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1.
BMC Med Educ ; 22(1): 765, 2022 Nov 08.
Artículo en Inglés | MEDLINE | ID: mdl-36348330

RESUMEN

BACKGROUND: Efficient metacognitive monitoring, that is the monitoring of one's own thought processes and specifically one's state of knowledge, is essential for effective clinical reasoning. Knowing what one does and does not know is a competency that students of health professions need to develop. Students often tend to develop false certainty in their own knowledge in the longer course of their education, but the time frame that is required for this effect to occur has remained unclear. We investigated whether students developed false certainty already after one course unit. METHODS: This study analysed data from one sample of medical students and four samples of physiotherapy students in two formal educational settings (total N = 255) who took knowledge tests before and after a course unit. We examined changes in students' confidence separately for correctly and incorrectly answered questions and analysed their ability to assign higher levels of confidence to correct answers than to incorrect answers (discrimination ability). RESULTS: Students' knowledge as well as confidence in their correct answers in knowledge tests increased after learning. However, consistently for all samples, confidence in incorrect answers increased as well. Students' discrimination ability improved only in two out of the five samples. CONCLUSIONS: Our results are in line with recent research on confidence increase of health professions students during education. Extending those findings, our study demonstrated that learning in two different formal educational settings increased confidence not only in correct but also in incorrect answers to knowledge questions already after just one learning session. Our findings highlight the importance of improving metacognition in the education of health professionals-especially their ability to know what they do not know.


Asunto(s)
Metacognición , Estudiantes de Medicina , Humanos , Estudiantes de Medicina/psicología , Aprendizaje , Empleos en Salud , Personal de Salud
2.
Health Expect ; 24(2): 257-268, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33517579

RESUMEN

OBJECTIVE: To participate in shared decision making (SDM), patients need to understand their options and develop trust in their own decision-making abilities. Two experiments investigated the potential of decision aids (DAs) in preparing patients for SDM by raising awareness of preference-sensitivity (Study 1) and showing possible personal motives for decision making (Study 2) in addition to providing information about the treatment options. METHODS: Participants (Study 1: N = 117; Study 2: N = 217) were put into two scenarios (Study 1: cruciate ligament rupture; Study 2: contraception), watched a consultation video and were randomized into one of three groups where they received additional information in the form of (a) narrative patient testimonials; (b) non-narrative decision strategies; and (c) an unrelated text (control group). RESULTS: Participants who viewed the patient testimonials or decision strategies felt better prepared for a decision (Study 1: P < .001, ηP2  = 0.43; Study 2: P < .001, ηP2  = 0.57) and evaluated the decision-making process more positively (Study 2: P < .001, ηP2  = 0.13) than participants in the control condition. Decision certainty (Study 1: P < .001, ηP2  = 0.05) and satisfaction (Study 1: P < .001, ηP2  = 0.11; Study 2: P = .003, d = 0.29) were higher across all conditions after watching the consultation video, and certainty and satisfaction were lower in the control condition (Study 2: P < .001, ηP2  = 0.05). DISCUSSION: Decision aids that explain preference-sensitivity and personal motives can be beneficial for improving people's feelings of being prepared and their perception of the decision-making process. To reach decision certainty and satisfaction, being well informed of one's options is particularly relevant. We discuss the implications of our findings for future research and the design of DAs.


Asunto(s)
Toma de Decisiones Conjunta , Participación del Paciente , Toma de Decisiones , Técnicas de Apoyo para la Decisión , Humanos , Motivación
3.
Health Expect ; 24(2): 269-281, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33274816

RESUMEN

OBJECTIVE: This study examined the influence of physicians' recommendations and gender on the decision-making process in a preference-sensitive situation. METHODS: N = 201 participants were put in a hypothetical scenario in which they suffered from a rupture of the anterior cruciate ligament (ACL). They received general information on two equally successful treatment options for this injury (surgery vs physiotherapy) and answered questions regarding their treatment preference, certainty and satisfaction regarding their decision and attitude towards the treatment options. Then, participants watched a video that differed regarding physician's recommendation (surgery vs physiotherapy) and physician's gender (female vs male voice and picture). Afterwards, they indicated again their treatment preference, certainty, satisfaction and attitude, as well as the physician's professional and social competence. RESULTS: Participants changed their treatment preferences in the direction of the physician's recommendation (P < .001). Decision certainty (P < .001) and satisfaction (P < .001) increased more strongly if the physician's recommendation was congruent with the participant's prior attitude than if the recommendation was contrary to the participant's prior attitude. Finally, participants' attitudes towards the recommended treatment became more positive (surgery recommendation: P < .001; physiotherapy recommendation: P < .001). We found no influence of the physician's gender on participants' decisions, attitudes, or competence assessments. CONCLUSION: This research indicates that physicians should be careful with recommendations when aiming for shared decisions, as they might influence patients even if the patients have been made aware that they should take their personal preferences into account. This could be particularly problematic if the recommendation is not in line with the patient's preferences.


Asunto(s)
Médicos , Actitud , Toma de Decisiones , Femenino , Humanos , Masculino , Relaciones Médico-Paciente , Proyectos de Investigación
4.
Psychol Health Med ; 25(3): 259-269, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31707838

RESUMEN

Making decisions based on their own evaluation of relevant information and beliefs is very challenging for patients. Many patients feel that they lack the knowledge to make a decision and expect a recommendation by their physician. We conducted an experimental study to examine the impact of physicians' recommendations on the decision-making process. N = 194 medical laypeople were placed in a hypothetical scenario where they suffered from a cruciate ligament rupture and were faced with the decision about a treatment (surgery or physiotherapy). In a 3 × 2 between-group design we investigated the impact of physicians' recommendations (for surgery, for physiotherapy, no recommendation) and reasoning style (scientific, narrative) on treatment preference, certainty and satisfaction regarding treatment preference, and attitudes. We found that the recommendation had a significant influence on treatment preference and attitudes toward both treatments. Additionally, we found a significant increase in certainty and satisfaction after the intervention, independently of whether they received a recommendation. This finding suggested that a recommendation was not required to strengthen participants' confidence in their decision. There were no effects of reasoning style. We discuss the implications and suggest that physicians should be careful with recommendations in situations in which patients' preferences are important.


Asunto(s)
Toma de Decisiones Conjunta , Prioridad del Paciente , Relaciones Médico-Paciente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad
5.
BMC Med Educ ; 19(1): 401, 2019 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-31676014

RESUMEN

BACKGROUND: Epistemological beliefs (EBs) and therapeutic health concepts are two important factors of influence that affect how healthcare professionals process treatment-relevant information. A previous investigation compared physiotherapy students' EBs and therapeutic health concepts with those of professionals in a cross-sectional study. That study design, however, did not allow for any conclusions about the temporal development of these concepts. This shortcoming has been addressed in the study presented here, which aimed to assess that temporal development. METHODS: In a longitudinal study, physiotherapists filled in a questionnaire that measured their personal EBs about physiotherapy and about medicine, as well as their biomedical and biopsychosocial therapeutic health concepts. The participants were first examined during their medical training (December 2011). The follow-up measure was about 3 years later when the participants had become professional physiotherapists (January 2015). The development of their EBs was examined using paired sample t-tests and Wilcoxon signed-rank test. RESULTS: The analysis was based on 41 participants who filled in the questionnaire at both time points and were working as physiotherapists at the time of the second measurement. There was a development of physiotherapy-related and a development of medicine-related EBs: Physiotherapy-related as well as medicine-related EBs were more sophisticated when physiotherapists had already entered the working world than during their physiotherapy training. Due to psychometric problems of the scales, the development of their therapeutic health concepts could not be analyzed. CONCLUSIONS: EBs are an important factor for (lifelong) learning. Physiotherapy-related and medicine-related EBs developed similarly in both domains. This is an indication that the temporal development of EBs is an expression of professionalization of healthcare personnel in their occupational field. The findings demonstrate that the development of EBs is not completed at the end of vocational training; it appears to be a development that continues even after the transition to professional life.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Fisioterapeutas/psicología , Adulto , Estudios Transversales , Femenino , Humanos , Estudios Longitudinales , Masculino , Especialidad de Fisioterapia/educación , Encuestas y Cuestionarios , Adulto Joven
6.
Health Expect ; 20(5): 845-851, 2017 10.
Artículo en Inglés | MEDLINE | ID: mdl-27860037

RESUMEN

OBJECTIVE: This study aimed at examining the impact of different types of physicians' communication styles on people's subsequent evaluation of physician attributes as well as on their information processing, attitude and decision making. METHOD: In a between-group experiment, 80 participants watched one of three videos in which a gynaecologist displayed a particular communication style in a consultation situation on contraception with an intrauterine device. We compared doctor-centred communication (DCC) vs patient-centred communication (PCC) vs patient-centred communication with need-orientation (PCC-N). RESULTS: In the PCC condition, participants perceived the physician to be more empathetic and more competent than in the DCC condition. In the DCC condition, participants showed less attitude change compared to the other conditions. In the PCC-N condition, the physician was perceived as more empathetic and more socially competent than in the other conditions. However, participants acquired less knowledge in the PCC-N condition. CONCLUSION: We conclude that appropriate application of particular communication styles depends on specific consultation goals. Our results suggest that patients' needs should be addressed if the main goal is to build a good relationship, whereas a traditional PCC style appears to be more effective in communicating factual information.


Asunto(s)
Comunicación , Anticoncepción/estadística & datos numéricos , Toma de Decisiones , Dispositivos Intrauterinos/estadística & datos numéricos , Médicos/psicología , Adolescente , Adulto , Competencia Clínica , Cognición , Empatía , Femenino , Humanos , Satisfacción del Paciente , Percepción , Relaciones Médico-Paciente , Habilidades Sociales , Grabación de Cinta de Video , Adulto Joven
8.
J Med Internet Res ; 17(11): e268, 2015 Nov 25.
Artículo en Inglés | MEDLINE | ID: mdl-26607233

RESUMEN

BACKGROUND: Medical expert forums on the Internet play an increasing role in patient counseling. Therefore, it is important to understand how doctor-patient communication is influenced in such forums both by features of the patients or advice seekers, as expressed in their forum queries, and by characteristics of the medical experts involved. OBJECTIVE: In this experimental study, we aimed to examine in what way (1) the particular wording of patient queries and (2) medical experts' therapeutic health concepts (for example, beliefs around adhering to a distinctly scientific understanding of diagnosis and treatment and a clear focus on evidence-based medicine) impact communication behavior of the medical experts in an Internet forum. METHODS: Advanced medical students (in their ninth semester of medical training) were recruited as participants. Participation in the online forum was part of a communication training embedded in a gynecology course. We first measured their biomedical therapeutic health concept (hereinafter called "biomedical concept"). Then they participated in an online forum where they answered fictitious patient queries about mammography screening that either included scientific or emotional wording in a between-group design. We analyzed participants' replies with regard to the following dimensions: their use of scientific or emotional wording, the amount of communicated information, and their attempt to build a positive doctor-patient relationship. RESULTS: This study was carried out with 117 medical students (73 women, 41 men, 3 did not indicate their sex). We found evidence that both the wording of patient queries and the participants' biomedical concept influenced participants' response behavior. They answered emotional patient queries in a more emotional way (mean 0.92, SD 1.02) than scientific patient queries (mean 0.26, SD 0.55; t74=3.48, P<.001, d=0.81). We also found a significant interaction effect between participants' use of scientific or emotional wording and type of patient query (F2,74=10.29, P<.01, partial η(2)=0.12) indicating that participants used scientific wording independently of the type of patient query, whereas they used emotional wording particularly when replying to emotional patient queries. In addition, the more pronounced the medical experts' biomedical concept was, the more scientifically (adjusted ß=.20; F1,75=2.95, P=.045) and the less emotionally (adjusted ß=-.22; F1,74=3.66, P=.03) they replied to patient queries. Finally, we found that participants' biomedical concept predicted their engagement in relationship building (adjusted ß=-.26): The more pronounced their biomedical concept was, the less they attempted to build a positive doctor-patient relationship (F1,74=5.39, P=.02). CONCLUSIONS: Communication training for medical experts could aim to address this issue of recognizing patients' communication styles and needs in certain situations in order to teach medical experts how to take those aspects adequately into account. In addition, communication training should also make medical experts aware of their individual therapeutic health concepts and the consequential implications in communication situations.


Asunto(s)
Consejo/estadística & datos numéricos , Educación Médica/métodos , Internet/estadística & datos numéricos , Estudiantes de Medicina/psicología , Adulto , Comunicación , Femenino , Humanos , Masculino , Relaciones Médico-Paciente , Encuestas y Cuestionarios
9.
Psychol Health Med ; 20(6): 670-9, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25629938

RESUMEN

Breast cancer awareness campaigns and screening programs are important public health issues. In order to deepen women's knowledge about mammography screening, a balanced presentation of arguments is considered to be relevant. Yet, little is known about how women process this information and assess pro and contra arguments, which, in turn, can be embedded in different health paradigms. The aim of this experimental study was to determine the impact of both women's pre-formed, tentative decisions about whether to participate in mammography screening and of their individual health concepts on their assessment of different arguments about mammography screening. The results showed that women who would tend at the outset to participate in mammography screening rated information about advantages as more relevant than information about disadvantages--in contrast to women who did not intend to participate. In addition, the greater the fit was between women's individual health concepts and the health concept presented in the arguments, the more they considered the information presented to be relevant. We conclude that presenting balanced information about mammography screening does not guarantee balanced processing of that information. Health professionals need to be aware of people's prior beliefs and of the health paradigm in which information is embedded.


Asunto(s)
Neoplasias de la Mama/diagnóstico , Toma de Decisiones , Detección Precoz del Cáncer/psicología , Conocimientos, Actitudes y Práctica en Salud , Mamografía/psicología , Procesos Mentales , Adolescente , Adulto , Femenino , Humanos , Intención , Persona de Mediana Edad , Adulto Joven
10.
J Med Internet Res ; 16(12): e277, 2014 Dec 04.
Artículo en Inglés | MEDLINE | ID: mdl-25486677

RESUMEN

BACKGROUND: On the Internet, people share personal experiences as well as facts and objective information. This also holds true for the exchange of health-related information in a variety of Internet forums. In online discussions about health topics, both fact-oriented and strongly personal contributions occur on a regular basis. OBJECTIVE: In this field experiment, we examined in what way the particular type of contribution (ie, factual information vs personal experiences) has an impact on the subsequent communication in health-related Internet forums. METHODS: For this purpose, we posted parallelized queries to 28 comparable Internet forums; queries were identical with regard to the information contained but included either fact-oriented descriptions or personal experiences related to measles vaccination. In the factual information condition, we posted queries to the forums that contained the neutral summary of a scientific article. In the personal experiences condition, we posted queries to the forums that contained the same information as in the first condition, but were framed as personal experiences RESULTS: We found no evidence that personal experiences evoked more responses (mean 3.79, SD 3.91) from other members of the Internet forums than fact-oriented contributions (mean 2.14, SD 2.93, t26=0.126, P=.219). But personal experiences elicited emotional replies (mean 3.17, SD 1.29) from other users to a greater extent than fact-oriented contributions (mean 2.13, SD 1.29, t81=3.659, P<.001). CONCLUSIONS: We suggest that personal experiences elicited more emotional replies due to the process of emotional anchoring of people's own style of communication. We recommend future studies should aim at testing the hypotheses with more general and with less emotionally charged topics, constructing different fact-oriented posts, and examining additional potential factors of influence such as personality factors or particular communication situations.


Asunto(s)
Emoción Expresada , Conducta en la Búsqueda de Información , Internet , Narrativas Personales como Asunto , Comunicación en Salud , Intercambio de Información en Salud/normas , Humanos , Masculino , Apoyo Social
11.
BMC Med Educ ; 14: 208, 2014 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-25273844

RESUMEN

BACKGROUND: Health knowledge develops fast and includes a lot of ambiguous or tentative information. In their daily routine, both health care students and professionals continuously have to make judgments about the viability of health knowledge. People's epistemological beliefs (EBs) and their therapeutic health concepts are factors that influence how they deal with health knowledge. However, very little is known about the occurrence of these factors at different stages of people's career. The present study examines the EBs and therapeutic health concepts of physiotherapy students in their vocational training and the EBs and therapeutic health concepts of professionals. METHODS: In a cross-sectional study physiotherapy students and professional physiotherapists filled in a questionnaire that measured their personal EBs about physiotherapy and medicine, as well as their biomedical and biopsychosocial therapeutic health concepts. We compared the participants' EBs regarding both knowledge domains, and their therapeutic health concepts using paired samples t-tests. We also examined the differences between first-year students, advanced students, and professionals regarding their EBs and their therapeutic health concepts using ANOVAs. RESULTS: Eighty-three students and 84 professionals participated in this study, 114/167 (68%) participants were female. EBs as well as therapeutic health concepts differed depending upon the participants' training status. Professionals had more sophisticated EBs than students regarding both knowledge in physiotherapy (F(2, 164) = 6.74, P = 0.002, η(2)(p) = 0.08) and knowledge in medicine (F(2, 164) = 5.93, P = 0.003, η(2)(p) = 0.07). In addition, high values in a biopsychosocial therapeutic health concept already occurred in an early phase of training (F(2, 164) = 5.39, P = 0.005, η(2)(p) = 0.06), whereas increased values in a biomedical concept did not occur until people's professional life (F(2, 164) = 10.99, P < 0.001, η(2)(p) = 0.12). CONCLUSIONS: The specificities of personal EBs and therapeutic health concepts in different stages of health care training have so far been insufficiently considered in medical education research. The current study has aimed to shed light on the occurrence of these concepts in students as compared to professionals. We point out implications of our findings for educational practice and make suggestions for future research.


Asunto(s)
Técnicos Medios en Salud/educación , Técnicos Medios en Salud/psicología , Actitud del Personal de Salud , Actitud Frente a la Salud , Cultura , Conocimiento , Fisioterapeutas/educación , Fisioterapeutas/psicología , Especialidad de Fisioterapia/educación , Adulto , Competencia Clínica , Humanos , Mentores , Países Bajos , Modalidades de Fisioterapia , Preceptoría , Investigación Cualitativa , Derivación y Consulta , Adulto Joven
12.
Front Public Health ; 12: 1343225, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38645444

RESUMEN

Background: Empathic concern and perspective-taking may contribute to avoiding stigmatization of adverse health behavior. Narrative writing has been shown to be effective in promoting perspective-taking and empathy. But since narrative writing is time consuming, we tested in the present study narrative reading as an alternative, more parsimonious approach. Methods: In a randomized controlled experiment, we compared writing a narrative text about a fictitious person who displays disapproved of health behavior to reading such a text and to a control condition in which participants wrote about an unrelated topic. With a sample of n = 194 participants, we investigated the impact of writing and reading a narrative text on promoting empathic concern and perspective-taking as well as on attitude change. Results: We found that both writing and reading a narrative text about the fictitious character increased empathic concern, F(1, 191) = 32.85, p < 0.001, part. η2 = 0.15, and perspective-taking, F(1, 191) = 24.76, p < 0.001, part. η2 = 0.12, more strongly than writing about an unrelated topic. Writing and reading a narrative text also resulted in a more positive attitude toward this person, F(1, 191) = 17.63, p < 0.001, part. η2 = 0.08. Simply reading a narrative text was equally efficient as narrative writing with respect to empathic concern, p = 0.581, perspective-taking, p = 0.629, and attitude, p = 0.197. Conclusion: The finding that narrative reading is as effective as narrative writing suggests that the readers appear to be able to comprehend and engage with the story being told. When narrative reading is as effective as narrative writing, it can succeed with reduced effort in increasing empathic concern, perspective-taking, and attitude. We discuss the benefits of this approach for reducing stigmatization of adverse health behavior.


Asunto(s)
Empatía , Narración , Lectura , Escritura , Humanos , Femenino , Masculino , Adulto , Adulto Joven , Conductas Relacionadas con la Salud , Actitud , Adolescente
13.
Med Educ ; 47(7): 683-90, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23746157

RESUMEN

OBJECTIVES: In their work, health care professionals have to deal daily with inconsistent health information and are confronted with differing therapeutic health concepts. Medical education should prepare students to handle these challenges adequately. The aim of this study was to contribute to a better understanding of how students deal with inconsistencies in health knowledge when they are presented with either a therapeutic concept they accept or one they reject. METHODS: Seventy-six students of physiotherapy participated in this 2 × 2 experiment with health information (consistent versus inconsistent information) and therapeutic concept (congruent versus contradictory therapeutic concept) as between-group factors. The participants' task was to improve the quality of a text about the effectiveness of stretching; participants were randomly assigned to one of four texts. Knowledge acquisition and text modification were measured as dependent variables. RESULTS: Students acquired more knowledge when they worked with a text containing inconsistent information. Medical information that was presented in agreement with a student's therapeutic concept was also more readily acquired than the same information presented posing a contradictory therapeutic concept. Participants modified the contradictory text in order to adapt it to their own point of view. Disagreement resulted in a disregard or devaluation of the information itself, which in turn was detrimental to learning. CONCLUSIONS: It is a problem when prospective health care professionals turn a blind eye to discrepancies that do not fit their view of the world. It may be useful for educational purposes to include a knowledge conflict caused by a combination of conviction and inconsistent information to facilitate learning processes.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Fisioterapeutas/educación , Fisioterapeutas/psicología , Aprendizaje Basado en Problemas/métodos , Adolescente , Adulto , Análisis de Varianza , Comprensión , Femenino , Humanos , Conocimiento , Masculino , Estudiantes , Enseñanza/métodos , Adulto Joven
15.
JMIR Mhealth Uhealth ; 9(4): e25717, 2021 04 21.
Artículo en Inglés | MEDLINE | ID: mdl-33881402

RESUMEN

BACKGROUND: Many people constantly use their smartphones in all kinds of situations. Often smartphones are used in a meaningful and targeted way, but frequently they are used as a pastime without any purpose. This also applies to patients and therapists in treatment situations. OBJECTIVE: The aim of this study was to investigate how purposeful smartphone use compared with recreational smartphone use (by a physiotherapist or by a patient) influenced the perception of a physiotherapeutic treatment situation. We examined the impact of smartphone use during a physiotherapy session on the perception of the physiotherapist, evaluation of attentiveness, and evaluation of smartphone use in physiotherapy in general. METHODS: Members of various music and sports clubs were invited to participate in an online randomized controlled trial. Participants were randomly assigned to one of four conditions. They watched a video in which a physiotherapeutic treatment was shown and in which a smartphone was used or not used in the following four different ways: (1) therapeutically purposeful use, (2) recreational use by the physiotherapist (looking at the phone from time to time with no therapeutic purpose), (3) recreational use by the patient, and (4) no smartphone use (control condition). After watching the video, the participants indicated their perception of the physiotherapist's professional competence, social competence, and empathetic behavior. They also rated the physiotherapist's and patient's attentiveness and evaluated the usage of smartphones generally in physiotherapy. RESULTS: The analysis included 118 participants (63 women and 55 men). When the physiotherapist used the smartphone in a purposeful way, the physiotherapist was perceived as more professionally competent (P=.007), socially competent (P=.03), and empathetic (P=.04) than if the physiotherapist used it with no therapeutic purpose. These effects occurred because recreational smartphone use by the physiotherapist was evaluated more negatively than the behavior in the control condition (professional competence: P=.001; social competence: P=.03; empathy: P=.04). Moreover, when the physiotherapist used the smartphone in a recreational way, the physiotherapist was perceived as being less attentive (P<.001). Likewise, when the patient used the smartphone in a recreational way, the patient was perceived as being less attentive (P<.001). Finally, smartphone use in physiotherapy was rated as more positive in general when the smartphone was used in a purposeful way compared with the conditions in which the physiotherapist or patient looked at the smartphone with no therapeutic purpose (P<.001). This positive evaluation occurred because purposeful use led to a more positive rating than no smartphone use (P<.001, R=0.42). CONCLUSIONS: Smartphones are only appropriate for therapists and patients if they are used directly for a therapeutic purpose. Otherwise, it is better not to use smartphones during treatment. TRIAL REGISTRATION: AsPredicted (aspredicted.org) #24740; https://aspredicted.org/blind.php?x=vv532i.


Asunto(s)
Fisioterapeutas , Teléfono Inteligente , Femenino , Humanos , Masculino , Percepción , Modalidades de Fisioterapia , Competencia Profesional
16.
Med Educ Online ; 26(1): 1886642, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33588696

RESUMEN

Successful shared decision making (SDM) in clinical practice requires that future clinicians learn to appreciate the value of patient participation as early as they can in their medical training. Narratives, such as patient testimonials, have been successfully used to support patients' decision-making process. Previous research suggests that narratives may also be used for increasing clinicians' empathy and responsiveness in medical consultations. However, so far, no studies have investigated the benefits of narratives for conveying the relevance of SDM to medical students. In this randomized controlled experiment, N = 167 medical students were put into a scenario where they prepared for medical consultation with a patient having Parkinson disease. After receiving general information, participants read either a narrative testimonial of a Parkinson patient or a fact-based information text. We measured their perceptions of SDM, their control preferences (i.e., their priorities as to who should make the decision), and the time they intended to spend for the consultation. Participants in the narrative patient testimonial condition referred more strongly to the patient as the one who should make decisions than participants who read the information text. Participants who read the patient narrative also considered SDM in situations with several equivalent treatment options to be more important than participants in the information text condition. There were no group differences regarding their control preferences. Participants who read the patient testimonial indicated that they would schedule more time for the consultation. These findings show that narratives can potentially be useful for imparting the relevance of SDM and patient-centered values to medical students. We discuss possible causes of this effect and implications for training and future research. Trial registration: The study was pre-registered on the pre-registration platform AsPredicted (aspredicted.org) before data collection began (registration number: #29,342). Date of registration: 17 October 2019.


Asunto(s)
Toma de Decisiones Conjunta , Narración , Enfermedad de Parkinson/terapia , Participación del Paciente/psicología , Estudiantes de Medicina/psicología , Adulto , Toma de Decisiones , Femenino , Humanos , Masculino , Percepción , Adulto Joven
17.
PLoS One ; 16(7): e0254501, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34252122

RESUMEN

OBJECTIVE: Two randomized controlled experiments investigated if writing a narrative text about a fictional person who shows disapproved of behavior in the Covid-19 pandemic influenced empathy, perspective-taking, attitude, and attribution of causes regarding that person's behavior. METHODS: In both studies, a fictional scenario was described, and participants answered questions regarding empathy, perspective-taking, attitude, and attribution regarding a fictional person's disapproved of behavior (pre-post-measurement). Participants were randomly assigned to one of two conditions. In the experimental condition, they wrote a narrative text about the fictional person. In the control condition, they wrote about an unrelated topic. RESULTS: We found that writing a narrative text increased empathy more strongly than writing about an unrelated topic; Study 1: p = 0.004, part.η2 = 0.06, Study 2: p < .001, part.η2 = 0.19. This did not apply to perspective-taking; Study 1: p = 0.415; Study 2: p = 0.074. We also found that writing a narrative text about a fictional person resulted in a more positive attitude toward this person; Study 1: p = 0.005, part.η2 = 0.06; Study 2: p<0.001, part.η2 = 0.10. Finally, in Study 2 we found that participants who wrote a narrative text attributed the person's behavior to internal causes to a lesser degree; p = 0.007, part.η2 = 0.05. CONCLUSION: Our findings indicate that empathy and attitude are positively modifiable through narrative writing tasks. Empathy training could potentially prevent discrimination related to Covid-19. TRIAL REGISTRATION: The studies presented in this article were pre-registered on the pre-registration platform AsPredicted (aspredicted.org) before we began data collection; registration numbers and URL: #44754 https://aspredicted.org/vx37t.pdf (Study 1), and #44753 https://aspredicted.org/ig7kq.pdf (Study 2).


Asunto(s)
COVID-19/epidemiología , COVID-19/prevención & control , Empatía , Conocimientos, Actitudes y Práctica en Salud , Narración , Escritura , Humanos
18.
Anat Sci Educ ; 14(4): 452-459, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32735751

RESUMEN

Interprofessional collaboration (IPC) in the medical field is an important factor for good clinical outcomes and should be taught as early as in undergraduate medical education. Since implementing IPC training is an organizational challenge, students are often limited in their opportunities to experience real-life IPC. Therefore, an approach where students observe successful IPC activities of role models in an applied anatomical format was proposed. It was studied whether observing IPC activities in undergraduate anatomical education has an impact on both students' attitude toward IPC and on knowledge acquisition. Further, it was examined whether the attitudes and knowledge of students from different medical disciplines were influenced in different ways. Therefore, 75 medical students and thirty-eight physiotherapy students participated in a study with the task of observing a live broadcast of an interprofessional teaching session. Participants were asked about their attitudes toward interprofessional learning, their evaluation of professional responsibilities, and their profession-specific knowledge before and after observing the IPC session. The participants' attitude toward interprofessional learning improved for both groups of students. Moreover, students of physiotherapy adjusted their evaluation of their own and others' professional responsibilities after observing IPC. In both student groups, knowledge increased, in particular, with respect to the field of knowledge in other professions. So, observing IPC can modify students' attitudes and support knowledge acquisition. The implementation of IPC observations provides students from various healthcare disciplines with a clearer impression of professionals' responsibilities and gives learners the opportunity to acquire knowledge from healthcare fields unfamiliar to them.


Asunto(s)
Anatomía , Estudiantes del Área de la Salud , Estudiantes de Medicina , Anatomía/educación , Actitud , Actitud del Personal de Salud , Conducta Cooperativa , Humanos , Relaciones Interprofesionales
19.
Artículo en Inglés | MEDLINE | ID: mdl-32422876

RESUMEN

The health care system is increasingly complex and specialized, but it presents the actors involved with the challenge of working together in interprofessional teams. One way to meet this challenge is through interprofessional training approaches, where representatives of different professions learn together with learners of other professions. This article contributes to the question of how interprofessional teaching in health care education can be designed with a low threshold by using digital media. We focus on learning with digital learning platforms and learning with videos. Based on existing empirical findings, these approaches are discussed in terms of their potential and limitations for interprofessional teaching. In particular, we examine how these approaches influence the core competence domains of interprofessional collaborative practice. Digital collaborative learning platforms are suitable for teaching interprofessional competences, since they enable social and professional exchange among learners of different professions. Videos are suitable for imparting medical declarative and procedural knowledge. Based on these considerations, the use of videos in combination with interaction possibilities is presented as a didactic approach that can combine the aspect of knowledge transfer with the possibility of interprofessional computer-based collaboration.


Asunto(s)
Educación en Salud , Internet , Relaciones Interprofesionales , Conducta Cooperativa , Atención a la Salud , Aprendizaje , Grupo de Atención al Paciente
20.
Front Public Health ; 8: 35, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32158738

RESUMEN

How patients assess the suitability of a certain therapy for treating a disease depends on a variety of influencing factors. Three key factors are people's subjective perceptions of a disease, the type of treatment, and the kind of communication used to convey information. The study presented here was a randomized controlled experiment in which we examined these three factors. We used a mixed design where we manipulated perceived etiology of gastritis (biopsychosocial vs. biomedical) as a between-group factor, and treatment type (behavioral vs. pharmacological) and wording of treatment information (holistic vs. scientific) as within-group factors. We found that gastritis treatments that matched the perceived etiology of the illness were assessed to be more effective. Moreover, treatments that matched the perceived etiology enhanced participants' intention to undergo the treatment themselves and their willingness to recommend it to a person close to them. Finally, participants' intention to undergo the treatment was also enhanced when the wording of the treatment information matched the perceived etiology. We discuss the implications of our findings in terms of health communication and patient education.


Asunto(s)
Comunicación , Gastritis , Gastritis/diagnóstico , Humanos , Intención
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