Biomedical subjects

W W Weston

Publications and source records attributed to W W Weston.

6 recordsLinked to original sources

PubMed1998

Educating future physicians for Ontario.

In 1987, Ontario's physicians conducted a strike, ultimately not successful, over the issue of "extra billing." The fact that the Ontario public did not support this action reflected a major gap between the profession's view of itself and the public's view of the profession. In 1990, the province's five medical schools launched a collaborative project to determine more specifically what the people of Ontario expect of their physicians, and how the programs that prepare future physicians should be changed in response. The authors report on the first five years of that ongoing project. Consumer groups were asked to state their views concerning the current roles of physicians, future trends that would affect these roles, changes in roles they wished to see, and suggestions for changes in medical education. Methods used included focus groups, key informant interviews, an extensive literature review, and surveys, including a survey of health professionals. Concurrently, inter-university working groups prepared tools and strategies for strengthening faculty development, assessing student performance, and preparing future leadership for Ontario's medical education system. Eight specific physician roles were identified: medical expert, communicator, collaborator, health advocate, learner, manager ("gatekeeper"), scholar, and "physician as person." Educational strategies to help medical students learn to assume these eight roles were then incorporated into the curricula of the five participating medical schools. The authors conclude that the project shows that it is feasible to learn specifically what society expects of its physicians, to integrate this knowledge into the process of medical education reform, and to implement major curriculum changes through a collaborative, multi-institutional consortium within a single geopolitical jurisdiction.

Consumer Behavior↗

PubMed1994

[Problem-based learning--a cautious approach].

Most medical schools in Canada have, over the last few years, introduced Problem Based Learning (PBL) into their undergraduate curricula. In contrast to some other schools which have radically transformed their entire curricula, the University of Western Ontario approach has been more cautious, setting aside 20 per cent of the time during the first two years of the curriculum to PBL, more traditional, didactic methods being used otherwise. The main challenges have been to integrate the underlying values of the two different approaches to teaching and learning to develop valid and reliable examination and evaluation procedures, and to sustain the enthusiasm and interest of a large, mostly voluntary, group of faculty members, continually improving their skills as tutors. The most beneficial results of this curricular change have been an increased interest in medical education reform in general, and an increased recognition of the importance of teaching in relation to appointments and promotions. Students have appreciated the break from a never ending stream of lectures, and many have welcomed the challenged to explore in depth areas of special interest.

Curriculum↗

PubMed1994

Self-assessed competence: before and after residency.

This study measures changes in clinical confidence experienced by 42 family practice residents as they progressed through a 2-year residency program. At the beginning, 20% or more of respondents reported they lacked confidence in 47 of the 177 topics. Self-assessed competence increased substantially in many areas. However, during the residency, new areas of concern emerged.

Clinical Competence↗

PubMed1993

Changes in residents' self-assessed competences during a two-year family practice program.

PURPOSE: To compare changes in self-assessed clinical confidence over a two-year residency between two groups of family practice residents, one starting in a family practice center and the other starting in a hospital. METHOD: All 44 entering residents at the University of Western Ontario in either 1984 or 1985 were eligible. Forty-two participated at baseline, and 24 (57%) provided completed responses after two years. Confidence regarding 177 topics in 19 general topic areas was assessed using self-completed questionnaires administered at baseline and after six, 12, and 24 months. The residents rotated every six months between sites, with approximately half starting in each site. Nonrandom assignment to starting site included consideration of the residents' stated preferences; hence self-selection bias was possible. Mean differences were evaluated using t-tests, and trends over time were assessed using repeated-measures analysis of variance. RESULTS: There was no difference between the groups' grand means at any time. In the 19 areas, five statistically significant differences were seen, four at six months and one at 12 months; four involved greater confidence by the center-start group. No difference was seen after two years, and both groups displayed substantial increases in confidence over two years. CONCLUSIONS: The few significant differences in confidence between the two groups suggest that their training might have been deficient if it had omitted one of the settings. However, because these differences had disappeared after the groups had each experienced 12 months in each setting, the initial site of training appears not to affect learning.

Adult↗

PubMedDate not supplied

A survey of residency-trained family physicians and their referral of psychosocial problems.

BACKGROUND: Communication between family physicians and other specialists has been identified as a central component of the referral process. This survey examines the referral process between family physicians and psychiatrists. METHODS: A questionnaire was mailed to all 167 graduates of a family practice residency program in Ontario; 154 (92.2%) responded. The questionnaire requested information from the family physicians about the frequency of, reason for, and satisfaction with referrals they made to psychiatrists. RESULTS: In the previous year, 41 percent of family physicians had regularly referred patients to a psychiatrist. The main reasons for referral were for assessment and advice on patient management and/or for ongoing psychiatric care. Family physicians referred to one of several psychiatrists, depending on the patient's problem. The primary method of interphysician communication was a personal conversation between the family physician and the psychiatrist. Only 50% of family physicians were satisfied with the assistance provided by psychiatrists to whom they referred patients, and only 40% were satisfied with feedback they received from these consultants. CONCLUSIONS: The high degree of dissatisfaction suggests that improvement is needed in the interactions between family physicians and psychiatrists.

Canada↗

PubMedDate not supplied

Introducing problem-based learning into a traditional undergraduate medical curriculum.

Problem-based learning (PBL) has been introduced into the undergraduate curricula in most Canadian medical schools. In the University of Western Ontario model, we set aside 20% of time to PBL in the first two years of the programme and the rest for didactic methods. The objective of this article is to discuss 6 years of our experience with the model and the process and problems of introducing PBL into a traditional curriculum. The importance, and methods for developing good cases which are multidisciplinary and 'three-dimensional' (biological, behavioural/ psychosocial and population issues) are emphasized. The challenges have been to: integrate the underlying teaching/learning values of two different methods, develop a valid and reliable examination/evaluation procedure, and keep the faculty interested and continually improving their skills. Students have welcomed the break from lectures and the challenge to explore in-depth areas of special interest. The most positive outcomes of this curricular change have been an increased interest in medical education reform in general, and enhanced recognition of teaching in relation to appointments and promotions.

Education, Medical, Undergraduate↗