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Biomedical subjects

J Lockyer

Publications and source records attributed to J Lockyer.

At least 19 recordsLinked to original sources
PubMed2000

Medical education in substance-related disorders: components and outcome.

AIMS: To analyze the process of acquisition by physicians of a body of knowledge and skills in the management of substance abuse. DESIGN: A comprehensive search of English-speaking literature was conducted over 20 years. Articles assessing the outcome of educational strategies in undergraduate, graduate and continuing medical education were examined to determine the targeted sample, the educational strategies involved and the outcomes assessed. FINDINGS: Nine studies in undergraduate education, 11 in graduate and 11 in continuing education met the inclusion criteria. They were generally difficult to compare in design, strategy and outcome analysis. Cognitive knowledge and behavioral skills appear to be easier to obtain compared to more complex attitudinal shifts. CONCLUSIONS: There is growing consensus in the selection of a combined didactic and interactive educational strategy but few empirical data as to the more cost-effective learning interventions. Training must be reinforced at regular intervals. While the expanding panoply of interventions available to physicians should enhance the perceptions of role legitimacy and treatment optimism, cohort studies across levels of education, specialty groups and across-substance and other addictive behaviors are required to determine cost-effective educational strategies.

Education, Medical↗
PubMed1999

Assessment of physician performance in Alberta: the physician achievement review.

The College of Physicians and Surgeons of Alberta, in collaboration with the Universities of Calgary and Alberta, has developed a program to routinely assess the performance of physicians, intended primarily for quality improvement in medical practice. The Physician Achievement Review (PAR) provides a multidimensional view of performance through structured feedback to physicians. The program will also provide a new mechanism for identifying physicians for whom more detailed assessment of practice performance or medical competence may be needed. Questionnaires were created to assess an array of performance attributes, and then appropriate assessors were designated--the physician himself or herself (self-evaluation), patients, medical peers, consultants and referring physicians, and non-physician coworkers. A pilot study with 308 physician volunteers was used to evaluate the psychometric and statistical properties of the questionnaires and to develop operating policies. The pilot surveys showed good statistical validity and technical reliability of the PAR questionnaires. For only 28 (9.1%) of the physicians were the PAR results more than one standard deviation from the peer group means for 3 or more of the 5 major domains of assessment (self, patients, peers, consultants and coworkers). In post-survey feedback, two-thirds of the physicians indicated that they were considering or had implemented changes to their medical practice on the basis of their PAR data. The estimated operating cost of the PAR program is approximately $200 per physician. In February 1999, on the basis of the operating experience and the results of the pilot survey, the College of Physicians and Surgeons of Alberta implemented this innovative program, in which all Alberta physicians will be required to participate every 5 years.

Alberta↗
PubMed1996

Improving the management of patients with schizophrenia in primary care: assessing learning needs as a first step.

OBJECTIVE: To assess family physician learning needs related to the care of patients with schizophrenia. METHODS: Questionnaires were mailed to all family physicians and general practitioners practising in southern Alberta. Physicians were asked to indicate the number of patients with schizophrenia cared for, their interest in improving the care the provided, their preferred learning methods, and the content they wished to learn. RESULTS: A total of 539 surveys were returned for a return rate of 43.8%. Over half of the physicians (53.5%) indicated that they saw 1 to 2 patients with schizophrenia each month. Almost half (48.5%) indicated they were somewhat or very interested in increasing the care provided. Primary learning needs included increasing their knowledge of psychopharmacologic agents and monitoring and adjusting medications. Lectures and half-day workshops were the preferred learning methods. CONCLUSION: Our study was helpful in identifying the types of education that physicians wanted as well as the duration of the programming prior to the development of teaching interventions.

Alberta↗
PubMed1993

Multicultural issues in medical curriculum: implications for Canadian physicians.

This descriptive study explored multicultural issues in medical education which should be included in the curricula of both the undergraduate and residency programs of the Faculty of Medicine, The University of Calgary. Face-to-face interviews were conducted with 21 male and female ethnic patients to determine their expectations of and experiences with the health care they had received in Canada. Telephone interviews were conducted with ten primary care physicians to determine their experiences of providing care to new immigrants from cultures other than their own. Content analyses and comparison of the two sets of interview data revealed barriers to satisfaction, diagnosis and treatment. Some barriers were perceived both by the physicians and the ethnic patients, e.g. language, and attitudes towards medical technology and treatment. Others were perceived just by the physicians, e.g. patients' belief in traditional practices. Still others were perceived just by the ethnic patient, e.g. perceived racial discrimination. Based on the data from the interviews, two simulated patients were developed and presented to the students of medicine, both undergraduate and resident, to teach them about multicultural health care. This study demonstrates how local data about multicultural health issues can be used to develop simulated patients for inclusion in the medical curriculum.

Adult↗
PubMed1988

Raising questions in clinical practice.

Answers are required by family physicians to numerous questions during a day of patient care. This study examined the number of questions that arose during one day to which family physicians did not have an answer, the library resources to which the family physicians had access and used, and the relationship between the number of questions that arose in practice and library resources or use. Volunteer family physicians (N = 87) reported a mean of 6.8 questions. When accessing libraries, physicians relied primarily on their office and home libraries. Personal libraries had fewer than ten textbooks published since 1980 and subscriptions to fewer than five journals. T-test analysis indicated that the physician with the most questions practiced in the medical school community, was a graduate of a Canadian or United States medical school, and attended a course on problem raising and solving. The number of questions did not differ by the holdings in the physician's library, the age or sex profile of the patients, the number of patients seen or the frequency with which the physician used his personal library. Medical educators and librarians should provide educational opportunities to assist family physicians develop their personal libraries, their problem solving skills and their use of modern technology to access the literature.

Alberta↗
PubMed1987

Structure and expression of human dihydropteridine reductase.

Dihydropteridine reductase (DHPR; EC 1.6.99.7) catalyzes the NADH-mediated reduction of quinonoid dihydrobiopterin and is an essential component of the pterin-dependent aromatic amino acid hydroxylating systems. A cDNA for human DHPR was isolated from a human liver cDNA library in the vector lambda gt11 using a monospecific antibody against sheep DHPR. The nucleic acid sequence and amino acid sequence of human DHPR were determined from a full-length clone. A 112 amino acid sequence of sheep DHPR was obtained by sequencing purified sheep DHPR. This sequence is highly homologous to the predicted amino acid sequence of the human protein. Gene transfer of the recombinant human DHPR into COS cells leads to expression of DHPR enzymatic activity. These results indicate that the cDNA clone identified by antibody screening is an authentic and full-length cDNA for human DHPR.

Amino Acid Sequence↗