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Biomedical subjects

M J Bass

Publications and source records attributed to M J Bass.

At least 55 records · Page 3Linked to original sources
PubMed1983

Characteristics of highly rated family practice preceptors.

Student ratings of teaching, though controversial, demonstrate high reliability and acceptable validity. The study on which this article is based attempted to define the aspects of the family medicine preceptor and his practice which are significantly associated with the medical student's assessment of the preceptor's teaching ability. Questionnaires were sent to preceptors at the University of Western Ontario, and their responses were compared with student ratings by means of t-tests, correlation coefficients, and multiple regression. Higher teaching ability ratings were given to preceptors in group practice and nonurban practice and to those delegating more responsibility to students and using medication lists. Multiple-regression analyses using questionnaire data plus teaching ability subscores accounted for 88.1 percent of variance in student assessments of their clinical teachers. Suggestions for selection of preceptors are presented, together with proposals for further research into clinical teaching by family practice preceptors.

Demography↗
PubMed1983

Creativity in management in family medicine.

Family practice presents some complex patient management problems with organic, social, and psychological components. There is a great potential for creative problem solving in such patient management problems, in that many alternative solutions are possible. A cross-sectional study was carried out to test the hypothesis that "more creative people as defined by a standard creativity test would have a better quality of management." Sixteen volunteers from the University of Western Ontario Family Practice Residency Program completed a written management problem and the Barron Welsh Art Scale, which is a measure of a person's preference for complexity. The number of options given in each answer was calculated, and the results showed that more creative residents had a higher quality of management score, a higher number of high-quality options, more options of an interpersonal nature, and a higher proportion of original options. The results suggest that creative people are more able to generate the number and types of options that are needed for quality management. The higher proportion of original options may represent a more comprehensive approach to management, and the creative groups' preference for complexity may enable them to deal more effectively with the problem. These results are not generalizable but indicate a need for further investigation into this area.

Creativity↗
PubMed1983

Determination of worries and expectations of family practice patients.

One of the cornerstones of family practice is the development of the physician-patient relationship within the context of the consultation. Each consultation is modified both by the prior expectations of the participants and by illness-related worries held by the patient. This paper describes the development of an instrument to record the worries and expectations of patients visiting their family physicians and changes occurring as a result of the consultation. The instrument comprises a card sort composed of 26 cards, on each of which is typed a statement relating to a worry or expectation that a patient might hold. One hundred patients were asked to sort these cards before and after the consultation. The major worries of the group were about discomfort, the effects of illness on the family, the prospect of a physical examination, and about explaining the problem to the physician. Prominent expectations were for an explanation of diagnosis and treatment and a friendly and understanding manner from the physician.

Adolescent↗
PubMed1983

How family physicians approach ethical problems.

The defining features of family medicine as described in the literature have important ethical implications. In an attempt to study the day-to-day practice of family physicians regarding these ethical issues, a 28-item questionnaire was sent to 95 part-time and 17 full-time family physician teachers associated with the University of Western Ontario's Department of Family Medicine. Of the 112 questionnaires mailed out, 97 were returned for a response rate of 86.6 percent. There was a significant spread of answers, suggesting there is no uniform opinion in the sample population. The findings suggest that there are important differences between the description of family medicine in the literature and what the family physicians in this study do in their day-to-day practice. The family physicians in this study, while prepared to coerce patients, were not prepared to discharge from their practices patients who were noncompliant. Physician age is an important variable in some ethical decisions, but not in others.

Adult↗
PubMed1981

Multiple choice questions for continuing education in family medicine.

Multiple choice questions used in continuing medical education may require characteristics different from those used in tests and examinations. The questions of three continuing education exercise were assessed by 48 board certified family physicians. Each physician answered one third of the questions and then judged them on usefulness in patient management, as discriminators of quality of medical care, and on educational value. The relevance of each question was determined by a composite index based on these factors. The content of each question was independently analyzed by three physicians. Relevant questions tended to be those concerned with surgery, symptoms, and management, and those requiring more than simple factual recall. Questions on office management or concerning specific diagnoses were considered less relevant. Neither the manner of asking the question nor the severity of the illness appeared to influence relevance. This information should benefit those developing continuing education programs for family physicians, especially those designed for self-administered individual learning.

Education, Medical, Continuing↗
PubMed1980

The relevance to family physicians of core content review: evaluation of a program of continuing education.

The Core Content Review of Family Medicine was assessed for its relevance to family practice. Three sets of questionnaires were completed and assessed by 48 experienced, certificated family physicians, of whom half were faculty members from university departments of family medicine and half were in private practice. The answers to 57% of the questions were correct. In the opinion of the panelists the answers to 62% of the questions permitted discrimination between physicians providing care of good quality and those providing care that was less than adequate. The panelists rated 78% of the questions as being educationally useful. Two thirds of the questions were deemed relevant according to a composite criterion. Examples are given of the questions considered most relevant and of those considered least relevant.

Canada↗
PubMed1980

Improving problem oriented medical records through self-audit.

In a teaching family medical center a strategy was sought to improve the quality of medical record keeping. A study was undertaken to determine the usefulness of a standardized form for self-audit. Validity and reliability of the form were established and it was shown that there was a significant improvement in the study group three weeks after the exposure period, as compared to a control group. Improvements occurred particularly in the recording of drugs prescribed and in the linkage of progress notes to the problem list. Despite this improvement, linkage to the problem list was seen to occur in only half of the studied charts. With modification the self-audit form appears to be a useful stimulus to good record keeping.

Academic Medical Centers↗
PubMed1980

The difficult patient and the troubled physician.

Some patient encounters may produce a variety of unpleasant reactions such as guilt, anger, frustration, or dissatisfaction in the physician. These troubling feelings may arise from various sources and can affect the outcome of medical care. Twelve community physicians who had similar training and practice locations evaluated a total of 722 patient encounters in their offices for the presence of these troubling emotions. Just under 30 percent of these encounters were troubling to the physician, but psychosocial problems and lower social class patients produced a significantly greater frequency of troubling. More experienced physicians had significantly fewer troubling encounters.

Adult↗
PubMed1976

An information system for family practice. Part 3: gathering encounter data.

This paper describes the development of a system for recording encounter data in family practice. The system has been developed by the Department of Family Medicine, University of Western Ontario, and came about as a natural addition to a previously reported method for describing and defining a practice population. The system gathers information on each encounter and includes data concerning the patient, the provider, the location, and certain other details concerning the encounter, including all problems dealt with on that occasion. The storage and analysis of these data are carried out by a computer. The uses of such data are many, and some of them will be dealt with in the fourth and last paper in this series.

Family Practice↗
PubMed1976

An information system for family practice. Part 4: encounter data and their uses.

This paper describes the ways in which encounter data from the family practice teaching units of the Department of Family Medicine, University of Western Ontario, have been used for teaching, service, and research. The fact that family physicians may deal with several problems at one visit is emphasized, as is the need to report morbidity in terms of the population at risk, so that comparisons can be made with other work. The value of encounter data in studies of patient utilization and resident experience is noted. The validity of the data has been examined and the extent of underrecording assessed. The system has helped to encourage the spirit of inquiry in its users.

Family Practice↗
PubMed1976

The arthritic complaint in primary care: prevalence, related disability, and costs.

Surveys conducted in five areas of Southern Ontario obtained clinical and service utilization data from 5,478 adults over 25 years of age. The two week period prevalence rates of arthritic and rheumatic (AR) complaints were 1.72 per cent and 2.14 per cent among two groups of users of primary care. In free-living general populations, the rates ranged from 6.23 per cent to 8.84 per cent. It was shown that only 25 per cent of complainants with AR symptoms sought health services. Of all adults seen by family physicians in one year, 28 per cent presented at least once with an AR complaint. While 20 per cent of all respondents reported some physical impairment, 43 per cent of those with AR complaints had impairment. The excess impairment was two per cent. Complaints with AR symptoms used health services at costs 78 per cent higher than the average expenditures in the same communities. The essential role of the primary care practitioner in the identification and control of AR disorders is strongly supported.

Adult↗
PubMed1976

An information system for family practice. Part 1: Defining the practice population.

Information systems for family practice are vital in its development as an academic discipline, in the teaching and learning process which ultimately improves the quality of care, and in the planning processes which must be used to rationalize the distribution of scarce resources in the health-care field. The provision of sufficient data for these purposes demands a flexible system, generally one based on the computer as a data storing and analyzing tool. Such a system has been developed in the teaching practices of the Department of Family Medicine, University of Western Ontario; the methods employed and the uses for that system are to be described in a series of four papers. This first paper describes the methods developed for gathering demographic information on the practice population.

Demography↗
PubMed1976

An information system for family practice. Part 2: The value of defining a practice population.

The gathering of information on the practice population is essential for practice monitoring, preventive medicine, and research. The minimum necessary information is the age and sex of individuals cared for in the practice. This allows the expression of age-sex specific morbidity rates for the at-risk population. In the Department of Family Medicine, University of Western Ontario, practice census information has been used to determine the suitable size for a teaching practice, the representativeness of our practices in terms of age, sex, residence location, and morbidity, and for the production of at-risk registers based on age and sex.

Adolescent↗
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Cholestyramine Resin↗