Use of images in a surgery consultation. Will it improve the communication?

INTRODUCTION: The interviews and interactions with patients are part of everyday health care provider. However, there is sometimes a difficulty in communication, linked to several factors. For this reason, the use of images to illustrate the medical conditions in the outpatient clinic can improve patient communication. We report our initial experience with the use of images to manage the quality of care to surigcal patients. METHODOLOGY: He used a computer to show pictures of the following conditions: surgery for an inguinal hernia, cholelithiasis, cholecystitis and the choledocholithiasis and finally thyroid pathology. Were randomized two groups of patients. Each of the affected patients in any stage of the disease, they explained their problems. In one of the groups also showed the patient was using the current image and continued to give appropriate explanations related to pathology. Thereafter, patients in both groups filled in an anonymous questionnaire in which they responded to what degree it was considered useful this methodology, and degree of satisfaction received outpatient treatment with or without the deployment of images by computer. We have analyzed the average time expected and made a visit. RESULTS: 187 patients will be visited in the consultations over a period of 8 months. In 83 patients have been using images to give the explanations in external consultations. Of these, 24 patients suffering from thyroid, 24 hernias or incisional hernias and 35 patients with biliary tract pathology. Patients in the group were shown images of conditions have responded mostly be very satisfied with the use of images while the explanations are given on the patient's illness. Also, over 80% of patients report being satisfied with this system. The visiting time was not lengthened. DISCUSSION: Despite the existence of different variables that can influence patient satisfaction, use of images to illustrate surgical diseases to patients improves communication and flow of the explanations of the physician. CONCLUSIONS: The relationship doctor-patient communication is the key event in an outpatient setting. It determines a good overall result of the clinical interview. The use of images in an outpatient improves communication between patients and doctors. Moreover, the degree of satisfaction is high and the degree of understanding of the disease. It seems useful to incorporate in our outpatient clinic.

La esencia de la comunicación en educación médica / The essence of communication in medical education

La comunicación, entendida como relación humana, desempeña un papel esencial en los procesos de enseñanza, aprendizaje y evaluación de la dimensión comunicativa de las competencias profesionales en el ámbito de la salud. Las principales instituciones de educación médica han alcanzado consenso, avalado por evidencias, respecto a los objetivos, contenidos y metodologías tanto docentes como evaluativas que deben llevarse a cabo para un adecuado aprendizaje de habilidades de comunicación. Sin embargo, debido a la enorme complejidad de la comunicación humana en contextos de salud, enfermedad y trastornos, es necesario repensar los fundamentos epistemológicos adecuados para estudiar y evaluar la comunicación. El estudio y la evaluación deberían contemplarse en las realidades donde se interrelacionan profesionales y pacientes (AU)

The communication, understood as human relationship, plays an essential role in the processes of teaching, learning and assessing the communicative dimension of the professional competencies in the healthcare system. The main institutions of medical education have reached consensus, guaranteed by evidences, about the aims, contents and so much educational as evaluative methodologies that should be carry out for an adequate communication skills learning. Nevertheless, according the great complexity of the human communication in contexts of health, illness, disease and sickness, is necessary to rethink the best epistemological bases to study and to assess communication. The study and the evaluation should be contemplated in the real scenarios where there is professional-patient relationship (AU)

La formación actual del médico: fortalezas y debilidades / The current training of doctors: strengths and weaknesses

Las ‘Jornadas estatales de estudio y debate sobre el futuro de la formación integral del médico ¿bioingeniería o medicina?’ que se realizaron en Barcelona el 8 y 9 de febrero de 2008 fueron el marco para que un grupo de trabajo abordara el tema de las fortalezas y debilidades de la formación actual del médico. Las principales aportaciones se estructuraron en los tres niveles educativos siguientes: pregrado, posgrado y formación continuada. Se destacó la necesidad de una formación integral y psicosocial en la enseñanza de pregrado, la conveniencia de una estructuración troncal de la formación de posgrado para conseguir una mayor transversalidad de la competencia del médico y la contextualización de la formación continuada en el desarrollo profesional de cada médico. El predominio de los conocimientos biomédicos y tecnológicos en la formación actual del médico contrastan con las demandas de carácter psicosocial de una gran parte de la población en el sistema sanitario( AU)

The ‘National Conference for study and debate on the future of the integral training of doctors: bioengineering or medicine? ’that were realized in Barcelona on February 8-9th, 2008 it was the context so that a work group was carried out on the topic about strengths and weaknesses of the current training of physicians. The main contributions were structured around three educational levels: undergraduate, postgraduate and continuing education. In the undergraduate level was emphasized the need to achieve an integral and psychosocial education. The postgraduate education should have a core subject in order to acquire a better global understanding of doctors’ competences. Continuing medical education in the context of professional development of every physician. The predominance of the biomedical and technological knowledge in the current training of doctors contrasts with psychosocial demands of the population of healthcare system (AU)

El desaprendizaje: propuesta para profesionales de la salud críticos / Unlearning: proposal for critic health professionals

El desaprendizaje como método reflexivo de cuestionamiento crítico de la realidad, ayuda a examinar las estructuras teóricas que cada sujeto ha asimilado, frecuentemente de manera acrítica, durante su trayectoria formativa y profesional. Este examen crítico de las formas habituales de pensar y actuar en el mundo no pretende erigirse como guía del proceso de transición hacia formas de conciencia más verdaderas y fundamentadas. Lo que se busca, por el contrario, es realizar un ejercicio constante de interrogación de lo evidente y de aceptar los límites del pensamiento y las incertidumbres del presente (AU)

Unlearning as a reflexive method of critical questioning of reality helps us examine the theoretical structures that each individual has mastered, more often than not in an "acritical" manner, during his or her professional and formative trajectory. This critical examination of the habitual ways of thinking and behaving in today’s world is not intended, however, to serve as a guide for this transition process towards more authentic and fundamental forms of awareness. On the contrary, what we are looking for is to Performa continuous questioning exercise of what is evident and to accept the limits of our thinking patterns and the uncertainties of our time

[Coaching in the health setting: an approach to its viability]. / El coaching en el ámbito sanitario: una aproximación a su viabilidad.

OBJECTIVE: To analyse the contributions that the participants in a formative activity elaborated respect the viability of the coaching in the health environment. METHOD: Qualitative study of the contributions of the 18 participants in the workshop upon applications of the coaching in the health environment carried out the month of March 2002 at the Institute of Health Studies (IHS). RESULTS: The contributions deal with: a) the opportunities: help to healthcare professionals that become to exercise directive responsibilities and strategies to help for the cultural change, and b) the objections: resistance to change, utilization as punishment, results difficult to measure. CONCLUSIONS: The methodology of the coaching is susceptible of being applied in persons that they should exercise a key paper in a health organization, above all in process of change.

El coaching en el ámbito sanitario: una aproximación a su viabilidad / Coaching in the health setting: an approach to its viability

Objetivo: Analizar las aportaciones que los participantes en una actividad formativa elaboraron respecto la viabilidad del coaching en el ámbito sanitario. Método: Estudio cualitativo de las aportaciones de los 18 participantes en el 'Taller sobre aplicaciones del coaching en el ámbito sanitario' llevado a cabo en marzo de 2002 en el Institut d'Estudis de la Salut (IES). Resultados: Las aportaciones versaron sobre: a) las oportunidades de aplicación: la potenciación de profesionales asistenciales que pasan a ejercer funciones directivas y como estrategia de ayuda para el cambio de cultura organizativa, y b) los inconvenientes: resistencia al cambio, riesgo de utilización como castigo, resultados difícilmente objetivables. Conclusiones: La metodología del coaching es susceptible de aplicarse en personas que deben ejercer un papel clave en una organización sanitaria, sobre todo en proceso de cambio (AU)

Objective: To analyse the contributions that the participants in a formative activity elaborated respect the viability of the coaching in the health environment. Method: Qualitative study of the contributions of the 18 participants in the workshop upon applications of the coaching in the health environment carried out the month of March 2002 at the Institute of Health Studies (IHS). Results: The contributions deal with: a) the opportunities: help to healthcare professionals that become to exercise directive responsibilities and strategies to help for the cultural change, and b) the objections: resistance to change, utilization as punishment, results difficult to measure. Conclusions: The methodology of the coaching is susceptible of being applied in persons that they should exercise a key paper in a health organization, above all in process of change (AU)

El aprendizaje de habilidades de comunicación por parte de profesionales sanitarios: reflexiones a partir de diversas experiencias / The learning of communication abilities by health care professional: reflections from different experiences

En los últimos años ha habido una demanda notable de actividades formativas relacionadas con un tema en común: la comunicación entre profesionales y usuarios del sistema sanitario. La mayoría de las demandas se han efectuado desde diferentes centros y servicios sanitarios, proviniendo otras de profesionales que decidían inscribirse en actividades programadas. El presente artículo pretende presentar las inquietudes y reflexiones de los autores sobre la experiencia formativa en habilidades de comunicación de los últimos años, concretamente en referencia al modelo centrado en el paciente, los paradigmas de la comunicación humana, la necesidad de un marco conceptual integrador y la metodología para favorecer el aprendizaje de habilidades de comunicación. Estas experiencias hacen referencia a las actividades que se han llevado a cabo en el Institut d'Estudis de la Salut de la Generalitat de Catalunya con profesionales sanitarios (médicos y mayoritariamente enfermeras) de centros de atención primaria y hospitalaria en el período que abarca desde el año 1995 al año 1998 (AU)