Exceptional Resident Projects

Clinical Education Tool
This involves developing a tool or resource useful for the education of physicians, other health care workers, patients or the public. The educational tool needs to be accompanied by a description of how the topic was selected, a literature review and the reason for the need of the tool.

Literature Appraisal
This involves a detailed review of the literature on a specific topic pertinent to Family Medicine.

Medical Education Tool
This involves developing a tool or resource useful for undergraduate or postgraduate medical education, with accompanied reason for tool and literature review to support the tool.

Medical/Health Humanities
This stream requires residents to ask an important question relevant to Family Medicine. The resident will conduct a review of the evidence on the topic and the final project may include an arts-based piece, or use of art in the scholarly project, both clinical and humanities. This may take the form of writing, visual art, performance (e.g. dance, theatre), production or a musical composition. While the health humanities may be considered a category of its own, it could also be a component of any of the above categories.

Paper/Essay
This involves an extensive treatise on a topic of importance to Family Medicine. Topics can also relate to a broad range of pertinent issues such as the history of medicine, medical philosophy, medical education, politics, etc.

Practice Quality Improvement Project
This involves identifying a practice-based question (aim statement), constructing a method for measuring change, developing that change by finding evidence-based guidelines/recommendations to guide the approach to clinical care with respect to the question, reporting the results and recommendations to target population, along with reassessments after change has been initiated (PDSA cycle; Plan, Do, Study, Act).

Research
This involves the posing of a question, reviewing the literature, selecting the methods needed to answer the research question, collecting original data, conducting the data analysis, and reporting the findings. Most research projects require approval by the local Research Ethics Board (REB).

A survey was sent to Dalhousie North Nova Family Medicine Residents and the Emergency Department physicians of the Colchester East Hants Health Centre to determine the 10 most used clinical decision rules in the Emergency Department. Based on these results a podcast designed to inform medical students about the 10 most used clinical decision rules was created. This podcast provides a brief summary and history of the 10 most common decision rules and how to use them, providing students a concise resource and introduction into a key aspect of Emergency Medicine. 

Machines that use human intelligence to solve problems, from simple to complex, have existed for a long time. The term "Artificial Intelligence (AI)" was first coined by John McCarthy during the Dartmouth conference in 1956 (1). Since then, research has focused on various components of AI, including rule-based systems, machine learning (ML), deep learning (DL) algorithms, and, more recently, natural language processing (NLP) (2,3). This evolution has enabled AI to address issues that directly or indirectly impact our daily lives (4). For instance, AI was used to break wartime codes in 1942, Deep Blue (a supercomputer) defeated chess champions, and technologies like Google Maps assist us with navigation. More recently, AI has been instrumental in taking medical notes and even diagnosing medical conditions (eg, Heidi, ChatGPT, OpenEvidence, FullCode). Beyond this, AI could help improve knowledge, especially in clinical reasoning,among medical learners and residents in family medicine practice (5).

Institutions have begun incorporating the teaching of Generative AI into their postgraduate family medicine education (6). Similarly, in the context of continuous training in family medicine residency, universities such as Dalhousie’s have adopted competency-based training that emphasizes clinical reasoning, selectivity, communication, professionalism, and procedural skills. This position paper will emphasize clinical reasoning,as it is essential for translating theoretical medical knowledge into everyday patient care (7,8)

Background: Cannabis hyperemesis syndrome (CHS) is becoming an increasingly common presentation in pediatrics. However, limited pediatric-specific evidence exist to guide management. This tool aims to summarize current recommendaJons for pediatric management of CHS and serve as a point-of-care reference for clinicians.

Methods: A PubMed search identified primary sources on pediatric CHS management. A recent narrative review by Ibia and Toce (2025) provided the framework for this tool, with primary sources reviewed in full. The tool includes diagnostic considerations, evaluation, management strategies, and an evidence summary to clarify the strength of recommendations.

Results: Nineteen primary studies were reviewed, including randomized controlled trials (RCTs), cohort studies, and case reports/series. The two RCTs involved adult patients; the remaining studies comprised the pediatric evidence base. Available data support D2 antagonists (haloperidol, droperidol), benzodiazepines, and topical capsaicin as the most effective therapies for pediatric CHS. Notably, intravenous D2 antagonists carry risks of extrapyramidal symptoms and QTc prolongation, which require careful consideraJon.

Interpreta8on: High-quality pediatric studies on CHS management are lacking. This tool provides a concise, evidence-based resource for identifying and managing CHS in pediatric paJents using the current literature.

Background: Psoriasis is an inflammatory skin condition closely associated with obesity which increases its risk of development, worsens pre-existing disease and negatively affects treatment response. Weight loss through diet and exercise has been proven to reduce disease severity and improve quality of life of psoriasis patients. The objective of this review was to explore the effect of anti-obesity medications on psoriasis in obese or overweight adults.

Methods: A comprehensive search of Embase, Medline and Central databases, citations of included articles, conference abstracts, clinical trial registries, and ProQuest was conducted on Nov 18, 2025. Clinical trials and cohort studies on adult patients with psoriasis investigating effect of anti-obesity medications were included. Studies on pediatric, pregnant or breastfeeding patients, studies exploring other weight loss strategies or involving medications withdrawn from the market and other types of studies including reviews and meta-analyses were excluded. Primary study outcomes included changes in Psoriasis Area and Severity Index (PASI) scores, changes in body mass index (BMI) and changes in Dermatology Quality of Life Index (DLQI). Secondary outcomes included changes in the metabolic profiles, inflammatory markers or psychological state of patients. Quality of studies was assessed using Revised Cochrane Risk of Bias tool 2 (RoB2) for randomized studies and Newcastle-Ottawa Scale for non-randomized studies. Results of the review were presented in a narrative fashion.

Results: The search identified 2 clinical trials and 3 cohort studies investigating effect on semaglutide (1 trial and 1 cohort study) and liraglutide (1 trial and 2 cohort studies) on psoriasis. Risk of bias was low in one clinical trial and high in the other which was an open-label study. The cohort studies were of medium quality as there were no comparator groups. Total participants were 151, more than 70% were male and had moderately severe psoriasis. Duration of follow up ranged from 8 weeks to 24 weeks. All studies reported significant decrease in PASI scores with decreases ranging from 1.8 to 11, significant decrease in DLQI scores with decreases ranging from 2.5 to 10 and significant reductions in BMI ranging from 2.3 kg/m2 to 4.4 kg/m2, except one clinical trial which found no significant changes. 

Conclusion: Anti-obesity medications reduce disease severity, decrease levels of inflammation and improve quality of life in obese or overweight psoriasis patients. Further research could explore mechanism of action, drug interactions and long-term effectiveness of these medications in psoriasis.

Background: Type 2 diabetes mellitus (T2DM) is a significant public health concern, with many individuals failing to achieve recommended glycemic targets despite the availability of evidence-based guidelines and pharmacologic therapies. In Canada, between 2007 and 2019, 52.3% of adults with diabetes aged 18-79 met targets for glycemic control (3). Primary care providers face increasing challenges in delivering comprehensive diabetes care within traditional one-on-one visit models (4). Group-based diabetes focused medical visits have been trialed as an alternative model designed to enhance patient education, peer support, resource efficiency, and ultimately glycemic control (5). The impact of this model on outcomes of glycemic control in primary care settings remains inconsistent in the literature (6).

Methods: A literature review was conducted using PubMed and Google Scholar. Studies were eligible if they employed experimental or quasi-experimental designs, were conducted in primary care settings, included adults with T2DM participating in group-based interventions, involved primary care providers, and reported A1C outcomes. Studies lacking a control group or adequate statistical power were excluded. Thirteen studies met inclusion criteria and were synthesized qualitatively in this review.

Results: Of the 13 included studies, eight demonstrated statistically significant improvements in A1C among participants receiving group-based care compared with usual care (1-2–4-8, 13). Four randomized controlled trials produced mixed findings, with some demonstrating short-term A1C improvements that were not sustained over longer follow-up (2, 7, 9,13). Secondary outcomes such as blood pressure and lipid levels were largely unchanged, whereas diabetes knowledge, quality of life, and patient satisfaction consistently improved (1,2,7,8).

Interpretation: Group-based diabetes focused medical visits in primary care settings are associated with modest improvements in glycemic control for selected populations, particularly in those with poor baseline control. While A1C outcomes are variable, consistent improvements in patient-centered and subjective outcomes suggest this model likely offers value beyond glycemic measures alone.

Background: Patient experience surveys are central to evaluating quality in primary care, particularly within interdisciplinary delivery models such as Patient Medical Homes (PMHs). This study aimed to examine the contextual relevance and acceptability of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Patient-Centred Medical Home (PCMH) survey for use in PMHs in Prince Edward Island (PEI) and to identify stakeholder-informed adaptations. 

Methods: A qualitative descriptive study was conducted at a single PMH in PEI. Five structured focus groups were held between September and November 2025, and included physicians, nursing professionals, allied health professionals, administrative staff, and patients affiliated with the PMH. Participants reviewed the CAHPS PCMH survey and provided feedback during 60 to 90-minute discussions guided by a standardized script. Audio recordings were transcribed verbatim and analyzed using deductive thematic analysis aligned with predefined CAHPS PCMH survey domains. 

Results: Fifteen stakeholders participated equally across five focus groups. Participants reported that the survey was generally clear and appropriately structured but identified limitations, including provider-centred language, insufficient representation of interdisciplinary care, ambiguous terminology, and concerns regarding anonymity. Stakeholders emphasized the need for clearer definitions, inclusion of allied health services, and adaptation of demographic items to reflect the PEI context.

Interpretation: Standardized patient experience surveys require contextual adaptation to accurately reflect team-based models of primary care delivery and should be interpreted alongside complementary measures of clinical quality. Incorporating stakeholder-informed modifications may enhance the validity, acceptability, and utility of patient experience measurement for quality improvement and system-level evaluation within PMHs in PEI.