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Biomedical subjects

V R Neufeld

Publications and source records attributed to V R Neufeld.

17 recordsLinked to original sources

The McMaster M.D. program: a case study of renewal in medical education.

This paper presents four aspects of health professions education at McMaster University: (1) a review of the key elements of the history and distinctive approach of the Doctor of Medicine (M.D.) program; (2) a description of the process and substance of curriculum change over the past decade, focusing on a major revision of the M.D. program that began in 1983; (3) a summary of the findings of follow-up studies of McMaster M.D. program graduates; and (4) an analysis of the current context within which the Faculty of Health Sciences (of which the M.D. program is a part) is operating and a description of strategies for renewal that are being implemented. The evidence and experience to date support the assertion that satisfactory--and in some ways special--physicians can be prepared using the "McMaster approach" to medical education, but that continuous review and periodic major revisions of the educational program are both necessary and possible; they must occur in concert with developments in other sectors of Faculty of Health Sciences activities.

Attitude of Health Personnel

Setting educational priorities for learning the concepts of population health.

Following the World Health Organization's policy of 'Health for All by the Year 2000', doctors are increasingly being seen as health care providers to populations of patients, in addition to their more traditional role as doctors to individuals in a one-to-one encounter. In order for doctors to take on this expanded role, they must learn the knowledge and skills appropriate to population health. In this paper, we propose a method of educational priority-setting which allows educational planners to identify those diseases and adverse health conditions most appropriate for studying the concepts of population health. Using the Measurement Iterative Loop of Tugwell and colleagues as a framework, a table of Priority Illness Conditions was developed and compared with a previous priority list developed from a survey of clinical teachers at the McMaster University Medical School. Discussion of the implications for this approach in setting educational priorities at undergraduate, postgraduate and continuing medical education levels is presented, along with a review of possible shortcomings and caveats in using this approach.

Community Medicine

Ranking clinical problems and ocular diseases in ophthalmology: an innovative approach to curriculum design.

The MD program of the Faculty of Health Sciences, McMaster University, Hamilton, Ont., has used a problem-based, self-directed, small-group learning approach to medical education since 1969. Substantial curriculum revision was begun in 1983 as part of a process of institutional renewal. A faculty survey of all academic clinicians in the Division of Ophthalmology, Department of Surgery, was carried out in 1984 to determine which problems and diseases the teaching faculty thought had the highest priority for student learning. The results have been used by educational planners in revising the curriculum. They have also served to clarify faculty members' expectations of students within an ophthalmology rotation.

Curriculum

A controlled trial of teaching critical appraisal of the clinical literature to medical students.

We carried out a controlled trial of teaching the critical appraisal of clinical literature among final-year clinical clerks. Tutors at two of four teaching hospitals were offered a short course in the critical appraisal of clinical articles that describe diagnostic tests and treatments and were assisted in identifying and appraising specialty-specific articles that described those diagnostic tests and treatments that clinical clerks were sure to encounter during their clerkship tutorials. Tutors and clerks at the other two hospitals received no special intervention and served as controls. Experimental and control clinical clerks completed pretests and posttests of their ability to take and defend a stand on whether to apply specific diagnostic tests and treatments in specific clinical situations. Experimental clerks demonstrated both statistically and "clinically" significant increases in their critical appraisal skills, improving 37% on the diagnostic test exercise and 8% on the treatment exercise; control students' scores deteriorated for both.

Clinical Clerkship

Measuring physicians' performances by using simulated patients.

The authors in this paper discuss a new approach to the assessment of physicians' performances in practice using undetected standardized (simulated) patients. Case-specific performance criteria were established for seven standardized patients by eight family physicians and two specialists. The patients were then introduced into the practices of the family physicians and of a second cohort of seven family physicians. No differences were found between the criteria-setting and the noncriteria-setting physicians; but large differences were found among the criteria, the physicians' performances as indicated by the patient, and the data recorded by the physicians on the patient chart. Depending on the method used to score the performance and the recorded data, about 30 to 45 percent of the procedures were not performed, and 50 to 70 percent of the criteria were not recorded. The implications of the study for assessment of physician performance are discussed.

Clinical Competence