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Biomedical subjects

A L Lesser

Publications and source records attributed to A L Lesser.

8 recordsLinked to original sources
PubMed1988

Improving the psychiatric skills of the general practice trainee: an evaluation of a group training course.

Fourteen general practice trainees took part in a course specifically designed to improve their psychiatric interviewing skills. The trainees were instructed in the problem-based model and were taught in a group setting with the use of videotape feedback. A significant improvement was demonstrated in the trainees' ability to identify psychiatric illness accurately, and there were significant changes in their interview behaviours after training. Those who were below average before training showed the greatest improvement. The implications of these findings are discussed. Group video feedback training is as effective as one-to-one video feedback training in improving the psychiatric interviewing skills of GP trainees, and could be more widely employed in general practice vocational training.

Clinical Competence↗
PubMed1985

Problem-based interviewing in general practice: a model.

A problem-based approach which can be utilized in general practice for 'diagnosis and treatment' is described. The various related phases and probable components have been defined, starting with problem sensing, problem detection, problem description and then proceeding to problem assessment and problem-oriented intervention and evaluation. This approach is empirical, patient-centered, geared to general practice, easily acquired and may well have utility in other fields of medicine. Investigation of its effectiveness and efficiency as well as its ability to be taught is needed.

Adult↗
PubMed1985

The resident as a teacher: a neglected role.

Residents are frequently requested to take on teaching responsibilities, especially with medical students, but they receive little formal preparation for this role. This paper reviews some of the problems residents may face when teaching and describes a training workshop designed to enhance the teaching skills of residents. The workshop is based around a simulated teaching event that focuses on the organizational and practical, as well as didactic tasks involved in supervision of a clinical clerk. Such a workshop helps the resident to identify and prepare for some of the problems they may encounter and provides them with an opportunity to develop new skills that will improve the quality of their teaching.

Education, Medical, Undergraduate↗
PubMed1983

Hypomania and marital conflict.

The author treated seven bipolar patients over seven years whose presenting problems were chronic marital conflict. The bipolar diagnosis had previously been made in only one case. Conjoint or family assessment was essential for accurate diagnosis. Lithium was the cornerstone of treatment and the best results were obtained with bipolar patients who were lithium compliant and whose marital conflict was resolved in conjoint therapy. Marital conflict clearly preceded the bipolar disorder and was not prototypical. Neither a family systems model nor a psychopharmacological model alone were sufficient for treatment. The diagnosis of bipolar disorder must be considered with chronic marital conflict.

Adult↗
PubMed1982

Psychiatric manpower in Ontario. Part I: A survey and recommendations.

Demand for psychiatric services is rising in part because many former patients are now in the community and the development of community services has not kept pace. Needs perceived by psychiatrists and family physicians are congruent with each other and with the many job opportunities for psychiatrists which now exist. In five years there will be an increase in attrition of psychiatrists by retirement at the same time as the demand for service by the high utilizers--the young middle age group--will increase. The number of psychiatric training positions funded by the Ministry of Health has diminished. The influx of foreign medical graduates on whom one-third of services depend has been severely curtailed. The net result of these trends, if unmodified, will be higher population-to-psychiatrist ratios, decline in quality, decline in effectiveness, and a decline in the availability of services.

Community Mental Health Services↗
PubMed1981

The psychiatrist and family medicine: a different training approach.

A unique 8-year training programme for 110 family medicine residents is described. The psychiatrist works in a family medicine setting with the staff doctors, residents, and patients. The approach evolved because patients wanted a brief problem intervention, and because doctors wanted rapid and efficient methods to identify and treat problems, without using a psychodynamic model. For empirical data collection and clear problem description, a behavioural model is employed. For assessment and therapy, a problem-orientated approach is emphasized, which is rapidly acquired and effectively applied. 'Diagnoses' are not used unless relevant, and paradigms or methods of handling common patient problems are employed. The residents learn in groups and develop skills through supervision of actual patient encounters. There is a phase progression of skill acquisition which is reinforced by the staff doctors. Eighty-seven per cent of the residents achieve the required objectives, and can apply and utilize an approach geared to the needs and realities of everyday practice.

Behavior↗