ABSTRACT
OBJECTIVE: To propose a comprehensive set of competencies and educational objectives for communication and social competencies in undergraduate medical education and to support the nationwide implementation of these issues in all medical schools. METHODS: Thirty experts from different medical and psychosocial disciplines participated in a 2-day workshop using the Nominal Group Technique (NGT) to develop an initial set of educational objectives. These were refined, structured, and rated according to their importance by means of a two-step Delphi Survey involving additional experts in medical education. RESULTS: The initial workshop resulted in 188 educational objectives assigned to 26 different topics. After the Delphi Survey, 131 objectives remained, assigned to 19 different topics. Some objectives that could be assigned to more than one topic were subsumed under a new more general category. CONCLUSION: The described consensus process proved successful as one method to develop a set of educational objectives. PRACTICAL IMPLICATIONS: The Basel consensus statement can be used to orientate curriculum reform and development in medical education.
Subject(s)
Clinical Competence/standards , Communication , Competency-Based Education/organization & administration , Consensus Development Conferences as Topic , Delphi Technique , Education, Medical, Undergraduate/standards , Austria , Curriculum , Education, Medical, Undergraduate/methods , Germany , Humans , Pilot Projects , Program Development , Schools, Medical , SwitzerlandABSTRACT
OBJECTIVE: The study focuses on physicians' ideas of their patients' attributes and examines how the German medical community employs the currently popular idea of the modern patient (mündiger Patient). METHODS: The official publication of the German medical community, the weekly journal "Deutsches Arzteblatt", was searched for articles addressing the topic of the modern patient during the 10-year period 1996-2005. A total of 73 articles were analyzed using qualitative research methods and from the perspective of discourse analysis. RESULTS: Assessments of the modern patient are heterogeneous. There are four definable discursive clusters ('law and ethics', 'knowledge and information', 'structural health care problems' and 'funding issues'). Each position views the modern patient in characteristic ways. CONCLUSION: Attributes currently ascribed to patients fit into broader modernization processes of health care systems. This involves new opportunities for patients' empowerment as well as new forms of involvement and the burden of self-reliance. PRACTICE IMPLICATIONS: Reflecting on the complexity of physicians' views of patients 'desirable' attributes within a particular physician-patient interaction, helps to assess the physician's expectations of the patient, e.g. prevailing ideas on autonomy or responsibility and whether they really are in the interest of the individual patient.
Subject(s)
Attitude of Health Personnel , Patient Participation , Physician-Patient Relations , Physicians/psychology , Germany , Health Knowledge, Attitudes, Practice , Health Services Needs and Demand , Humanism , Humans , Patient Advocacy , Patient Education as Topic , Patient Participation/methods , Patient Participation/psychology , Patient-Centered Care , Personal Autonomy , Philosophy, Medical , Physician's Role/psychology , Power, Psychological , Qualitative Research , Self Care , Social ResponsibilityABSTRACT
Electroconvulsive therapy (ECT) is a powerful antidepressive treatment, but its mechanism of action remains poorly understood. To clarify the influence of ECT on corticospinal tract excitability we tested the motor threshold, the motor evoked potential (MEP) input/output curve, and the intracortical excitability using transcranial magnetic stimulation in a depressed patient before and after successful treatment with ECT. Resting motor thresholds were increased bilaterally after treatment, and the input/output curve less steep. These results point to a decreased excitability of the corticospinal motor tract after successful ECT.
