Marie Desmartis - Academia.edu (original) (raw)

Papers by Marie Desmartis

Pédagogie Médicale, 2009

ABSTRACT Context: In 2005, a group of clinical teachers in family medicine at Laval University (Q... more ABSTRACT Context: In 2005, a group of clinical teachers in family medicine at Laval University (Québec) implemented a system assigning an educational adviser to each resident for the duration of the residency. The adviser's role was to guide the resident along his or her professional path by means of institutionalized and privileged relationship. Objective: To describe the implementation of an educational adviser system in a family medicine teaching unit. Methods: An action research was undertaken between June 2005 and June 2006 with the collaboration of educational advisers and residents. Data were collected from written individual questionnaires, focus groups and observations completed during regular educational meetings of clinical teachers. Questionnaires and focus groups were analyzed thematically. Results: During the implementation year, educational advisers have better clarified and adopted their new role. The continuous guidance regarding resident's professional development as well as its specific needs became specificities of educational advisers roles. Sources of information and data collection methods triangulation have enriched results. In general, the action research has positively contributed to the implementation of an educational change in this setting. Conclusion: The clarification and the assumption of the educational adviser's role and the application of concrete means to allow its practice are the main contributions of this study. The action research has promoted reflective practice and discussions within the teaching team and between teachers and residents. In addition, it helped to solve problems encountered during the implementation system. Contexte : En 2005, une équipe d'enseignants en médecine familiale à l'université Laval (Québec) a implanté un système jumelant chaque résident à un conseiller pédagogique pour la durée de la résidence. La fonction de conseiller était celle d'un guide accompagnant un résident dans son parcours de formation au moyen d'une relation interpersonnelle privilégiée et institutionnalisée. But : Décrire l'implantation du système de conseillers pédagogiques dans un milieu de formation en médecine familiale. Méthodes : Une recherche-action s'est déroulée de juin 2005 à juin 2006 avec la participation des conseillers pédagogiques et des résidents. Le recueil des informations s'est fait au moyen de questionnaires écrits individuels, de groupes de discussion et d'observation des réunions pédagogiques régulières des cliniciens enseignants. Les questionnaires et les groupes de discussion ont fait l'objet d'une d'analyse de contenu thématique. Résultats : Au cours de l'année d'implantation, les conseillers pédagogiques ont pu mieux définir et s'approprier leur nouvelle fonction. L'accompagnement continu du résident dans son développement professionnel et les conseils spécifiques en regard de besoins particuliers sont devenus les spécificités de cette fonction. La triangulation des sources d'information et des méthodes de recueil des données a permis d'enrichir les résultats. Globalement, la recherche-action a positivement contribué à l'implantation du changement pédagogique dans ce milieu. Conclusion : La clarification de la fonction de conseiller pédagogique, son appropriation et l'application de moyens concrets permettant de la mettre en pratique sont les principales retombées de cette étude. La recherche-action a permis d'offrir des lieux de réflexion et d'échanges dans l'équipe d'enseignants et entre les enseignants et les résidents en plus d'aider à trouver des solutions aux obstacles rencontrés dans l'implantation du système.

ABSTRACT Context: In 2005, a group of clinical teachers in family medicine at Laval University (Q... more ABSTRACT Context: In 2005, a group of clinical teachers in family medicine at Laval University (Québec) implemented a system assigning an educational adviser to each resident for the duration of the residency. The adviser's role was to guide the resident along his or her professional path by means of institutionalized and privileged relationship. Objective: To describe the implementation of an educational adviser system in a family medicine teaching unit. Methods: An action research was undertaken between June 2005 and June 2006 with the collaboration of educational advisers and residents. Data were collected from written individual questionnaires, focus groups and observations completed during regular educational meetings of clinical teachers. Questionnaires and focus groups were analyzed thematically. Results: During the implementation year, educational advisers have better clarified and adopted their new role. The continuous guidance regarding resident's professional development as well as its specific needs became specificities of educational advisers roles. Sources of information and data collection methods triangulation have enriched results. In general, the action research has positively contributed to the implementation of an educational change in this setting. Conclusion: The clarification and the assumption of the educational adviser's role and the application of concrete means to allow its practice are the main contributions of this study. The action research has promoted reflective practice and discussions within the teaching team and between teachers and residents. In addition, it helped to solve problems encountered during the implementation system. Contexte : En 2005, une équipe d'enseignants en médecine familiale à l'université Laval (Québec) a implanté un système jumelant chaque résident à un conseiller pédagogique pour la durée de la résidence. La fonction de conseiller était celle d'un guide accompagnant un résident dans son parcours de formation au moyen d'une relation interpersonnelle privilégiée et institutionnalisée. But : Décrire l'implantation du système de conseillers pédagogiques dans un milieu de formation en médecine familiale. Méthodes : Une recherche-action s'est déroulée de juin 2005 à juin 2006 avec la participation des conseillers pédagogiques et des résidents. Le recueil des informations s'est fait au moyen de questionnaires écrits individuels, de groupes de discussion et d'observation des réunions pédagogiques régulières des cliniciens enseignants. Les questionnaires et les groupes de discussion ont fait l'objet d'une d'analyse de contenu thématique. Résultats : Au cours de l'année d'implantation, les conseillers pédagogiques ont pu mieux définir et s'approprier leur nouvelle fonction. L'accompagnement continu du résident dans son développement professionnel et les conseils spécifiques en regard de besoins particuliers sont devenus les spécificités de cette fonction. La triangulation des sources d'information et des méthodes de recueil des données a permis d'enrichir les résultats. Globalement, la recherche-action a positivement contribué à l'implantation du changement pédagogique dans ce milieu. Conclusion : La clarification de la fonction de conseiller pédagogique, son appropriation et l'application de moyens concrets permettant de la mettre en pratique sont les principales retombées de cette étude. La recherche-action a permis d'offrir des lieux de réflexion et d'échanges dans l'équipe d'enseignants et entre les enseignants et les résidents en plus d'aider à trouver des solutions aux obstacles rencontrés dans l'implantation du système.

BMC Health Services Research, 2014

Background: Public and patient involvement in the different stages of the health technology asses... more Background: Public and patient involvement in the different stages of the health technology assessment (HTA) process is increasingly encouraged. The selection of topics for assessment, which includes identifying and prioritizing HTA questions, is a constant challenge for HTA agencies because the number of technologies requiring an assessment exceeds the resources available. Public and patient involvement in these early stages of HTA could make assessments more relevant and acceptable to them. Involving them in the development of the assessment plan is also crucial to optimize their influence and impact on HTA research. The project objectives are: 1) setting up interventions to promote patient participation in three stages of the HTA process: identification of HTA topics, prioritization, and development of the assessment plan of the topic prioritized; and 2) assessing the impact of patient participation on the relevance of the topics suggested, the prioritization process, and the assessment plan from the point of view of patients and other groups involved in HTA. Methods: Patients and their representatives living in the catchment area of the HTA Roundtable of Université Laval's Integrated University Health Network (covering six health regions of the Province of Quebec, Canada) will be involved in the following HTA activities: 1) identification of potential HTA topics in the field of cancer; 2) revision of vignettes developed to inform the prioritization of topics; 3) participation in deliberation sessions for prioritizing HTA topics; and 4) development of the assessment plan of the topic prioritized. The research team will coordinate the implementation of these activities and will evaluate the process and outcomes of patient involvement through semi-structured interviews with representatives of the different stakeholder groups, structured observations, and document analysis, mainly involving the comparison of votes and topics suggested by various stakeholder groups. Discussion: This project is designed as an integrated approach to knowledge translation and will be conducted through a close collaboration between researchers and knowledge users at all stages of the project. In response to the needs expressed by HTA producers, the knowledge produced will be directly useful in guiding practices regarding patient involvement in the early phases of HTA.

Cochrane Database of Systematic Reviews, 2009

Informatics in primary care, 2007

The Continuing Professional Development Center of the Faculty of Medicine at Laval University off... more The Continuing Professional Development Center of the Faculty of Medicine at Laval University offers an internet-based program on evidence-based medicine (EBM). After one year, only three physicians out of the 40 who willingly paid to register had completed the entire program. This descriptive study aimed to identify physicians' beliefs regarding their completion of this online program. Using theoretical concepts from the Theory of Planned Behaviour, a semi-structured telephone interview guide was developed to assess respondents' attitudes, perceived subjective norms, perceived obstacles and facilitating conditions with respect to completing this internet-based program. Three independent reviewers performed content analysis of the interview transcripts to obtain an appropriate level of reliability. Findings were shared and organised according to theoretical categories of beliefs. A total of 35 physicians (88% response rate) were interviewed. Despite perceived advantages to completing the internet-based program, barriers remained, especially those related to physicians' perceptions of time constraints. Lack of personal discipline and unfamiliarity with computers were also perceived as important barriers. This study offers a theoretical basis to understand physicians' beliefs towards completing an internet-based continuing medical education (CME) program on EBM. Based upon respondents' insights, several modifications were carried out to enhance the uptake of the program by physicians and, therefore, its implementation.

International Journal of Medical Informatics, 2010

Testicular cancer is one of the greatest threats to health and wellness among 15-to 40-year old m... more Testicular cancer is one of the greatest threats to health and wellness among 15-to 40-year old males. A concerted effort in the literature promoting awareness, risk factors, and preventative measures is warranted. There is limited discussion on the validity of interventions aimed at promoting testicular self-examination (TSE) performance; the existing body of evidence offers little discussion on what specific factors motivate performance. To assist in making Healthy People 2020 an all-inclusive success, a comprehensive assessment of existing evidence is necessary to assist in closing this research gap. A systematic review of interventions promoting TSE performance discovered moderate levels of effectiveness among 10 studies promoting the behavior. Concerning methodological quality, nine were of average quality and one was of high quality. In terms of significant TSE reporting between intervention and control/comparison groups, 3 out of 10 did not achieve the statistical causal threshold. Based on our assessment of TSE intervention quality and outcomes pertaining to behavior adoption, a best-practices guideline is presented for researchers in the field to consult as they design their interventions. This guideline aims to improve on internal and external validity of TSE promotion research in order to make them more effective.

The Patient - Patient-Centered Outcomes Research, 2013

There is growing interest in involving patients in decisions regarding healthcare technologies. T... more There is growing interest in involving patients in decisions regarding healthcare technologies. This research project was conducted in collaboration with decision makers and health technology assessment agents in order to involve healthcare service users (and their loved ones) in the assessment of alternatives to seclusion and restraint in short-term psychiatric wards and long-term care facilities for the elderly. This paper explores the viewpoints and suggestions of service users and service users' families about alternatives to restraint and seclusion, as well as conditions under which they could be used among adults in short-term psychiatric care and residents in long-term care facilities. Using a semi-structured guide, we held eight focus groups: five with mental health service users and three with family members of elderly people in long-term care facilities. Focus group discussions were digitally recorded and transcribed verbatim, and we performed content analysis using NVivo 8 software. In both care environments, participants emphasized the importance of communicating with service users, as well as assessing their needs and their particular situation, for reducing the use of restraint and seclusion. A better welcome and accompaniment of people admitted for short-term psychiatric care emerged also as key approaches to reduce the use of restraint and seclusion. Long-term care facilities could also reduce the need for restraint and seclusion by creating a stimulating home environment and individualized occupational therapy programs. Participants in both groups suggested that caregivers other than healthcare staff could be more involved, especially peer-support workers in the case of psychiatric care and volunteers in the case of long-term care facilities. Participants suggested that changes were needed at a broader and more systemic level than simply replacing current measures of restraint and seclusion with alternative techniques. They favored an approach focused more on the person than on the techniques: they suggested that listening to and communicating with the service user could reduce the use of restraint and seclusion in both healthcare environments.

Telemedicine and e-Health, 2010

We systematically reviewed PubMed and EBSCO business, looking for cost indicators of electronic h... more We systematically reviewed PubMed and EBSCO business, looking for cost indicators of electronic health record (EHR) implementations and their associated benefit indicators. We provide a set of the most common cost and benefit (CB) indicators used in the EHR literature, as well as an overall estimate of the CB related to EHR implementation. Overall, CB evaluation of EHR implementation showed a rapid capital-recovering process. On average, the annual benefits were 76.5% of the first-year costs and 308.6% of the annual costs. However, the initial investments were not recovered in a few studied implementations. Distinctions in reporting fixed and variable costs are suggested.

Nursing Education Perspectives, 2013

This study aimed to assess the effectiveness of a blended-teaching intervention using Internet-ba... more This study aimed to assess the effectiveness of a blended-teaching intervention using Internet-based tutorials coupled with traditional lectures in an introduction to research undergraduate nursing course. Effects of the intervention were compared with conventional, face-to-face classroom teaching on three outcomes: knowledge, satisfaction, and self-learning readiness. A two-group, randomized, controlled design was used, involving 112 participants. Descriptive statistics and analysis of covariance (ANCOVA) were performed. The teaching method was found to have no direct impact on knowledge acquisition, satisfaction, and self-learning readiness. However, motivation and teaching method had an interaction effect on knowledge acquisition by students. Among less motivated students, those in the intervention group performed better than those who received traditional training. These findings suggest that this blended-teaching method could better suit some students, depending on their degree of motivation and level of self-directed learning readiness.

Journal of Medical Systems, 2012

International Journal of Technology Assessment in Health Care, 2011

to support her research program. We thank Stéphane Ratté who was responsible for developing the l... more to support her research program. We thank Stéphane Ratté who was responsible for developing the literature search strategy. We are also grateful to Carrie Anna McGinn for the linguistic revision.

International Journal of Medical Informatics, 2010

Testicular cancer is one of the greatest threats to health and wellness among 15-to 40-year old m... more Testicular cancer is one of the greatest threats to health and wellness among 15-to 40-year old males. A concerted effort in the literature promoting awareness, risk factors, and preventative measures is warranted. There is limited discussion on the validity of interventions aimed at promoting testicular self-examination (TSE) performance; the existing body of evidence offers little discussion on what specific factors motivate performance. To assist in making Healthy People 2020 an all-inclusive success, a comprehensive assessment of existing evidence is necessary to assist in closing this research gap. A systematic review of interventions promoting TSE performance discovered moderate levels of effectiveness among 10 studies promoting the behavior. Concerning methodological quality, nine were of average quality and one was of high quality. In terms of significant TSE reporting between intervention and control/comparison groups, 3 out of 10 did not achieve the statistical causal threshold. Based on our assessment of TSE intervention quality and outcomes pertaining to behavior adoption, a best-practices guideline is presented for researchers in the field to consult as they design their interventions. This guideline aims to improve on internal and external validity of TSE promotion research in order to make them more effective.

Health Expectations, 2012

The recent establishment of health technology assessment (HTA) units in University hospitals in t... more The recent establishment of health technology assessment (HTA) units in University hospitals in the Province of Quebec (Canada) provides a unique opportunity to foster increased participation of patients in decisions regarding health technologies and interventions at the local level. However, little is known about factors that influence whether the patient's perspective is taken into consideration when such decisions are made. To explore the practices, perceptions and views of the various HTA stakeholders concerning patient involvement in HTA at the local level. Data were collected using semi-structured interviews with 24 HTA producers and hospital managers and two focus groups with a total of 13 patient representatives. Patient representatives generally showed considerable interest in being involved in HTA. Our findings support the hypothesis that the patient perspective contributes to a more accurate and contextualized assessment of health technologies and produces HTA reports that are more useful for decision makers. They also suggest that participation throughout the assessment process could empower patients and improve their knowledge. Barriers to patient involvement in HTA at the local level are also discussed as well as potential strategies to overcome them. This study contributes to knowledge that could guide interventions in favour of patient participation in HTA activities at the local level. Experimenting with different patient involvement strategies and assessing their impact is needed to provide evidence that will inform future interventions of this kind.

BMC Health Services Research, 2009

Background: Recognizing the importance of increased patient participation in healthcare decisions... more Background: Recognizing the importance of increased patient participation in healthcare decisions leads decision makers to consider effective ways to incorporate patient perspectives in Health Technology Assessment (HTA) processes. The implementation of local health HTA units in university hospitals in Quebec provides a unique opportunity to foster an increased participation of patients in decisions regarding health technologies and clinical interventions. This project explores strategies that could be effective in involving patients in HTA activities at the local level. To do so, three objectives are pursued: 1) To synthesise international knowledge and experiences on patient and public involvement in HTA activities; 2) To explore the perceptions of stakeholders (administrators, clinical managers, healthcare professionals, HTA producers, and patients) regarding strategies for involving patients in various HTA activities; and 3) To produce a consensual strategic framework that could guide interventions for involving patients in HTA activities at the local level.

BMC Health Services Research, 2012

Pédagogie Médicale, 2009

ABSTRACT Context: In 2005, a group of clinical teachers in family medicine at Laval University (Q... more ABSTRACT Context: In 2005, a group of clinical teachers in family medicine at Laval University (Québec) implemented a system assigning an educational adviser to each resident for the duration of the residency. The adviser's role was to guide the resident along his or her professional path by means of institutionalized and privileged relationship. Objective: To describe the implementation of an educational adviser system in a family medicine teaching unit. Methods: An action research was undertaken between June 2005 and June 2006 with the collaboration of educational advisers and residents. Data were collected from written individual questionnaires, focus groups and observations completed during regular educational meetings of clinical teachers. Questionnaires and focus groups were analyzed thematically. Results: During the implementation year, educational advisers have better clarified and adopted their new role. The continuous guidance regarding resident's professional development as well as its specific needs became specificities of educational advisers roles. Sources of information and data collection methods triangulation have enriched results. In general, the action research has positively contributed to the implementation of an educational change in this setting. Conclusion: The clarification and the assumption of the educational adviser's role and the application of concrete means to allow its practice are the main contributions of this study. The action research has promoted reflective practice and discussions within the teaching team and between teachers and residents. In addition, it helped to solve problems encountered during the implementation system. Contexte : En 2005, une équipe d'enseignants en médecine familiale à l'université Laval (Québec) a implanté un système jumelant chaque résident à un conseiller pédagogique pour la durée de la résidence. La fonction de conseiller était celle d'un guide accompagnant un résident dans son parcours de formation au moyen d'une relation interpersonnelle privilégiée et institutionnalisée. But : Décrire l'implantation du système de conseillers pédagogiques dans un milieu de formation en médecine familiale. Méthodes : Une recherche-action s'est déroulée de juin 2005 à juin 2006 avec la participation des conseillers pédagogiques et des résidents. Le recueil des informations s'est fait au moyen de questionnaires écrits individuels, de groupes de discussion et d'observation des réunions pédagogiques régulières des cliniciens enseignants. Les questionnaires et les groupes de discussion ont fait l'objet d'une d'analyse de contenu thématique. Résultats : Au cours de l'année d'implantation, les conseillers pédagogiques ont pu mieux définir et s'approprier leur nouvelle fonction. L'accompagnement continu du résident dans son développement professionnel et les conseils spécifiques en regard de besoins particuliers sont devenus les spécificités de cette fonction. La triangulation des sources d'information et des méthodes de recueil des données a permis d'enrichir les résultats. Globalement, la recherche-action a positivement contribué à l'implantation du changement pédagogique dans ce milieu. Conclusion : La clarification de la fonction de conseiller pédagogique, son appropriation et l'application de moyens concrets permettant de la mettre en pratique sont les principales retombées de cette étude. La recherche-action a permis d'offrir des lieux de réflexion et d'échanges dans l'équipe d'enseignants et entre les enseignants et les résidents en plus d'aider à trouver des solutions aux obstacles rencontrés dans l'implantation du système.

ABSTRACT Context: In 2005, a group of clinical teachers in family medicine at Laval University (Q... more ABSTRACT Context: In 2005, a group of clinical teachers in family medicine at Laval University (Québec) implemented a system assigning an educational adviser to each resident for the duration of the residency. The adviser's role was to guide the resident along his or her professional path by means of institutionalized and privileged relationship. Objective: To describe the implementation of an educational adviser system in a family medicine teaching unit. Methods: An action research was undertaken between June 2005 and June 2006 with the collaboration of educational advisers and residents. Data were collected from written individual questionnaires, focus groups and observations completed during regular educational meetings of clinical teachers. Questionnaires and focus groups were analyzed thematically. Results: During the implementation year, educational advisers have better clarified and adopted their new role. The continuous guidance regarding resident's professional development as well as its specific needs became specificities of educational advisers roles. Sources of information and data collection methods triangulation have enriched results. In general, the action research has positively contributed to the implementation of an educational change in this setting. Conclusion: The clarification and the assumption of the educational adviser's role and the application of concrete means to allow its practice are the main contributions of this study. The action research has promoted reflective practice and discussions within the teaching team and between teachers and residents. In addition, it helped to solve problems encountered during the implementation system. Contexte : En 2005, une équipe d'enseignants en médecine familiale à l'université Laval (Québec) a implanté un système jumelant chaque résident à un conseiller pédagogique pour la durée de la résidence. La fonction de conseiller était celle d'un guide accompagnant un résident dans son parcours de formation au moyen d'une relation interpersonnelle privilégiée et institutionnalisée. But : Décrire l'implantation du système de conseillers pédagogiques dans un milieu de formation en médecine familiale. Méthodes : Une recherche-action s'est déroulée de juin 2005 à juin 2006 avec la participation des conseillers pédagogiques et des résidents. Le recueil des informations s'est fait au moyen de questionnaires écrits individuels, de groupes de discussion et d'observation des réunions pédagogiques régulières des cliniciens enseignants. Les questionnaires et les groupes de discussion ont fait l'objet d'une d'analyse de contenu thématique. Résultats : Au cours de l'année d'implantation, les conseillers pédagogiques ont pu mieux définir et s'approprier leur nouvelle fonction. L'accompagnement continu du résident dans son développement professionnel et les conseils spécifiques en regard de besoins particuliers sont devenus les spécificités de cette fonction. La triangulation des sources d'information et des méthodes de recueil des données a permis d'enrichir les résultats. Globalement, la recherche-action a positivement contribué à l'implantation du changement pédagogique dans ce milieu. Conclusion : La clarification de la fonction de conseiller pédagogique, son appropriation et l'application de moyens concrets permettant de la mettre en pratique sont les principales retombées de cette étude. La recherche-action a permis d'offrir des lieux de réflexion et d'échanges dans l'équipe d'enseignants et entre les enseignants et les résidents en plus d'aider à trouver des solutions aux obstacles rencontrés dans l'implantation du système.

BMC Health Services Research, 2014

Background: Public and patient involvement in the different stages of the health technology asses... more Background: Public and patient involvement in the different stages of the health technology assessment (HTA) process is increasingly encouraged. The selection of topics for assessment, which includes identifying and prioritizing HTA questions, is a constant challenge for HTA agencies because the number of technologies requiring an assessment exceeds the resources available. Public and patient involvement in these early stages of HTA could make assessments more relevant and acceptable to them. Involving them in the development of the assessment plan is also crucial to optimize their influence and impact on HTA research. The project objectives are: 1) setting up interventions to promote patient participation in three stages of the HTA process: identification of HTA topics, prioritization, and development of the assessment plan of the topic prioritized; and 2) assessing the impact of patient participation on the relevance of the topics suggested, the prioritization process, and the assessment plan from the point of view of patients and other groups involved in HTA. Methods: Patients and their representatives living in the catchment area of the HTA Roundtable of Université Laval's Integrated University Health Network (covering six health regions of the Province of Quebec, Canada) will be involved in the following HTA activities: 1) identification of potential HTA topics in the field of cancer; 2) revision of vignettes developed to inform the prioritization of topics; 3) participation in deliberation sessions for prioritizing HTA topics; and 4) development of the assessment plan of the topic prioritized. The research team will coordinate the implementation of these activities and will evaluate the process and outcomes of patient involvement through semi-structured interviews with representatives of the different stakeholder groups, structured observations, and document analysis, mainly involving the comparison of votes and topics suggested by various stakeholder groups. Discussion: This project is designed as an integrated approach to knowledge translation and will be conducted through a close collaboration between researchers and knowledge users at all stages of the project. In response to the needs expressed by HTA producers, the knowledge produced will be directly useful in guiding practices regarding patient involvement in the early phases of HTA.

Cochrane Database of Systematic Reviews, 2009

Informatics in primary care, 2007

The Continuing Professional Development Center of the Faculty of Medicine at Laval University off... more The Continuing Professional Development Center of the Faculty of Medicine at Laval University offers an internet-based program on evidence-based medicine (EBM). After one year, only three physicians out of the 40 who willingly paid to register had completed the entire program. This descriptive study aimed to identify physicians' beliefs regarding their completion of this online program. Using theoretical concepts from the Theory of Planned Behaviour, a semi-structured telephone interview guide was developed to assess respondents' attitudes, perceived subjective norms, perceived obstacles and facilitating conditions with respect to completing this internet-based program. Three independent reviewers performed content analysis of the interview transcripts to obtain an appropriate level of reliability. Findings were shared and organised according to theoretical categories of beliefs. A total of 35 physicians (88% response rate) were interviewed. Despite perceived advantages to completing the internet-based program, barriers remained, especially those related to physicians' perceptions of time constraints. Lack of personal discipline and unfamiliarity with computers were also perceived as important barriers. This study offers a theoretical basis to understand physicians' beliefs towards completing an internet-based continuing medical education (CME) program on EBM. Based upon respondents' insights, several modifications were carried out to enhance the uptake of the program by physicians and, therefore, its implementation.

International Journal of Medical Informatics, 2010

Testicular cancer is one of the greatest threats to health and wellness among 15-to 40-year old m... more Testicular cancer is one of the greatest threats to health and wellness among 15-to 40-year old males. A concerted effort in the literature promoting awareness, risk factors, and preventative measures is warranted. There is limited discussion on the validity of interventions aimed at promoting testicular self-examination (TSE) performance; the existing body of evidence offers little discussion on what specific factors motivate performance. To assist in making Healthy People 2020 an all-inclusive success, a comprehensive assessment of existing evidence is necessary to assist in closing this research gap. A systematic review of interventions promoting TSE performance discovered moderate levels of effectiveness among 10 studies promoting the behavior. Concerning methodological quality, nine were of average quality and one was of high quality. In terms of significant TSE reporting between intervention and control/comparison groups, 3 out of 10 did not achieve the statistical causal threshold. Based on our assessment of TSE intervention quality and outcomes pertaining to behavior adoption, a best-practices guideline is presented for researchers in the field to consult as they design their interventions. This guideline aims to improve on internal and external validity of TSE promotion research in order to make them more effective.

The Patient - Patient-Centered Outcomes Research, 2013

There is growing interest in involving patients in decisions regarding healthcare technologies. T... more There is growing interest in involving patients in decisions regarding healthcare technologies. This research project was conducted in collaboration with decision makers and health technology assessment agents in order to involve healthcare service users (and their loved ones) in the assessment of alternatives to seclusion and restraint in short-term psychiatric wards and long-term care facilities for the elderly. This paper explores the viewpoints and suggestions of service users and service users' families about alternatives to restraint and seclusion, as well as conditions under which they could be used among adults in short-term psychiatric care and residents in long-term care facilities. Using a semi-structured guide, we held eight focus groups: five with mental health service users and three with family members of elderly people in long-term care facilities. Focus group discussions were digitally recorded and transcribed verbatim, and we performed content analysis using NVivo 8 software. In both care environments, participants emphasized the importance of communicating with service users, as well as assessing their needs and their particular situation, for reducing the use of restraint and seclusion. A better welcome and accompaniment of people admitted for short-term psychiatric care emerged also as key approaches to reduce the use of restraint and seclusion. Long-term care facilities could also reduce the need for restraint and seclusion by creating a stimulating home environment and individualized occupational therapy programs. Participants in both groups suggested that caregivers other than healthcare staff could be more involved, especially peer-support workers in the case of psychiatric care and volunteers in the case of long-term care facilities. Participants suggested that changes were needed at a broader and more systemic level than simply replacing current measures of restraint and seclusion with alternative techniques. They favored an approach focused more on the person than on the techniques: they suggested that listening to and communicating with the service user could reduce the use of restraint and seclusion in both healthcare environments.

Telemedicine and e-Health, 2010

We systematically reviewed PubMed and EBSCO business, looking for cost indicators of electronic h... more We systematically reviewed PubMed and EBSCO business, looking for cost indicators of electronic health record (EHR) implementations and their associated benefit indicators. We provide a set of the most common cost and benefit (CB) indicators used in the EHR literature, as well as an overall estimate of the CB related to EHR implementation. Overall, CB evaluation of EHR implementation showed a rapid capital-recovering process. On average, the annual benefits were 76.5% of the first-year costs and 308.6% of the annual costs. However, the initial investments were not recovered in a few studied implementations. Distinctions in reporting fixed and variable costs are suggested.

Nursing Education Perspectives, 2013

This study aimed to assess the effectiveness of a blended-teaching intervention using Internet-ba... more This study aimed to assess the effectiveness of a blended-teaching intervention using Internet-based tutorials coupled with traditional lectures in an introduction to research undergraduate nursing course. Effects of the intervention were compared with conventional, face-to-face classroom teaching on three outcomes: knowledge, satisfaction, and self-learning readiness. A two-group, randomized, controlled design was used, involving 112 participants. Descriptive statistics and analysis of covariance (ANCOVA) were performed. The teaching method was found to have no direct impact on knowledge acquisition, satisfaction, and self-learning readiness. However, motivation and teaching method had an interaction effect on knowledge acquisition by students. Among less motivated students, those in the intervention group performed better than those who received traditional training. These findings suggest that this blended-teaching method could better suit some students, depending on their degree of motivation and level of self-directed learning readiness.

Journal of Medical Systems, 2012

International Journal of Technology Assessment in Health Care, 2011

to support her research program. We thank Stéphane Ratté who was responsible for developing the l... more to support her research program. We thank Stéphane Ratté who was responsible for developing the literature search strategy. We are also grateful to Carrie Anna McGinn for the linguistic revision.

International Journal of Medical Informatics, 2010

Testicular cancer is one of the greatest threats to health and wellness among 15-to 40-year old m... more Testicular cancer is one of the greatest threats to health and wellness among 15-to 40-year old males. A concerted effort in the literature promoting awareness, risk factors, and preventative measures is warranted. There is limited discussion on the validity of interventions aimed at promoting testicular self-examination (TSE) performance; the existing body of evidence offers little discussion on what specific factors motivate performance. To assist in making Healthy People 2020 an all-inclusive success, a comprehensive assessment of existing evidence is necessary to assist in closing this research gap. A systematic review of interventions promoting TSE performance discovered moderate levels of effectiveness among 10 studies promoting the behavior. Concerning methodological quality, nine were of average quality and one was of high quality. In terms of significant TSE reporting between intervention and control/comparison groups, 3 out of 10 did not achieve the statistical causal threshold. Based on our assessment of TSE intervention quality and outcomes pertaining to behavior adoption, a best-practices guideline is presented for researchers in the field to consult as they design their interventions. This guideline aims to improve on internal and external validity of TSE promotion research in order to make them more effective.

Health Expectations, 2012

The recent establishment of health technology assessment (HTA) units in University hospitals in t... more The recent establishment of health technology assessment (HTA) units in University hospitals in the Province of Quebec (Canada) provides a unique opportunity to foster increased participation of patients in decisions regarding health technologies and interventions at the local level. However, little is known about factors that influence whether the patient's perspective is taken into consideration when such decisions are made. To explore the practices, perceptions and views of the various HTA stakeholders concerning patient involvement in HTA at the local level. Data were collected using semi-structured interviews with 24 HTA producers and hospital managers and two focus groups with a total of 13 patient representatives. Patient representatives generally showed considerable interest in being involved in HTA. Our findings support the hypothesis that the patient perspective contributes to a more accurate and contextualized assessment of health technologies and produces HTA reports that are more useful for decision makers. They also suggest that participation throughout the assessment process could empower patients and improve their knowledge. Barriers to patient involvement in HTA at the local level are also discussed as well as potential strategies to overcome them. This study contributes to knowledge that could guide interventions in favour of patient participation in HTA activities at the local level. Experimenting with different patient involvement strategies and assessing their impact is needed to provide evidence that will inform future interventions of this kind.

BMC Health Services Research, 2009

Background: Recognizing the importance of increased patient participation in healthcare decisions... more Background: Recognizing the importance of increased patient participation in healthcare decisions leads decision makers to consider effective ways to incorporate patient perspectives in Health Technology Assessment (HTA) processes. The implementation of local health HTA units in university hospitals in Quebec provides a unique opportunity to foster an increased participation of patients in decisions regarding health technologies and clinical interventions. This project explores strategies that could be effective in involving patients in HTA activities at the local level. To do so, three objectives are pursued: 1) To synthesise international knowledge and experiences on patient and public involvement in HTA activities; 2) To explore the perceptions of stakeholders (administrators, clinical managers, healthcare professionals, HTA producers, and patients) regarding strategies for involving patients in various HTA activities; and 3) To produce a consensual strategic framework that could guide interventions for involving patients in HTA activities at the local level.

BMC Health Services Research, 2012