scholarly journals Integration of complementary and integrative medicine competencies in general practice postgraduate education – development of a novel competency catalogue in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jan Valentini ◽  
Carina Klocke ◽  
Corina Güthlin ◽  
Stefanie Joos

Abstract Background Complementary and integrative medical procedures (CIM) play an important role in general practice (GP). Consequently, in some countries (e.g. USA, Australia) specific curricula for the integration of CIM competencies in GP postgraduate education exist. Although Germany is one of the countries where CIM is strongly integrated in general practice, no such catalogue exists up to date. The aim of this study was to define a set of CIM competencies that are seen as relevant and feasible for postgraduate education in the German general practice setting. Methods We used a multi-step, peer-based approach combining four different steps. Firstly, a survey among GP trainees (n = 138) was performed in order to assess needs and attitudes towards CIM. Then, existing competency-based CIM curricula were identified in international literature, translated into German and compared with the needs assessment from the survey. In a next step, we performed a survey among the CIM working group of the German Society for General Medicine and Family Medicine (DEGAM). As a last step, in a peer-based survey, GP trainers, GP trainees, and members of professional CIM associations (n = 131) evaluated a list of CIM competencies according to relevance and feasibility for general practice. Results Within this multistage process, a final catalogue of 16 competencies was defined, covering the following areas: Medical knowledge, patient care and communication, practice-based learning, professionalism, and competencies based on the German healthcare system. Conclusion The final catalogue of CIM competencies is intended to serve for GP training complementing the German competency-based curriculum for general practice. These competencies cover basic skills and are not intended to replace existing additional qualifications awarded by the medical associations in specific CIM methods, such as acupuncture or manual medicine. Therefore, a list of relevant competencies on CIM is available in order to serve as add-on for postgraduate education in general practice in Germany.

2021 ◽  
Author(s):  
Jan Valentini ◽  
Carina Klocke ◽  
Corina Güthlin ◽  
Stefanie Joos

Abstract BackgroundComplementary and Integrative medical procedures (CIM) play an important role in general practice (GP). Consequently, in some countries (e.g. USA, Australia) specific curricula for the integration of CIM competencies in GP postgraduate education exist. Although Germany is one of the countries where CIM is strongly integrated in general practice, no such catalogue exists up to date. The aim of this study was to define a set of CIM competencies that are seen as relevant and feasible for postgraduate education in the German general practice setting.MethodsFirstly, a survey among GP trainees (n= 138) was performed in order to assess needs and attitudes towards CIM. Then, existing competency-based CIM curricula were identified in international literature, translated into German and compared with the needs assessment from the survey. Finally, in a multi-stage Delphi procedure, GP trainers, GP trainees and members of professional CIM associations (n= 131) evaluated a list of CIM competencies according to relevance and feasibility for general practice.ResultsWithin this multistage process a final catalogue of 16 competencies was defined, covering the following areas: Medical knowledge, patient care and communication, practice-based learning, professionalism and competencies based on the German health care system.ConclusionThe final catalogue of CIM competencies is intended to serve for GP training complementing the German competency-based curriculum for general practice. These competencies cover basic skills and are not intended to replace existing additional qualifications awarded by the medical associations in specific CIM methods, such as acupuncture or manual medicine. Therefore, a list of relevant competencies on CIM is available in order to serve as add-on for postgraduate education in general practice in Germany.


2006 ◽  
Vol 99 (4) ◽  
pp. 168-169
Author(s):  
George I Varughese ◽  
Abd A Tahrani

Author(s):  
Peter Hunold ◽  
Andreas Michael Bucher ◽  
Jörn Sandstede ◽  
Rolf Janka ◽  
Lars Benjamin Fritz ◽  
...  

Background Magnetic Resonance Imaging (MRI) is a very innovative, but at the same time complex and technically demanding diagnostic method in radiology. It plays an increasing role in high-quality and efficient patient management. Quality assurance in MRI is of utmost importance to avoid patient risks due to errors before and during the examination and when reporting the results. Therefore, MRI requires higher physician qualification and expertise than any other diagnostic imaging technique in medicine. This holds true for indication, performance of the examination itself, and in particular for image evaluation and writing of the report. In Germany, the radiologist is the only specialist who is systematically educated in all aspects of MRI during medical specialty training and who must document a specified, high number of examinations during this training. However, also non-radiologist physicians are increasingly endeavoring to conduct and bill MRI examinations on their own. Method In this position statement, the following aspects of quality assurance for MRI examinations and billing by radiologists and non-radiologist physician specialists are examined scientifically: Requirements for specialist physician training, MRI risks and contraindications, radiation protection in the case of non-ionizing radiation, application of MR contrast agents, requirements regarding image quality, significance of image artifacts and incidental findings, image evaluation and reporting, interdisciplinary communication and multiple-eyes principle, and impact on healthcare system costs. Conclusion The German Roentgen Society, German Society of Neuroradiology, and Society of German-speaking Pediatric Radiologists are critical with regard to MRI performance by non-radiologists in the interest of quality standards, patient welfare, and healthcare payers. The 24-month additional qualification in MRI as defined by the physician specialization regulations (Weiterbildungsordnung) through the German state medical associations (Landesärztekammern) is the only competence-based and quality-assured training program for board-certified specialist physicians outside radiology. This has to be required as the minimum standard for performance and reporting of MRI exams. Exclusively unstructured MRI training outside the physician specialization regulations has to be strictly rejected for reasons of patient safety. The performance and reporting of MRI examinations must be reserved for adequately trained and continuously educated specialist physicians. Key Points: Citation Format


1988 ◽  
Vol 22 (5) ◽  
pp. 422-424 ◽  
Author(s):  
Robert M. McNulty ◽  
Jay M. Mirtallo

Senior Doctor of Pharmacy (Pharm.D.) students were surveyed by questionnaire to glean information about academic training, and residency, fellowship, or practice positions sought after graduation. There were 227 (27 percent of total surveys) responses. Of those responding, 71 percent were Bachelor of Science graduates, 29 percent were Pharm.D. primary degree students, and 18 percent completed a residency either before or during Pharm.D. training. Fifty percent had an average of three years of clinical services work experience prior to their Pharm.D. education. There was strong interest in postgraduate education by respondents: 41 percent for residencies and 26 percent for fellowships. Of resident candidates, 18 percent and 49 percent, respectively, considered research essential and important to the program. Areas of greatest interest in residencies were general medicine, infectious disease, and pharmacokinetics. Important to the selection of a fellowship was the research proposal and concurrent clinical practice. Pharm.D. students are interested in postgraduate training as residents (60 percent), fellows (38 percent), or both (2 percent). Desired activities are research and clinical practice independent of residency or fellowship interest.


2004 ◽  
Vol 122 (3) ◽  
pp. 81-86 ◽  
Author(s):  
Patrícia Lacerda Bellodi

CONTEXT: The reality of medical services in Brazil points towards expansion and diversification of medical knowledge. However, there are few Brazilian studies on choosing a medical specialty. OBJECTIVE: To investigate and characterize the process of choosing the medical specialty among Brazilian resident doctors, with a comparison of the choice between general medicine and surgery. TYPE OF STUDY: Stratified survey. SETTING: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC-FMUSP). METHODS: A randomized sample of resident doctors in general medicine (30) and surgery (30) was interviewed. Data on sociodemographic characteristics and the moment, stability and reasons for the choice of specialty were obtained. RESULTS: The moment of choice between the two specialties differed. Surgeons (30%) choose the specialty earlier, while general doctors decided progressively, mainly during the internship (43%). Most residents in both fields (73% general medicine, 70% surgery) said they had considered another specialty before the current choice. The main reasons for general doctors' choice were contact with patients (50%), intellectual activities (30%) and knowledge of the field (27%). For surgeons the main reasons were practical intervention (43%), manual activities (43%) and the results obtained (40%). Personality was important in the choice for 20% of general doctors and for 27% of surgeons. DISCUSSION: The reasons found for the choice between general medicine and surgery were consistent with the literature. The concepts of wanting to be a general doctor or a surgeon are similar throughout the world. Personality characteristics were an important influencing factor for all residents, without statistical difference between the specialties, as was lifestyle. Remuneration did not appear as a determinant. CONCLUSION: The results from this group of Brazilian resident doctors corroborated data on choosing a medical specialty from other countries with different social and educational characteristics. This congruence indicates that the choice involves very similar desires and needs in different settings and has little dependence on the students' educational context.


2012 ◽  
Vol 4 (4) ◽  
pp. 425-433 ◽  
Author(s):  
Mohammad U. Malik ◽  
David A. Diaz Voss Varela ◽  
Charles M. Stewart ◽  
Kulsoom Laeeq ◽  
Gayane Yenokyan ◽  
...  

Abstract Introduction The Accreditation Council for Graduate Medical Education (ACGME) introduced the Outcome Project in July 2001 to improve the quality of resident education through competency-based learning. The purpose of this systematic review is to determine and explore the perceptions of program directors regarding challenges to implementing the ACGME Outcome Project. Methods We used the PubMed and Web of Science databases and bibliographies for English-language articles published between January 1, 2001, and February 17, 2012. Studies were included if they described program directors' opinions on (1) barriers encountered when attempting to implement ACGME competency-based education, and (2) assessment methods that each residency program was using to implement competency-based education. Articles meeting the inclusion criteria were screened by 2 researchers. The grading criterion was created by the authors and used to assess the quality of each study. Results The survey-based data reported the opinions of 1076 program directors. Barriers that were encountered include: (1) lack of time; (2) lack of faculty support; (3) resistance of residents to the Outcome Project; (4) insufficient funding; (5) perceived low priority for the Outcome Project; (6) inadequate salary incentive; and (7) inadequate knowledge of the competencies. Of the 6 competencies, those pertaining to patient care and medical knowledge received the most responses from program directors and were given highest priority. Conclusions The reviewed literature revealed that time and financial constraints were the most important barriers encountered when implementing the ACGME Outcome Project.


10.2196/17729 ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. e17729 ◽  
Author(s):  
Ido Zamberg ◽  
Olivier Windisch ◽  
Thomas Agoritsas ◽  
Mathieu Nendaz ◽  
Georges Savoldelli ◽  
...  

Background Finding readily accessible, high-quality medical references can be a challenging task. HeadToToe is a mobile platform designed to allow easy and quick access to sound, up-to-date, and validated medical knowledge and guidance. It provides easy access to essential clinical medical content in the form of documents, videos, clinical scores, and other formats for the day-to-day access and use by medical students and physicians during their pre- and postgraduate education. Objective The aim of this paper is to describe the architecture, user interface, and potential strengths and limitations of an innovative knowledge dissemination platform developed at the University of Geneva, Switzerland. We also report preliminary results from a user-experience survey and usage statistics over a selected period. Methods The dissemination platform consists of a smartphone app. Through an administration interface, content is managed by senior university and hospital staff. The app includes the following sections: (1) main section of medical guidance, organized by clinical field; (2) checklists for history-taking and clinical examination, organized by body systems; (3) laboratory section with frequently used lab values; and (4) favorites section. Each content item is programmed to be available for a given duration as defined by the content’s author. Automatic notifications signal the author when the content is about to expire, hence, promoting its timely updating and reducing the risk of using obsolete content. In the background, a third-party statistical collecting tool records anonymous utilization statistics. Results We launched the final version of the platform in March 2019, both at the Faculty of Medicine at the University of Geneva and at the University Hospital of Geneva in Switzerland. A total of 622 students at the university and 613 health professionals at the hospital downloaded the app. Two-thirds of users at both institutions had an iOS device. During the practical examination period (ie, May 2019) there was a significant increase in the number of active users (P=.003), user activity (P<.001), and daily usage time (P<.001) among medical students. In addition, there were 1086 clinical skills video views during this period compared to a total of 484 in the preceding months (ie, a 108% increase). On a 10-point Likert scale, students and physicians rated the app with mean scores of 8.2 (SD 1.9) for user experience, 8.1 (SD 2.0) for usefulness, and 8.5 (SD 1.8) for relevance of content. In parallel, postgraduate trainees viewed more than 6000 documents during the first 3 months after the implementation in the Division of Neurology at our institution. Conclusions HeadToToe is an educator-driven, mobile dissemination platform, which provides rapid and user-friendly access to up-to-date medical content and guidance. The platform was given high ratings for user experience, usefulness, and content quality and was used more often during the exam period. This suggests that the platform could be used as tool for exam preparation.


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