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113 Promoting critical thinking about guidelines for screening and preventive care: the Canadian experience
  1. Guylene Theriault1,
  2. Roland Grad2,
  3. Neil Bell3,
  4. James Dickinson4
  1. 1McGill, Gatineau, Canada
  2. 2McGill, Montréal, Canada
  3. 3University of Alberta, Edmonton, Canada
  4. 4University of Calgary, Calgary, Canada


The Canadian Task Force on Preventive Health Care issued its first report in 1979 and its methods were subsequently widely adopted by others and included in development of evidence-based medicine. The Task Force ceased in 2006, but was then reconstituted in 2009, comprising up to 15 volunteer members. It revised its methods, using further advances in evidence-based medicine. Since then, it has issued 21 guidelines, including one reissue (mammography)

The Task Force is funded by the Public Health Agency of Canada, which also provides administrative support, but has no role in the development of guidelines. The guidelines are published in the Canadian Medical Association Journal. To raise awareness of their work and to help practitioners to educate their patients, the Task Force develops public education materials and other tools for knowledge translation and undertakes outreach at conferences.

Despite the Task Force reputation, Canadian physicians and their patients do not necessarily follow their recommendations. For example, many average-risk Canadian women undergo screening mammography in their 40s. The concepts of critical appraisal of screening recommendations within guidelines are poorly understood by practicing physicians, many of whom do not appear to understand the problem of overdiagnosis nor the process of shared decision-making.

To tackle this problem a group of current and past Task Force members are publishing a series of articles on prevention and screening. Using a patient-based approach, these articles seek to reach family doctors and nurses in primary care practice.

In this session, we will show how educators can use this series of articles on the topic of applying guideline recommendations for preventive care. We will promote a discussion around what key concepts and skills are most needed by physicians to understand and apply guideline recommendations in their practice.

Objectives Devise a list of core concepts on screening and preventive care for educators.

Discuss methods of enabling practices that incorporate critical thinking about guidelines and incorporation of shared decision making.

Discuss ideas about integrating concepts to teach preventive health care.

Method This 1-hour workshop will start with a presentation of the Task Force work and the article series. (10 minutes)

Participants (in small groups) will then be asked to reflect on which concepts are key to practice prevention and screening that makes sense (10 min)

We will reconvene in a large group to list those concepts (5 min)

We will then resume small group working on a different concept to highlight how we can ensure this is understood by practicing health professionals. (10 min)

Open discussion on the solutions (10 min)

Wrap up with a more in depth look at the content of our series of articles proposing a way forward. (10 min)

Last remarks (5 min)

We will adjust activities and timing accordingly to the numbers of participants

Results The insights of the group could be reported as a commentary on the series of article (depending on CFP acceptance)

Conclusions This workshop will help participants get a deeper insight on prerequisites to appropriate prevention and screening in practice. This will include a deeper understanding of how the harm of overdiagnosis influences decision-making. It will generate ideas and provide some practical tools to heightened clinical practice in regards to screening practices.

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