McGill Journal of Medicine

Approach to: Syncope

2023-08-09T14:57:17-04:00

Syncope, the transient and abrupt loss of consciousness with spontaneous recovery, is estimated to make up 1% of all emergency department presentations in Canada. (1) Syncopal cases are enigmatic as patients frequently present themselves as fully recovered from the episode, even though its etiology can still be present and life-threatening. It is up to the clinician to conduct a strong history, physical exam and the appropriate follow-up investigations to confirm a diagnosis. This Approach To article aims to provide an overview and step-wise approach to diagnosing and managing a syncopal presentation.

Approach to: Dysphagia

2024-03-04T14:34:05-05:00

Dysphagia, a condition marked by difficulty in swallowing, demands a comprehensive approach for effective management. It delves into the collaborative care essential for its successful treatment. Drawing upon the expertise of a multidisciplinary team—comprising speech-language therapists, nurses, physicians, occupational therapists, and physical therapists—this collective effort aims at an all-encompassing evaluation and tailored interventions for individuals grappling with swallowing disorders. Effective communication and mutual respect among team members form the cornerstone, shaping a holistic management strategy to address the challenges posed by dysphagia.

Ontario Student Medical Education Research Conference (OSMERC) 2025

2025-11-02T22:46:37-05:00

McGill Emergency Medicine Conference (MEMC), First Edition

2025-11-04T13:54:24-05:00

Understanding Lessons From the COVID-19 Pandemic in Creating Healthcare Initiatives for Indigenous Populations

2023-09-11T10:34:04-04:00

Over the course of the pandemic, Indigenous peoples in Canada experienced firsthand the devastating impact of COVID-19. Despite facing challenges, Indigenous communities, with the support of government organizations, were able to limit the spread of the SARS-CoV-2. Forming collaborative initiatives and integrating Indigenous medicinal practices with public health approaches shows promise in our ability to create effective and culturally-informed healthcare policies.

Information management during a complex meta-analysis: A practical guide for organizing data extraction.

2023-02-17T15:43:11-05:00

Information management is a key part of conducting a systematic review and meta-analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses clearly summarizes essential steps during the meta-analytic project and their reporting. Preparing for data extraction is generally suggested to be done at the stage of the protocol. However, in complex projects that aim to synthesize data from studies performed over a long time period or with a wide variability in study protocols, it is often impossible to fully account for all variations in data presentation before completing the full text screening. Here, we describe a protocol to methodically consider different aspects of the selected studies in order to update the data extraction template for the meta-analytic portion of the project. The protocol incorporates a process of identifying and removing non-compatible studies prior to the extraction of study-level outcomes, which is important for avoiding a potential confirmation bias. Using this protocol in combination with a pre-established data coding scheme simplifies data extraction and informs the subsequent meta-analysis.

VR over Matter

2024-02-09T09:45:54-05:00

Medical procedures, like IV insertions and pin removals, may cause pain and anxiety in children. While preventable, high rates of procedural pain persist in hospitals. The use of distraction, such as virtual reality (VR), offers a non-pharmacological approach for pain and anxiety management during medical procedures. More specifically, VR is an immersive technology that brings the user into a three-dimensional world that looks and feels real. The illustration depicts how VR works to decrease pain perception through the analogy of a tug-of-war between pain signaling and VR. During a medical procedure, a child``'s attention may be focused on the IV poke, increasing pain perception. However, if the child is immersed in a VR game during their medical procedure, the VR pulls the brain's attention away from the IV poke towards an imaginary and pleasant world. As VR is immersive and interactive, it consumes more attention than pain, thereby decreasing pain perception, and winning the tugr-of-war. Despite the evidence for VR, there is a 20-year gap in the implementation of VR across child healthcare settings. Our team is currently investigating the barriers, facilitators, and contextual challenges for VR use in child healthcare, and in parallel developing tools to disseminate research evidence and facilitate intergation of VR into the standard of care. This illustration serves as reminder of how VR is thought to help with pain management. To learn more about VR, visit: https://www.mcgill.ca/virtualrealityforchildcare/

Perceived Risk of Pesticide Exposure Among School Workers in San Carlos, Costa Rica

2024-07-10T13:44:48-04:00

Background: There is increasing literature examining the effect of pesticides on people in proximity to pesticide use. However, limited information exists on how bystanders perceive the risk of pesticides to their health. This study aims to explore how school workers perceive the exposure to pesticides in a region where agriculture is the dominant economic driving force, and how these perceptions vary by sociodemographic subgroup.

Methods: A total of 143 school workers from five districts in the San Carlos region of Costa Rica responded to the Technical Prevention Notes (NTP-578) perceived risk survey. The Mann-Whitney U test along with a Bonferroni control determined the statistical significance between subgroups. The four main sections for analysis of the results were prior knowledge on pesticide-related risks, perception of control over pesticide exposure, perception of current health risk and general knowledge of pesticide exposure.

Results: Statistically significant differences in perceptions were seen by location, sex, age, level of education and position. Males and teachers exhibited higher levels of prior knowledge of hazards, whereas the older population, people without a university degree and administrators had higher perception of control over exposure to pesticides.

Conclusion: School workers are knowledgeable on exposure to workplace pesticides and are aware of the severity of risk associated with pesticide exposure. In line with results from other studies, the older population and university educated people had higher perceived control over mitigating affects of pesticides. Our findings suggest that school workers could play a vital role in increasing knowledge dissemination pathways on pesticide-related harms. Further research could help in transforming school workers and bystanders into stakeholders and advocates for buffer zones.

A Usability Evaluation of a Touchscreen Workstation on Wheels in a Simulated Emergency Department Workflow

2024-12-02T11:42:08-05:00

Background: Touchscreens have become ubiquitous in our daily lives, offering a comfortable and natural human-technology interactive experience. There exists a gap in the literature regarding the usability and efficiency of a touchscreen workstation on wheels (WOW) within an emergency department (ED) workflow, specifically with electronic medical record (EMR) systems designed for keyboard and mouse.

Methods: This was a randomized, controlled, 2-intervention-2-period crossover study comparing a touchscreen to a non-touchscreen WOW. Participants were asked to complete a series of seven tasks that are typically done in the ED followed by the completion of a post-study questionnaire.

Results: A total of 24 people (12 attendings, 12 resident physicians) participated in the study. Results from the linear mixed model regression analyses showed no evidence to reject the hypothesis that the average time to complete each task and the average total time to complete all tasks combined were similar (p>0.05) between the touchscreen and non-touchscreen WOW. Results from the post-study questionnaire using a 7-point Likert scale (Figure 1) demonstrated that the majority (>50%) of participants agreed to most questions favoring intention to use (BU), ease of use (PEOU), perceived usefulness (PU), and attitude towards utilization (AU) of the touchscreen WOW.

Conclusion: This study builds on previous work on touchscreen devices by specifically evaluating the usability and efficiency of touchscreen WOWs in a controlled, simulation-based setting, differentiating from prior studies on tablets at the bedside. Future studies, should evaluate the impact of touchscreen-friendly EMR designs on clinical workflows in the ED.