RESUMEN
Planning. At the Department of General Medicine of the University of Aix-Marseille, an optional teaching of critical thinking has been proposed to the residents in General Practice during the academic year 2020-21. This project was conceived as an attempt to respond to the crisis of medical knowledge exacerbated by the COVID-19 health crisis. Implementation. The module was broken down into 3 courses: the first was devoted to epistemology and the history of science in order to explore the permanent links between science, medicine and society. The module was broken down into 3 courses: the first session was devoted to the epistemology and history of science in order to explore the permanent links between science, medicine and society. The variability of practices, opinions and attitudes of general practitioners were also questionned. In a second session, the interns were introduced to the ways of staging science and administering scientific evidence, but also to the social uses of knowledge in the internet era with a focus on cognitive biases. The last session was dedicated to the communication dimension with the patient and the essential role of the general practitioner when knowledge is subject to controversy and uncertainty. Students were asked to use motivational interviewing techniques to explore patients' knowledge, values and preferences. Evaluation. The workshop highlighted the strong needs of residents in General Practice. Most considered critical thinking to be a professional skill. Perspective. It is now essential that GP departments of family medicine strengthen the communication skills of future GPs so that they can remain trusted partners to their patients in the contemporary context of disenchantment with science and numerous medical controversies. Involving the patient in teaching critical thinking skills in a partnership approach would strengthen the interpersonal skills of future practitioners.
RESUMEN
While COVID-19 continues to progress worldwide, the French situation is particularly affected by a lack of masks, tests and, as everywhere else, by the lack of clinically validated therapeutic options. The French government has made the choice of confinement and remote monitoring of patients, with recourse to the healthcare system only when signs of worsening appear (hospitalisation). But in Marseille, a hospital research centre (IHU, led by Pr. Raoult) decided to apply the doctrine of ‘test and treat’ using hydroxychloroquine. This chapter explores the effects of this decision on local doctors’ practices relative to COVID-19. We will show the dilemmas faced by doctors: how they navigate the controversy over hydroxychloroquine as well as negotiate with their patients’ demand for testing and treatment with hydroxychloroquine. This chapter constitutes a first attempt at bringing together the results of a wider research project involving analysis several surveys and interviews conducted among GPs in Marseille and 1200 GPs in France, an analysis of the coverage of the hydroxychloroquine debate in the French national press and surveys conducted among representative samples of the French population. It will also draw on one of the authors’ experience of being a general practitioner in Marseille. © 2021 selection and editorial matter, Deborah Lupton and Karen Willis.