Context: One of health care's foremost challenges is the achievement of integration and collaboration among the groups providing care. Yet this fundamentally group‐related issue is typically discussed in terms of interpersonal relations or operational issues, not group processes. Methods: We conducted a systematic search for literature offering a group‐based analysis and examined it through the lens of the social identity approach (SIA). Founded in the insight that group memberships form an important part of the self‐concept, the SIA encompasses five dimensions: social identity, social structure, identity content, strength of identification, and context. Findings: Our search yielded 348 reports, 114 of which cited social identity. However, SIA‐citing reports varied in both compatibility with the SIA's metatheoretical paradigm and applied relevance to health care; conversely, some non‐SIA‐citers offered SIA‐congruent analyses. We analyzed the various combinations and interpretations of the five SIA dimensions, identifying ten major conceptual currents. Examining these in the light of the SIA yielded a cohesive, multifaceted picture of (inter)group relations in health care. Conclusions: The SIA offers a coherent framework for integrating a diverse, far‐flung literature on health care groups. Further research should take advantage of the full depth and complexity of the approach, remain sensitive to the unique features of the health care context, and devote particular attention to identity mobilization and context change as key drivers of system transformation. Our article concludes with a set of “guiding questions” to help health care leaders recognize the group dimension of organizational problems, identify mechanisms for change, and move forward by working with and through social identities, not against them.

Excessive heterogeneity exists in the literature to determine the internal and transfer validity of arthroscopic simulators currently available. Evidence suggests that simulators can discriminate between novice and expert users, but discrimination between novice and intermediate trainees in surgical education should be paramount. International standards for the assessment of arthroscopic simulator validity should be developed to increase the use and effectiveness of simulators in orthopedic surgery.

ObjectivesTo provide a comprehensive systematic overview of current evidence from pooled analyses/meta-analyses and systematic reviews (PMASRs) pertaining to dairy consumption and incident cancer and/or all-cause or cancer-specific mortality.DesignOverview of reviews.SettingCommunity setting.ParticipantsThe unit of analysis is PMASRs. A total of 42 PMASRs was included in this overview of reviews.Interventions/exposuresAny dairy product consumption (eg, milk, yogurt, etc).Primary and secondary outcomes measuresPrimary outcome measure is development of any type of cancer. Secondary outcome measures are all-cause mortality and cancer-specific mortality.ResultsFrom 9693 citations identified, we included 42 PMASRs (52 study reports) published between 1991 and 2017. Thirty-one (74%) of these was pooled analyses/meta analyses, and only 11 (26%) were systematic reviews and meta-analyses. There was a wide variability in the type of study designs included within the other PMASRs, thus contributing to variable and, in instances, divergent estimates of cancer risk for several cancer subtypes. For example, only one systematic review and meta-analysis exclusively included prospective study designs. Most PMASRs were of low to moderate quality based on the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) scores. The median AMSTAR score was 5 (IQR 2–7). Our overview identified conflicting evidence from PMASRs on association between dairy consumption and incident cancers or mortality. Heterogeneity in summary estimates reflected the inclusion of variable study designs and overall low methodological quality of individual PMASRs.ConclusionsThe association between dairy consumption and cancer risk has been explored in PMASRs with a variety of study designs and of low to moderate quality. To fully characterise valid associations between dairy consumption and risk of cancer and/or mortality rigorously conducted, PMASRs including only high-quality prospective study designs are required.Trial registration numberCRD42017078463.

Objective: Previous systematic reviews looking at timing of anterior cruciate ligament reconstruction (ACLR) examined the functional outcomes and range of motion; however, few have quantified the effect of timing of surgery on secondary pathology. The goal of this study was to analyze the effects of early ACLRs versus delayed ACLR on the incidence of meniscal and chondral lesions. Data Sources: We searched MEDLINE, EMBASE, and CINAHL on March 20, 2018, for randomized control trials (RCTs) that compared early and delayed ACLR in a skeletally mature population. Two reviewers independently identified trials, extracted trial-level data, performed risk-of-bias assessments using the Cochrane Risk of Bias tool, and evaluated the study methodology using the Detsky scale. A meta-analysis was performed using a random-effects model with the primary outcome being the total number of meniscal and chondral lesions per group. Results: Of 1887 citations identified from electronic and hand searches, we included 4 unique RCTs (303 patients). We considered early reconstruction as <3 weeks and delayed reconstruction as >4 weeks after injury. There was no evidence of a difference between early and late ACLR regarding the incidence of meniscal [relative risk (RR), 0.98; 95% confidence interval (CI), 0.74-1.29] or chondral lesions (RR, 0.88; 95% CI, 0.59-1.29), postoperative infection, graft rupture, functional outcomes, or range of motion. Conclusions: We found no evidence of benefit of early ACLR. Further studies may consider delaying surgery even further (eg, >3 months) to determine whether there are any real benefits to earlier reconstruction.

Purpose This review examines the topic of information literacy (IL) and its importance as a component of competency-based education in the health professions, and shares the process and outcome of a collaborative effort between The University of Manitoba Department of Anesthesia and Health Sciences Libraries to create, to introduce and integrate IL training into a new anesthesia curriculum. Principle findings Nine IL modules were developed according to standards set by the Association of College and Research Libraries (ACRL) and aligned with the Royal College of Physicians and Surgeons CanMEDS competencies. Taken collectively, they explore modern tools used to approach the medical literature in an organized, efficient manner, and to locate, evaluate and use information effectively to accomplish a specific purpose. Each module forms the basis of one IL session that combines self-study and group projects with librarian-led, computer-based training, designed to build competency in information need awareness, retrieval skills and resource appraisal. Facility with the concepts taught was evaluated though examples relevant to the anesthesia practice environment. The entire collection is available at http://wiki.lib.umanitoba.ca/ tiki-index.php?page=Anesthesia?Clinical?Assistants? Programme. While the original impetus for this project was to prepare Anesthesia Clinical Assistants for self-directed, life-long, active learning, what emerged was a curriculum in IL germane to medical specialties and flexible enough to be used by healthcare professions generally. Conclusion An IL program, directly relevant to current expectations of competent practice, education and lifelong learning, has been created and is discussed within the larger context of curriculum-integrated IL for the health professions. RésuméObjectif Ce compte-rendu examine le the`me de la maıˆ-trise de l'information (information literacy-IL) et son importance comme composante d'un mode`le de compe´-tence attendue dans les professions de la sante´, et pre´sente le processus et les re´sultats d'une collaboration entre le de´partement d'anesthe´sie de l'Universite´du Manitoba et les Bibliothe`ques des sciences de la sante´. Cette collaboration avait pour but de cre´er, d'introduire et d'incorporer une formation en maıˆtrise de l'information dans une nouvelle formation en anesthe´sie. Constatations principales Neuf modules de maıˆtrise de l'information ont e´te´e´labore´s selon les normes de´finies par l'ACRL (Association of College and Research Libraries) et ajuste´es aux compe´tences CanMEDS du Colle`ge royal des me´decins et chirurgiens. Collectivement, ces modules explorent les outils modernes utilise´s pour aborder la litte´rature me´dicale de façon organise´e et efficace, ainsi que pour localiser, e´valuer et utiliser l'information de manie`re efficace pour re´aliser un objectif spe´cifique. Chaque module constitue la base d'une session de maıˆtrise de l'information qui allie auto-apprentissage et projets de groupe avec une formation sur ordinateur d...