title: Use and teaching of pneumatic otoscopy in a family medicine residency program.
abstract: OBJECTIVE
  To determine to what extent FPs teach and use pneumatic otoscopy and to identify the chief influences on this behaviour.
  
  
  METHODS
  Mixed-methods descriptive study conducted between March and May 2011.
  
  
  METHODS
  The family medicine residency program at Laval University in Quebec city, Que.
  
  
  METHODS
  Directors of the family medicine teaching units (FMTUs), teachers, and residents.
  
  
  METHODS
  We used questionnaires to assess the availability of pneumatic otoscopy equipment in 12 FMTUs, current behaviour and behavioural intention among physicians (residents and teachers) to use or teach pneumatic otoscopy, and facilitators and barriers to these practices. We also conducted 2 focus groups to further explore the facilitators of and barriers to using pneumatic otoscopy. We used descriptive statistics for quantitative data, transcribed the qualitative material, and performed content analysis.
  
  
  RESULTS
  Eight of the 12 FMTUs reported having pneumatic otoscopy equipment. Four had it in all of their consulting rooms, and 2 formally taught it. Nine (4%) of 211 physicians reported regular use of pneumatic otoscopy. Mean (SD) intention to teach or use pneumatic otoscopy during the next year was low (2.4 [1.0] out of 5). Teachers identified improved diagnostic accuracy as the main facilitator both for use and for teaching, while residents identified recommendation by practice guidelines as the main facilitator for use. All physicians reported lack of availability of equipment as the main barrier to use. The main barrier to teaching pneumatic otoscopy reported by teachers was that they did not use it themselves. In focus groups, themes of consequences, capabilities, and socioprofessional influences were most dominant. Residents clearly identified role modeling by teachers as facilitating the use of pneumatic otoscopy.
  
  
  CONCLUSIONS
  Pneumatic otoscopy is minimally used and taught in the family medicine residency program studied. Interventions to increase its use should target identified underlying beliefs and facilitators of and barriers to its use and teaching.
authors.affiliation: Centre de santé et des services sociaux du Rocher Percé, 451 Mgr Ross E, CP 5500, Chandler, QC G0C 1K0. eva.ouedraogo.1@ulaval.ca.
authors.forename: Eva
authors.initials: E
authors.lastname: Ouedraogo
authors.forename: Michel
authors.initials: M
authors.lastname: Labrecque
authors.forename: Luc
authors.initials: L
authors.lastname: Côté
authors.forename: Katerine
authors.initials: K
authors.lastname: Charbonneau
authors.forename: France
authors.initials: F
authors.lastname: Légaré
mesh_terms: D005194:Family Practice / Q000193:education* / Q000295:instrumentation / Q000379:methods; D005260:Female; D017144:Focus Groups; D019538:Health Care Surveys; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D010033:Otitis Media / Q000175:diagnosis; D019720:Otoscopes / Q000706:statistics & numerical data / Q000600:supply & distribution; D038781:Otoscopy / Q000379:methods / Q000706:statistics & numerical data*; D011792:Quebec; D011795:Surveys and Questionnaires
references.citation: Int J Pediatr Otorhinolaryngol. 2002 Jun 17;64(2):89-95
references.pmid: 12049821
references.citation: Vaccine. 2010 Nov 19;28 Suppl 6:G39-52
references.pmid: 21075269
references.citation: Paediatr Drugs. 1999 Jan-Mar;1(1):31-50
references.pmid: 10937477
references.citation: Paediatr Drugs. 2003;5 Suppl 1:1-12
references.pmid: 14632101
references.citation: Can Fam Physician. 2011 Jan;57(1):60-5
references.pmid: 21252135
references.citation: Implement Sci. 2008 Jul 16;3:36
references.pmid: 18631386
references.citation: Vaccine. 2000 Dec 8;19 Suppl 1:S2-8
references.pmid: 11163456
references.citation: Pediatrics. 2003 Dec;112(6 Pt 1):1379-87
references.pmid: 14654613
references.citation: Med Teach. 2005 Jan;27(1):71-5
references.pmid: 16147774
references.citation: Pediatrics. 2002 Dec;110(6):1064-70
references.pmid: 12456901
references.citation: Paediatr Child Health. 2009 Sep;14(7):457-64
references.pmid: 20808476
references.citation: Otolaryngol Head Neck Surg. 2004 May;130(5 Suppl):S95-118
references.pmid: 15138413
references.citation: Pediatrics. 2004 May;113(5):1451-65
references.pmid: 15121972
references.citation: Pediatrics. 2003 Sep;112(3 Pt 1):510-3
references.pmid: 12949275
references.citation: Pediatrics. 2011 Jun;127(6):e1490-7
references.pmid: 21606146
references.citation: Am Fam Physician. 2000 Apr 1;61(7):2051-6
references.pmid: 10779248
references.citation: Arch Fam Med. 1998 May-Jun;7(3):249-54
references.pmid: 9596459
references.citation: Fam Med. 2002 Sep;34(8):598-603
references.pmid: 12269536