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Kendel F, Speiser D, Fechner K, Olbrich C, Stegen S, Rörig A, Feufel MA, Haering S. Talking about Familial Breast and Ovarian Cancer Risk-Evaluation of a Psychosocial Training Module for Gynecologists in Germany. Cancers (Basel) 2024; 16:310. [PMID: 38254800 PMCID: PMC10813984 DOI: 10.3390/cancers16020310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/02/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Primary care gynecologists are increasingly integrated into the care of patients with hereditary breast and ovarian cancer (HBOC) risks. These physicians should not only have basic genetic knowledge; they should also feel able to sensitively address an increased HBOC risk and deal with emotional, stressful situations in this context. Our project aimed at developing a training module, 'iKNOWgynetics', addressing psychosocial challenges in the context of HBOC care for primary care gynecologists. We developed the psychosocial training module in three phases: first, we conducted an online survey with n = 35 women with a family history of breast or ovarian cancer to assess patients' experiences and needs. Second, based on the results of the needs assessment, we developed the training module. Third, we evaluated the training by assessing physicians' (n = 109) self-efficacy with regard to communication skills in the context of HBOC before and after the training. In the needs assessment, seven psychosocial themes emerged. These themes, complementing a review of the literature, informed the training curriculum. The training was divided into two parts: (1) communicating with women before genetic testing and (2) care co-management for women with HBOC after genetic testing. After the training, participants reported a significant increase in self-efficacy in three domains: communicating empathetically, educating patients in a comprehensible way and dealing with emotionally challenging situations. Our results highlight the relevance of psychosocial issues for patients with HBOC. A genetic literacy training module that integrates aspects of psychosocial care increases physicians' confidence in dealing with emotionally challenging situations before and after their patients' genetic testing. Thus, such trainings may improve the care of women with hereditary cancer risks.
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Affiliation(s)
- Friederike Kendel
- Gender in Medicine, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt—Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany;
| | - Dorothee Speiser
- Hereditary Breast and Ovarian Cancer Center, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt—Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (D.S.); (K.F.); (C.O.); (S.S.)
| | - Karen Fechner
- Hereditary Breast and Ovarian Cancer Center, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt—Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (D.S.); (K.F.); (C.O.); (S.S.)
| | - Christine Olbrich
- Hereditary Breast and Ovarian Cancer Center, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt—Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (D.S.); (K.F.); (C.O.); (S.S.)
| | - Stephanie Stegen
- Hereditary Breast and Ovarian Cancer Center, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt—Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (D.S.); (K.F.); (C.O.); (S.S.)
- BRCA-Netzwerk e.V., Thomas-Mann-Str. 40, 53111 Bonn, Germany
| | - Alina Rörig
- Division of Ergonomics, Department of Psychology and Ergonomics (IPA), Technische Universität Berlin, Marchstr. 23, 10587 Berlin, Germany; (A.R.); (M.A.F.)
| | - Markus A. Feufel
- Division of Ergonomics, Department of Psychology and Ergonomics (IPA), Technische Universität Berlin, Marchstr. 23, 10587 Berlin, Germany; (A.R.); (M.A.F.)
| | - Stephanie Haering
- Gender in Medicine, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt—Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany;
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Knof H, Berndt M, Shiozawa T. The influence of collaborative learning and self-organisation on medical students' academic performance in anatomy. Ann Anat 2024; 251:152182. [PMID: 37879501 DOI: 10.1016/j.aanat.2023.152182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 10/13/2023] [Accepted: 10/19/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND In 2021, university teaching at the Faculty of Medicine Tuebingen was transferred to a digital setting. Due to the discontinuation of face-to-face teaching, students lacked the temporal and spatial framework of the curriculum and the possibility to socialise with fellow students was extremely limited. Increased demands were placed on the students' self-organisation, and the possibility of collaborative learning was drastically limited. The present study investigated the extent to which these study conditions affected the academic performance of medical students in the oral exam after the 60-hour introductory anatomy lecture. Specifically, collaborative, and organisational learning strategies were considered. METHODS Learning strategies of 146 students were assessed by means of a questionnaire. The anatomy exam was used to assess the academic performance. In addition, students were asked to rate their own oral exam performance. RESULTS Students used strategies of collaborative learning (M = 3.30, SD = 0.88) and self-organisation (M = 3.28, SD = 0.72) about equally as often. A significant correlation was found between the use of collaborative learning strategies and the ability for realistic self-assessment (ρ = -0.22, P =.02). Collaborative behaviour could be divided into Initiative Collaborative Learning and Subordinate Collaborative Learning. Only the former had an influence on the ability for realistic self-assessment. Neither organisational learning strategies nor collaborative learning strategies had an influence on academic performance. DISCUSSION AND CONCLUSION Initiative collaborative learners showed a higher degree of realistic self-assessment. This could be explained through a more distinct social referencing, as fellow students' knowledge levels can be related early on to their own academic performance. There was no correlation between the learning strategies used and the exam result.
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Affiliation(s)
- Harald Knof
- Department of Anatomy, Institute of Clinical Anatomy and Cell Analysis, Faculty of Medicine, Eberhard Karls University of Tuebingen, Elfriede-Aulhorn-Straße 8, Tuebingen 72076, Germany
| | - Markus Berndt
- Institute of Medical Education, LMU University Hospital, LMU Munich, Pettenkoferstr. 8a, Munich 80336, Germany
| | - Thomas Shiozawa
- Department of Anatomy, Institute of Clinical Anatomy and Cell Analysis, Faculty of Medicine, Eberhard Karls University of Tuebingen, Elfriede-Aulhorn-Straße 8, Tuebingen 72076, Germany.
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Lampart P, Häusler F, Langewitz W, Rubinelli S, Sigrist-Nix D, Scheel-Sailer A. Patients' experiences with goal setting during initial rehabilitation after newly acquired spinal cord injury: A pilot qualitative interview study. J Spinal Cord Med 2023; 46:837-847. [PMID: 35867389 PMCID: PMC10446827 DOI: 10.1080/10790268.2022.2095496] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE To explore patients' experiences with goal setting during initial rehabilitation after newly acquired spinal cord injury/disorder (SCI/D). DESIGN Qualitative design with semi-structured interviews and purposively sampled participants. Interviews were transcribed verbatim. Transcripts were analyzed for qualitative content analysis using the Mayring method. SETTING Specialized acute care and rehabilitation center for SCI/D-patients. PARTICIPANTS Patients in initial rehabilitation after a newly acquired SCI/D. INTERVENTIONS n.a. OUTCOME MEASURES n.a. RESULTS Ten participants were interviewed in the post-acute phase after a newly acquired SCI/D. Participants described individual patient characteristics as well as organizational elements influencing their experience with goal setting. Organizational elements comprised structural elements (e.g. ward rounds, rehabilitation meetings, etc.) and interaction with and among the interprofessional teams. Perspectives from various health care professionals (HCPs) were perceived as increasing adequate goal setting and motivation. Furthermore, the participants described their own involvement and motivation as crucial for goal achievement. The main point of the critique was the standardization of the goal setting process. Interviewees would have preferred individualized goal setting embedded in a clearly foreseeable rehabilitation plan. CONCLUSION Organization and collaboration with and among the HCPs should be geared towards identifying specific patient needs during the course of rehabilitation and deriving individually tailored goals from them. Communication plays an important role in the individual goal setting.
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Affiliation(s)
- Patricia Lampart
- Swiss Paraplegic Center, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Florin Häusler
- Swiss Paraplegic Center, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | | | - Sara Rubinelli
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
| | | | - Anke Scheel-Sailer
- Swiss Paraplegic Center, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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Lampart P, Schäppi L, Langewitz WA, Rubinelli S, Sigrist-Nix D, Scheel-Sailer A. Health care professionals’ experiences with goal setting during initial rehabilitation after newly acquired spinal cord injury/ disorder – a qualitative focus group study. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:982321. [PMID: 36189066 PMCID: PMC9397958 DOI: 10.3389/fresc.2022.982321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/02/2022] [Indexed: 11/13/2022]
Abstract
IntroductionGoal setting (GS) is an important aspect of initial spinal cord injury/ disorder (SCI/D) rehabilitation. However, because expected outcomes are individual and often difficult to determine, GS is not straightforward. The aim of this study was to explore the health care professionals' (HCP's) experiences with and perspectives on the goal-setting process (GSP) during initial SCI/D rehabilitation.MethodFive semi-structured focus groups (FG) (22 purposively sampled HCP, mostly in leadership positions, six different professions). The FG were transcribed verbatim. We analyzed the transcripts for qualitative content analysis following Braun and Clarke (2013).ResultsHCP described GS-influencing aspects at the macro, meso and micro levels. At the macro level, participants spoke about restrictions imposed by health insurers or difficulties in planning the post-inpatient setting. Regarding the meso level, HCP spoke of institutional structures and culture that facilitated the GSP. At the micro level, knowledge of the diagnosis, expected outcomes, and individual patient characteristics were mentioned as important to the rehabilitation process. It was important for HCP to be patient and empathetic, to endure negative emotions, to accept that patients need time to adjust to their new situation, and to ensure that they do not lose hope. Open communication and interprofessional collaboration helped overcome barriers in the GSP.DiscussionThis paper shows the complex relationship between external (e.g., health insurers), emotional, and communication aspects. It calls for a comprehensive approach to optimizing the GSP, so that patients' experiences can be fully considered as a basis to identify the most appropriate care pathway.
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Affiliation(s)
- Patricia Lampart
- Swiss Paraplegic Center, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Livia Schäppi
- Swiss Paraplegic Center, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | | | - Sara Rubinelli
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
| | | | - Anke Scheel-Sailer
- Swiss Paraplegic Center, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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Gebhardt C, Mehnert-Theuerkauf A, Hartung T, Zimmermann A, Glaesmer H, Götze H. COMSKIL: a communication skills training program for medical students. GMS JOURNAL FOR MEDICAL EDUCATION 2021; 38:Doc83. [PMID: 34056072 PMCID: PMC8136352 DOI: 10.3205/zma001479] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/30/2020] [Accepted: 01/09/2021] [Indexed: 06/12/2023]
Abstract
Objectives: Training communication skills has come to be recognized as a vital aspect of medical school education. A medical communication course based on the COMSKIL Communication Skills Training (CST) Program was developed, integrated into the core curriculum, and evaluated at the Leipzig University Medical School. Methods: Between October 2016 and July 2017, 312 medical students (mean age 21.80 years; 62% male) participated in the medical communication course. Each course unit was evaluated via questionnaires specifically designed to address the theoretical and practical content of the curriculum. The items correspond to the material covered in each course unit. Students responded using a 5-point-Likert scale (1="not at all helpful", 5="extremely helpful") to rate the degree to which the course helped them learn about the subject matter and train the skills covered in the curriculum. Results: The average score for the first part of the course (theoretical foundations) was M=3.69 (SD=0.35). The second part received a similar rating (M=3.84; SD=0.73). The role play exercises with actor-patients received a score of M=4.27 (SD=0.62). In an overall evaluation at the end of the course, students rated the administration of the course (setting, etc), knowledge gained, and skills trained with a score of M=4.11 (SD=0.66). The role play exercises received an overall score of M=4.36 (SD=0.61). Conclusion: A new curriculum for teaching medical students patient-physician communication skills based on the COMSKIL CST program was established at the University of Leipzig. The goal of this course is to teach students about the kinds of communication scenarios they will encounter in their future working lives as care providers and equip them with the fundamental communication techniques and skills they need to successfully handle those situations. A formal evaluation of the program resulted in satisfactory findings, indicating that it is well suited for use in medical universities.
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Affiliation(s)
- Claudia Gebhardt
- University Medical Center Leipzig, Department of Medical Psychology and Medical Sociology, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- University Medical Center Leipzig, Department of Medical Psychology and Medical Sociology, Leipzig, Germany
| | - Tim Hartung
- University Medical Center Leipzig, Department of Medical Psychology and Medical Sociology, Leipzig, Germany
| | - Anja Zimmermann
- University Medical Center Leipzig, LernKlinik Leipzig, Leipzig, Germany
| | - Heide Glaesmer
- University Medical Center Leipzig, Department of Medical Psychology and Medical Sociology, Leipzig, Germany
| | - Heide Götze
- University Medical Center Leipzig, Department of Medical Psychology and Medical Sociology, Leipzig, Germany
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Zimmermann A, Baerwald C, Fuchs M, Girbardt C, Götze H, Hempel G, von Klitzing K, Rotzoll D. The Longitudinal Communication Curriculum at Leipzig University, Medical Faculty - implementation and first experiences. GMS JOURNAL FOR MEDICAL EDUCATION 2021; 38:Doc58. [PMID: 33824894 PMCID: PMC7994878 DOI: 10.3205/zma001454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/20/2020] [Accepted: 09/21/2020] [Indexed: 06/12/2023]
Abstract
Purpose: Communication skills are an essential instrument for building a sustainable patient-doctor-relationship for future doctors. They are learnable and teachable. The learning should be facilitated with the help of a longitudinal curriculum, which is planned at Leipzig University. Project: At the Medical Faculty of Leipzig University, the Longitudinal Communication Curriculum is established since 2016/17. Up to now, the curriculum consists of four parts in which students repeatedly practise their communication skills in curricular and extracurricular courses. Several formats help to teach an integrated learning of communication and physical examination skills. Assessment of communication skills is also performed. Curricular implementation is accompanied by concomitant evaluation. Results: Three parts of the curriculum already have taken place. Students report an increase in communication skills. Students rate the units as instructive and helpful. The assessment of communication skills occurs in two clinical practical examinations (OSCEs). Together with summative assessment a formative feedback was implemented. Students judge this practice as highly positive. Discussion: The curriculum is part of undergraduate medical education in Leipzig. It would be beneficial to add another simulated patient encounter, as well as interprofessional units. Student questionnaires will be evaluated and results will help to develop the curriculum. Conclusion: Consolidation of the curriculum accompanied by evaluation and adaption of content can help to assure the quality of the curriculum. Additional professions and study units shall be integrated in the Longitudinal Communication Curriculum in the future.
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Affiliation(s)
- Anja Zimmermann
- University of Leipzig, Medical Faculty, LernKlinik Leipzig, Skills and Simulation Centre, Leipzig, Germany
- University of Leipzig, Medical Faculty, Centre for Didactics in Medicine, Leipzig, Germany
| | - Christoph Baerwald
- University of Leipzig Medical Centre, Medical Department III – Endocrinology, Nephrology, Rheumatology, Leipzig, Germany
| | - Michael Fuchs
- University of Leipzig Medical Centre, Department of Otorhinolaryngology, Head and Neck Surgery – Division of Phoniatrics and Audiology, Leipzig, Germany
| | - Christian Girbardt
- University of Leipzig Medical Centre, Department of Ophthalmology, Leipzig, Germany
| | - Heide Götze
- University of Leipzig, Medical Faculty, Division of Medical Psychology and Medical Sociology, Leipzig, Germany
| | - Gunther Hempel
- University of Leipzig Medical Centre, Department of Anaesthesiology and Intensive Care, Leipzig, Germany
| | - Kai von Klitzing
- University of Leipzig Medical Centre, Department of Paediatric Psychiatry, Psychotherapy and Psychosomatics, Leipzig, Germany
| | - Daisy Rotzoll
- University of Leipzig, Medical Faculty, LernKlinik Leipzig, Skills and Simulation Centre, Leipzig, Germany
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Roller D, Eberhard L. Quality over quantity - development of communicative and social competence in dentistry at the Medical Faculty of Heidelberg. GMS JOURNAL FOR MEDICAL EDUCATION 2021; 38:Doc60. [PMID: 33824896 PMCID: PMC7994886 DOI: 10.3205/zma001456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 09/23/2020] [Accepted: 10/01/2020] [Indexed: 06/12/2023]
Abstract
Given the context of implementing new licensing regulations for dentistry, this project report describes not only the current educational situation regarding communicative and social competency in dental education at the Medical Faculty of Heidelberg, but also introduces supportive and expanded measures that include medical educators and clinical staff. Based on less-than-satisfactory skills acquisition in students and experienced practitioners, it is necesssary to develop communicative and social competence not just in university courses with few hours of instruction, but also to practice and continually improve these skills in an educational clinical setting which serves as a system for teaching and learning knowledge and skills.
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Affiliation(s)
- Doris Roller
- Medizinische Fakultät Heidelberg, Studiendekanat Zahnmedizin, HeiCuDent Lehrentwicklung, Heidelberg, Germany
| | - Lydia Eberhard
- Medizinische Fakultät Heidelberg, Studiendekanat Zahnmedizin, HeiCuDent Lehrentwicklung, Heidelberg, Germany
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Exenberger S, Kumnig M, Huber A, Prodinger WM, Siller H, Medicus E, Brenner E, Schüßler G, Höfer S. Communicative and social competence in the medical curriculum of the Medical University of Innsbruck: learning objectives, content, and teaching methods. GMS JOURNAL FOR MEDICAL EDUCATION 2021; 38:Doc59. [PMID: 33824895 PMCID: PMC7994870 DOI: 10.3205/zma001455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 09/30/2020] [Accepted: 10/19/2020] [Indexed: 06/12/2023]
Abstract
Aim: The Austrian Competence Level Catalogue for Medical Skills clearly states the importance of teaching communicative and social competence in the different subject areas of undergraduate medical and dental education. This paper aims to present an overview of the academic courses at the Medical University of Innsbruck that explicitly address the promotion of communication and social skills in medical students. Method: This paper focuses on educators' descriptions of how communicating with patients is taught. The Medical University's longitudinal curriculum on medical interviewing is presented in detail. The courses on ethical principles in the dissection course, palliative medicine, and gender medicine are also outlined as examples. In addition, lecturers (n=536) participated in an online survey to determine the teaching and testing content regarding patient communication and to measure the value attached to the associated teaching and learning methods. Results: The examples given by educators to illustrate learning objectives, educational content, and the teaching methods used to impart communicative and social competence provide an overview of the courses which focus on this topic or intentionally address it during the course. The results of the online survey offer a broad overview of the awareness of the topic at the university. Different testing formats are used to assess the skills being taught. Conclusion: Familiarity with the various teaching methods used in the different courses is important for developing communicative and social competence in medical education. Active networking is necessary to anchor communicative and social competency as a major thread throughout an entire medical curriculum.
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Affiliation(s)
- Silvia Exenberger
- Medical University Innsbruck, Department of Medical Psychology, Innsbruck, Austria
| | - Martin Kumnig
- Medical University Innsbruck, Department of Medical Psychology, Innsbruck, Austria
| | - Alexandra Huber
- Medical University Innsbruck, Department of Medical Psychology, Innsbruck, Austria
| | - Wolfgang M. Prodinger
- Medical University Innsbruck, Department of Hygiene and Medical Microbiology, Innsbruck, Austria
| | - Heidi Siller
- Medical University Innsbruck, Gender Medicine Unit, Innsbruck, Austria
| | | | - Erich Brenner
- Medical University Innsbruck, Institute for Clinical and Functional Anatomy, Innsbruck, Austria
| | - Gerhard Schüßler
- Medical University Innsbruck, Department of Medical Psychology, Innsbruck, Austria
| | - Stefan Höfer
- Medical University Innsbruck, Department of Medical Psychology, Innsbruck, Austria
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Buchtler K, Carrard V, Jochum H, Ledermann K, Lude P, Scheel-Sailer A. Body experience during post-acute rehabilitation in individuals after a traumatic spinal cord injury: a qualitative interview-based pilot study. Spinal Cord Ser Cases 2021; 7:14. [PMID: 33623003 PMCID: PMC7902831 DOI: 10.1038/s41394-020-00375-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 12/26/2020] [Accepted: 12/26/2020] [Indexed: 11/09/2022] Open
Abstract
STUDY DESIGN Qualitative interview-based pilot study. OBJECTIVES A traumatic spinal cord injury (TSCI) profoundly disrupts the way individuals experience their body. Awareness of one's body is an important element in the psychological adjustment process after TSCI. This pilot study aimed to explore the body experience of individuals during post-acute rehabilitation following TSCI. SETTING Specialized acute care and rehabilitation center in Switzerland. METHODS Eight semi-structured face-to-face interviews were conducted with patients in the post-acute phase of their TSCI. Body experience was explored in relation to perceptive, cognitive, emotional, and behavioral aspects. The interviews were transcribed verbatim, and a structured content analysis was performed according to the Mayring method. RESULTS The individuals verbalized body experience in all explored aspects. The two participants with tetraplegia described high body-related awareness, including dependence on other persons or aids, whereas individuals with paraplegia focused on their ability to regain activity and perceived autonomy, which was sustained by increasing injury- and self-related comprehension. They expressed uncertainty in their understanding of their paralyzed body while also verbalizing to see a continuity in their identity pre and post TSCI. Their emotions varied from anxiety and anger to hope and optimism. The interviewees confirmed that the growing ability to describe perceptions related to their body increased their active participation in the rehabilitation process and stimulated hope for the future. CONCLUSIONS Exploration of individual body experience after a recent TSCI can strengthen patients' body awareness, communication and engagement in rehabilitation and help the interprofessional rehabilitation team individualize the rehabilitation process.
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Affiliation(s)
- Katharina Buchtler
- Swiss Paraplegic Centre (SPC), Nottwil, Switzerland
- Department of Clinical and Health Psychology, University of Fribourg, Fribourg, Switzerland
| | - Valerie Carrard
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Hermine Jochum
- Private, former, University Hospital Basel, Basel, Switzerland
| | - Katharina Ledermann
- Department of Clinical and Health Psychology, University of Fribourg, Fribourg, Switzerland
- Department of Consultation-liaison Psychiatry and Psychosomatics, University Hospital Zurich, Zurich, Switzerland
| | - Peter Lude
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Consultation-liaison Psychiatry and Psychosomatics, University Hospital Zurich, Zurich, Switzerland
- School of Applied Psychology, Zurich University of Applied Sciences (ZHAW), Zurich, Switzerland
| | - Anke Scheel-Sailer
- Swiss Paraplegic Centre (SPC), Nottwil, Switzerland.
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
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Wagner-Menghin M, de Bruin ABH, van Merriënboer JJG. Communication skills supervisors' monitoring of history-taking performance: an observational study on how doctors and non-doctors use cues to prepare feedback. BMC MEDICAL EDUCATION 2020; 20:36. [PMID: 32028941 PMCID: PMC7006145 DOI: 10.1186/s12909-019-1920-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 12/30/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Medical students need feedback to improve their patient-interviewing skills because self-monitoring is often inaccurate. Effective feedback should reveal any discrepancies between desired and observed performance (cognitive feedback) and indicate metacognitive cues which are diagnostic of performance (metacognitive feedback). We adapted a cue-utilization model to studying supervisors' cue-usage when preparing feedback and compared doctors' and non-doctors' cue usage. METHOD Twenty-one supervisors watched a video of a patient interview, choose scenes for feedback, and explained their selection. We applied content analysis to categorize and count cue-use frequency per communication pattern (structuring/facilitating) and scene performance rating (positive/negative) for both doctors and non-doctors. RESULTS Both groups used cognitive cues more often than metacognitive cues to explain their scene selection. Both groups also used metacognitive cues such as subjective feelings and mentalizing cues, but mainly the doctors mentioned 'missing information' as a cue. Compared to non-doctors, the doctors described more scenes showing negative performance and fewer scenes showing positive narrative-facilitating performance. CONCLUSIONS Both groups are well able to communicate their observations and provide cognitive feedback on undergraduates' interviewing skills. To improve their feedback, supervisors should be trained to also recognize metacognitive cues, such as subjective feelings and mentalizing cues, and learn how to convert both into metacognitive feedback.
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Affiliation(s)
| | - Anique B. H. de Bruin
- Maastricht University, School of Health Professions Education, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - Jeroen J. G. van Merriënboer
- Maastricht University, School of Health Professions Education, P.O. Box 616, 6200 MD Maastricht, The Netherlands
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11
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Schleicher I, van der Mei SH, Mika J, Kreuder JG. [Teaching medical students informed consent]. Unfallchirurg 2019; 121:216-222. [PMID: 28083630 DOI: 10.1007/s00113-016-0298-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Teaching competencies in communication are important for medical education, but implementation in the surgical curriculum is still deficient. Communication during informed consent is one main issue. The aim of the study was to implement a reproducible teaching module for informed consent, which closely represents reality. MATERIAL AND METHODS In the existing practical surgical course we implemented a module for practising communication during surgical informed consent with the help of standardized patients and feedback rounds. The outcome was assessed during a clinical examination and the students evaluated the module. RESULTS The module was evaluated by the students positively and deemed helpful for their later work as a doctor. The outcome at clinical examination was 63% (mean) for content and structure of the informed consent and 92% for competency in communication. CONCLUSION For improving the quality of informed consent, teaching competencies in communication during informed consent should be implemented in the curriculum of medical studies, but legal and content-based aspects should not be ignored.
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Affiliation(s)
- I Schleicher
- Klinik für Orthopädie, Unfallchirurgie und Sportmedizin, Agaplesion Evangelisches Krankenhaus Mittelhessen in Gießen, Gießen, Deutschland.
| | - S H van der Mei
- Klinik für Psychosomatik und Psychotherapie, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen, Gießen, Deutschland
| | - J Mika
- Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, operative Notaufnahme, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen, Gießen, Deutschland
| | - J G Kreuder
- Studiendekanat des Fachbereichs Humanmedizin, Justus-Liebig-Universität Gießen, Gießen, Deutschland
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Niglio de Figueiredo M, Krippeit L, Ihorst G, Sattel H, Bylund CL, Joos A, Bengel J, Lahmann C, Fritzsche K, Wuensch A. ComOn-Coaching: The effect of a varied number of coaching sessions on transfer into clinical practice following communication skills training in oncology: Results of a randomized controlled trial. PLoS One 2018; 13:e0205315. [PMID: 30289905 PMCID: PMC6173449 DOI: 10.1371/journal.pone.0205315] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 09/24/2018] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To investigate the effect of the number of coaching sessions after communication skills training on the medical communicative performance of oncologists in clinical practice. METHODS/DESIGN The training, consisting of a workshop and one (control group) vs. four (intervention group) sessions of individual coaching, was evaluated in a randomized controlled trial. Eligible participants included physicians working in any setting where patients with oncological diseases were treated. Real medical consultations were video recorded at three time points: before the workshop (t0), after the workshop (t1) and after completion of coaching (t2). The 1.5-day workshop was based on role-playing in small groups; in the coaching sessions, the videos recorded at t1 were analyzed in detail by both the trainer and the physician. The coaching sessions were manualized and based on the physician's learning goals. The primary hypothesis was that the intervention group would improve to a higher extent than the control group, as assessed by external raters using rating scales specially developed for this project. Physicians were stratified for sex and setting and randomized by an independent statistician. The group assignment was revealed for physicians and trainers at the end of the workshop, while the raters were blinded to group assignments and assessment points. RESULTS A total of 72 physicians participated in one of 8 workshops and could be allocated to either the control or intervention group. The intervention group showed a statistically significant improvement (ES d = 0.41, p<.01) in the All items domain of the rating scales between t1 and t2 and showed a significant advantage compared with the CG (ES = .41, p = .04). The impact on diverse specified skills was heterogeneous; a larger sample is necessary for more detailed analysis. CONCLUSIONS The training achieved some observable and significant changes in the communicative behavior of oncologists in clinical practice. The four coaching sessions showed some significant advantages compared to the single coaching session. Considerable effort is necessary to achieve sustained changes in communication in clinical every-day practice. Thus, our coaching concept is a promising method for this purpose.
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Affiliation(s)
- Marcelo Niglio de Figueiredo
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Clinic of Dermatology and Venereology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Lorena Krippeit
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Gabriele Ihorst
- Clinical Trials Unit, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Heribert Sattel
- Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Carma L. Bylund
- College of Journalism and Communications, College of Medicine, University of Florida, Gainesville, Florida, United States of America
| | - Andreas Joos
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jürgen Bengel
- Institute of Psychology, Rehabilitation Psychology and Psychotherapy, University of Freiburg, Freiburg, Germany
| | - Claas Lahmann
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kurt Fritzsche
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Alexander Wuensch
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Schmitz FM, Schnabel KP, Stricker D, Fischer MR, Guttormsen S. Learning communication from erroneous video-based examples: A double-blind randomised controlled trial. PATIENT EDUCATION AND COUNSELING 2017; 100:1203-1212. [PMID: 28179074 DOI: 10.1016/j.pec.2017.01.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 01/18/2017] [Accepted: 01/24/2017] [Indexed: 05/22/2023]
Abstract
OBJECTIVE Appropriate training strategies are required to equip undergraduate healthcare students to benefit from communication training with simulated patients. This study examines the learning effects of different formats of video-based worked examples on initial communication skills. METHODS First-year nursing students (N=36) were randomly assigned to one of two experimental groups (correct v. erroneous examples) or to the control group (no examples). All the groups were provided an identical introduction to learning materials on breaking bad news; the experimental groups also received a set of video-based worked examples. Each example was accompanied by a self-explanation prompt (considering the example's correctness) and elaborated feedback (the true explanation). RESULTS Participants presented with erroneous examples broke bad news to a simulated patient significantly more appropriately than students in the control group. Additionally, they tended to outperform participants who had correct examples, while participants presented with correct examples tended to outperform the control group. CONCLUSION The worked example effect was successfully adapted for learning in the provider-patient communication domain. PRACTICE IMPLICATIONS Implementing video-based worked examples with self-explanation prompts and feedback can be an effective strategy to prepare students for their training with simulated patients, especially when examples are erroneous.
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Affiliation(s)
| | | | - Daniel Stricker
- Institute of Medical Education, University of Bern, 3010 Bern, Switzerland.
| | - Martin Rudolf Fischer
- Institute for Medical Education, University Hospital, LMU Munich, 80336 Munich, Germany.
| | - Sissel Guttormsen
- Institute of Medical Education, University of Bern, 3010 Bern, Switzerland.
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Löffler-Stastka H, Datz F, Parth K, Preusche I, Bukowski X, Seidman C. Empathy in Psychoanalysis and Medical Education - what can we learn from each other? BMC MEDICAL EDUCATION 2017; 17:74. [PMID: 28464865 PMCID: PMC5414377 DOI: 10.1186/s12909-017-0907-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 04/01/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Several research areas, including medical education (ME), focus on empathy as an important topic in interpersonal relationships. This focus is central to the use of communication skills related to empathy and even more crucial to provide information in a way that makes patients feel more involved in the treatment process. Psychoanalysis (PA) provides its initial concept of empathy based on affective aspects including findings from neuroscience and brain research. Enhancing cooperation between ME and PA can help to integrate both aspects of empathy into a longitudinal training program. DISCUSSION The condition of psychoanalytic empathy definitions is the understanding of unconscious processes. It is important to primarily attend especially the dominant affects towards the patient before interpreting his or her behaviour, since in explaining the emerging affects, the analyst has to empathize with the patient to understand the (unconscious) reasons for its behaviour. A strong consideration of nonverbal communication, clinical perceptions, intuitive interaction, contagion-like processes and their implementation and empowerment in medical and therapeutic curricula is one way of beneficially using interdisciplinary approaches to yield empathy in clinical interaction. CONCLUSION Established methods of PA, like training of containment, reflective functioning, affective holding and giving meaningful interpretations in accordance with countertransferential and transferential aspects may help to put a focus on the clinican-patient-interaction and the preservation of the physicians' (mental) health. In consequence of the discussion of various training methods that take the theoretical and practical concepts of empathy into account, we aim for an implementation of the named methods in the medical curricula.
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Affiliation(s)
- Henriette Löffler-Stastka
- Department for Psychoanalysis und Psychotherapy and University Program for Psychotherapy Research, Medical University of Vienna, Währingerstraße 18-20, 1090 Vienna, Austria
- Medical University of Vienna, Teaching Center, Postgraduate Program, Vienna, Austria
| | - Felicitas Datz
- Department for Psychoanalysis und Psychotherapy and University Program for Psychotherapy Research, Medical University of Vienna, Währingerstraße 18-20, 1090 Vienna, Austria
| | - Karoline Parth
- Department for Psychoanalysis und Psychotherapy and University Program for Psychotherapy Research, Medical University of Vienna, Währingerstraße 18-20, 1090 Vienna, Austria
| | - Ingrid Preusche
- University of Veterinary Medicine, Teaching Center, Vienna, Austria
| | - Xenia Bukowski
- International Psychoanalytic University, Berlin, Germany
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Hauser K, Matthes J. Medical students' medication communication skills regarding drug prescription-a qualitative analysis of simulated physician-patient consultations. Eur J Clin Pharmacol 2017; 73:429-435. [PMID: 28091704 DOI: 10.1007/s00228-016-2192-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 12/28/2016] [Indexed: 11/25/2022]
Abstract
PURPOSE Poor medication communication of physicians to patients is detrimental, e.g. for medication adherence. Reasons for physicians' deficits in medication communication may be unfavourable conditions in daily practice or already insufficient training during their (undergraduate) medical studies. We explored medical students' communication on new medications in simulated physician-patient conversations to identify actual deficits indicating apparent educational needs. METHODS Fifth year medical students attending a mandatory course at the University of Cologne had simulated physician-patient consultations aiming at drug prescription. In 2015, 21 consultations were recorded, transcribed and subjected to qualitative content analysis based on the method of inductive coding. RESULTS Even essential information on drug therapy was often lacking (e.g. adverse effects, drug administration). Some aspects were addressed more frequently than others. This seemed to differ depending on the diagnosis underlying the particular treatment (acute event vs. chronic disease). The extent of information on drug treatments given in simulated physician-patient consultations varied significantly between students. CONCLUSIONS Fifth year medical students showed appreciable deficits in communicating drug prescriptions to patients though there were remarkable inter-individual differences. Our findings suggest that communication on drug therapy to patients is no self-evolving skill. Thus, there is obviously a need for emphasizing medication communication in the training of medical students. Communication aids specifically aiming at medication communication might facilitate learning of adequate medication communication skills.
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Affiliation(s)
- Katarina Hauser
- Department of Pharmacology II, University of Cologne, Gleueler Strasse 24, 50931, Köln (Cologne), Germany
| | - Jan Matthes
- Department of Pharmacology II, University of Cologne, Gleueler Strasse 24, 50931, Köln (Cologne), Germany.
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Klein J, von dem Knesebeck O. [Social disparities in outpatient and inpatient care: An overview of current findings in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017; 59:238-44. [PMID: 26631009 DOI: 10.1007/s00103-015-2283-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
There is controversy about social disparities in healthcare services in Germany, but a differentiated analysis regarding various dimensions of healthcare is lacking. This narrative review intends to summarize conceptually the current state of research and draw subsequent conclusions. Separated into access, utilization and quality, the findings of social inequality in outpatient and inpatient care in Germany are summarized. Besides the common individual indicators of socioeconomic status (SES), regional deprivation and health insurance status are also included. Despite methodical diversity, the results show that healthcare inequalities due to SES exist, but not universally. Furthermore, there is a differentiated pattern respecting separate dimensions of healthcare. Concerning access (e.g. waiting times, co-payments) lower status groups and patients covered by statutory health insurance are deprived. Higher utilization becomes apparent among higher status groups and privately insured patients in terms of specialist consultations and prevention services. The findings regarding quality of process and outcome differ depending on quality indicator and disease. In different dimensions of medical healthcare, social disparities still exist, though the impact on health remains unclear for some types of healthcare inequalities. Moreover, it is often difficult to conclude from unequal outcome quality the inequalities of healthcare. Depending on access, utilization and quality, separate interventions for reducing these disparities are to be introduced.
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Affiliation(s)
- Jens Klein
- Institut für Medizinische Soziologie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20146, Hamburg, Deutschland.
| | - Olaf von dem Knesebeck
- Institut für Medizinische Soziologie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20146, Hamburg, Deutschland
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Drdla S, Löffler-Stastka H. Influence of conversation technique seminars on the doctoral therapeutic attitude in doctor-patient communication. Wien Klin Wochenschr 2016; 128:555-9. [PMID: 27334007 PMCID: PMC5010600 DOI: 10.1007/s00508-016-1023-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Accepted: 05/25/2016] [Indexed: 02/07/2023]
Abstract
This study investigates medical students' therapeutic attitude before and after communication skills training seminars with simulated patients. The aim was to find out whether the therapeutic attitude of medical students is trainable and whether there is a difference in therapeutic attitude before and after the communication skills training with standardized patients. The participating groups are medical students in their 4th year. The collected parameter is the therapeutic attitude on the basis of the therapeutic attitude questionnaire. The questionnaires are filled out at two different points in time, which are the following: once before and the second time after the communication skills training. The results of this study indicate that therapeutic attitude is trainable. Further studies in the area of communication skills training in medical students are needed to emphasise these results.
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Affiliation(s)
- Sandra Drdla
- Klinik für Psychoanalyse und Psychotherapie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Henriette Löffler-Stastka
- Klinik für Psychoanalyse und Psychotherapie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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Professionelle ärztliche Kommunikation in der Kinder- und Jugendmedizin. Monatsschr Kinderheilkd 2016. [DOI: 10.1007/s00112-016-0101-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Weyers S, Jemi I, Karger A, Raski B, Rotthoff T, Pentzek M, Mortsiefer A. Workplace-based assessment of communication skills: A pilot project addressing feasibility, acceptance and reliability. GMS JOURNAL FOR MEDICAL EDUCATION 2016; 33:Doc70. [PMID: 27990466 PMCID: PMC5135413 DOI: 10.3205/zma001069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 06/24/2016] [Accepted: 07/22/2016] [Indexed: 05/22/2023]
Abstract
Background: Imparting communication skills has been given great importance in medical curricula. In addition to standardized assessments, students should communicate with real patients in actual clinical situations during workplace-based assessments and receive structured feedback on their performance. The aim of this project was to pilot a formative testing method for workplace-based assessment. Our investigation centered in particular on whether or not physicians view the method as feasible and how high acceptance is among students. In addition, we assessed the reliability of the method. Method: As part of the project, 16 students held two consultations each with chronically ill patients at the medical practice where they were completing GP training. These consultations were video-recorded. The trained mentoring physician rated the student's performance and provided feedback immediately following the consultations using the Berlin Global Rating scale (BGR). Two impartial, trained raters also evaluated the videos using BGR. For qualitative and quantitative analysis, information on how physicians and students viewed feasibility and their levels of acceptance was collected in written form in a partially standardized manner. To test for reliability, the test-retest reliability was calculated for both of the overall evaluations given by each rater. The inter-rater reliability was determined for the three evaluations of each individual consultation. Results: The formative assessment method was rated positively by both physicians and students. It is relatively easy to integrate into daily routines. Its significant value lies in the personal, structured and recurring feedback. The two overall scores for each patient consultation given by the two impartial raters correlate moderately. The degree of uniformity among the three raters in respect to the individual consultations is low. Discussion: Within the scope of this pilot project, only a small sample of physicians and students could be surveyed to a limited extent. There are indications that the assessment can be improved by integrating more information on medical context and student self-assessments. Despite the current limitations regarding test criteria, it is clear that workplace-based assessment of communication skills in the clinical setting is a valuable addition to the communication curricula of medical schools.
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Affiliation(s)
- Simone Weyers
- Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf - Centre for Health and Society (CHS), Institut für Medizinische Soziologie, Düsseldorf, Germany
- *To whom correspondence should be addressed: Simone Weyers, Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf - Centre for Health and Society (CHS), Institut für Medizinische Soziologie, Universitätsstraße 1, D-40225 Düsseldorf, Germany, Phone: +49 (0)211/81-14825, Fax: +49 (0)211/81-12390, E-mail:
| | - Iman Jemi
- Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - André Karger
- Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf, Klinisches Institut für Psychosomatische Medizin und Psychotherapie, Düsseldorf, Germany
| | - Bianca Raski
- Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf, Klinisches Institut für Psychosomatische Medizin und Psychotherapie, Düsseldorf, Germany
| | - Thomas Rotthoff
- Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf, Studiendekanat, Düsseldorf, Germany
- Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf, Klinik für Endokrinologie und Diabetologie, Düsseldorf, Germany
| | - Michael Pentzek
- Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf, Institut für Allgemeinmedizin, Düsseldorf, Germany
| | - Achim Mortsiefer
- Heinrich-Heine-Universität Düsseldorf, Universitätsklinikum Düsseldorf, Institut für Allgemeinmedizin, Düsseldorf, Germany
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Härtl A, Bachmann C, Blum K, Höfer S, Peters T, Preusche I, Raski B, Rüttermann S, Wagner-Menghin M, Wünsch A, Kiessling C. Desire and reality--teaching and assessing communicative competencies in undergraduate medical education in German-speaking Europe--a survey. GMS ZEITSCHRIFT FUR MEDIZINISCHE AUSBILDUNG 2015; 32:Doc56. [PMID: 26604998 PMCID: PMC4647163 DOI: 10.3205/zma000998] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 08/03/2015] [Accepted: 09/16/2015] [Indexed: 01/26/2023]
Abstract
Objectives: Increasingly, communicative competencies are becoming a permanent feature of training and assessment in German-speaking medical schools (n=43; Germany, Austria, Switzerland – ”D-A-CH”). In support of further curricular development of communicative competencies, the survey by the “Communicative and Social Competencies” (KusK) committee of the German Society for Medical Education (GMA) systematically appraises the scope of and form in which teaching and assessment take place. Methods: The iterative online questionnaire, developed in cooperation with KusK, comprises 70 questions regarding instruction (n=14), assessment (n=48), local conditions (n=5), with three fields for further remarks. Per location, two to three individuals who were familiar with the respective institute’s curriculum were invited to take part in the survey. Results: Thirty-nine medical schools (40 degree programmes) took part in the survey. Communicative competencies are taught in all of the programmes. Ten degree programmes have a longitudinal curriculum for communicative competencies; 25 programmes offer this in part. Sixteen of the 40 programmes use the Basler Consensus Statement for orientation. In over 80% of the degree programmes, communicative competencies are taught in the second and third year of studies. Almost all of the programmes work with simulated patients (n=38) and feedback (n=37). Exams are exclusively summative (n=11), exclusively formative (n=3), or both summative and formative (n=16) and usually take place in the fifth or sixth year of studies (n=22 and n=20). Apart from written examinations (n=15) and presentations (n=9), practical examinations are primarily administered (OSCE, n=31); WPA (n=8), usually with self-developed scales (OSCE, n=19). With regards to the examiners’ training and the manner of results-reporting to the students, there is a high variance. Conclusions: Instruction in communicative competencies has been implemented at all 39 of the participating medical schools. For the most part, communicative competencies instruction in the D-A-C-H region takes place in small groups and is tested using the OSCE. The challenges for further curricular development lie in the expansion of feedback, the critical evaluation of appropriate assessment strategies, and in the quality assurance of exams.
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Affiliation(s)
- Anja Härtl
- Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Deutschland
| | - Cadja Bachmann
- Universitätsklinikum Hamburg-Eppendorf, Institut für Allgemeinmedizin, Hamburg, Deutschland
| | - Katharina Blum
- Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Deutschland
| | - Stefan Höfer
- Medizin Universität Innsbruck, Universitätsklinik für Medizinische Psychologie, Innsbruck, Österreich
| | - Tim Peters
- Ruhr-Universität Bochum, Medizinische Fakultät, Zentrum für Medizinische Lehre, Bochum, Deutschland
| | - Ingrid Preusche
- Medizinische Universität Wien, Department für Medizinische Aus- und Weiterbildung, Wien, Österreich
| | - Bianca Raski
- Universitätsklinikum Düsseldorf, Studiendekanat, Düsseldorf, Deutschland ; Universitätsklinikum Düsseldorf, Klinisches Institut für Psychosomatische Medizin und Psychotherapie, Düsseldorf, Deutschland
| | - Stefan Rüttermann
- Goethe-Universität Frankfurt, ZZMK Carolinum, Poliklinik für Zahnerhaltung, Frankfurt, Deutschland
| | - Michaela Wagner-Menghin
- Medizinische Universität Wien, Department für Medizinische Aus- und Weiterbildung, Wien, Österreich
| | - Alexander Wünsch
- Klinikum rechts der Isar, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, München, Deutschland ; Technische Universität München, TUM MeDiCAL, München, Deutschland
| | - Claudia Kiessling
- Medizinische Hochschule Brandenburg Theodor Fontane, Bereich Assessment und Prüfungsorganisation, Neuruppin, Deutschland
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Langewitz W, Ackermann S, Heierle A, Hertwig R, Ghanim L, Bingisser R. Improving patient recall of information: Harnessing the power of structure. PATIENT EDUCATION AND COUNSELING 2015; 98:716-721. [PMID: 25770048 DOI: 10.1016/j.pec.2015.02.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 01/20/2015] [Accepted: 02/07/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Assess the amount of medical information laypeople recall, investigate the impact of structured presentation on recall. METHODS 105 first-year psychology students (mean age 21.5±3.8 years; 85% female) were randomised to two information-presentation conditions: structured (S group) and nonstructured (NS group). Students watched a video of a physician discharging a patient from the emergency department. In the S Group, content (28 items of information) was divided into explicit "chapters" with "chapter headings" preceding new information. Afterwards, participants wrote down all information they recalled on an empty sheet of paper. RESULTS The S group (N=57) recalled significantly more items than NS group (N=41) (8.12±4.31 vs. 5.71±3.73; p=0.005), rated information as easier to understand (8.0±1.9 vs. 6.1±2.2; p<0.001) and better structured (8.5±1.5 vs. 5.5±2.7; p<0.001); they rather recommended the physician to friends (7.1±2.7 vs. 5.8±2.6; p<0.01). CONCLUSION University students recalled around 7/28 items of information presented. Explicit structure improved recall. PRACTICE IMPLICATIONS Practitioners must reduce the amount of information conveyed and structure information to improve recall.
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Affiliation(s)
- Wolf Langewitz
- Department of Psychosomatic Medicine, University Hospital Basel, Basel, Switzerland.
| | - Selina Ackermann
- Department of Emergency Medicine, University Hospital Basel, Basel, Switzerland.
| | - Anette Heierle
- Department of Emergency Medicine, University Hospital Basel, Basel, Switzerland.
| | - Ralph Hertwig
- Center for Adaptive Rationality, Max Planck Institute for Human Development, Berlin, Germany.
| | | | - Roland Bingisser
- Department of Emergency Medicine, University Hospital Basel, Basel, Switzerland.
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Bussmann S, Muders P, Zahrt-Omar CA, Escobar PLC, Claus M, Schildmann J, Weber M. Improving end-of-life care in hospitals: a qualitative analysis of bereaved families' experiences and suggestions. Am J Hosp Palliat Care 2013; 32:44-51. [PMID: 24301081 DOI: 10.1177/1049909113512718] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To explore and document the experiences and expectancies of bereaved family members concerning the end-of-life (EOL) care of their deceased relative in a general hospital setting. METHODS Cross-sectional study using a questionnaire that included open-ended questions. Free-text answers were evaluated with qualitative content analysis. A total of 270 family members provided information about improvements in inpatient care. RESULTS Families described structural deficiencies. Furthermore, they requested a more holistic patient health care beyond medical treatment and expressed the wish for more professional support for families. DISCUSSION The view of bereaved families confirmed the need for improvement in general hospital EOL care. The results underline the importance of a more holistic EOL care. The application of communication skills training, structured family meetings, and integrated pathways is recommended.
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Affiliation(s)
- Sonja Bussmann
- Interdisciplinary Palliative Care Unit, III. Department of Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Pia Muders
- Interdisciplinary Palliative Care Unit, III. Department of Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Corinna Aruna Zahrt-Omar
- Interdisciplinary Palliative Care Unit, III. Department of Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Pinzon Luis Carlos Escobar
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Matthias Claus
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Jan Schildmann
- Institute for Medical Ethics and History of Medicine, NRW-Junior Research Group "Medical Ethics at the End of Life: Norm and Empiricism", Ruhr-University Bochum, Bochum, Germany
| | - Martin Weber
- Interdisciplinary Palliative Care Unit, III. Department of Medicine, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
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Kiessling C, Langewitz W. The longitudinal curriculum "social and communicative competencies" within Bologna-reformed undergraduate medical education in Basel. GMS ZEITSCHRIFT FUR MEDIZINISCHE AUSBILDUNG 2013; 30:Doc31. [PMID: 24062811 PMCID: PMC3778532 DOI: 10.3205/zma000874] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 04/29/2013] [Accepted: 05/02/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Within the Bologna reform, a longitudinal curriculum of "social and communicative competencies" (SOKO) was implemented into the new Bachelor-Master structure of undergraduate medical education in Basel (Switzerland). PROJECT DESCRIPTION The aim of the SOKO curriculum is to enable students to use techniques of patient-centred communication to elicit and provide information to patients in order to involve them as informed partners in decision making processes. The SOKO curriculum consists of 57 lessons for the individual student from the first bachelor year to the first master year. Teaching encompasses lectures and small group learning. Didactic methods include role play, video feedback, and consultations with simulated and real patients. Summative assessment takes place in objective structured clinical examinations (OSCE). CONCLUSION In Basel, a longitudinal SOKO curriculum based on students' cumulative learning was successfully implemented. Goals and contents were coordinated with the remaining curriculum and are regularly assessed in OSCEs. At present, most of the workload rests on the shoulders of the department of psychosomatic medicine at the university hospital. For the curriculum to be successful in the long-term, sustainable structures need to be instituted at the medical faculty and the university hospital to guarantee high quality teaching and assessment.
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Affiliation(s)
- Claudia Kiessling
- Klinikum der LMU München, Lehrstuhl für Didaktik und Ausbildungsforschung in der Medizin, München, Deutschland
| | - Wolf Langewitz
- Universitätsspital Basel, Innere Medizin, Psychosomatik, Basel, Schweiz
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