The MOT model of clinical reasoning processes has potentially important applications for use within undergraduate and graduate medical curricula to inform teaching, learning and assessment. Specifically, it could be used to support curricular development because it can help to identify opportune moments for learning specific elements of clinical reasoning. It could also be used to precisely identify and remediate reasoning errors in students, residents and practising doctors with persistent difficulties in clinical reasoning.

This research provides a case study of how an empirical research approach can be used to identify and validate priorities for changes in medical education at a national level. This approach may be of interest in other countries.

Me s s a g e s -c l é s • La société réclame des médecins plus humains et qui communiquent mieux avec les patients. Les cliniciens expérimentés et les chercheurs des domaines de l'éducation médicale et de la communication o t i o n ou de certification ; 5) des activités de connaissance de soi permettant de re c o n n a î t re ses pro p res valeurs et émotions intervenant dans la relation médecin-patient ; 6) des cliniciens-enseignants qui soient des modèles de rôle d'une communication p rofessionnelle en santé adéquate. • Les tra vaux du groupe Ca l g a ry -Cambridge proposent un référentiel solide et détaillé sur les habiletés de communication requises au cours de la pratique médicale et représentent une base intéressante pour éla-b o rer des pro g rammes de formation pertinents et efficients. • Les facultés de médecine francophones ont la responsabilité de f o rmer des médecins aptes à communiquer avec leurs patients, entre eux et avec les autres membres de l'équipe de soin. Il est essentiel et urgent qu'elles mettent en place les stratégies pro p res à re l e ver ce défi et à améliorer ainsi le résultat des soins médicaux. Mots clés Key Me s s a g e s • Society calls for more humane physicians better able to communicate with patients. Experienced clinicians and medical education and communication re s e a rchers underline the central and essential role of doctor-patient communication to the success of clinical processes such as diagnosis and treatment. • Re s e a rch conducted during the last decades has allowed the identification of key factors of efficient teaching and learning health communication skills which include: 1) a solid, evidence-based guide, of the communication skills to be mastered by health professionals; 2) frequent rehearsals and re p e t i t i ve p ractice of these skills associated with immediate and specific feedback; 3) a longitudinal and integrated curriculum on doctor-patient communication all along medical training years; 4) communication skills assessment re c o g n i zed as a formal pro

The excretion of dehydroepiandrosterone glucuronide and sulfate was studied in a group of patients with essential hypertension and a group of normal subjects by a new single-label isotopic-dilution procedure. A very marked decrease in excretion of the sulfate was found in the patients with essential hypertension.