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Baessler F, Zafar A, Koelkebeck K, Frodl T, Signerski-Krieger J, Pinilla S, Barth GM, Jannowitz D, Speerforck S, Roesch-Ely D, Kluge I, Aust M, Utz J, Kersten GM, Spitzer P. What do the teachers want? A targeted needs assessment survey for prospective didactic training of psychiatry medical educators. GMS JOURNAL FOR MEDICAL EDUCATION 2024; 41:Doc18. [PMID: 38779695 PMCID: PMC11106569 DOI: 10.3205/zma001673] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 12/19/2023] [Accepted: 02/09/2024] [Indexed: 05/25/2024]
Abstract
Objectives Physicians and psychologists at psychiatric university hospitals are assigned teaching tasks from the first day of work without necessarily having the prerequisite training in teaching methods. This exploratory survey provides a needs-based analysis for the prospective didactic training of physicians and psychologists at psychiatric hospitals in Germany, Austria and Switzerland. Methods An online questionnaire was distributed at medical schools via email in German-speaking countries in Europe. All physicians involved in teaching medical students at psychiatry faculties were eligible to participate in the survey. Participants were further requested to recruit eligible participants (snowball sampling). Responses were analyzed descriptively, and differences between groups were calculated using nonparametric Mann-Whitney U tests (p<.05). Results Overall, 97 respondents (male=55, female=42; mean age= 40.6) from 19 medical schools completed the survey. The respondents consisted of 43 residents, 39 specialists, 6 chief physicians and 9 psychologists. Of the respondents, 97.6% rated didactic competence as either highly relevant or rather relevant for teaching medical students. The highest overall interest was shown for bedside teaching (mode=4; IQR: 2-4) and error culture (mode=3; IQR: 2-4). Respondents expressed the highest training needs for topics regarding presentation and communication (mode=3; IQR: 2-3). Resident physicians were significantly more interested in bedside teaching (U=362.0, p=0.004) and roleplay (U=425.0; p=0.036) than specialist physicians, who were more interested in examination didactics (U=415.0; p=0.022). Chief physicians displayed significantly deeper interest in group dynamics (U=51; p=0.023) than specialist physicians. In-person training was preferred by a majority of respondents, and 27.4% preferred online/web-based training. Conclusions The majority of physicians and psychologists at psychiatric university hospitals considered professional development for faculty to be helpful for teaching medical students. Bedside teaching and error culture management were the most desired teaching topics for training medical teachers. Tailored educational interventions are recommended, with target-oriented priorities for different hierarchical levels.
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Affiliation(s)
- Franziska Baessler
- Heidelberg University Hospital, Department of General, Internal and Psychosomatic Medicine, Center for Psychosocial Medicine, Heidelberg, Germany
- Heidelberg Academy of Sciences and Humanities, Heidelberg, Germany
| | - Ali Zafar
- Heidelberg University Hospital, Department of General, Internal and Psychosomatic Medicine, Center for Psychosocial Medicine, Heidelberg, Germany
- Heidelberg Academy of Sciences and Humanities, Heidelberg, Germany
| | - Katja Koelkebeck
- University Duisburg-Essen, Faculty of Medicine, LVR-University Hospital Essen, Department of Psychiatry and Psychotherapy, Essen, Germany
- University Duisburg-Essen, Center for Translational Neuro- & Behavioral Sciences (C-TNBS), Essen, Germany
| | - Thomas Frodl
- University Hospital Aachen, Department of Psychiatry, Psychotherapy and Psychosomatics, Aachen, Germany
| | - Jörg Signerski-Krieger
- University Medical Center Göttingen, Center for Psychosocial Medicine, Göttingen, Germany
| | - Severin Pinilla
- University Hospital of Old Age Psychiatry and Psychotherapy, Bern, Switzerland
- Marion von Tessin-Memory Zentrum, Munich, Germany
| | - Gottfried M. Barth
- University Hospital of Tübingen, Department Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Tübingen, Germany
| | - Deborah Jannowitz
- Helios Hanse Hospital Stralsund, Clinic for Psychiatry and Psychotherapy, Stralsund, Germany
| | - Sven Speerforck
- University of Leipzig, Medical Faculty, Department of Psychiatry, Leipzig, Germany
| | - Daniela Roesch-Ely
- University of Heidelberg, Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg, Germany
| | - Ina Kluge
- Marburg University, Department of Psychiatry and Psychotherapy, Marburg, Germany
| | - Miriam Aust
- University of Münster, University Hospital Münster, Department of Psychiatry, Münster, Germany
| | - Janine Utz
- Friedrich-Alexander University Erlangen-Nuremberg, Erlangen University Hospital, Department of Psychiatry and Psychotherapy, Erlangen, Germany
| | - Gian-Marco Kersten
- Friedrich-Alexander University Erlangen-Nuremberg, Erlangen University Hospital, Department of Psychiatry and Psychotherapy, Erlangen, Germany
| | - Philipp Spitzer
- Friedrich-Alexander University Erlangen-Nuremberg, Erlangen University Hospital, Department of Psychiatry and Psychotherapy, Erlangen, Germany
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Valentine K, Leavitt L, Simmons L, Sepucha K, Atlas SJ, Korsen N, Han PKJ, Fairfield KM. Talking, not training, increased the accuracy of physicians' diagnosis of their patients' preferences for colon cancer screening. PATIENT EDUCATION AND COUNSELING 2024; 119:108047. [PMID: 37976668 PMCID: PMC10841970 DOI: 10.1016/j.pec.2023.108047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/13/2023] [Accepted: 10/29/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Identify if primary care physicians (PCPs) accurately understand patient preferences for colorectal cancer (CRC) testing, whether shared decision making (SDM) training improves understanding of patient preferences, and whether time spent discussing CRC testing improves understanding of patient preferences. METHODS Secondary analysis of a trial comparing SDM training plus a reminder arm to a reminder alone arm. PCPs and their patients completed surveys after visits assessing whether they discussed CRC testing, patient testing preference, and time spent discussing CRC testing. We compared patient and PCP responses, calculating concordance between patient-physician dyads. Multilevel models tested for differences in preference concordance by arm or time discussing CRC. RESULTS 382 PCP and patient survey dyads were identified. Most dyads agreed on whether CRC testing was discussed (82%). Only 52% of dyads agreed on the patient's preference. SDM training did not impact accuracy of PCPs preference diagnoses (55%v.48%,p = 0.22). PCPs were more likely to accurately diagnose patient's preferences when discussions occurred, regardless of length. CONCLUSION Only half of PCPs accurately identified patient testing preferences. Training did not impact accuracy. Visits where CRC testing was discussed resulted in PCPs better understanding patient preferences. PRACTICE IMPLICATIONS PCPs should take time to discuss testing and elicit patient preferences.
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Affiliation(s)
- Kathrene Valentine
- Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| | | | - Leigh Simmons
- Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Karen Sepucha
- Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Steven J Atlas
- Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Neil Korsen
- MaineHealth Institute for Research, Portland, ME, USA
| | | | - Kathleen M Fairfield
- MaineHealth Institute for Research, Portland, ME, USA; MaineHealth Department of Medicine, Portland, ME, USA
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Valentine KD, Scherer LD. Interpersonal (mis)perceptions and (mis)predictions in patient-clinician interactions. Curr Opin Psychol 2022; 43:244-248. [PMID: 34461604 PMCID: PMC8801540 DOI: 10.1016/j.copsyc.2021.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/15/2021] [Accepted: 07/26/2021] [Indexed: 02/03/2023]
Abstract
Patient-clinician interactions require an interpersonal exchange of information, preferences, expectations, values, and priorities. Given the brief interaction patients and clinicians are allowed, many barriers to effective communication exist, resulting in patients and clinicians leaving an interaction with discordant perceptions of what has occurred and what is to come. We review literature on concordance and lack thereof, between patient and clinician perceptions, reasons why discordance may occur, how to decrease discordance as well as how dischordance impacts patient care and outcomes.
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Affiliation(s)
- KD Valentine
- Massachusetts General Hospital,Harvard Medical School
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Groene OR, Bergelt C, Ehrhardt M. How good are medical students at communicating risk? An implementation study at three German medical schools. PATIENT EDUCATION AND COUNSELING 2022; 105:128-135. [PMID: 34020838 DOI: 10.1016/j.pec.2021.05.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/01/2021] [Accepted: 05/11/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To assess the objective and subjective risk communication skills of medical students in three universities in Germany METHODS: We developed a risk communication skills Objective Structured Clinical Examination (OSCE) station and implemented it in three medical schools in Germany. 596 students contributed data to a risk communication checklist and a risk communication self-assessment. Multiple linear regression models were used to identify factors associated with the risk communication OSCE performance. RESULTS Participants in our study achieved on average 73.5% of the total risk communication skills score, which did not differ between locations (F(2-595) = 1.96; p = 0.142). The mean objective performance of students who assessed their skills as poor was significantly worse than the performance of students who assessed their skills as good (t(520) = -5.01, p < 0.001). The risk communication skills score was associated with native language but not with gender nor General Point Average (p < 0.001). CONCLUSIONS Medical students demonstrated acceptable risk communication skills scores and were able to self-assess their performance. However, selected communication techniques should be re-emphasised in the undergraduate medical curriculum. PRACTICE IMPLICATIONS Our research identified shortcomings in particular subgroups that can be addressed through tailored curriculum interventions.
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Affiliation(s)
- Oana R Groene
- Institute of Biochemistry and Molecular Cell Biology, Center for Experimental Medicine, University Medical Center Hamburg-Eppendorf, Germany.
| | - Corinna Bergelt
- Corinna Bergelt, Institute of Medical Psychology, University Medical Center Hamburg-Eppendorf, Germany
| | - Maren Ehrhardt
- Maren Ehrhardt, Institute of General Practice, University Medical Center Hamburg-Eppendorf, Germany
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Hoffmann TC, Del Mar C, Santhirapala R, Freeman A. Teaching clinicians shared decision making and risk communication online: an evaluation study. BMJ Evid Based Med 2021; 26:253. [PMID: 32962972 PMCID: PMC8479734 DOI: 10.1136/bmjebm-2020-111521] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/01/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To describe the development and initial evaluation of a brief e-learning course as a means of teaching shared decision making and risk communication skills to clinicians of all specialties. DESIGN Comparison pre-course and post-course of scores in subjective confidence and objective knowledge about shared decision making and risk communication. SETTING Online and open to all specialties and levels of clinical experience, including students. PARTICIPANTS The course is freely available online and all who started the course from September 2018 to May 2020 were invited to participate in the evaluation study. INTERVENTION The self-guided e-learning course is made up of four modules and takes approximately 2 hours to complete. It is hosted on the website of the Winton Centre for Risk Communication and the UK's National Health Service e-learning platform. MAIN OUTCOME MEASURES Pre-course and post-course confidence in performing shared decision making (as measured by a 10-item scale adapted from the OPTION tool; total score range 10-50), and objective knowledge about basic principles of shared decision making and risk communication, as measured by performance on four knowledge questions and three calculations. At course commencement, a single item from the Berlin Numeracy Test, and the eight-item Subjective Numeracy Test were also asked. RESULTS Of 366 unique participants who consented and commenced the course, 210 completed all modules and the final post-course test. Participants' mean age was 38.1 years, 69% were in current clinical practice and had a mean of 10.5 years of clinical practice. Numeracy was relatively low, with 50.7% correctly answering the Berlin Numeracy Test item pre-course. Participants who completed the course showed a significant improvement in their confidence by a mean summed score of 3.7 units (95% CI 2.9 to 4.6, p<0.0001) from a mean pre-course of 37.4 (SD 6.1) to post-course of 41.1 (SD 6.9). There was an increase in the proportion of correct answers for most knowledge questions (p<0.0001, p=0.013 for two directly compared), although no improvement in most skill questions that involved numbers (eg, calculating relative risks). Participants with higher numeracy appeared to show higher skill and confidence on most questions. CONCLUSIONS This online, free e-learning course was successful in increasing participants' confidence in, and some aspects of knowledge about, shared decision making and risk communication. It also highlighted the need for improvements in clinicians' numerical skills as a vital part of training. We suggest that the course is used in combination with practical face-to-face experience and more intensive numerical skills training.
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Affiliation(s)
- Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
| | - Chris Del Mar
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
| | - Ramai Santhirapala
- Department of Anaesthesia and Perioperative Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Alexandra Freeman
- Winton Centre for Risk & Evidence Communication, University of Cambridge, Cambridge, UK
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