALTHCARE RESEARCH UNIT (PHRU) DR. MARSHALL GODWIN DR. SHABNAM ASGHARI DR. KRIS AUBREY-BASSLER ANDREA PIKE KAREN GRIFFITHS RICHARD CULLEN OLIVER HURLEY ADAM PIKE TAO CHEN SHANNON AYLWARD NICOLE SHEA SARA O REILLY THOMAS HEELEY ERFAN AREF-ESHGHI JACQUES VAN WIJK DOUGLAS DORWARD KRYSTAL PIKE ALLISON MAYBANK SAMANTHA FOSTER Unit Director Faculty Research Associate/Project Co-ordinator Adminstrative Assistant Research Coordinator Research Coordinator Research Computing Specialist Data Manager CPCSSN Program Evaluator Program Evaluator Program Evaluator Research Assistant Research Assistant Research Assistant Research Assistant Research Assistant Research Assistant Research Assistant The Primary Healthcare Research Unit is a research and program evaluation unit based in the discipline of family medicine. Three family medicine faculty members have their primary appointments with the PHRU and several other family medicine faculty members collaborate as principal or coinvestigators on research projects. Most of the research conducted by faculty members within the discipline of family medicine uses the resources of the PHRU and is reported here. The June 2015 edition of The Primary Report is available for viewing at Downloads/primaryreport/2015.pdf ACTIVITIES AND ACCOMPLISHMENTS Education Faculty members with appointments to and affiliations with the PHRU are heavily involved in education in the following areas: Graduate Teaching: PHRU faculty members are actively engaged in teaching and supervising graduate students in Department of Clinical Epidemiology as well as the Department of Geography and the division of Community Health and Humanities.

46 Current graduate students supervised by PHRU faculty include: DR. GODWIN DR. ASGHARI DR. AUBREY-BASSLER Farah McCrate PhD, Clinical Epidemiology Andrea Pike PhD, Clinical Epidemiology Shannon Aylward PhD, Clinical Epidemiology Penelope Turton MSc, Clinical Epidemiology Cassidy Brothers MSc, Clinical Epidemiology (Co-supervised by Dr. Kris Aubrey-Bassler) Amelia Moffatt MSc, Clinical Epidemiology Douglas Dorward MSc, Clinical Epidemiology Jacques van Wijk MSc, Clinical Epidemiology Samantha Foster MSc, Clinical Epidemiology Laurie Goyeche MSc, Clinical Epidemiology Ereny Ibrahim MSc, Clinical Epidemiology Justin Oake MSc, Clinical Epidemiology Scott Lee MSc, Clinical Epidemiology Heather Foley MSc Clinical Epidemiology (Co-supervisor) Jerome Siromani PhD, Clinical Epidemiology Allison Maybank MSc, Clinical Epidemiology Cassidy Brothers MSc, Clinical Epidemiology (Co-supervised by Dr. Marshall Godwin) Current graduate student teaching activities include: DR. GODWIN Full semester course on Conducting and Publishing a Systematic Review and Meta-analysis Lecture on Prognosis, Introduction to Clinical Epidemiology Course, Med 6250 Lecture on Diabetes, Disease and Injury Prevention, Med 6721 Lecture on Obesity, Disease and Injury Prevention, Med 6721 Lecture on Systematic Review and meta-analysis, Epidemiology II Course, Med 6275 DR. ASGHARI Chair/co-chair and instructor Epidemiology I, Introduction to Epidemiology, MED 6270 (Online and on site) Medical Geography I, MED 6900 Medical Geography II, Med 6901 Chronic Disease Epidemiology, MED 6274 Lecture on Cancer Epidemiology, MED-6580 Family Medicine Residency EBM teaching: This work has been led by Dr. Kris Aubrey-Bassler who is coresearch director for the discipline of family medicine with Dr. Godwin. Dr. Aubrey-Bassler oversees teaching in EBM, Audit, and the Residents Project program. The critical appraisal curriculum for family medicine residents uses up-to-date teaching tools developed by the Centre for Evidence Based Medicine based at Oxford University. Teaching is concentrated in the Academic Family Medicine Rotation in the first residency year to overcome difficulties with a greater number of academic sites away from St. John s in second year. The introduction of distributed academic family medicine teaching sites for first year FM residents has required the use of e-learning (Desire2Learn) technology to deliver the EBM curriculum to these residents.

47 Emergency Medicine Residency EBM teaching: The EBM teaching curriculum for emergency medicine residents has undergone a process of standardization and increased formalization with the involvement of Dr. Kris Aubrey-Bassler. The four residents in the program each year are required to pick current papers in the EM literature and to prepare a presentation including an overview of the paper, background information on relevant epidemiological and statistical methodology and a formal critical appraisal and summary recommendation regarding translation into practice or policy. Two such presentations are delivered approximately eight-10 times per year to an audience of 20 to 40 students, residents and staff physicians. Faculty Development: A formal program for all faculty members in Writing for Publication is on-going for the last several years. This has been organized by Dr. Shabnam Asghari of the PHRU, and Dr. Cheri Bethune and has incorporated presentations both by PHRU members and external researchers. Several family medicine faculty members have submitted successful grant applications for the first time following these sessions. Scholarship in Medical Research: Under the leadership of Drs. Godwin, Aubrey-Bassler, Asghari, and Bethune, the PHRU continues to offer a faculty scholarship in evidence based medicine teaching and research. Each year, one faculty member from the discipline is selected to attend two Centre for Evidence Based Medicine workshops in Oxford, England, one on practicing EBM and the other on teaching EBM. The faculty member is also expected to develop a research project and submit both a grant application and conference presentation application. Dr. Pamela Snow is the current holder of this award. Upon successful completion of the program, graduates receive a certificate and participate in teaching EBM to residents. The 6 for 6 Project: This project is the latest and most ambitious faculty development project the discipline of family medicine has undertaken. It is led by Drs. Cheri Bethune and Shabnam Asghari, and Patti McCarthy. It is funded by the Dean of Medicine to run for three years. Each year six rural preceptors will be chosen to participate in the program. The program involves travelling to St. John s six times for 2 days each over the period of one year. The purpose is to learn to develop a research question and proceed through the process of developing a methodology to answer it. The experts/mentors and resources at the university will be at their disposal to help them with their project. During each of the six visits there are formal teaching sessions as well as meetings and discussions with key people who can help them move their project along. The first cohort of six physicians has recently graduated. The second cohort started in the early spring of The feedback from participants has been highly positive and the one year report to the dean of medicine is being written. Curriculum Development in Medical Geography: Dr. Shabnam Asghari has led this initiative for the discipline of family medicine. Previously at Memorial, there was no course or program in place to provide students with knowledge of geographic information systems and health research. For faculty members with these research interests, applicants for research assistant positions either had a strong background in GIS or epidemiology but not both. In addition, there is a demand for these skills at the provincial Department of Health and Community Health. To address this gap, we established a team of researchers and educators who were interested in Health/Medical Geography. The team developed two courses on Medical Geography and is currently pursuing development of a graduate program in Medical Geography. The Medical Geography courses represent a cross-disciplinary program in Geography and Health. The courses are also very unique in the field of Medical Geography, given that they are team-taught by GIS specialists in Geography, Epidemiologists and Clinical Practitioners in the Faculty of Medicine. The courses are available to graduate students in Geography, Epidemiology, Community Health, Public Health and Medicine. Offering Medical Geography courses and the graduate program in Medical Geography will provide new career opportunities for graduate students in Geography, Health and Medicine. In addition, these courses offer opportunities for practicing health professionals to enhance their knowledge and skills.

48 COMMUNITY ENGAGEMENT AND KNOWLEDGE TRANSLATION Primary Healthcare Partnership Forum: The PHRU organizes the Primary Healthcare Partnership Forum (PriFor), a scientific conference based on a call for abstracts for posters, oral, presentations, and workshops. It is the largest conference of its type in Atlantic Canada and in addition to the call for abstracts we invite keynote speakers that fit with the theme of the conference for that year. This conference serves an important role in connecting Newfoundland and Labrador researchers to policy makers and researchers in this province and other parts of Canada. These relationships are increasingly important to maximize success with largescale grant applications and to translate the results of studies funded by these grants into policy and clinical practice. In September 2014, the PHRU hosted the sixth annual Prifor conference which included over 110 attendees from across Canada. On June 29 and 30, 2015 the seventh annual Prifor conference was held. The theme was Patient Oriented Research That Matters and there were 176 registrants. Content included three keynote addresses, three workshops, 42 oral presentations and 59 posters. While participants were primarily from Newfoundland and Labrador, there were 20 from across the rest of Canada and several international attendees. Partnerships: Many of the projects run in the PHRU require active engagement from policy makers and health care professionals outside of the university. The largest collaborative effort in the past year has been around the SPOR Network in Primary and Integrated Health Care Innovations. We were successful in receiving funding for Phase 1 of the SPOR network which involved $25,000 in matching funds from each of the Janeway Foundation, the Newfoundland and Labrador Medical Association, and the Department of Health and Community Services. In June 2015 we received notification that the Phase 2 application for the SPOR Network was successful for a total of $1 Million. This project is being led by Dr. Aubrey-Bassler as the Research lead with Dr. Kevin Chan as the clinical lead and Mr. Bruce Cooper, Deputy Minister of Health and Community Services, as the policy lead. Many of the research projects conducted by PHRU investigators have been made possible by the involvement of members of the Atlantic Practiced Based Research Network. This is a network of practicing family physicians who are interested in participating in PHRU research projects; they make recruitment into clinical research studies possible. Over the past five years nearly 80 family physicians in clinical practice in St. John s and across the province, have participated in research projects conducted by the PHRU. Within the university, PHRU researchers collaborate with faculty members from across the spectrum including many of the units within the Faculty of Medicine (nursing, pharmacy, community health and humanities, clinical epidemiology, emergency medicine, internal medicine). They also work closely with members of the Department of Geography, as well as investigators from research communities in Canada, and are involved in several multi-centered studies. Research in Progress: The PHRU organizes a Research in Progress (RiP) seminar series open to all departments, disciplines and divisions. Each month it hosts a speaker on a research project at various stages of completion ranging from those at the earliest stages of conception to those approaching publication. This series has increased visibility in the university community, has led to important collaborations and has helped presenters to refine their projects using the advice of seminar attendees. The topics presented during the 2014/2015 academic year can be found at Research Expertise: PHRU faculty members provide input into the design of studies, offer feedback to grant writers to increase the quality of their proposals and become co-applicants and/or co-investigators when expertise is requested. They also help to ensure that research output is accurate and relevant. The dramatic increase in research funding and in research output in family medicine since the PHRU was formed is a testament to these roles.

49 FAMILY MEDICINE PUBLICATIONS Bold denotes a MUN Family Medicine author 1. Asghari S, Aref-Eshghi E, Hurley O, Godwin M, Duke P, Williamson T, Mahdavian M. Does the prevalence of dyslipidemias differ between Newfoundland and the rest of Canada? Findings from the electronic medical records of the Canadian Primary Care Sentinel Surveillance Network. Front Cardiovasc Med. 2015; 2:1. 2. Aref-eshghi, E., Leung J.., Godwin, M., Duke, P., Williamson, T., Mahdavian, M. Asghari, S., LDL Control Status among Canadians at Risk for Cardiovascular Disease: Findings from the Canadian Primary Care Sentinel Surveillance Network. BMC-Lipid Disease and Health 3. Birtwhistle R, Barber D, Drummond N, Godwin M, Greiver M, Singer A, Lussier MT, Manca D, Natarajan N, Terry A, Wong S, Martin RE, Mangin D. Horses and buggies have some advantages over cars, but no one is turning back. Can Fam Physician 2015 May; 61(5): Birtwhistle R, Godwin M, Leggett JA, Martin K. Linking health databases for research. Can Fam Physician 2015 Apr; 61(4): Duke P, Brunger F. The MUN Med Gateway Project: Marrying medical education and social accountability. Can Fam Physician 2015 Feb; 61:e Duke P, Brunger F, Ohle E. Morning in refugee health: An introduction for medical students. Intl J of Migration, Health and Social Care 2015; 11(2). 7. Duke P, Godwin M, Ratnam S, Dawson L, Fontaine D, Lear A, Traverso-Yepez M, Graham W, Ravalia M, Mugford G, Pike A,Fortier J, Peach M. Effect of vaginal self-sampling on cervical cancer screening rates: a communitybased study in Newfoundland. BMC Women s Health 2015; 15:47. DOI /s Fortier J, Godwin M. Doula support compared with standard care. Can Fam Phys 2015 Jun: 61:e Fung D, Schabort I, MacLean CA, Asrar FM, Khory A, Vandermeer B, Allan GM. Test ordering for preventive health care among family medicine residents. Can Fam Physician 2015 March; 61:e165-e Godwin M, Pike A, McCrate K, Parsons K, Parsons W, Pitcher H, Buehler S, Gadag V, Miller R, Sclater A. The healthy aged: Descriptive analysis by sex of cognitively functioning elderly patients 80 years and older living independently in the community. Can Fam Physician 2015 Mar; 61(3):e142-e Godwin, M., Williamson, T., Khan, S., Kaczorowski, J., Asghari, S., Morken, R., Dawes, M., Birtwhistle, R. (2015). A Cross Sectional Analysis of Hypertension in Family Physician Practices with Electronic Medical Records: A Report from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). CMAJ Open 12. Godwin M, Williamson T, Khan S, Kaczorowski J, Asghari S, Morkem R, Dawes M, Birtwhistle R. Prevalence and management of hypertension in primary care practices with electronic medical records: A report from the Canadian Primary Care Sentinel Surveillance Network. CMAJ Open 2015 Feb; 3(1):E76-E82. cmajopen.ca/content/3/1/e76.full 13. Huguet A, McGrath PJ, Wheaton M, MacKinnon SP, Rozario S, Tougas M, Stinson J, MacLean C. Testing the Feasibility and Psychometric Properties of a Mobile Diary (mywhi) in Adolescents and Young Adult with Headaches. 14. Hogg WE, Wodchis WP, Katz A, Wong ST, Cullen R, Yelland G. Bringing Canada together: Effective organizational structure for multijurisdictional health services research projects. Can Fam Phys 2015;61(5): Kinghorn KJ, Castillo-Quan JI, Bartolome F, Plamena RA, Li L, Pope S, Cochemé HM, Khan S, Asghari S, Kallash PB, Hardy J, Abramov AY, Partridge L. Loss of PLA2G6 leads to elevated mitochondrial lipid peroxidation and mitochondrial dysfunction. Brain 2015, in press. Advance Access Publish available: org/ /brain/awv MacLean, C (2014). Nausea in Adults. In C. Repchinsky (Eds.), Therapeutic Choices ( ). Ottawa: Canadian Pharmacists Association. (7thed). In press.

50 17. Manca DP, Aubrey-Bassler K, Kandola K, Aguilar C, Campbell-Scherer D, Sopcak N, O Brien MA, Meaney C, Faria V, Baxter J, Moineddin R, Salvalaggio G, Green L, Cave A, Grunfeld E. Implementing and evaluating a program to facilitate chronic disease prevention and screening in primary care: A mixed methods program evaluation. Implementation Science 2014, 9(135) 18. McColl MA, Aiken A, Smith K, McColl A, Green M, Godwin M, et al. Actionable nuggets: Knowledge translation tool for the needs of patients with spinal cord injury. Can Fam Phys 2015;61: e Ploughman M, Manning OJ, Beaulieu S, Harris C, Hogan SH, Mayo N, Fisk JD, Sadovnick AD, O Connor P, Morrow SA, Metz LM, Smyth P, Allderdice PW, Scott S, Marrie RA, Stefanelli M, Godwin M. Predictors of chronic cerebrospinal venous insufficiency procedure use among older people with multiple sclerosis: a national case control study. BMC Health Services Research 2015, 15:161 doi: /s y 20. Tarrant G. Psychotherapy in Newfoundland and Labrador. GP Psych Winter;22(1): Wong ST, Chau LW, Hogg W, Teare GF, Miedema B, Breton M, Aubrey-Bassler K, Katz A, Burge F, Boivin A, Cooke T, Francoeur D, Wodchis WP. An international cross-sectional survey on the Quality and Costs of Primary Care (QUALICO-PC): Recruitment and data collection of places delivering primary care across Canada. BMC Family Practice Open 2015;16:20. com/ /16/ Bethune C, Asghari S, Godwin M, McCarthy P. Finding their voices: How a group of academic family physicians became writers. Can Fam Physician 2014 December;60 (12): Brouwers FM, Courteau J, Cohen AA, Farand P, Cloutier L, Asghari S, Vanasse A. Beta-blockers are associated with increased risk of first cardiovascular events in nondiabetic hypertensive elderly patients. Pharmacoepidemiol Drug Saf Jul 5: Available online doi/ /pds.3675/pdf 24. Brunger F, Duke P, Kenny R. Matching physicians to newly arrived refugees in a context of physician shortage: Innovation through advocacy. International Journal of Migration, Health and Social Care. 2014;10(1): doi: / ijmhsc Brussières A, Côté P, French S, Godwin M, et al. Creating a chiropractic practice-based research network (PBRN): enhancing the management of musculoskeletal care. J Can Chiropr Assoc 2014 Mar;58(1): Cornish P, Church E, Callanan T, Bethune C, Younghusband L. Self-help is no help: Negative study results lead to important lessons. Can J Rural Med 2014; 19(3): Dillon CM, Mahoney JJ, Genge TL, Conway AE, Stringer KC. Prevalence of medication management by community pharmacists in patients of a Newfoundland family medicine clinic. Can Pharm J (Ott) May;147(3): Duke P, Fardy J. Recurrent Clostridium difficile infection treated with home fecal transplantation: A case report. J Med Case Reports 2014; 8: Eaton W. Video review: communication skillsoriented approach for community preceptors. Can Fam Phys Jan;60(1): El Emam K, Arbuckle L, Essex A, Samet S, et al. Secure Surveillance of Antimicrobial Resistant Organism Colonization or Infection in Ontario Long Term Care Homes. PLoS One Apr 8;9(4):e doi: /journal. pone Forsey RG. Prevalence of childhood eczema and food sensitization in the First Nations reserve of Natuashish, Labrador, Canada. BMC Pediatr Mar 20;14:76. doi: / Gruber R, Carrey N, Weiss S, Frappier J, Rourke L, Brouillette R, Wise M. Position Statement on Pediatric Sleep for Psychiatrists. J Can Acad Child Adolesc Psychiatry Fall 2014; 23(3): Heath O, Church E, Curran V, Hollett A, Cornish P, Callanan T, Bethune C, Younghusband L. Interprofessional mental health training in rural primary care: findings

51 from a mixed methods study. J Interprof Care Oct 7: Kidd M, Broderick V. An unusual presentation of a swollen arm: A case report. J Med Case Rep Jan 27;8:22. doi: / Myers MG, Kaczorowski J, Dawes M, Godwin M. Automated office blood pressure measurement in primary care. Can Fam Phys Feb;60(2): Ploughman M, Beaulieu S, Harris C, Hogan S, Manning OJ, Alderdice PW, Fisk JD, Sadovnick AD, O Connor P, Morrow SA, Metz LM, Smyth P, Mayo N, Marrie RA, Knox KB, Stefanelli M, Godwin M. The Canadian survey of health, lifestyle and aging with multiple sclerosis: methodology and initial results. BMJ Open Jul 10;4(7):e doi: /bmjopen Rourke L, Rourke J. Boundaries and balance: Managing relationships in rural practice. In Chater AB, Rourke J, Couper ID, Strasser RP, Reid S (eds.) WONCA Rural Medical Education Guidebook. World Organization of Family Doctors (WONCA): WONCA Working Party on Rural Practice, 2014 Apr Rourke J, Strasser R, Reid S, Couper I, eds. Chater B, ed. in chief. WONCA Rural Medical Education Guidebook. World Organization of Family Doctors (WONCA): WONCA Working Party on Rural Practice; 2014 Apr. Accessed April 28, Stewart M, Wuite S, Ramsden V, Burge F, Beaulieu MD, Fortin M, Godwin M, Harris S, Reid G, Haggerty J, Brown JB, Thomas R, Wong S. Transdisciplinary understandings and training on research: successfully building research capacity in primary health care. Can Fam Physician Jun;60(6): Vanasse, A., Courteau, J., Asghari, S., Leroux, D., & Cloutier, L. (2014). Health inequalities associated with neighbourhood deprivation in the Quebec population with hypertension in primary prevention of cardiovascular disease. Chronic diseases and injuries in Canada, 34(4), Dalton, B. (2014). Pharmacologic management of adult breakthrough cancer pain. Canadian Family Physician; 60 (12), Resident Publications 1. Sue, K. (2014). The occasional ED ultrasound abdominal aorta. Society of Rural Physicians of Canada, 19(3), Micks, Taft. (2015). From the T-dot to the Rock: my journey in rural family medicine. Society of Rural Physicians of Canada, 20(2), Research Reports 1. Asghari S., Minichiello A., Maybank A., Swab M, Marshall Z., Gahagan J., Hot A., Schwandt M., Gaudry S. (2015)HIV Point-of-Care Testing in Canadian Settings A Scoping Review. A report to the Research Center for Evidence into Action for Community Health (REACH) 2. Godwin, M. (Corresponding Author),Pike A., Aubrey K., Asghari S., Primary care reform Initiative in Canada and abroad: A systematic review of scientific and gray literature Report to Newfoundland and Labrador Medical Association March M Laberge, J Pang, K Walker, S Wong, W Hogg, WP Wodchis, K Aubrey et al. QUALICOPC (Quality and Costs of Primary Care) Canada: A focus on the aspects of primary care most highly rated by current patients of primary care practices. Canadian Foundation for Healthcare Improvement Report. June 2014.

52 PRESENTATIONS AND POSTERS AT SCIENTIFIC CONFERENCES Oral presentations Aref-Eshghi E, Godwin M, Duke P, Williamson T, Mahdavian M, Asghari S. A comparison of Newfoundlanders lipid profiles with the rest of Canada: Findings from Canadian Primary Care Sentinel Surveillance Network data. Primary Healthcare Partnership Forum; Sep 2014; St. John s, NL. Asghari S, Farrell A, Hogel M, Johnston S, Kendall C, Liddy C, Rourke S. Perspective of People Living with HIV on Access to Healthcare: A Scoping Review The primary care partnership forum; Sep 2014; St John s, NL. Asghari S, Godwin M, Duke P, Aref-Eshghi E, Williamson T, Mahdavian M, Hurley O. HDL conundrum in NL. CFPC-NL Annual Scientific Assembly; Oct 2014; St. John s, NL. Asghari S, Simms A, Godwin M, Aubrey-Bassler K, Collins K. Medical Geography: A Promising Cross- Disciplinary Program. Geomatics Atlantic; Nov 2014; St. John s, NL. Asghari S, Simms A, Valcour J, Brunelle C. Exploring the Feasibility and Process of Establishing an Online Spatiotemporal Information System (OSTIS) for Chronic Diseases in Newfoundland and Labrador. Geomatics Atlantic; Nov 2014; St. John s, NL. Bethune C, Asghari S. The 6 for 6 program: A research skills program for rural and remote family medicine faculty. The Primary Care Partnership Forum; Sep 2014; St John s, NL. Bethune C. Uncovering the latent researcher. Keynote presentation at New Brunswick Medical Education Forum; May 2014; Upper River Valley, NB. Bishop L, Darcy S. Many voices One community: Investigating the perceptions of youth mental health and substance use in a small urban community. Primary Healthcare Partnership Forum; Sep 2014; St. John s, NL. Duggan N. Effectiveness of a rural family medicine academic half day via webinar versus audio conferencing: Student and faculty perspectives. WONCA Rural Health Conference; Apr 2015; Dubrovnik, Croatia. Duggan N. Strategies to maximize rural-based education for medical students: The Memorial University experience. WONCA Rural Health Conference; Apr 2015; Dubrovnik, Croatia. Duke P, Brunger F, Duff K, Farrell G, Mulay S, Allison J, Albrechtsons B, Dedinca A, Roche K. MUN MED Gateway: Bridging medical education, refugee health care, and social accountability. WONCA Rural Health Conference; Apr 2015; Dubrovnik, Croatia. Duke P, Duff K, Farrell F, Mulay S, Albrechtsons B, Allison J, Brunger F, Dedinca A, Roche K. MUN MED Gateway: An examination of health issues among new refugees in St. John s, Newfoundland and Labrador, Canada, WONCA Rural Health Conference; Apr 2015; Dubrovnik, Croatia. Gamble JM, Rourke L. Prescribing tips. CFPC-NL Annual Scientific Assembly; Oct 2014; St. John s, NL. Karkera VS, Samet S. Privacy Preserving Analysis Tool (PPAT): A platform independent privacy analysis tool for large anonymized data sets. Newfoundland Electrical and Computer Engineering Conference, Nov 2014; St. John s, NL. MacDonald W, Miller R. NunaFam: Training family physicians in the Canadian Arctic. WONCA Rural Health Conference; Apr 2014; Gramado, Brazil.

53 MacLean, C. Dr. Google: Patient education in family practice. CFPC-NL Annual Scientific Assembly; Oct 2014; St. John s, NL. MacLean, C. Prifor Soapbox Session Dangerous Ideas ; June 2015; St. John s, NL. MacLean, C. Hub and Spoke Models for Family Medicine Education and Primary Care in NL workshop, PriFor; June 2015; St. John s, NL. MacLean, C. Patient Advisory Councils in the Patients Medical Home Model workshop with Alex States, PriFor; June 2015; St. John s, NL. O Keefe D. Social accountability considerations for the restructuring of a family medicine residency training program. WONCA Rural Health Conference; April 2015; Dubrovnik, Croatia. Parsons W, McHugh J, Searcy C, Dowd K. Do scores on the new Psychological, Social and Biological Foundations of Behavior (PSBB) section of MCAT 2015 predict medical students academic performance in behavioral and social sciences courses? Student Selection for the Health Professions Conference; Apr 2015; Melbourne, Australia. Parsons W, McHugh J, Yi Y, Rourke J, Godwin M. A randomized sequence study of a traditional interview versus multiple-mini interview approach to assess candidates for suitability for acceptance into medical school at Memorial University Student Selection for the Health Professions Conference; Apr 2015; Melbourne, Australia. Ravalia, M. The geographic pipeline to rural family medicine at Memorial. WONCA Rural Health; Apr 2014; Gramato, Brazil. Rourke J. Generalism and generalists defined: Implications for medical education, the health system, and health human resources. Canadian Conference on Medical Education; Apr 2014; Ottawa, ON. Rourke J. How can medical schools best respond to the needs of their rural regions? WONCA Rural Health Conference; Apr 2014; Gramado, Brazil. Rourke J. Let s start at the very beginning Med Quest. The Muster Global Community Engaged Medical Education; Nov 2014; Uluru, Australia. Rourke J. Pipeline or life cycle journey or pathways to rural generalist medicine. Society of Rural Physicians of Canada Annual Meeting; Apr 2015; Montreal, QC. Rourke J, Ravalia M, Parsons W, O Keefe D, Stringer K, Duggan N, Walsh K, Hippe J, Moffatt S. Memorial s life cycle approach to rural family medicine. WONCA Rural Conference; Apr 2015; Dubrovnik, Croatia. Rourke J. Rural/Distributed learning symposium. Association for Medical Education in Europe Conference; Sep 2014; Milan, Italy. Rourke L, Collins S, Nakajima M, Osborne G, Arbour L. The Nunavut well-baby record: Modifying a standard tool for a remote indigenous population. WONCA Rural Health Conference; Apr 2014; Gramado Brazil. Snow, P. A physician reviewer s perspective on accrediting continuing medical education programs: Best practices and lessons learned. Association for Medical Education in Europe Conference; Sep 2014; Milan, Italy.

54 Poster presentations Asghari S, Aref-Eshghi E, Aubrey-Bassler K, Duke P, Mahdavian M; Williamson T, Godwin M. Regional Variation in Dyslipidemia and Lipid Profile of Canadians: Findings from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). NAPCRG Annual meeting; Nov 2014; New York, NY. Asghari S, Aref-Eshghi E, Leung J, Godwin M, Duke P, Williamson T, Mahdavian M. Rural-urban differences in LDL-cholesterol control among patients at cardiovascular risk in Canada: Findings from Canadian Primary Care Sentinel Surveillance Network database, WONCA Rural Health; Apr 2015; Dubrovnik, Croatia. Asghari S, Aubrey-Bassler K, Buehler S, Gadag V, Godwin M, Maddalena V, McCrate F, Parsons K, Parsons W, Pike A. The Life After 80 Study: A Cross-sectional and case-control analysis of physically independent and physically dependent cohorts of octogenarians. NAPCRG Annual Meeting; Nov 2014; New York, NY. Asghari S, Hurley O, Simms A, Godwin M. Rural/Urban Variations in Diabetes Diagnosis and Outcomes in Newfoundland and Labrador. WONCA World Rural Health Conference; Apr 2015; Dubrovnik, Croatia. Asghari S, Ismail I, Kelly D, Burt K, Hurley O, Pittman B, Gilbert L, Knight J. Creating a dynamic populationbased cohort of persons living with HIV to inform policy, practice and ongoing research in Newfoundland and Labrador. Canadian Association for HIV Research Conference; Apr 2015; Toronto, ON. Asghari S, Kendall C, Farrell A, Hogel M, Rourke S, Liddy C. Perspective of People Living With HIV on Access to Healthcare: A Scoping Review. NAPCRG; Nov 2014; New York, NY. Asghari S, Modir H, Olsen C, Farrell A, Kendall C, Hurley O, Marshall Z, Johnston S, Hogel M, Rourke S, Liddy C. Perception of people Living with HIV on Access to Healthcare: Protocol of Search for a Scoping Review. CAHR; Apr 2015; Toronto, ON. Asghari S, Liddy C, Rourke S, Kaposy C, Becker M, Caetano P, Kendall C. McGee F. Advancing primary healthcare for persons living with HIV in Canada. The Primary Care Partnership Forum; Sept 2014; St John s, NL. Aubrey-Bassler K, Cullen R, Asghari S, Godwin M, Wang P, Crane J. Obstetrical Outcomes by Family Physicians: Analysis by Instrumental Variables. NAPCRG; Nov 2014; New York, NY. Bethune C, Asghari S, Godwin M, Fitzgerald S. The 6 for 6 Program: A Research Skills Program for Rural and Remote Family Medicine Faculty. NAPCRG; Nov 2014; New York, NY. Buehler S, Gadag V, Godwin M, McCrate F, Miller R, Parsons K, Parsons W, Pike A, Pitcher H. The Eldercare Project: Final results of the RCT. NAPCRG Annual Meeting; Nov 2014; New York, NY. Butler L, Rourke L, Pardy T. The Rourke Baby Record for parents: Web portal for reliable online information. Canadian Conference on Medical Education; Apr 2014; Ottawa, ON. Darcy S, Bishop L, El-Bialy R, Singleton C, Duggan N, Avery S, Bethune C, Sinnott R. Many voices, one community: Investigating the perceptions of youth mental health and substance abuse. Family Medicine Forum; Nov 2014; Quebec City, QC. Debnath M, Samet S, Vidyasankar K. A PHR system with policy based fine-grained access control and revocation mechanism. Newfoundland Electrical and Computer Engineering Conference; Nov 2014; St. John s, NL.

55 Dray M, Kirby F, Warren J, Moffatt S, Rourke J, Hippe J, Walsh K. Let s start at the very beginning Med Quest: A pipeline program to medical school and rural family practice. Family Medicine Forum; Oct 2014; Ottawa, ON. Duke P, O Dea H, Pieroway A. Clinical program evaluation of a refugee well woman health project in Newfoundland, Canada. WONCA Europe Conference; Jul 2014; Lisbon, Portugal. Godwin M, Duke P, Ratnam S, Ravalia M, Pike A, Fortier J, Graham W, Lear A, Mugford G, Traverso M. Effect of vaginal self-sampling on cervical cancer screening rates: A community based study in Newfoundland. WONCA Rural Health Conference; Apr 2015; Dubrovnik, Croatia. Godwin M, McCrate F, Gadag V, Pitcher H, Pike A, Buehler S, Parsons K, Parsons W, Miller R. The effect of a homebased nursing intervention on measures of health status in independent, community-living old elderly: The Eldercare Program. NAPCRG; Nov 2014; New York, NY. Godwin M, McCrate F, Gadag V, Pitcher H, Pike A, Buehler S, Parsons K, Parsons W, Miller R. The effect of a homebased nursing intervention on measures of health status in independent, community-living old elderly: The Eldercare Program. Third Congress of the Association of General Practitioners and Family Physicians of South East Europe; Sep 2014; Sarajevo, Bosnia. Godwin M, Moffatt A, Asghari S, O Keefe D. Retrospective Cohort of Patients on Statin Drugs for Five Years. NAPCRG; Nov 2014; New York, NY. Kelly D, Asghari S, Kielly J, Biggin J, Burt K. Validation of the Patient Assessment of Chronic Illness Care (PACIC) Survey for Chronic HIV Care. CAHR; Apr 2015; Toronto, ON. Liddy C, Rourke S, Asghari S, Kaposy C, Becker M, McGee F, Caetano P, Crowe L, Kendall C. Advancing Primary Healthcare for Persons Living With HIV in Canada. NAPCRG; Nov 2014; New York, NY. MacLean C, Faour E, Development of an MVC Clinical Reporting Tool. PriFor; June 2015; St. John s, NL. MacLean C, Coleman A, Physical Activity and Obesity in NL ; PriFor; June 2015; St. John s, NL. Moffatt S, Warman A, Walsh K, Hippe J. Supporting medical students in distributed sites: A Memorial University approach. WONCA Rural Health; Apr 2015; Dubrovnik, Croatia. O Keefe D. Social accountability considerations for the restructuring of a family medicine residency training program. Canadian Conference on Medical Education; April 2015; Vancouver, BC. Parihar R, Asghari S. Diabetes Complications and Comorbidities in Patients Newly Diagnosed With Diabetes in Newfoundland and Labrador (NL): Gender Differences. NAPCRG; Nov 2014; New York, NY. Parsons W, McHugh J, Searcy C, Dowd K. Do scores on the new Psychological, Social and Biological Foundations of Behavior (PSBB) section of MCAT 2015 predict medical students academic performance in behavioral and social sciences courses? Canadian Conference on Medical Education; Apr 2015; Vancouver, BC. Parsons W, McHugh J, Yi Y, Rourke J, Godwin M. A randomized sequence study of a traditional interview versus multiple mini interview approach to assess candidates for suitability for acceptance into medical school at Memorial University. Association for Medical Education in Europe Conference; Sep 2014; Milan, Italy. Peters S, Parsons W, McHugh J, Rourke J, Hippe J, Harris Walsh K. MUN MD Program: New curriculum, new class geographic descriptions. Canadian Conference on Medical Education; Apr 2015; Vancouver, BC.

56 Pike A, Godwin M, Aubrey-Bassler K, Asghari S, Hewitt D, Howse D, Cullen R, McCrate F. Family Physicians Attitudes Toward and Adherence to Prevention and Screening Guidelines in Newfoundland and Labrador, Canada. NAPCRG; Nov 2014; New York, NY. Pike A, Godwin M, Aubrey-Bassler K, Asghari S, Solberg S, Gaudine A, Lefort S, Etchegary H, Gadag V, McCrate F. Health Coaching to Effect Lifestyle Behavior Change: A Clinical Trial of Patients With Pre-Disease. NAPCRG; Nov 2014; New York, NY. Pike K, Godwin M, Pike A, Aubrey-Bassler K, Asghari S, Maddalena V, Buehler S, Gadag V, McCrate F, Parsons K, Parsons W. The Life After 80 Study: A Cross-Sectional and Case-Control Analysis of Physically Independent and Physically Dependent Cohorts of Octogenarians. NAPCRG; Nov 2014; New York, NY. Ravalia M, Parsons W, McHugh J, Rourke J, Hippe J, Harris Walsh K. Geographic diversity and the MUN MD program. Canadian Conference on Medical Education; Apr 2015; Vancouver, BC. Ravalia M. Should I apply to medical school? Barriers of applying to medical school as perceived by rural and urban students. WONCA Rural Health; Apr 2015; Dubrovnik, Croatia. Ravalia M. The geographic pipeline to rural family medicine at Memorial. World Summit on Generalism; Oct 2014; Cairns, Australia. Rourke J. Geographic diversity and the MUN MD program. Canadian Conference on Medical Education; Apr 2015; Vancouver, BC. Rourke J. How is rural defined and used in Canada? Canadian Conference on Medical Education; Apr 2015; Vancouver, BC and The Muster Global Community Engaged Medical Education; Nov 2014; Uluru, Australia. Rourke J. Memorial s life cycle approach to rural family medicine. WONCA Rural Health; Apr 2015; Dubrovnik, Croatia. Rourke J, Parsons W, Duggan N, Stringer K, Ravalia M, O Keefe D. The geographic pipeline to rural family medicine at Memorial. The Muster Global Community Engaged Medical Education; Nov 2014; Uluru, Australia. Rourke L, Hann S, Drover A, Stokes D, Hickey D, Duggan N, Reddigan J, Zipperlen K. Evaluation of an elearning module for an effective well-baby visit using the Rourke Baby Record. Canadian Paediatric Society 91st Annual Conference; Apr 2015; Montreal, QC and Canadian Conference on Medical Education; Apr 2014; Ottawa, ON. Stokes D, Rourke L, Hann S, Drover A, Duggan N, Hickey D, Reddigan J, Zipperlen K. Technical issues re development of the e-learning module for teaching medical students to conduct an effective well-baby visit using the Rourke Baby Record. Canadian Conference on Medical Education; Apr 2014; Ottawa, ON. Stringer K, Curran V, Asghari S, Dillon K, O Keefe D. Exploring pharmacists expectations of competent and family physicians. The Primary Care Partnership Forum; Sept 2014; St John s, NL. Stringer K, Moffatt S, Donovan C, Bartlett J, Eustace S, Penton P, McGrath G. Community engagement: Integration through the Memorial University medical school curriculum. The Muster Global Community Engaged Medical Education; Nov 2014; Uluru, Australia. Vanasse A, Orzanco M, Bergeron P, Cohen A, Niyonsenga T, Asghari S, Cloutier L, Leroux D, Courteau, J. The Neighbourhood Effect of Immigration on an Urban Diabetic Population. NAPCRG; Nov 2014; New York, NY.

57 Number of different peer-reviewed publications where a DFM faculty member is first or subsequent author Number of different publications where a DFM faculty member is first author to June Number of different publications where a DFM faculty member is first author to June