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PubMed · 482529

Teaching the future general practitioner.

Abstract

Medical students today still graduate with insufficient skills for their role as general practitioner (family doctor, primary care physician). In particular they are lacking in their ability to use psychotherapeutic and counselling techniques for patients with psychological and psychosomatic problems. The author presents the results of a study which suggest that it is unrealistic to teach skills that demand more than, say, 15 min a session on a total of four occasions. This severe limitation poses difficult questions for those teachers who customarily think in terms of 50 min a week over many months as the basis of the model for psychotherapeutic help. The challenge of these implications is considered, and some practical ways of meeting the requirements are suggested.

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BibTeXRIS

R G Priest. 1979. Teaching the future general practitioner.. https://doi.org/10.1159/000287320

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Teaching medical students how to break bad news.

UNLABELLED: PROGRAM OBJECTIVE: To teach medical students to break bad news to patients and their families empathically and competently. SETTING: Seven teaching hospitals affiliated with the University of Toronto since 1987. PARTICIPANTS: All medical students in their third preclinical year. PROGRAM: The course presents a 6-point protocol to guide students in breaking bad news and comprises 2 half-day (3-hour) teaching sessions. Each session incorporates a video presentation, a discussion period and small-group teaching, consisting of exercises followed by 4 different role-playing scenarios conducted with the use of standardized patients. The course was evaluated through 2 questionnaires, 1 administered before and 1 after the course, which measured changes in the students' attitude and strategy. Questionnaires were administered during 5 of the years since the course was started. A total of 914 precourse and 503 postcourse questionnaires were completed, of which 359 matched pairs of precourse and postcourse questionnaires were analysed to study any changes due to the course. OUTCOMES: Precourse questionnaires showed that 68% of the students had thought about the task of breaking bad news often or very often. Of the 56% of students who had seen clinicians performing this task, 75% felt that they had seen good examples. The proportion of the students who had a plan for how to conduct such an interview rose from 49% before the course to 92% after it, and the proportion who felt they might be reasonably competent in breaking bad news rose from 23% before the course to 74% after it. CONCLUSIONS: The subject of breaking bad news is important to medical students, and it is practicable to design a course to teach the basic techniques involved. Most students perceive such a course as enjoyable and useful and find that it increases their sense of competence and their ability to formulate a strategy for such situations.

Clinical Competence