Research & Quality Improvement
Health for All Family Health Team – Markham Family Medicine Teaching Unit
Health for ALL FHT / Markham Family Medicine Teaching Unit
Research & Quality Improvement Web Page
November 2023 Issue
About Us…
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The Markham Family Medicine Teaching Unit (MFMTU) at Oak Valley Health is a primary care teaching and research centre affiliated with the Department of Family & Community Medicine at the University of Toronto
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Academic Chief: Dr. Donatus Mutasingwa
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Co- Program Director: Dr. Nadine Al-Aswad
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Co-Program Director: Dr. Nathasha Dias
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Research Director: Dr. Stephen Marisette
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Quality Improvement Directors: Dr. Gina Yip & Dr. Karuna Gupta
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Global Health Director: Dr. Jess Wong
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Faculty Development: Dr. Michelle Homer
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Program Administrator: Beverley Nutt
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Research Assistant: Joanne Permaul
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Our team includes 14 core faculty, 27 community-based physicians, 19 residents, and a research assistant, working in collaboration with our interdisciplinary health professionals
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Our research focus: health equity
“Health equity is created when individuals have the fair opportunity to reach their fullest health potential. Achieving health equity requires reducing unnecessary and avoidable differences that are unfair and unjust. Many causes of health inequities relate to social and environmental factors including: income, social status, race, gender, education and physical environment.” – Public Health Ontario https://www.publichealthontario.ca/en/health-topics/health-equity
2021-22 Education and Scholarship Annual Report
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To learn more about our education, research, QI and global health programmes, take a look at our MFMTU 2021-22 Education and Scholarship Annual Report which was released in January 2023!
You can access the report here: https://flipbookpdf.net/web/site/40ef4d41da5d4563376e21b5cecab0eb680e88e0202301.pdf.html
Celebrating our Family Medicine Residents!
Resident Academic Project Day 2023
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On May 31st, 2023 our 2nd year residents presented their academic projects at our annual Resident Academic Project Day. These five very interesting projects were presented:
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Resident(s) |
Academic Project Title |
Supervisor |
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Dr. Asmarah Amin Dr. Sijia Wang |
Barriers to advanced care planning discussions in family medicine: a comparison of staff and resident physician perspectives |
Dr. Gina Yip |
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Dr. Saleem Kamalodeen Dr. Jason Zhou |
Assessing the impact of medical templates on patient outcomes in primary care: a scoping review |
Dr. Michelle Homer |
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Dr. Junyi Mei Dr. Zhiheng Zeng |
Chinese newcomers’ perceptions of primary health care in Markham, Ontario: a qualitative study |
Dr. Stephen Marisette |
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Dr. Hadi Sarir Dr. Chris Weigand |
Role of artificial intelligence (AI) in guiding decision making in primary care: a scoping review |
Dr. Yasir Khan |
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Dr. Emily Allison |
Population screening for Wilson Disease: a scoping review |
Dr. Yuet Ming Lam |
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Congratulations to the winners, Dr. Junyi Mei and Dr. Zhiheng Zeng for their project investigating Chinese newcomers’ perceptions of health care in Ontario! A special thank you goes out to Dr. Gail Morris and Dr. Tiffany Tang, who were the judges for this year.
L to R: Dr. Tiffany Tang, Dr. Zhiheng Zeng, Dr. Gail Morris
Resident Quality Improvement Presentation Day 2023
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On June 28th, 2023 our 1st year residents presented their quality improvement projects at our annual Resident Quality Improvement Presentation Day! This year’s projects were exceptional! Here’s the list:
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Resident(s) |
QI Project Title |
Supervisor(s) |
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Dr. Amolak Dhillon Dr. Simon Hendy Dr. Kenneth Lin |
Developing an exercise prescription template for patients with hypertension at the Health for All Clinic |
Dr. Jess Wong |
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Dr. Lanujan Kaneswaran Dr. Travis Quevillon |
Increasing Pneumovax-23 in patients aged 18-64 with Type I or Type II Diabetes at the Health for All Family Health Team |
Dr. Karuna Gupta Dr. Yasir Khan |
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Dr. Noor Adil Dr. Munerra Al Khalifa |
Reducing prescription requests in the residents’ practice at the Health for All Clinic |
Dr. Karuna Gupta Dr. Yuet Ming Lam |
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Dr. Mariana Da Silva Jardim Dr. Samantha Rossi Dr. Alicia Sheng |
Improving the Use of an Evidence-Based Smoking Cessation Tool Among Family Medicine Residents at an Academic Family Health Team |
Dr. Melanie Henry |
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Congratulations to Drs. Mariana Da Silva Jardim, Samantha Rossi, and Alicia Sheng who received the Margaret Maxted Memorial QI Award for their winning project looking at how to improve the use of a smoking cessation tool! A special thank you goes out to Dr. Dennis Wong and Dr. John Maxted, who were the adjudicators for this year.
L to R: Dr. Dennis Wong (adjudicator), Dr. Samantha Rossi, Dr. Melanie Henry (supervisor), Dr. Mariana Da Silva Jardim, Dr. Alicia Sheng, Dr. Karuna Gupta, Dr. Gina Yip, Dr. Margaret Jin, Dr. John Maxted (adjudicator)
RESEARCH
In the SPOTLIGHT!
Featured Publication
Congratulations to Dr. Yasir Khan and his research team for their recent publication titled “Assessing the impact of a health education intervention for post-secondary international students in Canada”!
Dr. Khan has been working with the international student population for 7 years; he is passionate about improving health literacy while providing culturally appropriate and evidence-based healthcare to international students. Along with colleagues, Dr. Khan conducted this 2–year research study on various markers of International student health, as well assessing the impact of an educational intervention on self-rated health knowledge, and ability to access supports.
The article can be accessed here:
Featured Research Study
Chinese newcomers’ perceptions of primary health care in Ontario: A qualitative study
Principal Investigator: Dr. Stephen Marisette
Co-Investigators: Joanne Permaul, Dr. Donatus Mutasingwa, Natalie Johnson, Dr. Melanie Henry, Andrea Groff, Dr. Zhiheng Zeng, Dr. Junyi Mei, Kathleen Homiak
Newcomers to Canada face unique challenges to accessing health care including language barriers, cultural differences, socioeconomic issues, and health system factors. Did you know that 58% of Markham’s population are immigrants to Canada, that 10% of newcomers to Markham immigrated in the last 5 years, and that 34% of newcomers to Markham emigrated from China?
This study was launched in December 2022 by Dr. Stephen Marisette and his research team to determine how newcomers to Canada from mainland China perceive the role of primary health care in Ontario, how they learn about primary health care, their understanding of the importance of continuity of care, and their understanding of preventive health care. The team received a $5,000.00 Cass Family Grant, with matching funds from the Markham Family Medicine Teaching Unit, to conduct this study.
Participants were recruited for this study with the assistance of staff at the Centre for Immigrant and Community Services. Chinese newcomers who immigrated to Canada in the last 5 years, spoke English or Mandarin, were at least 25 years of age, and lived in Eastern York Region, North Durham, or Scarborough, were eligible to participate. We were able to recruit 10 individuals, who met the study inclusion criteria, to take part in a one-hour telephone or Zoom interview. A questionnaire was used to collect demographic data. All of the interviews were audio-recorded, transcribed and translated if necessary.
Thematic analysis was used to analyze the qualitative data in the transcripts. Three key themes that arose from the interviews were: 1) Lack of information and understanding of the role of family physicians; 2) Difficulty adjusting to the Ontario health care system; and 3) Lack of access fuels dissatisfaction with the Ontario health care system. The results of this study highlight unique challenges and knowledge gaps that Chinese newcomers face navigating a foreign health care system. Further studies are needed to develop tools to assist Chinese newcomers with understanding and accessing primary health care in Ontario.
This fall, members of the research team will be presenting the preliminary study results at the upcoming Oak Valley Health Research Day 2023 and the North American Primary Care Research Group (NAPCRG) annual meeting in San Francisco!
Research Grant
Grant: Cass Family Grant for Catalyzing Access and Change, Department of Family and Community Medicine, University of Toronto
Principal Investigator: Dr. Stephen Marisette
Co-Investigators: Joanne Permaul, Dr. Donatus Mutasingwa, Natalie Johnson, Dr. Melanie Henry, Andrea Groff, Kathleen Homiak
Project: Chinese Newcomers’ Perceptions of Primary Health Care in Ontario: A Qualitative Study.
Amount: $5,000 (with matching funds from the MFMTU)
Research Grant
Grant: Cass Family Grant for Catalyzing Access and Change, Department of Family and Community Medicine, University of Toronto
Principal Investigator: Dr. Stephen Marisette
Co-Investigators: Joanne Permaul, Dr. Donatus Mutasingwa, Natalie Johnson, Dr. Melanie Henry, Andrea Groff, Kathleen Homiak
Project: Chinese Newcomers’ Perceptions of Primary Health Care in Ontario: A Qualitative Study.
Amount: $5,000 (with matching funds from the MFMTU)
Recent Peer-Reviewed Publications
Agarwal P, Wang R, Meaney C, Walji S, Damji A, Gill Toor N, Yip G, Elman D, Florindo T, Fung S, Witty M, Pham TN, Ramji N, Kiran T. Sociodemographic differences in patient experience with virtual care during COVID-19: Results from a cross-sectional survey in Ontario, Canada. BMJ Open 2022;12(5):e056868.
Ashcroft R, Donnelly C, Gill S, Dancey M, Lam S, Grill AK, Mehta K. The Delivery of patient care in Ontario’s Family Health Teams during the first wave of the COVID-19 pandemic. Healthc Policy Nov 2021;17(2):72-89.
Carson JD, Diep D, Baker C, Kraft SA, Kuwahara N, Garel A, Frémont P. Relapse of concussion symptoms in the context of premature return to learn and return to play: Comparative analysis of 2006 to 2011 and 2011 to 2016. Can Fam Physician 2022;68(3):e87-e91. https://www.cfp.ca/content/cfp/68/3/e87.full.pdf
Dainton C, Gorman C, Cherniak W, Lopez L, Chu CH. Reliability of the Service Trip Audit Tool to assess the quality of short-term medical missions. International Health Nov 2021;13(6):606–614. https://doi.org/10.1093/inthealth/ihaa006
Donald M, Beanlands H, Straus SE, Smekal M, Gil S, Elliott MJ, Herrington G, Harwood L, Waldvogel B, Delgado M, Sparkes D, Tong A, Grill A, et al. A web-based self-management support prototype for adults with chronic kidney disease (My Kidneys My Health): Co-design and usability testing. JMIR Form Res Feb 2021;5(2):e22220. https://formative.jmir.org/2021/2/e22220/PDF
Fleming K, Horton S, Wilson M, Atun R, De Stigter K, Flanigan J, Sayed S, Adam P, Aguilar B, Andronikou S, Boehme C, Cherniak W, et al. The Lancet Commission on diagnostics: transforming access to diagnostics. The Lancet 2021;398:1997-2050.
Gagne M, Lam Shin Cheung J, Kouri A, Boulet L-P, Fitzgerald JM, Grill A, O’Byrne PM, Gupta S. An electronic patient decision aid comparing as-needed budesonide-formoterol combination to regular use of inhaled corticosteroid (ICS) in mild asthma: a rapid-cycle design study. European Respiratory Journal Sep 2021:58 (suppl 65) PA3559.
Gagne M, Lam Shin Cheung J, Kouri A, Fitzgerald JM, O’Byrne PM, Boulet L-P, Grill A, Gupta S. A patient decision aid for mild asthma: Navigating a new asthma treatment paradigm. Respiratory Medicine Aug 2021:106568.
Khan YH, Sivapalan S, Wang S. Assessing the impact of a health education intervention for post-secondary international students in Canada. Cureus July 2023;15(7):e42243. https://www.cureus.com/articles/168553-assessing-the-impact-of-a-health-education-intervention-for-post-secondary-international-students-in-canada#!/
Okpechi IG, Tinwala MM, Muneer S, Zaidi D, Ye F, Hamonic LN, Khan M, Sultana N, Brimble S, Grill A, et al. Prevalence of polypharmacy and associated adverse health outcomes in adult patients with chronic kidney disease: protocol for a systematic review and meta-analysis. Syst Rev July 2021;10:198. https://systematicreviewsjournal.biomedcentral.com/track/pdf/10.1186/s13643-021-01752-z.pdf
Yu CH, Medleg F, Choi D, Spagnuolo CM, Pinnaduwage L, Straus SE, Cantarutti P, Chu K, Frydrych P, Hoang-Kim A, Ivers N, Kaplan D, Leung F-H, Maxted J, Resmovitz J, Sale J, Sodhi S, Stacey D, Telner D. Integrating shared decision-making into primary care: lessons learned from a multi-centre feasibility randomized controlled trial. BMC Med Inform Decis Mak 2021;21:323. https://doi.org/10.1186/s12911-021-01673-w
Recent Research Presentations
Henry M, Meunier C, Rossander V, Kedzierski N, Taglione C, Chojnacki J. Medical supports for transitional shelter clients. Shaping the Future of Family Medicine – Department of Family and Community Medicine (DFCM) Conference, May 6, 2022.
Kam A, Husain A. Interactive e-learning: How to make your virtual learning shine! Workshop presented at Convergence 2022 Healthcare Education Conference, The Michener Institute of Education at University Health Network, February 23, 2022.
Kam A, Melkuev A, Husain A, Richardson D, Summers A. The effect of a concussion curriculum on enhancing postgraduate trainees’ competency: A systematic review. 2022 Traumatic Brain Injury Conference, University Health Network, February 11, 2022.
Kam A, Melkuev A, Summers A, Husain A, Richardson D. Future direction of concussion education development. The 9th Canadian Concussion Symposium, Canadian Concussion Centre, University Health Network, April 30, 2022.
Kam A, Melkuev A, Summers A, Husain A, Richardson D. Effectiveness of concussion curriculum in postgraduate education. Canadian Association of Physical Medicine and Rehabilitation Annual Conference, June 2022.
Khan Y. (Panelist). Health and well-being: Culture and gender sensitive supports. Improving the International Student Experience Summit, Sheridan College, July 25, 2022.
Marisette S, Wood S. Wellness in family medicine residency: Exploring the hidden curriculum. Shaping the Future of Family Medicine – Department of Family and Community Medicine (DFCM) Conference, May 6, 2022.
Marisette S, Permaul JA, Johnson N, Zeng Z, Mei J, Mutasingwa D, Henry M, Groff A, Homiak K. Chinese newcomers’ perceptions of primary care: A qualitative study in progress [presentation]. Oak Valley Health Research Day, November 1, 2022.
Marisette S, Permaul JA, Johnson N, Zeng Z, Mei J, Mutasingwa D, Henry M, Groff A, Homiak K. Chinese newcomers’ perceptions of primary care: A qualitative study in progress [poster]. Oak Valley Health Research Day, November 23, 2022.
Mutasingwa D, Permaul JA, Meaney C, Rayner J, Moineddin R, Marisette S, Upshur R. Maintaining excellence during the COVID-19 pandemic: The state of care coordination in Ontario multidisciplinary teams. Association of Family Health Teams of Ontario (AFHTO) Conference, October 28, 2021.
Mutasingwa D, Permaul JA, Meaney C, Rayner J, Moineddin R, Marisette S, Upshur R. Maintaining excellence during the COVID-19 pandemic: The state of care coordination in Ontario multidisciplinary health teams. Collaborating to Create the Future of Health Care Education – Oak Valley Health, Academic Week Conference, November 23, 2021.
Recent Research Presentations
Henry M, Meunier C, Rossander V, Kedzierski N, Taglione C, Chojnacki J. Medical supports for transitional shelter clients. Shaping the Future of Family Medicine – Department of Family and Community Medicine (DFCM) Conference, May 6, 2022.
Kam A, Husain A. Interactive e-learning: How to make your virtual learning shine! Workshop presented at Convergence 2022 Healthcare Education Conference, The Michener Institute of Education at University Health Network, February 23, 2022.
Kam A, Melkuev A, Husain A, Richardson D, Summers A. The effect of a concussion curriculum on enhancing postgraduate trainees’ competency: A systematic review. 2022 Traumatic Brain Injury Conference, University Health Network, February 11, 2022.
Kam A, Melkuev A, Summers A, Husain A, Richardson D. Future direction of concussion education development. The 9th Canadian Concussion Symposium, Canadian Concussion Centre, University Health Network, April 30, 2022.
Kam A, Melkuev A, Summers A, Husain A, Richardson D. Effectiveness of concussion curriculum in postgraduate education. Canadian Association of Physical Medicine and Rehabilitation Annual Conference, June 2022.
Khan Y. (Panelist). Health and well-being: Culture and gender sensitive supports. Improving the International Student Experience Summit, Sheridan College, July 25, 2022.
Marisette S, Wood S. Wellness in family medicine residency: Exploring the hidden curriculum. Shaping the Future of Family Medicine – Department of Family and Community Medicine (DFCM) Conference, May 6, 2022.
Marisette S, Permaul JA, Johnson N, Zeng Z, Mei J, Mutasingwa D, Henry M, Groff A, Homiak K. Chinese newcomers’ perceptions of primary care: A qualitative study in progress [presentation]. Oak Valley Health Research Day, November 1, 2022.
Marisette S, Permaul JA, Johnson N, Zeng Z, Mei J, Mutasingwa D, Henry M, Groff A, Homiak K. Chinese newcomers’ perceptions of primary care: A qualitative study in progress [poster]. Oak Valley Health Research Day, November 23, 2022.
Mutasingwa D, Permaul JA, Meaney C, Rayner J, Moineddin R, Marisette S, Upshur R. Maintaining excellence during the COVID-19 pandemic: The state of care coordination in Ontario multidisciplinary teams. Association of Family Health Teams of Ontario (AFHTO) Conference, October 28, 2021.
Mutasingwa D, Permaul JA, Meaney C, Rayner J, Moineddin R, Marisette S, Upshur R. Maintaining excellence during the COVID-19 pandemic: The state of care coordination in Ontario multidisciplinary health teams. Collaborating to Create the Future of Health Care Education – Oak Valley Health, Academic Week Conference, November 23, 2021.
Research Posters
Research Posters
QUALITY IMPROVEMENT
QI Presentations
Groff A, Mutasingwa D, Gupta K, Yip G, Forse K, Permaul JA, Shi Z. Health for All Family Health Team: Patient perspectives on care during the COVID-19 pandemic. Collaborating to Create the Future of Health Care Education – Oak Valley Health, Academic Week Conference, November 23, 2021.
Hilland D, Groff A. Patient engagement in primary care. How Health for All FHT is harnessing the power of patient perspectives. Collaborating to Create the Future of Health Care Education – Oak Valley Health, Academic Week Conference, November 23, 2021.
Jin M, Belli S, Groff A. Virtual Cognitive behaviour therapy for insomnia (CBTi) during a pandemic. Association of Family Health Teams of Ontario (AFHTO) Conference, October 27, 2021.
Mutasingwa DR, Groff A, Johnson NL, Wiradharma J, Hilland D. Redefining patient engagement in primary care: A case study from an Academic Family Health Team, Ontario, Canada. North American Primary Care Research Group (NAPCRG) Annual Meeting, Phoenix, Arizona, November 21, 2022.
QI Posters
RESEARCH, QUALITY IMPROVEMENT & TEACHING AWARDS
Quality and Innovation – PGY1 Impact Award, 2022
Department of Family & Community Medicine, University of Toronto
Awarded to: Dr. Dylan Demarco
Project: Improving the Efficiency of Virtual Blood Pressure Appointments at Health for All
Postgraduate – Leadership Award, 2022
Department of Family & Community Medicine, University of Toronto
Awarded to: Dr. Angela Duan
Postgraduate – Excellence in Teaching Award, 2022
Department of Family & Community Medicine, University of Toronto
Awarded to: Dr. Yuet Ming Lam
Excellence in Social Responsibility Award (Community-Affiliated), 2022
Department of Family & Community Medicine, University of Toronto
Awarded to: Dr. Melanie Henry
Excellence in Creative Professional Activity Award (Community-Affiliated), 2022
Department of Family & Community Medicine, University of Toronto
Awarded to: Dr. Allan Grill
Excellence in New Leadership Award – Nomination 2022
Department of Family & Community Medicine, University of Toronto
Nominee: Dr. Donatus Mutasingwa
Excellence in Clinical Teaching Award – Nomination 2022
Department of Family & Community Medicine, University of Toronto
Nominee: Dr. Aisha Husain
Oak Valley Health Honoured to Care Award – Nomination 2021-22
Nominee: Dr. Deepti Pasricha
Oak Valley Health Medical Staff Association, Bruce Books Award – Nominations 2021
Nominee: Dr. Melanie Henry
Nominee: Dr. Aisha Husain
Oak Valley Health Best Rotation Award, 2022
Selected by Family Medicine Residents
Awarded to: General Surgery Department
Best Preceptor Award, 2022
Markham Family Medicine Teaching Unit, Oak Valley Health
Awarded to: Dr. Stephen Marisette
Undergraduate – Teaching Excellence (Electives) Award, 2022
Department of Family & Community Medicine, University of Toronto
Awarded to: Dr. Tom Leventis
CFPC Award of Excellence, 2022
The College of Family Physicians of Canada
Awarded to: Dr. Allan Grill
Dr. Harrison Waddington Fellowship in Family & Community Medicine, 2021-22
Awarded to: Dr. Aisha Husain
MD Program Teaching Award for Excellence, 2021-22
Department of Family & Community Medicine, University of Toronto
Awarded to: Dr. Megan Tan
MD Program Teaching Award for Excellence, 2021-22
Department of Family & Community Medicine, University of Toronto
Awarded to: Dr. Jeff Weissberger
OCFP Early Years Award, 2022
Ontario College of Family Physicians
Awarded to: Dr. Emilie Lam
Oak Valley Health 5-Year Long Service Award, 2022
Awarded to: Dr. Kelly Forse
PGY2 Academic Project Award
Markham Family Medicine Teaching Unit, Oak Valley Health
Awarded to: Dr. Avee Naidoo
Project: Embracing the skin spectrum: Diagnosis and management of common dermatological manifestations in skin of colour – A systematic review
MFMTU Margaret Maxted Memorial QI Award
Markham Family Medicine Teaching Unit, Oak Valley Health
Awarded to: Dr. Asmarah Amin, Dr. Saleem Kamalodeen, Dr. Hadi Sarir
Project: Improving the Use of a Mental Health Tracking Tool at Health for All
Oak Valley Health Research Council Award
Oak Valley Health Research Day 2022
Awarded to: Dr. Stephen Marisette and Joanne Permaul
Upcoming Research Conferences
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Oak Valley Health Research Day “Advancing Global Health as a Connected Community” September 27, 2023, Markham, ON
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NAPCRG 51st Annual Meeting October 30 – November 3, 2023, San Francisco, CA
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Family Medicine Forum Conference (FMF) 2023, November 8-11, Montreal, PQ
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Association of Family Health Teams of Ontario (AFHTO) 2023, October 25, Toronto, ON
NEXT ISSUE…
The next issue of our Research & QI web page, coming in January 2024, will feature our Fall 2023 conference presentations, and highlight the education and scholarship activities from our 2022-23 annual report!
Contact: Joanne Permaul, Research Assistant jpermaul@oakvalleyhealth.ca