scholarly journals Integration of Complementary and Integrative Medicine Competencies in General Practice Postgraduate Education – Development of a Novel Competency Catalogue in Germany

2021 ◽  
Author(s):  
Jan Valentini ◽  
Carina Klocke ◽  
Corina Güthlin ◽  
Stefanie Joos
Keyword(s):  
General Practice ◽  
Medical Knowledge ◽  
Postgraduate Education ◽  
Education Development ◽  
Communication Practice ◽  
Medical Associations ◽  
Multi Stage ◽  
Complementary And Integrative Medicine ◽  
Competency Based ◽  
Gp Training

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.

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
Keyword(s):  
General Practice ◽  
Medical Knowledge ◽  
General Medicine ◽  
Postgraduate Education ◽  
German Society ◽  
Education Development ◽  
Communication Practice ◽  
Medical Associations ◽  
German Healthcare System ◽  
Competency Based

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.

scholarly journals Applying evidence-based medicine in general practice: a video-stimulated interview study on workplace-based observation

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Lisanne S. Welink ◽  
Kaatje Van Roy ◽  
Roger A. M. J. Damoiseaux ◽  
Hilde A. Suijker ◽  
Peter Pype ◽  
...  
Keyword(s):  
Decision Making ◽  
General Practice ◽  
Evidence Based Medicine ◽  
Evidence Based ◽  
Clinical Expertise ◽  
Stimulated Recall ◽  
Previous Discussion ◽  
Based Medicine ◽  
Stimulated Recall Interviews ◽  
Gp Training

Abstract Background Evidence-based medicine (EBM) in general practice involves applying a complex combination of best-available evidence, the patient’s preferences and the general practitioner’s (GP) clinical expertise in decision-making. GPs and GP trainees learn how to apply EBM informally by observing each other’s consultations, as well as through more deliberative forms of workplace-based learning. This study aims to gain insight into workplace-based EBM learning by investigating the extent to which GP supervisors and trainees recognise each other’s EBM behaviour through observation, and by identifying aspects that influence their recognition. Methods We conducted a qualitative multicentre study based on video-stimulated recall interviews (VSI) of paired GP supervisors and GP trainees affiliated with GP training institutes in Belgium and the Netherlands. The GP pairs (n = 22) were shown fragments of their own and their partner’s consultations and were asked to elucidate their own EBM considerations and the ones they recognised in their partner’s actions. The interview recordings were transcribed verbatim and analysed with NVivo. By comparing pairs who recognised each other’s considerations well with those who did not, we developed a model describing the aspects that influence the observer’s recognition of an actor’s EBM behaviour. Results Overall, there was moderate similarity between an actor’s EBM behaviour and the observer’s recognition of it. Aspects that negatively influence recognition are often observer-related. Observers tend to be judgemental, give unsolicited comments on how they would act themselves and are more concerned with the trainee-supervisor relationship than objective observation. There was less recognition when actors used implicit reasoning, such as mindlines (internalised, collectively reinforced tacit guidelines). Pair-related aspects also played a role: previous discussion of a specific topic or EBM decision-making generally enhanced recognition. Consultation-specific aspects played only a marginal role. Conclusions GP trainees and supervisors do not fully recognise EBM behaviour through observing each other’s consultations. To improve recognition of EBM behaviour and thus benefit from informal observational learning, observers need to be aware of automatic judgements that they make. Creating explicit learning moments in which EBM decision-making is discussed, can improve shared knowledge and can also be useful to unveil tacit knowledge derived from mindlines.

scholarly journals Barriers to Implementing the ACGME Outcome Project: A Systematic Review of Program Director Surveys

2012 ◽  
Vol 4 (4) ◽  
pp. 425-433 ◽  
Author(s):  
Mohammad U. Malik ◽  
David A. Diaz Voss Varela ◽  
Charles M. Stewart ◽  
Kulsoom Laeeq ◽  
Gayane Yenokyan ◽  
...  
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Medical Knowledge ◽  
Program Directors ◽  
Faculty Support ◽  
Inclusion Criteria ◽  
Competency Based Education ◽  
Inadequate Knowledge ◽  
Competency Based

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.

scholarly journals A Mobile Medical Knowledge Dissemination Platform (HeadToToe): Mixed Methods Study

10.2196/17729 ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. e17729 ◽  
Author(s):  
Ido Zamberg ◽  
Olivier Windisch ◽  
Thomas Agoritsas ◽  
Mathieu Nendaz ◽  
Georges Savoldelli ◽  
...  
Keyword(s):  
Medical Students ◽  
User Experience ◽  
Clinical Skills ◽  
Medical Knowledge ◽  
Postgraduate Education ◽  
Third Party ◽  
University Hospital ◽  
Knowledge Dissemination ◽  
Easy Access ◽  
The University

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.

scholarly journals Medical students’ perceptions of a career in general practice

2019 ◽  
Vol 69 (suppl 1) ◽  
pp. bjgp19X702773
Author(s):  
Kimberley Banner ◽  
Hugh Alberti ◽  
Jane Stewart
Keyword(s):  
General Practice ◽  
Longitudinal Study ◽  
Medical Students ◽  
Family Life ◽  
Personal Narratives ◽  
Career Intentions ◽  
Form Part ◽  
Training Programmes ◽  
The Uk ◽  
Gp Training

BackgroundRecruitment into general practice is falling and many training programmes in the UK have unfilled training posts. In 2016 NHS England pledged to increase the number of graduates entering GP training to 50%. However in 2017 only 15.3% of foundation year 2 doctors commenced general practice.AimThis work aims to understand medical students’ perceptions of a career in general practice, and how this may affect their career intentions.MethodAs part of a larger, longitudinal study at four UK universities. First and fourth year students were invited to a focus group to discuss their perceptions of a career in general practice. The recordings were transcribed and content analysis was performed.ResultsThe perceptions discussed could be broadly grouped into three categories. ‘The GP’ highlighted students’ ideas of the GP as someone who was dedicated, could create rapport, and wanted a family life. The ‘Job of the GP’ indicated students were positive about the continuity of care the job offered, but felt the work was isolating and paperwork heavy. Finally, external factors such as denigration and the ‘GP land’ concept also had an impact on students’ perceptions.ConclusionFurther work is needed to understand how these perceptions develop, how this may impact students career intentions, and how this research could be used to improve GP recruitment. This data will form part of a wider longitudinal study, the results of which will be analysed for themes and personal narratives of the students.

Myelodysplastic syndromes – current diagnostics

2019 ◽  
Vol 55 (1) ◽  
pp. 35-42
Author(s):  
Beata Celuch ◽  
Iwona Urbanowicz ◽  
Jadwiga Nowicka ◽  
Wiesława Nahaczewska ◽  
Iwona Bil-Lula
Keyword(s):  
Myelodysplastic Syndromes ◽  
Myeloid Leukemia ◽  
Medical Knowledge ◽  
Laboratory Diagnostics ◽  
Multi Stage ◽  
Increased Risk ◽  
Cytogenetic Changes ◽  
Near Future ◽  
Clinical Problems ◽  
Over Time

Myelodysplastic syndromes (MDS) are a heterogeneous group of hematopoietic neoplastic diseases characterized by inefficient hematopoiesis, resistant peripheral cytopenias and an increased risk of transformation to acute myeloid leukemia. They may exist as primary forms, which most often are accompanied by molecular and cytogenetic changes or secondary forms, among others after chemotherapy or other cancers. MDS diagnostics are multi-stage and time-consuming. Includes multidirectional examination of peripheral blood and bone marrow for cytomorphology, cytogenetics, molecular disorders, immunohistopatology and immunophenotyping. The evolution of molecular changes in the course of MDS makes the clinical picture and laboratory parameters change over time, which requires constant updating of medical knowledge and high competences from cytomorphologists and histopathologists. The development of hematooncological diagnostics resulted in updating the MDS classification in 2016. The aging population will undoubtedly increase the incidence of myelodysplastic syndromes, which will be one of the most demanding diagnostic and clinical problems for haematologists and laboratory diagnostics in the near future.

Usefulness of a virtual community of practice and Web 2.0 tools for general practice training: experiences and expectations of general practitioner registrars and supervisors

2013 ◽  
Vol 19 (4) ◽  
pp. 292 ◽  
Author(s):  
Stephen Barnett ◽  
Sandra C. Jones ◽  
Sue Bennett ◽  
Don Iverson ◽  
Andrew Bonney
Keyword(s):  
Social Media ◽  
General Practice ◽  
Knowledge Sharing ◽  
Community Of Practice ◽  
Virtual Communities ◽  
Survey Study ◽  
Professional Isolation ◽  
Social Media Tools ◽  
General Practice Training ◽  
Gp Training

General practice training is a community of practice in which novices and experts share knowledge. However, there are barriers to knowledge sharing for general practioner (GP) registrars, including geographic and workplace isolation. Virtual communities of practice (VCoP) can be effective in overcoming these barriers using social media tools. The present study examined the perceived usefulness, features and barriers to implementing a VCoP for GP training. Following a survey study of GP registrars and supervisors on VCoP feasibility, a qualitative telephone interview study was undertaken within a regional training provider. Participants with the highest Internet usage in the survey study were selected. Two researchers worked independently conducting thematic analysis using manual coding of transcriptions, later discussing themes until agreement was reached. Seven GP registrars and three GP supervisors participated in the study (average age 38.2 years). Themes emerged regarding professional isolation, potential of social media tools to provide peer support and improve knowledge sharing, and barriers to usage, including time, access and skills. Frequent Internet-using GP registrars and supervisors perceive a VCoP for GP training as a useful tool to overcome professional isolation through improved knowledge sharing. Given that professional isolation can lead to decreased rural work and reduced hours, a successful VCoP may have a positive outcome on the rural medical workforce.

POSTGRADUATE EDUCATION IN GENERAL PRACTICE

The Lancet ◽  
1962 ◽  
Vol 279 (7234) ◽  
pp. 863
Author(s):  
S HOWARD
Keyword(s):  
General Practice ◽  
Postgraduate Education
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