Most medical schools in Canada have, over the last few years, introduced Problem Based Learning (... more 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 ...
The authors present findings of 2nd year nursing students’ (N = 352) perceptions of their clinica... more The authors present findings of 2nd year nursing students’ (N = 352) perceptions of their clinical teachers’ use of empowering teaching behaviours (ETB) and to highlight steps undertaken to establish psychometric properties of the Empowering Teaching Behaviours Questionnaire – Student (ETBQ-S). The authors identify a) the process involved in the adoption of the ETBQ-S, b) ETBQ-S validity procedures completed prior to instrument implementation, c) results of nursing students’ responses to the ETBQ-S, d) criterion validity, and e) ETBQ-S confirmatory factor analysis findings conducted after study completion. The ETBQ-S reliably measures five facets of empowering actions that clinical teachers can employ with nursing students in practice to enhance their confidence, involve them in decision-making and goal setting, make learning meaningful, and help them to become more autonomous nurses
Introduction. Understanding both the patient's disease and illness experience. Understanding ... more Introduction. Understanding both the patient's disease and illness experience. Understanding the whole person. Finding common ground. Incorporating prevention and health promotion. Enhancing the patient-doctor relationship. Being realistic.
ABSTRACT This long awaited 3rd edition fully illuminates the patient-centered model of medicine, ... more ABSTRACT This long awaited 3rd edition fully illuminates the patient-centered model of medicine, continuing to provide the foundation for the Patient-Centered Care series. It redefines the principles underpinning the patient-centered method using four major components – clarifying its evolution and consequent development – to bring the reader fully up-to-date. By examining and evaluating both qualitative and quantitative research, including reviews and recent studies, the book offers an invaluable compendium of relevant education literature and methods. Illustrating patient-centered concepts through case studies, Patient-Centered Medicine provides clear, inspirational messages about the instrumental role of patient-centered clinical care for both students and clinicians in all healthcare environments.
The effects of community-based family nursing and medicine clinical rotations on students&#39... more The effects of community-based family nursing and medicine clinical rotations on students' confidence in their knowledge and ability to counsel clients in selected health promotion areas were examined from the perspective of Bandura's (1986) self-efficacy theory. Nursing students (n=66) enrolled in a community family nursing course and medical students (n=71) enrolled in a 6-week family practice clerkship rotation completed questionnaires at three points: prior to, at completion of, and 3 months following their clinical rotations. Nursing and medical students' self-efficacy levels at pretest were similar. At-posttest, nursing students' self-efficacy was significantly higher than that of the medical students. This difference was sustained at 3 months follow up. Students' conception of health (clinical vs. nonclinical) did not have an effect on posttest self-efficacy levels. Self-efficacy scores accounted for 63% of the variance in the nursing students' self-reported use of health promotion principles in their daily practice; but only 11% of the variance in medical students' daily practice. The results of this exploratory study provide information to guide theory-informed curricular decisions to design clinical learning activities that foster the development of health promotion counseling skills in both nursing and medical students.
Canadian family physician Médecin de famille canadien, 1987
The Mini Mental State Examination (MMSE) was performed on 90% of patients over age 65 in a full-t... more The Mini Mental State Examination (MMSE) was performed on 90% of patients over age 65 in a full-time teaching practice associated with the University of Western Ontario during a six-month study period. Before screening, dementia was documented clinically in 5.6% of the patients over age 65. The "iceberg phenomenon" did not occur: all patients with dementia identified by the MMSE had already been recognized by the physician; no new treatable problems were discovered. This study challenges the value of screening with this instrument, since it failed to identify one of the six patients in this practice with clinical dementia.
Although medical faculty are frequently encouraged to participate in education scholarship, there... more Although medical faculty are frequently encouraged to participate in education scholarship, there is a paucity of literature addressing how to support those who wish to do so. The purpose of this study was to explore faculty involvement in and support needs for pursuing education scholarship. A purposive sample of 108 medical faculty with an interest in medical education were invited to participate in a two-phase, mixed-methods study (survey and focus groups). Seventy-three faculty (67.6%) completed the questionnaire with 16 subsequently participating in focus group sessions. Nearly 40% had enrolled in or completed formal education training. Although the majority had been involved in at least one education project during the past five years, few had received funding or published their work. Three support-related themes emerged: education research support; enhancing colleague interactions; and ongoing development activities. Three related barriers were identified: time, access to support staff, and knowledge of research methodology. No significant differences were identified between those with and without additional education training. Assisting faculty to participate in education scholarship is a complicated endeavor. Institutional supports should not be limited to those with advanced degrees nor rely on Master-level degree programs to provide all the necessary training.
In May 1999, 21 leaders and representatives from major medical education and professional organiz... more In May 1999, 21 leaders and representatives from major medical education and professional organizations attended an invitational conference jointly sponsored by the Bayer Institute for Health Care Communication and the Fetzer Institute. The participants focused on delineating a coherent set of essential elements in physician-patient communication to: (1) facilitate the development, implementation, and evaluation of communication-oriented curricula in medical education and (2) inform the development of specific standards in this domain. Since the group included architects and representatives of five currently used models of doctor-patient communication, participants agreed that the goals might best be achieved through review and synthesis of the models. Presentations about the five models encompassed their research base, overarching views of the medical encounter, and current applications. All attendees participated in discussion of the models and common elements. Written proceedings generated during the conference were posted on an electronic listserv for review and comment by the entire group. A three-person writing committee synthesized suggestions, resolved questions, and posted a succession of drafts on a listserv. The current document was circulated to the entire group for final approval before it was submitted for publication. The group identified seven essential sets of communication tasks: (1) build the doctor-patient relationship; (2) open the discussion; (3) gather information; (4) understand the patient's perspective; (5) share information; (6) reach agreement on problems and plans; and (7) provide closure. These broadly supported elements provide a useful framework for communication-oriented curricula and standards.
This is the peer reviewed version of the following article: Babenko-Mould, Y., Iwasiw, C. L., And... more This is the peer reviewed version of the following article: Babenko-Mould, Y., Iwasiw, C. L., Andrusyszyn, M., Laschinger, H. K. S., & Weston, W. (2012). Nursing students ' perceptions of clinical teachers ' use of empowering teaching behaviours: Instrument psychometrics and application. International Journal of Nursing Education Scholarship, 9(1), 1-15, which has been published in final form at doi: 10.1515/1548-923X.2245.This article may be used for non-commercial purposes in accordance With
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2001
Thirty-five years ago, when I was a medical student, we were taught to be paternalistic. We were ... more Thirty-five years ago, when I was a medical student, we were taught to be paternalistic. We were trained to withhold information from patients, especially painful information about a potentially terminal illness; we were also instructed to take charge of interviews and to avoid getting “
Canadian family physician Médecin de famille canadien, 1988
MEDICAL EDUCATION NEEDS TO MOVE BEYOND THE BIOMEDICAL MODEL TO REDRESS THE BALANCE BETWEEN THE TW... more MEDICAL EDUCATION NEEDS TO MOVE BEYOND THE BIOMEDICAL MODEL TO REDRESS THE BALANCE BETWEEN THE TWO GREAT HISTORICAL TRADITIONS IN MEDICINE: the reductionistic and the whole person approaches. Students need to understand the distinctions between disease as an abstract concept and illness as an experience lived by their patients. They need to approach the study of both the sciences and the humanities with a rigorous, thoughtful, and balanced approach, and learn to integrate these understandings and to apply them to the care of sick persons. Medical education should be more than vocational training: it must be a liberal education. The missing dimension in medical education is the person, both the person of the patient and the person of the student. The experiences of both are the very foundations of learning, growth, and healing.
Canadian family physician Médecin de famille canadien, 1972
It is important for the family physician to be able to utilize family treatment concepts to help ... more It is important for the family physician to be able to utilize family treatment concepts to help him understand the families in his care. He should recognize how family dysfunction contributes to the problems of his individual patients. He should be able to help these families recognize and deal with many of their problems and should be aware of his own limitations and when consultation is indicated.
Most medical schools in Canada have, over the last few years, introduced Problem Based Learning (... more 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 ...
The authors present findings of 2nd year nursing students’ (N = 352) perceptions of their clinica... more The authors present findings of 2nd year nursing students’ (N = 352) perceptions of their clinical teachers’ use of empowering teaching behaviours (ETB) and to highlight steps undertaken to establish psychometric properties of the Empowering Teaching Behaviours Questionnaire – Student (ETBQ-S). The authors identify a) the process involved in the adoption of the ETBQ-S, b) ETBQ-S validity procedures completed prior to instrument implementation, c) results of nursing students’ responses to the ETBQ-S, d) criterion validity, and e) ETBQ-S confirmatory factor analysis findings conducted after study completion. The ETBQ-S reliably measures five facets of empowering actions that clinical teachers can employ with nursing students in practice to enhance their confidence, involve them in decision-making and goal setting, make learning meaningful, and help them to become more autonomous nurses
Introduction. Understanding both the patient's disease and illness experience. Understanding ... more Introduction. Understanding both the patient's disease and illness experience. Understanding the whole person. Finding common ground. Incorporating prevention and health promotion. Enhancing the patient-doctor relationship. Being realistic.
ABSTRACT This long awaited 3rd edition fully illuminates the patient-centered model of medicine, ... more ABSTRACT This long awaited 3rd edition fully illuminates the patient-centered model of medicine, continuing to provide the foundation for the Patient-Centered Care series. It redefines the principles underpinning the patient-centered method using four major components – clarifying its evolution and consequent development – to bring the reader fully up-to-date. By examining and evaluating both qualitative and quantitative research, including reviews and recent studies, the book offers an invaluable compendium of relevant education literature and methods. Illustrating patient-centered concepts through case studies, Patient-Centered Medicine provides clear, inspirational messages about the instrumental role of patient-centered clinical care for both students and clinicians in all healthcare environments.
The effects of community-based family nursing and medicine clinical rotations on students&#39... more The effects of community-based family nursing and medicine clinical rotations on students' confidence in their knowledge and ability to counsel clients in selected health promotion areas were examined from the perspective of Bandura's (1986) self-efficacy theory. Nursing students (n=66) enrolled in a community family nursing course and medical students (n=71) enrolled in a 6-week family practice clerkship rotation completed questionnaires at three points: prior to, at completion of, and 3 months following their clinical rotations. Nursing and medical students' self-efficacy levels at pretest were similar. At-posttest, nursing students' self-efficacy was significantly higher than that of the medical students. This difference was sustained at 3 months follow up. Students' conception of health (clinical vs. nonclinical) did not have an effect on posttest self-efficacy levels. Self-efficacy scores accounted for 63% of the variance in the nursing students' self-reported use of health promotion principles in their daily practice; but only 11% of the variance in medical students' daily practice. The results of this exploratory study provide information to guide theory-informed curricular decisions to design clinical learning activities that foster the development of health promotion counseling skills in both nursing and medical students.
Canadian family physician Médecin de famille canadien, 1987
The Mini Mental State Examination (MMSE) was performed on 90% of patients over age 65 in a full-t... more The Mini Mental State Examination (MMSE) was performed on 90% of patients over age 65 in a full-time teaching practice associated with the University of Western Ontario during a six-month study period. Before screening, dementia was documented clinically in 5.6% of the patients over age 65. The "iceberg phenomenon" did not occur: all patients with dementia identified by the MMSE had already been recognized by the physician; no new treatable problems were discovered. This study challenges the value of screening with this instrument, since it failed to identify one of the six patients in this practice with clinical dementia.
Although medical faculty are frequently encouraged to participate in education scholarship, there... more Although medical faculty are frequently encouraged to participate in education scholarship, there is a paucity of literature addressing how to support those who wish to do so. The purpose of this study was to explore faculty involvement in and support needs for pursuing education scholarship. A purposive sample of 108 medical faculty with an interest in medical education were invited to participate in a two-phase, mixed-methods study (survey and focus groups). Seventy-three faculty (67.6%) completed the questionnaire with 16 subsequently participating in focus group sessions. Nearly 40% had enrolled in or completed formal education training. Although the majority had been involved in at least one education project during the past five years, few had received funding or published their work. Three support-related themes emerged: education research support; enhancing colleague interactions; and ongoing development activities. Three related barriers were identified: time, access to support staff, and knowledge of research methodology. No significant differences were identified between those with and without additional education training. Assisting faculty to participate in education scholarship is a complicated endeavor. Institutional supports should not be limited to those with advanced degrees nor rely on Master-level degree programs to provide all the necessary training.
In May 1999, 21 leaders and representatives from major medical education and professional organiz... more In May 1999, 21 leaders and representatives from major medical education and professional organizations attended an invitational conference jointly sponsored by the Bayer Institute for Health Care Communication and the Fetzer Institute. The participants focused on delineating a coherent set of essential elements in physician-patient communication to: (1) facilitate the development, implementation, and evaluation of communication-oriented curricula in medical education and (2) inform the development of specific standards in this domain. Since the group included architects and representatives of five currently used models of doctor-patient communication, participants agreed that the goals might best be achieved through review and synthesis of the models. Presentations about the five models encompassed their research base, overarching views of the medical encounter, and current applications. All attendees participated in discussion of the models and common elements. Written proceedings generated during the conference were posted on an electronic listserv for review and comment by the entire group. A three-person writing committee synthesized suggestions, resolved questions, and posted a succession of drafts on a listserv. The current document was circulated to the entire group for final approval before it was submitted for publication. The group identified seven essential sets of communication tasks: (1) build the doctor-patient relationship; (2) open the discussion; (3) gather information; (4) understand the patient's perspective; (5) share information; (6) reach agreement on problems and plans; and (7) provide closure. These broadly supported elements provide a useful framework for communication-oriented curricula and standards.
This is the peer reviewed version of the following article: Babenko-Mould, Y., Iwasiw, C. L., And... more This is the peer reviewed version of the following article: Babenko-Mould, Y., Iwasiw, C. L., Andrusyszyn, M., Laschinger, H. K. S., & Weston, W. (2012). Nursing students ' perceptions of clinical teachers ' use of empowering teaching behaviours: Instrument psychometrics and application. International Journal of Nursing Education Scholarship, 9(1), 1-15, which has been published in final form at doi: 10.1515/1548-923X.2245.This article may be used for non-commercial purposes in accordance With
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2001
Thirty-five years ago, when I was a medical student, we were taught to be paternalistic. We were ... more Thirty-five years ago, when I was a medical student, we were taught to be paternalistic. We were trained to withhold information from patients, especially painful information about a potentially terminal illness; we were also instructed to take charge of interviews and to avoid getting “
Canadian family physician Médecin de famille canadien, 1988
MEDICAL EDUCATION NEEDS TO MOVE BEYOND THE BIOMEDICAL MODEL TO REDRESS THE BALANCE BETWEEN THE TW... more MEDICAL EDUCATION NEEDS TO MOVE BEYOND THE BIOMEDICAL MODEL TO REDRESS THE BALANCE BETWEEN THE TWO GREAT HISTORICAL TRADITIONS IN MEDICINE: the reductionistic and the whole person approaches. Students need to understand the distinctions between disease as an abstract concept and illness as an experience lived by their patients. They need to approach the study of both the sciences and the humanities with a rigorous, thoughtful, and balanced approach, and learn to integrate these understandings and to apply them to the care of sick persons. Medical education should be more than vocational training: it must be a liberal education. The missing dimension in medical education is the person, both the person of the patient and the person of the student. The experiences of both are the very foundations of learning, growth, and healing.
Canadian family physician Médecin de famille canadien, 1972
It is important for the family physician to be able to utilize family treatment concepts to help ... more It is important for the family physician to be able to utilize family treatment concepts to help him understand the families in his care. He should recognize how family dysfunction contributes to the problems of his individual patients. He should be able to help these families recognize and deal with many of their problems and should be aware of his own limitations and when consultation is indicated.
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