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  1. Article ; Online: Different Ways of Traveling the Cancer Road-Daytime Running Lights at Night?

    Sanatani, Michael

    JAMA oncology

    2023  Volume 9, Issue 6, Page(s) 761–762

    MeSH term(s) Humans ; Accidents, Traffic ; Travel ; Neoplasms/epidemiology ; Neoplasms/therapy
    Language English
    Publishing date 2023-02-10
    Publishing country United States
    Document type Journal Article
    ISSN 2374-2445
    ISSN (online) 2374-2445
    DOI 10.1001/jamaoncol.2022.7143
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  2. Article ; Online: Three to tango: Making the case for shared shared decision-making.

    Sanatani, Michael

    Patient education and counseling

    2023  Volume 112, Page(s) 107754

    MeSH term(s) Humans ; Decision Making, Shared ; Decision Making ; Physician-Patient Relations ; Patient Participation
    Language English
    Publishing date 2023-04-13
    Publishing country Ireland
    Document type Letter ; Comment
    ZDB-ID 605590-4
    ISSN 1873-5134 ; 0738-3991
    ISSN (online) 1873-5134
    ISSN 0738-3991
    DOI 10.1016/j.pec.2023.107754
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    Zs.A 1465: Show issues Location:
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  3. Article ; Online: True transition to practice: a role-reversal simulation.

    Preti, Beatrice / Sanatani, Michael

    Canadian medical education journal

    2023  Volume 14, Issue 4, Page(s) 120–122

    Abstract: Implication statement: This article explores a direct-observation simulation swapping resident and consultant roles as a measure to assess competence during the final "transition to practice" phase of residency. As indicated by the Royal College, ... ...

    Abstract Implication statement: This article explores a direct-observation simulation swapping resident and consultant roles as a measure to assess competence during the final "transition to practice" phase of residency. As indicated by the Royal College, assessment of competency in this stage should include direct observation; however, this is challenging to implement, both from the perspective of a busy clinical environment, but also logistically, as a final-stage resident is still a learner in a consultant clinic. Our suggested approach allows for both real-world experience for the resident as well as direct observation and assessment by the consultant, thus providing the resident with targeted, actionable feedback, as well as ensuring the final-stage resident is competent for practice.
    Énoncé des implications de la recherche: Cet article explore une simulation utilisant l'observation directe et où les rôles de résident et de consultant sont inversés comme moyen d'évaluation des compétences durant l'étape finale de la résidence, la « transition vers la pratique ». Le Collège royal indique qu'à ce stade, l'observation directe doit faire partie de l'évaluation des compétences; or, cette modalité d'évaluation est difficile à mettre en œuvre dans un environnement clinique animé et un contexte logistique où le résident est encore un apprenant dans une clinique de consultants. L'approche que nous proposons permet à la fois au résident d'acquérir une situation réelle et au consultant de faire une observation directe pour l'évaluation, et d'offrir une rétroaction ciblée et utile, tout en s'assurant que le résident en fin de parcours a les compétences requises pour pratiquer.
    MeSH term(s) Humans ; Ambulatory Care Facilities ; Computer Simulation ; Consultants ; Internship and Residency ; Lactic Acid
    Chemical Substances Lactic Acid (33X04XA5AT)
    Language English
    Publishing date 2023-09-08
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2689512-2
    ISSN 1923-1202 ; 1923-1202
    ISSN (online) 1923-1202
    ISSN 1923-1202
    DOI 10.36834/cmej.75125
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  4. Article ; Online: Oncology residents' experiences of decision-making in a clinical learning environment: a phenomenological study.

    Sanatani, Michael / Muir, Fiona

    Advances in health sciences education : theory and practice

    2023  Volume 28, Issue 5, Page(s) 1371–1390

    Abstract: Oncology residents routinely engage in ethically complex decision-making discussions with patients, while observing and interacting with their teaching consultant. If clinical competency in oncology decision-making guidance is to be taught deliberately ... ...

    Abstract Oncology residents routinely engage in ethically complex decision-making discussions with patients, while observing and interacting with their teaching consultant. If clinical competency in oncology decision-making guidance is to be taught deliberately and effectively, it is necessary to understand resident experiences in this context to develop appropriate educational and faculty development initiatives. Four junior and two senior postgraduate oncology residents participated in semi-structured interviews during October and November 2021 which explored their experiences of real-world decision-making scenarios. Van Manen's phenomenology of practice was used in an interpretivist research paradigm. Transcripts were analysed to articulate essential experiential themes, and composite vocative narratives were created. Three essential themes were identified: (1) residents often endorsed different decision-making approaches than supervising consultants, (2) residents experienced inner conflict, and (3) residents struggled to find their own approach to decision-making. Residents experienced being torn between a perceived obligation to defer to consultant directives, and a desire for increasing ownership of decision-making while not feeling empowered to discuss their opinions with the consultants. Residents described their experiences around ethical position awareness during decision-making in a clinical teaching context as challenging, with experiences suggesting moral distress combined with inadequate psychological safety to address ethical conflicts and unresolved questions of decision ownership with supervisors. These results suggest the need for enhanced dialogue and more research to reduce resident distress during oncology decision-making. Future research should be aimed at discovering novel ways in which residents and consultants could interact in a unique clinical learning context including graduated autonomy, a hierarchical gradient, ethical positions, physician values, and sharing of responsibility.
    MeSH term(s) Humans ; Learning ; Internship and Residency ; Physicians ; Decision Making ; Cognition
    Language English
    Publishing date 2023-04-20
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1352832-4
    ISSN 1573-1677 ; 1382-4996
    ISSN (online) 1573-1677
    ISSN 1382-4996
    DOI 10.1007/s10459-023-10223-0
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    Zs.A 4671: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Combination of Osimertinib and Olaparib Therapy to Treat Non-Small Cell Lung Cancer and High-Grade Serous Ovarian Carcinoma: A Case Report.

    Lin, Jane / Welch, Stephen / Sanatani, Michael / Ramadan, Sherif

    Current oncology (Toronto, Ont.)

    2024  Volume 31, Issue 1, Page(s) 558–565

    Abstract: We present the case of a 75-year-old female with simultaneous EGFR-mutated stage IV lung cancer and advanced BRCA2-mutated ovarian cancer, treated with a unique regimen. In this case report, the patient was treated with alternating months of osimertinib ... ...

    Abstract We present the case of a 75-year-old female with simultaneous EGFR-mutated stage IV lung cancer and advanced BRCA2-mutated ovarian cancer, treated with a unique regimen. In this case report, the patient was treated with alternating months of osimertinib and olaparib to control her lung and ovarian cancers, respectively. When both diseases showed progression, the patient underwent a trial of concurrent therapy with both drugs, yet this was discontinued due to patient-reported adverse side effects. Combination targeted drug therapy may be required to treat complex diagnoses such as dual malignancies. However, combination drug therapy consisting of osimertinib and olaparib has not previously been explored. This case report represents the first to demonstrate osimertinib and olaparib combination therapy as a unique treatment regimen for concurrent lung and ovarian cancers. These two drugs can either be given in an alternating way or given together, short-term, with a higher but tolerable toxicity profile.
    MeSH term(s) Female ; Humans ; Aged ; Carcinoma, Non-Small-Cell Lung/drug therapy ; Carcinoma, Non-Small-Cell Lung/genetics ; Lung Neoplasms/drug therapy ; Lung Neoplasms/genetics ; Ovarian Neoplasms/drug therapy ; Ovarian Neoplasms/genetics ; Ovarian Neoplasms/pathology ; Carcinoma, Ovarian Epithelial ; Phthalazines ; Piperazines ; Acrylamides ; Aniline Compounds ; Indoles ; Pyrimidines
    Chemical Substances olaparib (WOH1JD9AR8) ; osimertinib (3C06JJ0Z2O) ; Phthalazines ; Piperazines ; Acrylamides ; Aniline Compounds ; Indoles ; Pyrimidines
    Language English
    Publishing date 2024-01-19
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 1236972-x
    ISSN 1718-7729 ; 1198-0052
    ISSN (online) 1718-7729
    ISSN 1198-0052
    DOI 10.3390/curroncol31010039
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    Zs.A 4305: Show issues Location:
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  6. Article ; Online: Should I have played death's advocate?

    Sanatani, Michael

    CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne

    2019  Volume 189, Issue 46, Page(s) E1422–E1423

    MeSH term(s) Attitude to Death ; Canada ; Choice Behavior ; Euthanasia, Active, Voluntary/ethics ; Euthanasia, Active, Voluntary/legislation & jurisprudence ; Humans ; Patient Advocacy
    Language English
    Publishing date 2019-03-29
    Publishing country Canada
    Document type Journal Article ; Personal Narrative
    ZDB-ID 215506-0
    ISSN 1488-2329 ; 0008-4409 ; 0820-3946
    ISSN (online) 1488-2329
    ISSN 0008-4409 ; 0820-3946
    DOI 10.1503/cmaj.170348
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    Ua VI Zs.136: Show issues Location:
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  7. Article ; Online: Exploring the Inner Lens: Examining Oncology Consultants' Use of Competency and Assessment Frameworks in Clinical Teaching Settings.

    Lin, Cindy / Nguyen, Timothy K / Sanatani, Michael

    Journal of cancer education : the official journal of the American Association for Cancer Education

    2022  Volume 38, Issue 4, Page(s) 1149–1156

    Abstract: Medical education in oncology has adopted a competency-based medical education (CBME) approach in Canada. Oncologist competencies are arranged within assessment frameworks, but it is unknown whether oncologists routinely use assessment frameworks when ... ...

    Abstract Medical education in oncology has adopted a competency-based medical education (CBME) approach in Canada. Oncologist competencies are arranged within assessment frameworks, but it is unknown whether oncologists routinely use assessment frameworks when determining what to teach oncology trainees. Understanding oncologists' actual approaches to assessment and teaching as a form of enacted CBME could inform and focus faculty development efforts. Using a participatory action research approach, oncology faculty were interviewed regarding their teaching practices and use of assessment frameworks. Faculty suggestions regarding challenges in setting teaching goals and completing assessment within the CBME paradigm were solicited. Furthermore, teaching objectives developed by faculty in-house were assessed regarding the domains of competence targeted. Thirty-one of the 40 faculty members in the Department of Oncology, Western University, agreed to participate. Trainee factors (training level, areas of interest), faculty personal values and experience, the teaching setting, and some components of frameworks (medical expert, communicator, advocate, and professional) were articulated as determinants of teaching goals. Of the 1117 in-house objectives reviewed, 76% focused on the medical role. Faculty held widely disparate views on assessment framework features which would enable teaching and assessment. Oncology faculty members used a multifaceted approach to determine what to teach trainees. This approach contains elements both of the conventional apprenticeship models under which many faculty members themselves were trained and of the CBME paradigm. Future research should focus on exploring ways to resolve the tension between established individual teaching approaches and nationally standardized competency frameworks which are being implemented.
    MeSH term(s) Humans ; Consultants ; Competency-Based Education ; Education, Medical ; Canada ; Faculty, Medical ; Clinical Competence
    Language English
    Publishing date 2022-11-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 632898-2
    ISSN 1543-0154 ; 0885-8195 ; 1543-1154
    ISSN (online) 1543-0154
    ISSN 0885-8195 ; 1543-1154
    DOI 10.1007/s13187-022-02241-0
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    Zs.A 2185: Show issues Location:
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  8. Article ; Online: Clinician-teacher: Doffing two hats for the sake of one.

    Sanatani, Michael

    Medical teacher

    2015  Volume 37, Issue 3, Page(s) 296–297

    MeSH term(s) Clinical Competence ; Faculty, Medical ; Humans ; Needs Assessment ; Professional Role
    Language English
    Publishing date 2015-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 424426-6
    ISSN 1466-187X ; 0142-159X
    ISSN (online) 1466-187X
    ISSN 0142-159X
    DOI 10.3109/0142159X.2014.917162
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    Zs.B 2176: Show issues Location:
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  9. Article: "It unsticks your mind": Using a musicians' masterclass to introduce oncology faculty and trainees to the practice of direct observation and coaching.

    Sanatani, Michael / Potvin, Kylea

    Canadian medical education journal

    2020  Volume 11, Issue 5, Page(s) e78–e80

    Language English
    Publishing date 2020-09-23
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2689512-2
    ISSN 1923-1202
    ISSN 1923-1202
    DOI 10.36834/cmej.69892
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  10. Article ; Online: Assessment of urine colour using a wallet card: a randomised study of a novel patient self-care tool during chemoradiation for oesophageal cancer.

    Preti, Beatrice / Wang, Cathy / Dindial, Nicole / Malik, Shiraz / Rieger, Susan / Black, Morgan / Sachdeva, Robin / Sanatani, Michael

    BMJ open quality

    2024  Volume 13, Issue 1

    Abstract: Background: Patients undergoing neoadjuvant chemoradiation for oesophageal cancer often experience dehydration from decreased fluid intake and increased losses. Despite frequent clinical visits during treatment, patients can still present with ... ...

    Abstract Background: Patients undergoing neoadjuvant chemoradiation for oesophageal cancer often experience dehydration from decreased fluid intake and increased losses. Despite frequent clinical visits during treatment, patients can still present with dehydration, suggesting the need for increased patient awareness and engagement around adverse event management at home. Evidence for benefits of self-monitoring may help motivate patients to engage proactively in their own care to improve their treatment experience.
    Methods: We performed a randomised single-centre study of a urine colour self-monitoring card (UCC) during chemoradiation therapy for oesophageal cancer, compared with standard dietitian counselling. Primary outcome was self-efficacy as determined by the Self-Management Resource Centre Self-Efficacy for Managing Chronic Disease Scale (SMCD). Secondary outcomes included Burge thirst scores, Edmonton Symptom Assessment System scores (ESAS), patient-initiated hydrations, creatinine rise and satisfaction with the UCC.
    Results: Thirty-five patients were randomised. UCC use was not associated with improved SMCD or ESAS scores compared with standard counselling. The card was highly rated by patients as a welcome tool for self-monitoring.
    Conclusions: No beneficial effect on self-efficacy or dehydration markers with UCC use was demonstrated. The study nonetheless drew attention to several factors potentially hindering its use for effective self-care: the unexpected severity of other symptoms consuming patients' attention, reduced sensitivity of urine colour due to chemotherapy, absence of active inquiry by the healthcare team and the inconvenient location of the UCC in wallet/purse. Urine colour monitoring in patients with oesophageal cancer to improve the patient experience during treatment warrants further study but supported by active healthcare provider inquiry, more accessible format of the card, and possibly home vital checks to increase its sensitivity in the clinical context.
    MeSH term(s) Humans ; Self Care ; Color ; Dehydration ; Esophageal Neoplasms/therapy ; Patient Care
    Language English
    Publishing date 2024-01-12
    Publishing country England
    Document type Randomized Controlled Trial ; Journal Article
    ISSN 2399-6641
    ISSN (online) 2399-6641
    DOI 10.1136/bmjoq-2023-002439
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