Donald H. Cowan

A strategy to improve communication between health care professionals and people living with cancer: II. Follow-up of a workshop on the teaching and assessment of communication skills in Canadian Medical Schools.

Abstract Background and methods. Follow‐up questionnaires were sent to all Canadian medical schools in 1994 and 1996 in order to evaluate changes that had taken place in the teaching of physician—patient communication skills since recommendations were made by a national “Workshop on the Teaching and Assessment of Communication Skills in Canadian Medical Schools” in 1992. Results and conclusions. Fifteen of 16 schools responded. All 15 reported major changes in the teaching of physician—patient communication over the preceding four years or planned changes in the very near future. However, barriers to improving the communications curriculum still existed. The most frequently cited barrier was the lack of trained faculty to teach communication skills; this was followed in frequency by poor coordination over the four years of medical school with lack of scheduled time in the clerkship years. There were identified needs to train faculty to teach communication skills and to extend formal teaching of the subjec...

Commitment of a cancer organization to a program for training in communication skills

An Ontario cancer agency started an initiative to improve and promote effective communications between health care providers and their patients, using a 4.5-hour workshop developed by the Bayer Institute for Health Care Communications. Each of the eight regional cancer centers in Ontario sent two people, one physician and one other health care professional, for training in delivery of the workshop. Subsequently, each center provided workshops for physicians, nurses, pharmacists, physicists, social workers, psychologists, radiotherapists, and secretarial staff. The ongoing workshops are multiprofessional in composition and interactive and participatory in design. Between September 1996 and September 1997, the workshops involved over 400 cancer care professionals. Their success has been attributed to the knowledge, skills, and enthusiasm of the trained pair of facilitators; the interactive and participatory nature of the workshop design; the multiprofessional participation; and the support of the board of directors and senior management and the administration of each cancer center.

Herpes Zoster During Gold Therapy

Excerpt To the editor: Studies describing the various cutaneous reactions associated with gold therapy for rheumatoid arthritis have not included herpes zoster (1). Known precipitants of zoster inc...

Vera Peters and the conservative management of early-stage breast cancer.

During the first three quarters of the twentieth century, radical mastectomy was an accepted and common procedure in the management of patients with early stage cancer of the breast. After a lifetime of thinking about and working with patients with early-stage breast cancer, Vera Peters presented and published, in the mid-1970s, a retrospective historical case-control study that demonstrated the lack of a survival benefit for radical or modified radical mastectomy as compared with more conservative surgery with lumpectomy. In the years that followed, prospective randomized studies confirmed her findings.

O. Harold Warwick: Canada's first medical oncologist.

O. Harold Warwick graduated in medicine from McGill University as a gold medalist and Rhodes Scholar in 1940. After World War II, he started postgraduate training in Montreal, and in 1946, he began studying the newly described drug treatment of cancer in London, England. There he carried out the first study of nitrogen mustard in a group of adult patients with a non-hematologic solid tumour, lung cancer. After a brief period of practice in Montreal, he moved in 1948 to Toronto, where he became executive director of the Canadian Cancer Society and the National Cancer Institute of Canada. Simultaneously, he joined the staff of Toronto General Hospital and its Radiotherapy Institute, where he became the first physician-oncologist to provide medical care and administer anticancer drugs in a Canadian cancer centre. In 1958, the new Princess Margaret Hospital opened in Toronto; Warwick became its first chief physician, responsible for clinical drug trials. Here he carried out his best known clinical study-the use of vinblastine sulphate in patients with Hodgkin lymphoma. From 1961 to 1971, he served as dean and then vice-president Health Sciences at the University of Western Ontario. He returned to the practice of medical oncology from 1972 to 1980 at the London Cancer Clinic, after which he had a long and productive retirement. He died in October 2009. Although the specialty was not named until the latter years of his career, Harold Warwick satisfied all the criteria for and was undoubtedly Canadas first medical oncologist.