D Deslauriers | PubMed Health

PubMed1998

An interactive workshop: An effective means of integrating the Canadian Cardiovascular Society clinical practice guidelines on congestive heart failure into Canadian family physicians' practice.

OBJECTIVE: To use an interactive workship as a means of integrating clinical practice guidelines on congestive heart failure into Canadian family physicians' practice. SETTING: Interested practitioners from the Association des Médecins Omnipraticiens de Québec, the Centre de Santé Publique de Québec and the continuing medical education (CME) department, Merck Frosst Canada, Montreal, formed the initial task force. Train-the-trainer sessions took place in many provinces in a variety of CME settings. DESIGN: The interactive, problem-based workshop was facilitated by local interested general practitioners, while local experts served as consultants to reinforce key messages from clinical practice guidelines and to guide participants through the learning process. MAIN RESULTS: By December 31, 1996, 187 family practitioners and 81 specialists had been trained in train-the-trainer sessions across the country. A total of 1698 general practitioners had participated in over 52 workshops during the same time. Pre- and postworkshop testing indicate that the workshops improved knowledge, and that the knowledge gained during the workshop was retained at three- and six-months' follow-up. Separate chart evaluations conducted before and after the workshop showed that participants provided more complete chart information related to congestive heart failure and that they significantly increased their use of angiotensin-converting enzyme inhibitor therapy after the workshop. Participant evaluation of the workshop also indicates a high index of satisfaction with the presentation and the content of the workshop as being relevant to clinical practice. CONCLUSION: An interactive, problem-based, small group workshop developed by a core group of interested practitioners and guided by local trained facilitators and experts is an effective teaching tool through which clinical practice guidelines can be successfully transferred into clinical practice in a timely and meaningful way.

Angiotensin-Converting Enzyme Inhibitors↗

PubMed1989

How are dreams made? Towards a computational model.

In order to account for how dreams are made, both information structures and energy systems must be made more explicit. This paper attempts to spell out in more detail two of the three components that Foulkes postulated as essential to dream construction, namely, memory and planning. It draws on the mechanisms in Mueller's computational model of human daydreaming, in particular, a planner--which consists of personal goals, daydreaming goals, and planning and inference rules for a particular domain--and a set of emotions that determine the choice of daydreaming goals. We analyzed the laboratory REM dream of an adult male subject in terms of the three kinds of goals in Mueller's model: namely, the personal goals that derive form the day residue elicited from the subject prior to the dream; the dream goals of reversal, rehearsal, rationalization, and revenge; and the planning goals or script identified in a metaphoric problem space. The sequence of scenes from the script determines the skeletal structure of the dream, and the emotion of humiliation, decomposed into embarrassment and anger, largely determines the choice of dream goals. Much of the dream content itself is the instantiation of an inference rule for restoring social esteem. Finally, it is argued that the kind and quantity of mechanisms that are postulated by Mueller for human daydreaming are also necessary to account for basic processes of night dream construction.

Computer Simulation↗