CAPA 2019 Program

PROGRAM-AT-A-GLANCE

Thursday and Friday

Saturday and Sunday

FULL PROGRAM

Thursday, October 24

Workshop: Point of Care Ultrasound

0800 – 0830

Jordan Levinter, CCPA, The Hospital for Sick Children

This short introductory workshop offers novices and those with no point-of-care ultrasound experience the opportunity to learn about the emerging field of POCUS from experts in the field. A flipped-classroom model coupled with guided, hands-on instruction is designed to enhance participant learning. This is combined with case-based learning to allow for optimal translation into clinical practice.

Workshop: Stop the Bleed

1100 – 1230 and 1330 – 1500

Andrew Lim, BHSc (PA), BASc. (Hons), CCPA; Mike Dalliday, CCPA; Kimberley May, CCPA; David Kuhns, MPH, CCPA, PA-C

Massive bleeding from any cause, but particularly from an active shooter or explosive event where a response is delayed can result in death. Victims can quickly die from uncontrolled bleeding, within five to 10 minutes.

Stop the Bleed is an initiative of the American College of Surgeons and the Hartford Consensus that provides civilian bystanders the skills and basic tools to stop uncontrolled bleeding in an emergency situation and save lives.

Similar to how the general public learns and performs CPR, the public must learn proper bleeding control techniques, including how to use their hands, dressings, and tourniquets. Only certified healthcare providers can administer a Stop the Bleed course.

Who is it for?

Certified healthcare providers offer Stop the Bleed training to the general public as well as people that work in public areas or venues who may be a first person on scene until a first responder arrives (e.g. security, event staff, vendors etc.).

Lunch

1230 – 1330

Workshop: When in Doubt Punch it Out – The skin and all that lies within

1330 – 1630

Doris Hansen, MS, PA-C, Bassett Healthcare Network;

Amanda Perrotta, CCPA, BHSc(PA), BSc, Honors Kinesiology

The objective of this hands-on workshop is to enhance clinical skills and knowledge for addressing Dermatology/Plastic Surgical procedures in an outpatient/inpatient setting and wound care/dressing techniques.

Participants will learn the following skills: Assessing and diagnosing clinical picture appropriately, how to perform a biopsy of a lesion or chronic wound, applying skills and proper technique. Subcutaneous cyst, keloids and hypertrophic scars, how to inject and treat. Interpreting pathology and determine a medical plan.

Welcome Reception presented by:

MD Financial Management and Scotia Bank

1700 – 1900

 

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Friday, October 25

Breakfast

0745 – 0845

Welcome and Opening Remarks

0845 – 0900

Dr. Sohail Gandhi, President, Ontario Medical Association

The Burnout Crisis: How Can We Heal the Healers?

0900 – 1030

Facilitator: Sharona Kanofsky, PA-C, CCPA

Panelists: E. Ann Collins, BSc, MD, President-elect Canadian Medical Association;

Kirsten Luomala, CD, MPAS, CCPA;

Third panelist TBC

Professional burnout, among clinicians and beyond, is reaching crisis levels. Among Canadian physicians, more than one in four doctors report high levels of burnout and one in three screened positive for depression.

Unfortunately, much less is known about how burnout is affecting Canadian PAs, both in the public health system and the military, where PAs serve in unique and stressful environments. However, we do know that burnout across all health professions, is linked to increased medical errors, increased health care costs, and poor patient outcomes.

In this opening plenary, physician and PA leaders will share their candid thoughts on the influence of team dynamics, scope of practice, and role ambiguity on one’s job satisfaction. They will also discuss what it will take to reverse these trends and how health professionals can come together to pursue a better path to wellness.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Define burnout and discuss how it is affecting Canadian health care professionals

2. Differentiate between individual and systemic factors that negatively affect PA health

3. Explain how burnout affects patient outcomes

Resiliency Skills for Healthcare Providers

1035 – 1125

Dr. Leslie Nickell, Medical Director, PA Program, University of Toronto and Shayna Kulman-Lipsey, Manager, Counselling Services, Health Professions Student Affairs, Faculty of Medicine, University of Toronto

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Recognize the importance of the resilience continuum that can impact well-being

2. Describe the seven key behaviours that support an ‘upward spiral’

3. Identify challenges/opportunities for resilience in your working environment

Practicing Evidence-Based Medicine while Respecting Indigenous Healing Beliefs and Culture

1035 – 1125

Amy Montour BScN, MSc, MD, CCFP, Clinical Professor, McMaster University 

Wake up its time to talk about Sleep Apnea!

1035 – 1125

Emily Murphy MPS, PA-C; Assistant Professor and Director of Clinical Education, University of Pittsburg; Jamie Hammond MS, MPAS, PA-C, Assistant Professor, University of Pittsburg

One half of US adults report sleep disturbances with only 30% of adult Americans report obtaining sufficient sleep. The prevalence of sleep apnea 20 to 30 percent in males (1 in 4) and 10 to 15 percent in females (1 in 10). Symptoms include excessive daytime fatigue, insomnia, lack of energy, morning headaches, difficulty focusing, frequent nocturnal urination , mood changes including irritability and depression, waking up with breath holding, gasping or choking, habitual snoring or breathing interruptions which are noted by bed partner.

Comorbidities often include obesity, treatment resistant hypertension, arrhythmias, heart disease and history of stroke and myocardial infarction.

Short-term physiologic and psychological effects of sleep apnea include impaired daytime cognitive functioning, irritability, difficulty concentrating, lack of motivation, depressed mood, difficulty with work, school and driving and heightened perception of pain. Long term physiologic and psychological effects of sleep apnea include glucose intolerance, obesity, impaired immune responses, accelerated atherosclerosis and increased risk of cardiac disease and stroke.

Simple and validated screening tools include STOP-BANG and Epworth Sleepiness Scale can be easily utilized by providers to identify patients who should be tested. Gold standard for diagnosis is in a lab or home polysomnography.

Treatments include weight loss, oral appliance, positive pressure airway therapy, medical implant and surgery.

Sleep apnea is easy to screen and treat and has a huge impact on the patients overall health and comorbidities with proper treatment and monitoring.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Discuss the etiology, presentation, and diagnosis of obstructive sleep apnea

2. Review strategies for management of obstructive sleep apnea

3. Explain the long-term physiologic and psychological effects of sleep-wake disorders

Networking Lunch with Exhibitors

1125 – 1240

Urology: A Quick Clinician Guide A to P

1245 – 1335

Todd Bryden, CCPA

This presentation will cover common Urologic conditions, emergencies, investigations and treatments. The presentation will include topics such as Hematuria (Micro & Macro/Gross), Acute Urinary Retention, Kidney Stones, Epididymitis/Orchitis/Orchialgia, Testicular Torsion and Fournier’s Gangrene and the important clinical features of each that would require immediate Urology consult. If time permits, some of the commonly encountered problems of inserting Urinary Catheters will be addressed.

Attendees will increase their knowledge and comfort level when dealing with the various common Urological complaints and emergencies that present to clinics, emergency rooms and hospital wards that are seen on a regular basis.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Recognize true Urologic Emergencies

2. Treat/Investigate Common Urologic complaints

3. Recognize difficult Foley Catheter insertions

Initiating Insulin in an Outpatient Setting

1245 – 1335

Elizabeth Roessler, MMSc., PA-C, Assistant Professor, Yale University

Type 2 diabetes mellitus is a chronic, progressive disease characterized by multiple defects in glucose metabolism and associated with insulin resistance and slowly progressive beta-cell failure. By the time that Type 2 diabetes is diagnosed in patients, up to one half of their beta-cells are not functioning properly. Due to this, patients with Type 2 diabetes often don’t meet treatment goals and may need insulin to augment therapy. Furthermore, studies have shown that on average, as many as 40-80% of patients with Type 2 diabetes will need insulin within 10 years of diagnosis. Since most of these patients are cared for primarily in Primary Care outpatient settings, initiation of insulin therapy should be routine in any practice. However, it is not surprising that the initiation of insulin is one of the most difficult aspects of managing patients with Type 2 diabetes. Challenges of initiating insulin therapy are two-fold. First is the patients fear of and reluctance to begin insulin. Second, and more significant, is clinicians’ hesitancy due to lack of knowledge and the view that initiating insulin is a complex and time consuming process, a treatment of last resort. This presentation will review the challenges of initiating insulin in the outpatient setting and provide clear, evidence-based guidelines related to the management of insulin therapy.

Learning Objectives

At the conclusion of this session, the particiapnt will be able to:

1. Identify current Canadian Diabetes Association Standards of Care, Hgb, A1C and glucose goals

2. Review and understand the current diabetes treatment algorithms

3. Explain how to calculate and initiate insulin and maximize oral medications

4. Summarize when and how to intensify insulin therapy

Workshop: Frozen Shoulder – Anatomy, Management, Injections, Risks, and Exercise Therapy

1245 – 1430

Daniel Avrahami, BPHE,DC, MSc, PA and Kim Scott, BSc, PA 

Frozen shoulder is a poorly understood condition that typically involves substantial pain, movement restriction, and considerable morbidity. The lifetime prevalence of frozen shoulder is estimated to be 2 to 5 percent of the general population. Full recovery can take up to 3 years. However, if diagnosed and treated early an episode of Frozen Shoulder can be significantly shortened, and possible reversed. The aim of this presentation is to provide a framework for the assessment and management of Frozen Shoulder. Included in the presentation is a review of relevant anatomy, patient management strategies, injection skills, and patient self-management strategies. A hands-on workshop on corticosteroid injections for the glenohumeral and subacromial joint will be provided.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Clinically identify Frozen Shoulder

2. Recommend how to manage a patient with Frozen Shoulder and patient self-management strategies

3. Practice glenohumeral and subacromial joint injection skills

Intermittent Fasting as An Approach to Metabolic Syndrome and Insulin Resistance

1340 – 1430

Andrea Lombardi, HBA, MBA, BHScPA, CCPA

The Intensive Dietary Management (IDM) Program is one that focuses on meal-timing, time restricted eating (TRE) and intermittent fasting (IF) in the treatment of patients and clients with metabolic syndrome (MetS) and insulin resistance (IR).  The IDM Program was founded in June 2012 as a physical clinic in serving the Greater Toronto Area, and has now expanded to an online program serving clients worldwide.  Founders, Dr. Jason Fung and clinical researcher Megan Ramos have become world-leading authorities on the topic of therapeutic fasting.

The IDM Program seeks to investigate the significance of meal timing, rather than composition of the meal itself.  Many patients with MetS and/or IR, such as pre-diabetes, T2 diabetes, non-alcoholic fatty liver disease, and polycystic ovarian syndrome, have attempted some kind of dietary program or regimen, but continue to struggle with their metabolic disease.

Since its inception, the IDM Program and has worked with over 8000 patients and clients world-wide on various fasting protocols, primarily and IF.  This presentation seeks to demonstrate that when one eats matters just as much as how one eats.  It will explain the physiology of IF as well as commonly used protocols to treat various metabolic disorders.  It will also share up-to-date research on IF in the treatment of MetS as well as clinical data collected from the IDM Program, including a new case series on the use of IF in the reversal of T2 diabetes published in the British Medical Journal in 2018.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Explain the physiology of time-restricted eating and intermittent fasting

2. Identify time-restricted eating and intermittent fasting as approaches to metabolic syndrome and insulin resistance (with or without the concurrent use of medication)

3. Prescribe basic protocols to patients with various metabolic disorders (with or without the concurrent use of medication)

Thoracic and Lumbar Spine Disorders in a Primary Care Practice

1340 – 1430

Tom Gocke, DMSc, PA-C, DFAAPA, Orthopaedic Educational Services Inc.

Managing Thoracic & Lumbar Spine Disorders by the Primary Care Physician Assistant lecture is designed to enhance the diagnostic skills in the evaluation of non-traumatic Thoracic & Lumbar spine conditions.  Attendees’ will enhance their ability to recognize normal radiographic anatomy of the thoracic & Lumbar spine. Attendees will use this knowledge to master skills needed for the evaluation and management of common non-traumatic Thoracic & Lumbar spine conditions seen by the Primary Care Physician Assistant. Using physical examination review and clinical case study attendee’s will be able to demonstrate their abilities to recognize common conditions of the Thoracic & Lumbar spine.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Determine and accurately communicate radiographic image results of Thoracic and Lumbar Spine conditions to patients and supervising physician(s)

2. Describe physical exam techniques necessary in the assessment of Lumbar spine conditions in a primary care patient

3. Describe the diagnosis and determine appropriate management techniques for a primary care patient with Lumbar Spine conditions

Networking Break with Exhibitors

1435 – 1455

Common Pediatric Overuse Injuries and Growth Plate Fractures

1500 – 1550

Adam Moore, MHS, PA-C, ATC, Assistant Professor, Salus University

Children are becoming more active in sports and physical recreation and at earlier ages than ever before. Per the United States Center of Disease Control (CDC.gov). “More than 2.6 million children 0-19 years old are treated in the emergency department each year for sports and recreational-related injuries.”

The goal of this lecture is to cover in detail the most common pediatric overuse injuries and growth plate fractures and treatment of each. The etiology, pathophysiology, clinical presentation, diagnostic testing, and treatment options for conditions including Sever’s Disease, Osgood-Schlatter Disease, Sinding-Larsen Johannson Syndrome, Little League Shoulder, elbow medial epicondylitis, torus fractures, and Salter Harris I fractures will be discussed. All of the information is relevant to those physician assistants providing care to children in both the primary care and orthopaedic realms.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Recognize and diagnose common pediatric overuse musculoskeletal injuries

2. Discuss the treatment of common pediatric overuse musculoskeletal injuries

3. Identify and treat common pediatric growth plate fractures

Implementation of a PA-led Patient Centered Goals of Care Consultation Service in a Community Hospital

1500 – 1550

Monica Monchis, CCPA, Royal Victoria Regional Health Centre

This presentation will highlight a program implemented at a community hospital that was designed to identify hospitalized patients at high risk of dying and ensure that their treatment preferences for end-of-life care were aligned with their values and goals of care. The program also assessed the feasibility of using an intensive care unit (ICU) physician assistant (PA) to implement this advance care planning (ACP). Findings from the program demonstrates the impact that PAs can have in ensuring that patients are making informed decisions about their care and the value this will add to our health care system.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Show the unique role of an ICU physician assistant engaging in advance care planning discussions with hospitalized patients and collaborating within an inter-professional team

2. Outline a systematic approach for eliciting hospitalized patients’ values and goals of care surrounding life sustaining therapies

3.  Illustrate the demand for an integrated advance care planning service that ensures patients can provide informed consent and appreciate the value this will add to the health care system

The Past, Present and Future of Orthopaedic Surgery PAs in Canada: A Panel Discussion

1500 – 1550

Anne Dang, BHSc (PA), BHSc. (Hons), CCPA;

Ohood Elzibak, BHSc.(PA), MPAS, CCPA;

Deanna Groenestege, BScPA, BASc Kin.(Hons), CCPA;

Andrew Lim, BHSc (PA), BASc. (Hons), CCPA

Orthopaedic Surgery is one of the key areas for PA practice and growth in Canada. In 2016, The Conference Board of Canada published a report identifying orthopaedics as one of top three practice areas that hold the most promise for increased productivity by greater use of PAs. The Canadian Institute for Health Information also released a report showing that 3 of the top 5 most commonly performed surgeries in Canada are orthopaedic procedures. As more orthopaedic PAs enter the workforce, it is important to discuss practice trends and avenues for professional growth and development.

This session is aimed at practicing orthopaedic surgery PAs and students or current PAs looking to transition into a role in orthopaedics.  The session is moderated by an orthopaedic surgery PA with a near-decade experience in the field and will provide insight from three expert panelists who practice in diverse orthopaedic settings and are actively involved in professional advocacy.  Topics explored during the question-answer session include the orthopaedic PA job market, current clinical roles in orthopaedics, challenges affecting practice growth and strategies to overcome them.  Additionally, the panelists will provide insight and recommendations related to funding/billing, role expansion and professional advocacy.  This session is interactive and audience members will have the opportunity to participate in live polling as well as pose questions to the speakers.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Appraise the growth of the orthopaedic PA role in Canada over the past decade

2. Outline the diverse roles and responsibilities of an orthopaedic surgery PA in outpatient vs. inpatient and trauma vs. elective practice settings

3.  Outline the current status of the orthopaedic surgery PA job market and identify strategies to assist PAs in securing employment in orthopaedic surgery

4. Identify challenges faced by orthopaedic PAs in clinical practice and strategies used to overcome them

5. Explore the future of the orthopaedic PA profession in Canada and brainstorm initiatives to help propel the profession forward in matters related to funding, role expansion and professional advocacy

CAPA Annual Members Meeting

1600 – 1730

Leslie St. Jacques, CCPA, CAPA President; Patrick Nelson, Executive Director

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Recall the progress that the association has made for the organization and PA profession within the past year

2. Recognize the issues the association and PA profession is currently facing

3. Identify next steps for sustainability of the association and advancement of the PA profession

Provincial Member Forums:

1735 – 1815
Provincial Directors for Ontario, Pacific, Atlantic, Prairie and Quebec

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Recall the progress that has been made for the Physician Assistant (PA) profession within the region in the past year

2. Recognize the issues specific to the geographic area that the PA profession is currently facing

3. Identify next steps for advancement of the PA profession in that area

 

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Saturday, October 26

Breakfast

0715 – 0800

The Top 10 Missed Emergency Medicine Complaints

0800 – 0850

John Bielinski, Jr. MS, PA-C, CME4Life

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Implement the HEART score in the discharge of patients with low risk chest pain

2. Recall the most effective test to now miss the diagnosis of acute appendicitis

3. Recognize the presentation of a pulmonary embolism

Cannabis and the Current Landscape since Legalization

0800 – 0850

Jason Busse, DC, PhD, Associate Professor, McMaster University

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Identify who uses cannabis and why

2. Discuss current evidence for therapeutic use of cannabis

3. Outline promising areas for future research

Housekeeping and Speaker Introductions

0900 – 0910

The Power of Kindness: A Personal and Professional Search

0910 – 1000

Dr. Brian Goldman, Radio Host – White Coat, Black Art 

Dr. Brian Goldman is a staff emergency physician at Sinai Health System in Toronto. Since 2007, he has hosted White Coat, Black Art an award-winning show about the patient experience in the culture of modern medicine. He is author of three Canadian bestselling books. His latest book, The Power of Kindness: Why Empathy is Essential in Everyday Life, his personal and professional search for empathy inside his brain, his heart and around the world.

Learning Objectives

At the conclusion of this session the participant will be able to:

1. Define the key parts of empathy and distinguish them from sympathy

2. List personal and system factors that detract from empathy in health care

3. Develop ways to be more empathic on the job

Networking Break with Exhibitors

A Beautiful Death: An Overview of Medically Assisted Dying (MAID) in Canada

1030 – 1120

Dr. Tatiana Conrad, University Health Network, Princess Margaret Hospital-Ontario Cancer Institute

This session will serve to inform physician assistants about the evolution of Medically Assisted Dying (MAiD) in Canada and will also identify roles for PAs in the patient/family experience.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Develop a cultural context of MAID in Canada

2. Identify the process & eligibility criteria for MAID in Canada

3. Discuss barriers to access of MAID

4. Identify role for PA’s in discussion of MAID

Making Friends and Influencing People: Practical Tips on Starting Your PA Career

1030 – 1220

Vanessa Martino, CCPA; Mike Dalliday, CCPA

This mentorship session is for everyone, from students and new graduates seeking their first job to experienced PAs looking for a career change. You’ll hear from PAs who started networking early to land their ideal job. They will share approaches to job searching and networking, and describe the lessons they learned over the course of many conversations and meetings with physicians, administrators, and health care decision makers.

There’s great demand for health care professionals who prove themselves to be enterprising and proactive in everything they do, starting with their job search. This session will give you the chance to ask questions and get practical advice for career success.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Illustrate the PA value proposition and how to effectively make the case for hiring a PA

2. Prepare for different networking scenarios and how to respond

3. Develop a step-by-step approach to your job search

Workshop: Demystifying EKG Interpretation

1030 – 1220

John Bielinski, Jr. MS, PA-C, CME4Life

ECG interpretation is an art. You need to have a clear picture of patient presentation in conjunction with an understanding of pathophysiology and the ECG. It’s a puzzle. The objectives of this workshop is to teach clinical application of ECG interpretation as taught through the 5 causes of ST segment elevation, 4 causes of ST depression, 4 causes of a clipped T wave and the 3 causes of a wide complex QRS.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1.  Explain the two safety nest of EKG Interpretation

2.  Identify the five causes of ST segment elevation

3.  Define the four causes of ST segment depression

4.  Examine the four causes of a flipped T wave

5.  Evaluate the causes of a wide complex QRS

6.  Review the three causes of hyperkalemia

Opioids for Chronic non-Cancer Pain

1130 – 1220

Jason Busse, DC, PhD, Associate Professor, McMaster University

Learning Objectives

At the conclusion of this session, the participant will be able to:

1.  Recognize benefits and harms of opioids for chronic pain

2.  Interpret treatment effects

3.  Identify the role of patient values and preferences

Finding your Funding Panel Discussion

1130 – 1220

Maitry Patel, CCPA, University Health Network; Deniece O’Leary, MPAS, PA-C, Faculty Member, University of Toronto 

This session will offer strategies and advice on how to find funding to secure your position.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Recognize potential barriers in identifying funding for your position

2. Identify various routes for funding to explore

3. Apply strategies to secure funding

Networking Lunch with Exhibitors

Implementation of Standardized Discharge Prescriptions to Manage Post-Operative Pain in Thoracic Surgery

1330 – 1420

Yousra Hasnain (CCPA); Alison Wallace (MD, PHD)

The overuse of opioids for post-operative pain has contributed to an opioid epidemic. Over prescribing of opioids after Thoracic Surgery can be prevented with standardized discharge prescriptions. This presentation will outline guidelines for discharge medications and explain how a patient information sheet can be effective in counseling patients on opioid use, adjunct pain medications, and advising on safe disposal. The aim is to avoid over-prescribing and ensure patients have adequate pain management after being discharged.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Summarize opioid epidemic effects on healthcare specifically in surgery

2. Explain the rational of implementation of standardized discharge medications

3. List the benefits of a team based approach of a PA and MD team

ADHD Awareness and Management

1330 – 1420

Dr. Joan Flood

Learning Objectives

At the conclusion of this activity, participants will be able to:

1. Define ADHD as well as its various presentations and associations with other comorbid psychiatric disorders

2. Identify common misperceptions that prevent many primary care practitioners from treating ADHD

3. Apply 2018 Canadian ADHD Practice Guidelines to the assessment and management of ADHD

Pre-Operative Assessment – Considerations and Guidelines for the Primary Care PA

1430 – 1520

Rita A. Rienzo MMSc, PA-C, Assistant Professor, Yale University

Primary Care providers are frequently asked to evaluate a patient’s readiness for surgery and to provide medical clearance. The goal of the evaluation is to detect unrecognized diseases and risk factors that may increase the risk of surgery, as well as to maximize the patient’s status relative to their pre-existing conditions in order to mitigate potential post-operative complications. The significance of the task, however, may compel providers to over-test, which can be costly, may over-expose patients to needless labs and procedures, create additional anxiety, and may also cause an unnecessary delay of the surgery, potentially worsening the underlying condition. Providers may feel compelled to order a battery of labs and studies based on existing protocols that may not provide any additional or useful information to the anesthesiologist or the surgeon. Current guidelines recommend that preoperative assessment focus on 1) the individual patient’s pre-existing conditions and 2) investigation of previously undiagnosed conditions, as suggested by the history and physical exam that may present a post-operative risk. This presentation seeks to advise PAs on the appropriate pre-operative evaluation of adults undergoing elective non-cardiac surgery.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Determine the appropriate patient-specific pre-operative work-up, based on past medical history and physical exam, to mitigate post-operative complications

2. Identify medical problems that increase morbidity and mortality related to non-cardiac surgery

3. Identify current Canadian Cardiovascular Society guidelines for assessing and managing cardiac risk for non-cardiac surgery patients

Hypertension Guidelines

1430 – 1520

Dr. George Zimakas

Learning Objectives

At the conclusion of this activity, participants will be able to:

1. Apply appropriate methods for making a diagnosis of hypertension

2. Implement evidence-based threshold and target BPs

3. Integrate new guidelines for hypertension management including:

– Use of longer-acting over shorter-acting diuretics

– Use of single pill combinations as a first-line treatment

Student Workshop: How to Succeed on Clinical Rotations and Early in Your Career

1430 – 1620

Ohood Elzibak, BHSc.(PA), MPAS, CCPA, Assistant Clinical Professor (Adjunct), McMaster University

This is an interactive workshop aimed at first and second year Physician Assistant students who are looking to optimize their time and experience while on clinical rotations. The session will begin with a brief overview of the CanMEDS-PA framework and its relevance to the clinical PA student.  Audience members will have an opportunity to share examples of how the framework can be applied to clinical encounters with patients, colleagues, co-learners and supervisors.  The speaker will then share concrete, practical tips on becoming “The Ideal PA Clerk”, incorporating feedback form current PA educators and clinical evaluators. The second part of the workshop involves a breakout session where students will be presented with a conflict scenario related to clinical rotations and will collaborate in small groups to brainstorm conflict resolution strategies. An open, large group discussion will follow and a model will be proposed by the speaker to help students strategically and systematically address conflict. The session will conclude with general tips on scheduling electives, tackling a challenging job market and transitioning into new employment.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Outline the duties and responsibilities of a PA clerk and a newly graduated PA by applying the CanMEDS-PA framework

2. Identify the characteristics of “The Ideal PA Clerk” based on the principles of the CanMEDS-PA profile

3. Outline strategies for developing an effective clerkship schedule and setting up suitable electives

4. Investigate appropriate avenues for resolving conflict between a PA clerk and a supervisor, another learner, a patient or a staff member

5. Discuss strategies for turning a rotation into a potential job opportunity

6. Explore the utility of networking and inquiry skills to allow for a smooth transition into a new career

Nurse Practitioners’ Association of Ontario

1530 – 1620

Dawn Tymianski, NP

Liability Insurance

1630 – 1700

Adèle E. Robinson, BCom, CIP, CRM, Vice President Programs, Bradley’s Commercial Insurance Limited

CPAEA AGM

CAF Members Forum

1630 – 1720

Marc Bilodeau, Deputy Surgeon General, Canadian Armed Forces

The Deputy Surgeon General will address CAF members.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Recall the progress that has been made for the Physician Assistant (PA) profession within the CAF in the past year.

Cocktails

1830 – 1900

Awards Gala and President’s Dinner

1900 – 0100

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Sunday, October 27

Breakfast

0745 – 0800

A Fast Trip Around the World Highlighting PA Expansion

0800 – 0850

Ruth Ballwag, MPA, PA-C Emeritus, DFAAPA; David Kuhns, MPH, CCPA, PA-C, Consultant on International Development of the Physician Assistant/Associate (PA) Education and Clinical Roles

PAs involved in the International Development of PAs will update attendees on the most recent developments for PAs globally. In addition to reviewing the history and priorities of specific countries as they “Adapt” the flexible PA role and educational training model to their unique needs, the presenters will also discuss new and promising developments in the United Kingdom, India, Israel, the Republic of Ireland  and Australia/New Zealand.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Recognize and describe the complexities of creating a new career in the health workforce by comparing the experience of Canada—with multiple levels in a federated governance structure—to the experience in The Netherlands, a geographically small country with a single governmental structure

2.  Recall of the long history of the PA concept in multiple countries including Sub-Saharan

Africa beginning in the 1970’s as a side effect of revolutions which drove doctors (both ex-pats and citizens) out of Africa

3.  With respect to the creation of innovative workforce models—such as PAs—be able to describe and discuss common barriers, facilitating factors and opportunities as the career moves forward toward full development

CPAEA Round-Table Discussion: Ongoing Research

0800 – 0850

Facilitator: Ian W Jones, MPAS, PA-C, CCPA, DFAAPA

Learning Objectives

After participating in this round table discussion, the PA will:

1. Improve their understanding of current issues within PA research.

2. Develop problem-solving and team building strategies supporting PA research.

3. Learn where to develop a range of information and research skills enabling clinical environment quality assurance.

Quality Improvement initiatives for Physician Assistants

0800 – 0850

Saira Rashid, CCPA

Quality Improvement is crucial for all healthcare providers including Physician Assistants to ensure that we continue to escalate standards of patient care. As relatively new healthcare professionals in Canada, PAs can play a vital role in improving patient care, healthcare organizations’ efficiency and in reducing medical errors/wastes. Furthermore no workplace is perfect hence having an approach to solving work-related problems from a QI perspective can be fruitful at many levels.

In this session, PAs will be inspired to conduct quality improvement projects in their workplace. Through a small-group based interactive session, PAs will be able to identify QI opportunities in their work environment and will establish an approach at QI projects.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Define Quality Improvement (QI)

2. Recognize why QI is important for PAs

3. Identify a simple approach to QI projects for PA students and practicing PAs

4. Discuss examples of successful PA-led QI projects

Housekeeping and Speaker Introduction

0900 – 0905

Poster Presentations

0905 – 1030

Authors of the poster presentations will be given five minutes to go over the highlights of their research poster, followed up by questions from attendees.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Explain the importance of PA led research

2. Recall current research conducted and identify relevance to PA profession

3. Identify gaps in research

Opioid Use Disorder: Diagnosis and Treatment

1040 – 1130

Nino Parunashvili CCPA; Darren J. Holub, MD, Halton RAAM Clinic

Opioid Use Disorder (OUD) has often been stigmatized as a bad choice or moral weakness. We intend to demonstrate evidence of addiction as a chronic relapsing and remitting disease. A primary aim of this talk is to familiarize the audience with OUD and current treatment options available in Ontario. Further, we will discuss aspects of Opioid Agonist Therapy (OAT), including advantages and disadvantages, along with details regarding the individual medications (methadone and buprenorphine/naloxone). This presentation will also review general objective and subjective approach to OUD patients, as well as the signs and symptoms of opioid withdrawal and toxicity.

OUD not only greatly affects the individuals who suffer from it, but has devastating effects on families, healthcare systems, and society as a whole. With increasing demand, greater numbers of primary care practitioners are involved in OAT provision. As a result, it is crucial for PAs to be able to recognize, evaluate, refer, and establish treatment plans for patients with Opioid Use Disorder.

PAs are comfortable with the management of most chronic conditions, such as hypertension, dyslipidemia, thyroid disease etc., however, Substance Use Disorder, despite being a common chronic condition, remains an area that requires greater understanding among health care providers.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Explain what opioids are; a brief history

2. Recognize signs and symptoms of opioid withdrawal and toxicity

3. Demonstrate Opioid Use Disorder as a chronic condition, breaking the stigma

4. Diagnose Opioid Use Disorder (DSM-5)

5. Outline the effects of Opioid Use Disorder on individuals and society

6. Review Opioid Agonist Therapy: basics of methadone and buprenorphine treatment

Together We Are Stronger: Building Capacity for PA Leadership

1040 – 1130

Facilitator: Leslie St. Jacques, CCPA, University Health Network – Krembil Brain Institute; Panelists: Anne Dang, BHSc (PA), BHSc. (Hons), CCPA;

Dee Naidu, CCPA, Sunnybrook Health Sciences Centre;

Anna D’Angela, MBA, PA student class of 2021;

Sahand Ensafi, CCPA, University of Toronto;

Kirsten Luomala, CCPA, University of Alberta Hospital;

Deniece O’Leary, MPAS, PA-C, University of Toronto.

Physician Assistants in Canada have built a strong foundation for the profession, and point the way forward to future work to be done. PAs demonstrate our clinical skills on a daily basis in our workplaces and frequently take on leadership roles in that context. Within our clinical areas and in offices of governance, we have created new paths for PAs, and built the structures for PA governance and education in Canada. Building leadership skills amongst our members will ensure that PAs will have the ability to speak for our profession and to chart its course into the future.

This panel discussion will explore:

• Building capacity for leadership among PAs

• Qualities of leadership

• How to get started in leadership roles

• Mentors and supports and how to find them

• Preparing for leadership roles in health care organizations, research, education, government and advocacy

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Recognize qualities required for leadership

2. Identify pathways to develop leadership skills – clinical, administrative, education, research and other (entrepreneurship, industry, consulting, volunteering)

3.  Recognize oneself as a potential leader

4. Recognize the role of mentors and learn strategies to develop supportive relationships

Workshop: How to Initiate Insulin

1040 – 1250

Priya Narula, CCPA, LMC Diabetes & Endocrinology 

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Effectively introduce the start of basal insulin to patients

2. Review the steps on how to initiate basal insulin to patients

3. Discuss hypoglycemia, basal insulin dosing and how to empower patients to titrate

Networking Lunch

1130 – 1200

Rashes to Recognize in Primary Care

1200 – 1250

Nino Parunashvili, CCPA; Dr. Peter Tzakas

Rashes that are drastically different in the eyes of dermatologists look all too similar to other medical professionals. This is because the majority of dermatological conditions look similar and may have varying overlapping stages.

To avoid unnecessary biopsies, excisions, and other costly and invasive procedures it is essential to recognize common and dangerous dermatological conditions.

Some of the key differentiators for these conditions will be reviewed in a clinical contest with considerations of age, presenting symptom, and visual illustrations. Brief pathophysiology, diagnostic, and treatment options for each condition will be covered.

Intro to dermatology: skin anatomy, skin function, basic dermatological terminology, medical history intake principles in dermatology.

Common skin lesions: Cellulitis, Impetigo, Keloid, Folliculitis, Herpes Zoster, Pytireasis rosea, HSP, Roseola, Scarlet Fever, Candideal Intertrigo, HFMD, Kawasaki disease, Erythema infectiosum, Folliculitis, Molluscum contagiosum.

Rashes that may be dangerous: meningococcemia, necrotizing fasciitis, toxic epidermal necrolysis, Steven- Johnson syndrome, Toxic shock syndrome, pemphigus vulgaris, anaphylaxis, Kawasaki’s Disease, Erysipelas, Rocky Mountain Spotted fever, endocarditis, burns, skin malignancy (SCC/ BCC).

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Review skin anatomy, function, and basic dermatological terminology

2. Recognize common dermatological conditions

3. Recognize dermatological conditions that are dangerous

4. Identify diagnostic and treatment options for those conditions

Eye Pain What not to miss?

1200 – 1250

Sahand Ensafi, CCPA, Assistant Clinical Professor, University of Toronto 

It’s a busy shift and the next patient waiting to be seen is screaming in agony as a result of eye pain. You haven’t brushed up on your ophthalmology skills in a long time and think twice about picking up the chart. This talk will provide you with some helpful tips and tricks to guide you in your assessment of painful eye conditions.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Identify painful eye conditions that can cause significant morbidity if not diagnosed/managed appropriately

2. Assess painful eye conditions

3. Increase familiarity with the management of painful eye conditions

Medical Education and Physician Assistants: A Global Collaboration

1300 – 1350

Marie Meckel, BA, BS, MS(PA), MPH, PA-C, Assistant Professor, Bay Path University; Kristen Burrows, BSc, BHSc(PA), MSc, CCPA), Assistant Clinical Professor (Adjunct), McMaster University

This presentation will highlight a project initiated in 2018 to bolster the profession globally and to establish a global database on PA education. Data collection, analysis, and evaluation of worldwide educational methodologies was collated from Canada, India, Israel, South Africa, Botswana, Australia, the Republic of Southern Sudan, UK, and the USA. Real-time data is being collected using an online survey template developed by the initial working group, and allows for additional recruitment of other countries as they are identified.

It is anticipated that the findings from this project will help establish a database to understand where PAs have been integrated to support the delivery of healthcare worldwide, and to examine the various approaches to PA education. In addition, the findings from this project will support policy change and incentivize financial support for worldwide PA educator and practitioner exchange programs. Collaborating, collecting data and sharing best practices will allow us to bolster our profession and enhance our contributions to solving healthcare issues that exist globally.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Summarize the global impact of physician assistants in delivering healthcare

2. Identify various approaches to PA education and training pathways in other countries

3. Recognize the importance of global collaboration with PA educators and clinicians

Practicing Medicine Across Canada and Abroad: PA’s in the Canadian Armed Forces

1300 – 1350

Major Stuart Russelle MMM, CD, MPAS, CCPA

The Canadian Armed Forces exists within a federal jurisdiction as such the laws that regulate health care in the Provinces do not apply. This provides a unique opportunity for Physician Assistants to work broadly across the Canadian countryside even when provincial regulation is not well established. The CAF understands the importance on effective regulation of PAs to ensure the care they provide to military members is effective and safe, as military PAs practice in a myriad of environments. As Physician Assistants have rapidly evolved in Canada, so too has the profession evolved in the CAF. These promising next steps offer a new career landscape to practicing medicine as a Physician Assistant.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Describe practicing medicine in the Federal jurisdiction

2. Compare and contrast Professional Regulation of PAs in the CAF

3. Diversity, Diversity, Diversity! Describe the diversity the CAF has to offer

4. Articulate PA Evolution in the CAF and describe The Next Steps

Workshop: Ultrasound Guided Central Line and Arterial/Venous Line Placement

1300 – 1450

David A. Smith, MPAS, PA-C, Assistant Professor, Salus University; Adam Moore, PA-C, AT-C 

Central venous access devices (CVADs) and arterial line placement are commonly used in the inpatient and outpatient settings. Physician assistants must understand CVADs and arterial line indications, intended uses, functional lifespans, complications, and indications for removal. This workshop will instruct the participant on how to place a central and arterial line using ultrasound guidance. The workshop will also allow each participant to conduct each procedure on state of the art simulation manikins specifically designed for ultrasound insertion.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Recognize the indications and contraindications for central and arterial line placement

2. Apply basic concepts of ultrasound training to locate arterial and venous vasculature

3. Via ultrasound with the use of manikins properly demonstrate arterial and venous line placement

HPB Surgery: What is it and how does it affect my practice?

1400 – 1450

Julie Krista Slavinski, CCPA

HPB (hepato-pancreatic biliary) surgery is a subspecialty of General Surgery involving the surgical management of cancers of the pancreas, liver, and bile ducts, bile duct injuries, and other pathologies of the HPB region. The surgeries performed are complex and often necessitate prolonged hospital admissions to manage the immediate postoperative period and any complications that can develop. Most Physician Assistant’s experience with HPB surgery will be confined to the initial presentation of patients at time of diagnosis or in the management of any postoperative complications once the patient has been discharged from hospital. This presentation will provide several case studies to illustrate pathologies managed by an HPB service. It will briefly explain the surgeries involved in their management. The postoperative complications and how they are managed as an outpatient will then be discussed in greater detail. After the presentation, the PA should be able to understand the diagnosis and referral of HPB pathologies. They will be able to have informed discussions with their patients about HPB surgeries, the repercussions of HP surgeries, and be comfortable with managing some of the complications.

Learning Objectives

At the conclusion of this session, the participant will be able to:

1. Identify the pathologies managed by an HPB surgical practice and how they present

2. Identify common complications of HPB surgery and how to manage them in an outpatient setting

3.  Communicate to their patient population management details of HPB pathologies

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