[Shared decision making. The perspective of practicing physicians]. / "Shared Decision Making"Gemeinsame Entscheidungsfindung aus der ärztlichen Perspektive.

BACKGROUND AND PURPOSE: More and more, patients want to participate in medical decision making. They expect a patient-centered communication as well as adequate information. However, little is known about the physicians' perspective and skills regarding shared decision making (SDM). This paper presents data about the physicians' perspective and allows focused comparison with the patients' views. METHODS: Standardized survey of 502 physicians from ambulatory care practices and of 1,512 German-speaking people, aged 18-79 years. Patient data were collected from a population-based random sample of an access panel. The following topics were included in this survey: medical decision making in daily practice, communication skills and behavior of physicians from the perspectives of physicians and patients. RESULTS: A majority of physicians approve the concept of SDM. Especially younger physicians favor the concept of SDM. Overall, physicians underestimate their patients' preference to participate in medical decision making. Physicians also tend to overestimate their information and communication skills. CONCLUSION: Not only in the general public, but also among physicians, a model of SDM is widely accepted. The communication skills necessary for this process appear to exist. However, they need to be promoted and extended. Learning to communicate adequately should receive a greater focus in medical education and postgraduate training.

[Evidence-based medicine in professional training and education in practice? The integrated evidence-based medicine curriculum at the Medical School at the University of Witten/Herdecke]]. / Evidenzbasierte Medizin: Eingebettet in die Ausbildung--Selbstverständlich in der Praxis? Das integrierte EbM-Curriculum im Modellstudiengang Medizin der Universität Witten/Herdecke.

Applying the principles of evidence-based medicine in clinical practice is becoming more and more important for healthcare professionals in Germany. In this context Witten/Herdecke University has implemented an EbM Curriculum for medical students that is closely related to problem-based learning and clinical rotations within the scope of the six-year medical reform curriculum. Starting with the first semester, students will be able to acquire the necessary skills to search medical databases, to critically review the information retrieved according to EbM standards, to gather evidence for answering diagnostic or therapeutic questions during their clinical education and to ultimately participate in the development of clinical guidelines during their last year.

[Family physicians, the internet and new knowledge. Utilization and judgment of efficiency of continuing education media by general physicians and internists in family practice]. / Hausärzte, Internet und neues Wissen. Nutzung und Effizienzeinschätzung von Fortbildungsmedien durch Allgemeinärzte und hausärztlich tätige Internisten.

BACKGROUND AND OBJECTIVE: The application of new information technologies has a lasting impact on the physicians' working environment. Not only practice administration is undergoing substantial change, increasingly, individual learning preferences and continuing medical education are influenced by new media. This survey is designed to demonstrate current methods of and demand for continuing medical education by primary care physicians. METHODS: Standardized survey of 72 primary care physicians (21% female, 79% male) regarding three topics: medical knowledge acquired after medical school, current use of and expectations for continuing medical education tools. RESULTS: Primary care physicians estimate the fraction of their knowledge which was acquired after medical school at 60%. For their continuing medical education primary care physicians predominantly use scientific journals, colleagues and quality circles. The internet, scientific staff at research institutions and pharmaceutical representatives were less valued and less used. The most favored attributes for continuing medical education tools were: reliable, relevant for daily practice, and user-friendly. CONCLUSION: Continuing medical education is important and necessary. Thus far, new media still have a minor role among the relevant educational media for primary care physicians. The introduction of modern information technologies may become more successful if primary care physicians' preferences are better understood and education tools are designed according to these preferences.

[www.evidence.de--assessment and utilization of clinical guidelines by primary care physicians and internists]. / www.evidence.de--Netzbasierte Leitlinien im Praxistest. Beurteilung und Nutzung von evidenzbasierten und netzgestützten Leitlinien durch Allgemeinärzte und hausärztlich tätige Internisten.

BACKGROUND AND OBJECTIVE: Compared to the generation of new scientific results, implementation and utilization of evidence based knowledge is lacking far behind. Strengths and weaknesses of evidence- and HTML-based guidelines were evaluated in an academic network of primary care physicians to better understand the expectations and information needs of GPs. METHODS: Standardized survey of 72 primary care physicians (21% female, 79% male) regarding three network based issues: "frequency of guideline use", "reasons to use/not to use guidelines", "evaluation and overall judgement of guidelines". RESULTS: 62.9% of participating had used net based guidelines at least once, the percentage of more frequent users (> 2 times in two months) was 40.3%. Curiosity and non-specific interest as well as a concrete medical question were the main reasons for utilization of guidelines. The overall judgement of the guidelines was positive, however, only a minority of participating physicians viewed them as a concrete help in daily practice. CONCLUSION: Transformation of new scientific medical knowledge into daily primary care practice is only insufficiently developed. Netbased instruments of continuing medical education may serve as catalysts and should be further developed as well as evaluated.