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BACKGROUND: In the context of implementing a new framework for pre-graduate medical education in Switzerland (PROFILES) and the ongoing reform of the medical curriculum at the Faculty of Biology and Medicine of the University of Lausanne, we set out to determine the priority teaching themes of family medicine and to collect expert opinions about the most appropriate teaching methods for family medicine. Such data would contribute to the production of a coherent family medicine teaching programme encompassing its specificities as well as future challenges facing medicine in general. METHOD: We mapped the current family medicine courses at the Faculty of Biology and Medicine to obtain an overview of current learning objectives and teaching content priorities. We classified and analysed the lessons using the PROFILES grid and the principles of family medicine described by the World Organization of Family Doctors (WONCA). Then we used a modified Delphi method with a selected panel of experts and two consensus rounds to prioritise objectives for family medicine teaching at the University of Lausanne. After choosing the top objectives/activities for family medicine, subgroups of experts then discussed what would be the best teaching methods for family medicine at the University of Lausanne. RESULTS: The mapping of family medicine teaching at the University of Lausanne showed that current teaching addresses most of the primary topics of family medicine education. The modified Delphi method allowed us to identify priority themes for teaching family medicine at the University of Lausanne: (1) take a medical history and clinical examination; (2) doctor-patient relationship / patient-centred care; (3) clinical reasoning; (4) interprofessional collaboration; (5) care planning/ documentation; (6) shared decision-making; (7) communication; (8) cost-effective care; (9) health promotion; (10) assessment of urgency. The discussion with the experts identified the strengths and weaknesses of the various teaching modalities in family medicine education. Teaching should be structured, coherent and show continuity. Clinical immersion and small group teaching were the preferred teaching modalities. CONCLUSION: This approach made it possible to create the guidelines for restructuring the family medicine teaching curriculum at the University of Lausanne.
Assuntos
Medicina de Família e Comunidade , Relações Médico-Paciente , Humanos , Medicina de Família e Comunidade/educação , Técnica Delphi , Currículo , Médicos de Família , EnsinoRESUMO
BACKGROUND: GP dissatisfaction and stress at work have been a growing domain of interest for several decades. However, few studies have focused on positive predictors of GPs' satisfaction and wellbeing. The diversity of activities could be one area that could be explored to aid job satisfaction. AIM: The aim of this study was to investigate the association between the meaning in GPs' work and medical teaching activity. DESIGN & SETTING: This is a secondary analysis of the Swiss data of the QUALICOPC study, a multicentric European-wide study, investigating primary care quality, costs, and equity. METHOD: A total of 199 GPs in Switzerland answered a 60-question postal questionnaire. Descriptive and multivariate logistic regression analyses were performed using Stata (version 15). A focus group with six GPs gave qualitative data to help interpret the results. RESULTS: Thirty-one per cent of GPs reported a loss of meaning in their work. In multivariate analyses, loss of meaning was lower in GPs with teaching activity (odds ratio [OR] = 0.50; 95% confidence interval [CI] = 0.27 to 0.90). In addition, loss of meaning was associated with late hospital discharge letter reception time (OR = 2.28; 95% CI = 1.20 to 4.35 if ≥15 days) and an administrative overload (OR = 4.18; 95% CI = 2.04 to 5.58). For GPs in the focus group, medical teaching occurred mostly because of intrinsic motivations. CONCLUSION: Loss of meaning in GPs' work was lessened with teaching activity. Therefore, encouraging a GP practice that is varied in its activities may encourage GP satisfaction. Ultimately, job satisfaction may impact patient quality of care and this study offers some insight on how to improve work satisfaction for the next generation of GPs.
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Ecodesign is relatively new to the family medicine practice. It consists of a pro-active approach in order to reduce harmful environmental impacts from an organization or a product. These environmental impacts, such as climate change, clearly represent major public health concerns. It seems legitimate for the medical community to question its role in «â preventingâ ¼ rather than «â curingâ ¼ through its contribution to the protection of the environment. This review lays some definitions and explains the current situation. It tries to gather the existing ecodesign initiatives in the outpatient area. At last, some lines of thought and of progress are presented, with a focus on the Swiss context.
L'écoconception est un terme relativement nouveau pour les cabinets de médecine de famille. Il s'agit d'une démarche pro-active visant à réduire les impacts environnementaux nuisibles engendrés par une organisation ou un produit. Ces impacts environnementaux, comme le dérèglement climatique, représentent clairement des problèmes majeurs de santé publique, il semble donc légitime que le milieu médical s'interroge sur son rôle à «â prévenirâ ¼ plutôt que «â guérirâ ¼, également via sa contribution à la protection de l'environnement. Après avoir posé quelques éléments de définitions et de situations, cet article dresse un état des lieux global de la pratique écoconception dans le domaine médical ambulatoire. Enfin, des pistes de réflexion et de progrès sont présentées pour le contexte suisse.
Assuntos
Meio Ambiente , Medicina de Família e Comunidade , Medicina Geral , Mudança Climática , Saúde PúblicaRESUMO
Family medicine is now an integral part of the curriculum of medical schools in Switzerland. The current challenge is to convey information about the attractive aspects of family medicine to medical students to address the growing shortage of primary care physicians. This article describes the implementation of a research program to promote career choice in family medicine, which leads to the development of a conceptual framework as a theoretical basis for teaching and research. Innovations from three medical schools in French-speaking Switzerland are presented. The authors describe the implication for family physicians in private practice, who are key partners of academic family medicine.
L'enseignement de la médecine de famille fait désormais partie intégrante du curriculum d'enseignement des facultés de médecine en Suisse. Le défi actuel est de mettre en valeur les aspects attractifs de cette discipline afin d'assurer la relève. Cet article décrit la mise en place d'un programme de recherche visant à promouvoir le choix de carrière en médecine de famille, aboutissant à des connaissances et à un cadre conceptuel comme base théorique pour le développement de l'enseignement en médecine de famille. Des innovations pédagogiques de trois facultés en Suisse romande sont présentées. Les auteurs décrivent les implications pour les médecins de famille pratiquant en cabinet, qui sont les partenaires incontournables de la médecine de famille académique.
Assuntos
Currículo , Medicina de Família e Comunidade , Universidades , Escolha da Profissão , Medicina de Família e Comunidade/educação , Faculdades de Medicina , SuíçaRESUMO
Email is a great communication tool, but it's still rarely used by healthcare professionals. It can be used in exchanging information between healthcare professionals, but also among healthcare providers and patients. Studies that demonstrate a positive impact of email communication between health professionals and patients in the quality of healthcare are still lacking. Hence, an increasing number of patients want to communicate through email with their doctors. Clinical use of electronic mail should respect a certain number of rules, first of all using an encrypted system.
Le courrier électronique est un moyen de communication puissant mais encore peu utilisé par les professionnels de la santé. Il peut être utilisé pour des échanges entre professionnels mais aussi entre soignants et patients. Même si les études qui prouvent l'impact positif de la communication électronique entre médecins et patients sur la qualité des soins manquent encore, une part grandissante de patients souhaite pouvoir communiquer par courriel avec leurs médecins. L'utilisation médicale du courrier électronique doit répondre à un certain nombre de règles, la première étant l'utilisation d'un système de courrier sécurisé.
