CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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To examine the attitudes toward, the experience with and the knowledge of advance directives of family physicians in Ontario. ⋯ Family physicians favour advance directives but use them infrequently. Most physicians support offering them to terminally or chronically ill patients but not to all patients at the time of admission to hospital. Although governments emphasize legislation, most physicians believe that public and professional education programs would be at least as likely as legislation to encourage them to offer advance directives to their patients.
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Since 1988 in Quebec the completion of a residency training program in family medicine or a specialty and of a comprehensive examination has been necessary to obtain a licence. An objective, structured clinical examination (OSCE) was designed by the Corporation professionnelle des médecins du Québec and Quebec's four medical schools to evaluate the clinical competence of newly trained family physicians. The certification examination of the College of Family Physicians of Canada was added to the OSCE. ⋯ The overall success rate for the licensing examination was 92%. The integration of such a large-scale OSCE into a licensing examination and the results obtained show that assessment of clinical competence for licensing purposes is feasible. The Quebec experience may help other organizations that are developing OSCEs for summative purposes.