Vic Neufeld

• McMaster University

Global health research partnerships have many benefits, including the development of research capacity and improving the production and use of evidence to improve global health equity. These partnerships also include many challenges, with power and resource differences often leading to inequitable and unethical partnership dynamics. Responding to t...

Global health innovators must navigate substantial complexities to successfully develop, implement and sustain global health innovations with impact through application of an Integrated InnovationTM approach. We sought to examine the nature of the literature and evidence around mentoring, training and support of global health innovators. We conduct...

The aim was to describe how selected health research funding agencies active in low- and middle-income countries promote the translation of their funded research into policy and practice. We conducted inductive analysis of semi-structured interviews with key informants from a purposive sample of 23 national and international funding agencies that f...

Collaborative action is required to address persistent and systematic health inequities which exist for most diseases in most countries of the world. The Academic NGO initiative (ACANGO) described in this paper was set up as a focused network giving priority to twinned partnerships between Academic research centres and community-based NGOs. ACANGO...

The Commission on Health Research for Development concluded that "for the most vulnerable people, the benefits of research offer a potential for change that has gone largely untapped." This project was designed to assess low and middle income country capacity and commitment for equity-oriented research. A multi-disciplinary team with coordinators f...

From a global perspective, large disparities persist between the focus of health research investments and the global burden of illness. Over the past four years, Canadian efforts to address these disparities have steadily increased. The objectives of this paper are to present these recent achievements and to highlight continuing challenges. We summ...

Research resources for addressing health problems of developing countries remain disproportionately low compared with the tremendous disease burdens borne by these countries. There is a need to focus these scarce resources on research that will optimize health benefits and lead to equity. This paper reviews processes and methods that have been used...

In 1990, a collaborative project was launched to determine what the people of Ontario expect of their physicians and how the programs that prepare future physicians should be changed in response. The project, called Educating Future Physicians for Ontario (EFPO), brought together the five Ontario medical schools, the Council of Ontario Faculties of...

In 1987, Ontario's physicians conducted a strike, ultimately not successful, over the issue of "extra billing." The fact that the Ontario public did not support this action reflected a major gap between the profession's view of itself and the public's view of the profession. In 1990, the province's five medical schools launched a collaborative proj...

It is therefore somewhat surprising — and disturbing — to read the results of Beaudoin and colleagues' study. Senior clerks and second-year residents in 3 of Quebec's medical schools were questioned about the degree to which they per- ceived their teachers as demonstrating humanistic qualities, in both the doctor- patient relationship and the teach...

The process of networking has great potential for facilitating and accelerating global health development. This article presents some of the experiences of the Network of Community-Oriented Educational Institutions for Health Sciences. Three components are identified, each of which is illustrated by a specific Network activity: (1) tasks and projec...

Initiated by Associated Medical Services (AMS), Educating Future Physicians for Ontario is a 5-year collaborative project whose overall goal is to make medical education in Ontario more responsive to that province's evolving health needs. It is supported by AMS, the five universities with medical schools or academic health sciences centres and the...

For many years, Canadian academic health science centres have been active in international health. This brief review describes the activities of the Canadian Society for International Health, the Canadian University Consortium for Health in Development, and McGill, McMaster and Ottawa universities. Three principles are derived from these examples....

The article reviews the literature on the effects of direct versus indirect hypnotic suggestions. A conceptual and methodological analysis of direct versus indirect suggestions is also provided. Three conclusions follow from the review: (a) Contrary to views of Ericksonian hypnotists, suggestion style has little effect on objective responding to hy...

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 knowle...

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 be...

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...

This study examined the effects of direct (Harvard Group Scale of Hypnotic Susceptibility: [{hgshs}:{a}]; Shor & Orne, 1962) versus indirect (Alman-Wexler Indirect Hypnotic Susceptibility Scale [{awihss}]; Pratt, Wood, & Alman, 1984) suggestions on arcahaic involvement (Nash & Spinler, in press) with the hypnotists, objective responding, and subjec...

This study examined the effects of direct (Harvard Group Scale of Hypnotic Susceptibility: [HGSHS: A]; Shor & Orne, 1962) versus indirect (Alman-Wexler Indirect Hypnotic Susceptibility Scale [AWIHSS]; Pratt, Wood, & Alman, 1984) suggestions on arcahaic involvement (Nash & Spinler, in press) with the hypnotist, objective responding, and subjective i...

This study was designed to assess the efficacy of a manual-based, single-session group self-hypnosis intervention. At 3 months follow-up, 25.92% of the total number of participants (14 male, 13 females) reported continuous abstinence, and at 6 months, 18.52% of the participants reported continuous abstinence. Reported social support and motivation...

Health science educators have a commitment to the health of our society, and doing what they can to ease the burden of suffering - in particular, that due to malignancy. This article is intended as a contribution to this objective, with some ideas for improving the education of health professionals, most specifically physicians. The proposals in th...

A Continuing Medical Education short course was designed to examine the effect of presenting topics in three learning formats - traditional lectures, large-group, case discussions or small-group, problem-solving sessions, on knowledge and performance of family physicians. The physicians in the small group session rated the CME short course higher a...

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-spec...

This study examined the effects of direct wording (authoritative language, specific responses) versus indirect wording (permissive language, choice of responses) of hypnotic inductions and suggestions on measures of behavioral and subjective responding. Subjects experienced suggestion-related involuntariness and suggested effects to a greater degre...

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...

The article describes the development of methods to use live simulated patients for assessment of quality of care of primary physicians. Methods used to train patients and achieve undetected entry into physicians' practices are described. The study demonstrated that patients can be entered into practices with a low rate of detection (13%) and that...

Monumental challenges confront medical educators as they design curricula which will produce physicians for the last part of this century. These challenges include new knowledge about the factors which determine health and illness, a worldwide maldistribution of health services with physician over‐supply in many countries, and student discontent wi...

We randomly allocated family physicians meeting explicit entry criteria to experimental and control groups to determine whether CME affects the quality of patient care. The experimental group received educational packages, the control group did not. These educational packages were closely matched with explicit criteria used in the indicator conditi...

To determine whether continuing medical education affects the quality of clinical care, we randomly allocated 16 Ontario family physicians to receive or not receive continuing-education packages covering clinical problems commonly confronted in general practice. Over 4500 episodes of care, provided before and after study physicians received continu...

Most formal studies of the clinical reasoning process have been carried out on physicians in the sub-specialties and do not permit generalizations about the nature of the process in the average practising physician. Eighteen family physicians and 19 general internists were randomly selected and assigned to 1 of 4 standardized simulated patient prob...

The evolution of clinical reasoning in medical students was studied. A cross-sectional sample consisted of randomly-selected medical students from three classes. Additionally, twenty-two students were observed at yearly intervals from the preclerkship period to the first post-graduate year. Subjects were observed in a clinical examination of a simu...

In order to evaluate the librarian's educational role in patient care settings, an information service was provided for health professionals, patients, and families by two part-time clinical librarians. Eight clinical areas were randomly selected from a pool of settings which met predetermined entry criteria. Four of these settings were randomly al...

The case history and pathological findings in an excisional biopsy are described of a sixth example of giant-cell arteritis affecting the female internal genitalia. Histologically, giant-cell arteritis in this location tends to focus on the outer layers of the blood vessel, and it is thought that this is due to the "senile" elastosis of the adventi...

The paper describes a new evaluation method, the 'Triple Jump', intended to assess knowledge, problem-solving ability, and self-directed learning. The Triple Jump is a structured three-part oral examination. In the first part, the student elicits clinical information about the patient by requests from the tutor/evaluator. At the conclusion of the f...

Objective evidence exists for a model of clinical problem solving by family physicians. Previous studies have examined the activities of family physicians, but there have been no data indicating the mental process behind these activities. This study, exploring the thought processes of family physicians engaged in clinical problem solving, has lead...

The authors describe a new technique for measuring the outcomes of a clinical encounter using objective criteria derived from the performance of a criterion group.

A method for conducting residency program reviews is presented, based on experience with four reviews at McMaster University. The key elements are the stance of the review group as fact finders rather than judges, direct communication with the program director at the beginning and end of the review, and the relatively unbiased perspective which ind...

The M.D. program at McMaster University is in its 5th year. An important factor in the growth and development of this program has been a commitment to a central set of ideas, known as the 'McMaster Philosophy'. Component features include self directed learning, problem based learning, and small group tutorial learning. Additionally, there is an emp...

The worldwide investment in health research is currently about US$100 billion. Of this amount, less than 10% is targeted on the problems of societies that bear 90% of the global burden of illness. This article addresses this unac- ceptable situation in three ways: • by describing the global problem in more detail, including what is currently being...

This paper is one in a series of speculative working papers examining past, current and future African health system directions – from the theoretical to the practical, from blue skies to the ground perspective. Seven different authors responded to our question of, "What might an affordable and sustainable 21 st century sub-Saharan African health s...

Capacity building is often equated with supply-side strategies, principally training. Part of the reason for this is the assumption that incentives typically associated with scientific activity – increasing returns to scale, high rates of return on investment and application-driven production processes -will do the rest. The experience of the past...