1. Academic general practice/family medicine in times of COVID-19 - Perspective of WONCA EuropeAdam Windak, Thomas Frese, Eva Hummers-Pradier, Zalika Klemenc-Ketiš, Sonia Tsukagoshi, Josep Vilaseca, Shlomo Vinker, Mehmet Ungan, 2020, original scientific article Abstract: COVID-19 outbreak has significantly changed all aspects of general practice in Europe. This art-icle focuses on the academic challenges for the discipline, mainly in the field of education,research, and quality assurance. The efforts of the European Region of the World Organisationof National Colleges, Academies, and Academic Associations of General Practitioners/FamilyPhysicians (WONCA Europe) to support academic sustainability of the discipline in the time ofpandemic are presented. Medical education was affected by the pandemic, threatening both itsproductivity and quality. Emerging new educational methods might be promising, but theresults of their rapid implementation remain uncertain. A relatively small number of publicationsrelated to COVID-19 and general practice is available in the medical literature. There is a short-age of original data from general practice settings. This contrasts with the crucial role of GPs infighting a pandemic. COVID-19 outbreak has opened widely new research areas, which shouldbe explored by GPs. Maintaining the quality of care and safety of all patients during the COVID-19 pandemic is the utmost priority. Many of them suffer from poor access or inadequate man-agement of their problems. Rapid implementation of telemedicine brought both threats andopportunities. The COVID-19 pandemic also challenged doctors' safety and well-being. Theseaspects will require discussion and remedy to prevent deterioration of the quality of primarycare. WONCA Europe is making a multi-faceted effort to support GPs in difficult times of thepandemic. It is ready to support future efforts to uphold the integrity of family medicine as anacademic discipline.
Keywords: infectious diseases, quality of care, public health, community medicine, health care organisation, management, medical education
Published in DKUM: 07.01.2025; Views: 0; Downloads: 4
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2. Clinical reasoning needs to be explicitly addressed in health professions curricula : recommendations from a European consortiumIoannis Parodis, Lina Andersson, Steven J. Durning, Inga Hege, Jure Knez, Andrzej Kononowicz, Marie Lidskog, Tadej Petreski, Magdalena Szopa, Samuel Edelbring, 2021, original scientific article Abstract: Clinical reasoning entails the application of knowledge and skills to collect and integrate information, typically with the goal of arriving at a diagnosis and management plan based on the patient’s unique circumstances and preferences. Evidence-informed, structured, and explicit teaching and assessment of clinical reasoning in educational programs of medical and other health professions remain unmet needs. We herein summarize recommendations for clinical reasoning learning objectives (LOs), as derived from a consensus approach among European and US researchers and health professions educators. A four-step consensus approach was followed: (1) identification of a convenience sample of the most relevant and applied national LO catalogues for health professions educational programs (N = 9) from European and US countries, (2) extraction of LOs related to clinical reasoning and translation into English, (3) mapping of LOs into predefined categories developed within the Erasmus+ Developing, implementing, and disseminating an adaptive clinical reasoning curriculum for healthcare students and educators (DID-ACT) consortium, and (4) synthesis of analysis findings into recommendations for how LOs related to clinical reasoning could be presented and incorporated in LO catalogues, upon consensus. Three distinct recommendations were formulated: (1) make clinical reasoning explicit, (2) emphasize interprofessional and collaboration aspects of clinical reasoning, and (3) include aspects of teaching and assessment of clinical reasoning. In addition, the consortium understood that implementation of bilingual catalogues with English as a common language might contribute to lower heterogeneity regarding amount, structure, and level of granularity of clinical reasoning LOs across countries. These recommendations will hopefully motivate and guide initiatives towards the implementation of LOs related to clinical reasoning in existing and future LO catalogues.
Keywords: clinical reasoning, curriculum development, curriculum mapping, health professions education, medical education
Published in DKUM: 08.10.2024; Views: 0; Downloads: 4
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3. Safety culture and the positive association of being a primary care training practice during COVID-19 : the results of the multi-country European PRICOV-19 studyBianca Silva, Zlata Ožvačić Adžić, Pierre Vanden Bussche, Esther Van Poel, Bohumil Seifert, Cindy Heaster, Claire Collins, Canan Tuz Yilmaz, Felicity Knights, Zalika Klemenc-Ketiš, 2022, original scientific article Abstract: The day-to-day work of primary care (PC) was substantially changed by the COVID-19 pandemic. Teaching practices needed to adapt both clinical work and teaching in a way that enabled the teaching process to continue, while maintaining safe and high-quality care. Our study aims to investigate the effect of being a training practice on a number of different outcomes related to the safety culture of PC practices. PRICOV-19 is a multi-country cross-sectional study that researches how PC practices were organized in 38 countries during the pandemic. Data was collected from November 2020 to December 2021. We categorized practices into training and non-training and selected outcomes relating to safety culture: safe practice management, community outreach, professional well-being and adherence to protocols. Mixed-effects regression models were built to analyze the effect of being a training practice for each of the outcomes, while controlling for relevant confounders. Of the participating practices, 2886 (56%) were non-training practices and 2272 (44%) were training practices. Being a training practice was significantly associated with a lower risk for adverse mental health events (OR: 0.83; CI: 0.70-0.99), a higher number of safety measures related to patient flow (Beta: 0.17; CI: 0.07-0.28), a higher number of safety incidents reported (RR: 1.12; CI: 1.06-1.19) and more protected time for meetings (Beta: 0.08; CI: 0.01-0.15). No significant associations were found for outreach initiatives, availability of triage information, use of a phone protocol or infection prevention measures and equipment availability. Training practices were found to have a stronger safety culture than non-training practices. These results have important policy implications, since involving more PC practices in education may be an effective way to improve quality and safety in general practice.
Keywords: safety culture, patient safety, quality of care, primary health care, COVID-19, medical education, vocational training, PRICOV-19, infectious disease, multi-country, general practice
Published in DKUM: 04.07.2024; Views: 128; Downloads: 17
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4. Deficiency areas in decision making in undergraduate medical studentsZalika Klemenc-Ketiš, Janko Kersnik, 2014, original scientific article Abstract: Background: In family medicine, decisions can be difficult due to the early presentation of often poorly developed symptoms or the presentation of undifferentiated conditions that require competencies unique to family medicine, such as; primary care management, specific problem-solving skills, and a comprehensive and holistic approach to be taught to medical students.
Purpose: The aim of this study was to assess the decision-making process covering all theoretical aspects of family practice consultation and to recognize possible areas of deficiency in undergraduate medical students.
Materials and methods: This was a cross-sectional, observational study performed at the Medical School of the University of Maribor in Slovenia. The study population consisted of 159 fourth-year medical students attending a family medicine class. The main outcome measure was the scores of the students' written reports on solving the virtual clinical case. An assessment tool consisted of ten items that could be graded on a 5-point Likert scale.
Results: The final sample consisted of 147 (92.5%) student reports. There were 95 (64.6%) female students in the sample. The mean total score on the assessment scale was 35.1+-7.0 points of a maximum 50 points. Students scored higher in the initial assessment items and lower in the patient education/involvement items. Female students scored significantly higher in terms of total assessment score and in terms of initial assessment and patient education/involvement.
Conclusion: Undergraduate medical education should devote more time to teaching a comprehensive approach to consultation, especially modification of the health behavior of patients and opportunistic health promotion to patients. Possible sex differences in students' performance should be further evaluated.
Keywords: assessment, family medicine, undergraduate medical education, decision making
Published in DKUM: 03.08.2017; Views: 1282; Downloads: 384
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5. From virtual library over dictum and intel until refine : a story about ten-years of reform of medical education in Bosnia-HerzegovinaVladimir Šimunović, Hans-Günther Sonntag, Richard Marz, Maja Ostojić, Axel Horsch, Bojana Filej, Danica Železnik, Ana Marušić, 2008, review article Abstract: The purpose of this paper is to recall how we, medical teachers in Bosnia-Herzegovina (BH), coped with the challenge of reform in higher education and to analyze what in our doing was fashion, which trends we have chosen to follow, and what were the real, substantial and tangible results of our work. Financial support for reform across the board came through the Trans-European Program for Co-operation in Higher Education in Central and Eastern Europe (Tempus), and, since 1997, the five schools of medicine in Bosnia and Herzegovina partnered with academic institutions from nine EU countries in seven granted Tempus projects. The results were tangible: a network of medical libraries was established; medical schools were assessed internally and externally; several important documents were drafted and agreed on; a core group of faculty from Bosnia and Herzegovina was trained in new teaching methods; and research was done and published. Not less important,there were also some less tangible, but perhaps even more important fruits of this cooperation. A sense of trust was established, which is essential for any future collaborative action. Representatives from all sides, previously divided by the war, had a chance to communicate with each other, dispelling some prejudices and regaining belief that it is possible to work together. This example of the schools of medicine of Bosnia and Herzegovina shows that higher education can be a favorable arena for reconciliation. Financial incentive can serve as a catalyst in the process and the presence of impartial partners (in our case, schools of medicine from the EU) proved beneficial for establishing and maintaining trust and good-will.The conclusion is that society rebuilding can be promoted indirectly,through formal education and professional engagement,not necessarily by pressing the “opposing” sides to talk about reconciliation and sign peace declarations.
Keywords: medical education, Tempus, ECTS, Quality assurance, curriculum reform, catalogue, knowledge and skills
Published in DKUM: 24.07.2017; Views: 2434; Downloads: 106
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6. Using movies in family medicine teaching : a reference to EURACT Educational AgendaZalika Klemenc-Ketiš, Igor Švab, 2017, original scientific article Abstract: Introduction: Cinemeducation is a teaching method where popular movies or movie clips are used. We aimed to determine whether family physicians’ competencies as listed in the Educational Agenda produced by the European Academy of Teachers in General Practice/Family Medicine (EURACT) can be found in movies, and to propose a template for teaching by these movies.
Methods: A group of family medicine teachers provided a list of movies that they would use in cinemeducation. The movies were categorised according to the key family medicine competencies, thus creating a framework of competences, covered by different movies. These key competencies are Primary care management, Personcentred care, Specific problem-solving skills, Comprehensive approach, Community orientation, and Holistic approach.
Results: The list consisted of 17 movies. Nine covered primary care management. Person-centred care was covered in 13 movies. Eight movies covered specific problem-solving skills. Comprehensive approach was covered in five movies. Five movies covered community orientation. Holistic approach was covered in five movies.
Conclusions: All key family medicine competencies listed in the Educational Agenda can be taught using movies. Our results can serve as a template for teachers on how to use any appropriate movies in family medicine education.
Keywords: family practice, medical education, narration, professional competences, movies, family medicine, education, EURACT
Published in DKUM: 06.04.2017; Views: 1471; Downloads: 172
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