The Primary Care and Environmental Health (PCEH) online course to integrate environmental health in general practice: a pilot e-learning intervention (Preprint)
Obstacles et perspectives pratiques de la consultation en médecine générale du migrant porteur de troubles psychologiques. Étude qualitative auprès de médecins généralistes français
BACKGROUND: Colorectal cancer (CRC) is the third most common cancer in men and the second in wome... more BACKGROUND: Colorectal cancer (CRC) is the third most common cancer in men and the second in women worldwide. During the period 2017-2018, in France, 32.1% of the eligible population completed screening, which is under the acceptable uptake rate. The FORCEPS study aimed to test whether a training program focused on improving general practitioners' (GPs') communication skills could increase their patients' CRC screening rate. Our study reports on the construction of, participation in and evaluation of the e-learning training program tested in the FORCEPS study. METHODS: An interdisciplinary team designed an e-learning program for French GPs on the Moodle® platform. Learning activities related to the stated learning objectives and interactive approaches were speci ed. Two sessions took place, in May and November 2018. The training lasted 6 weeks. RESULTS: In all, 116 GPs registered for the training program. Seventy per cent of the GPs who registered for the rst session opted to follow the training via e-learning rather than in person. Among the participants, 36.0% followed the training in its entirety during session 1, as did 24.0% during session 2. At the end of the training, none of the participating GPs self-assessed themselves as a "novice", and the number of GPs self-assessing as "intermediate" or "experienced" increased. Overall, 62.9% of the participants were generally satis ed with the e-learning course. CONCLUSIONS: The web-based program focused on improving GPs' communication skills to encourage CRC screening was chosen by a large majority of the participating GPs and received positive reviews. While GPs' theoretical knowledge can be improved through our training program, it remains to be seen whether or not this will be re ected in their everyday practice, thus resulting in an increased CRC screening participation rate among patients.
FAMG-Score : proposition fondée sur des scores validés pour une prise en charge appropriée des patients atteints de fibrillation auriculaire en médecine générale
The Primary Care and Environmental Health (PCEH) online course: a pilot e-learning intervention to integrate environmental health in general practice (Preprint)
Objectif : Explorer la relation médecin-patient dans les études qualitatives traitant de la théor... more Objectif : Explorer la relation médecin-patient dans les études qualitatives traitant de la théorie de l'attachement, qui en apportent une compréhension en médecine générale. Méthode : méta-synthèse : méthode d'analyse secondaire d'études qualitatives. Revue de littérature, analyse thématique, translation et synthèse. Résultats : la relation médecin-patient était une relation d'attachement nécessaire au patient pour se sentir apaisé en situation de vulnérabilité. Les stratégies de régulation des émotions négatives du patient et du médecin guidaient les comportements de santé. Le propre style du médecin conditionnait la qualité de la relation. Le médecin, « base sécure », exerçait un effet régulateur des émotions négatives du patient. La confiance mutuelle était thérapeutique dans une approche « liée-patient ». Conclusion : la théorie de l'attachement est utile pour l'étude de la relation médecin-patient.
Iconographies supplémentaires de l'article : La théorie de l’attachement est une ressource pour la relation médecin-patient : méta-synthèse qualitative
Integrating general practitioners into crisis management would accelerate the transition from victim to effective professional: Qualitative analyses of a terrorist attack and catastrophic flooding
FAMG-Score : proposition fondée sur des scores validés pour une prise en charge appropriée des patients atteints de fibrillation auriculaire en médecine générale
Current normative or formative assessments of medical students tend to focus more on skills rathe... more Current normative or formative assessments of medical students tend to focus more on skills rather than knowledge. The script concordance test has good psychometric qualities to assess reasoning skills required to resolve complex problems in situations of uncertainty. Objective structured clinical examinations assess clinical competence in realistic situations (clinical situation, standardized and simulated patients, neutral observers, observation check lists) however their organization is complex and costly. The introduction of human factors (panel of experts, simulated and standardized patients and observers) reduces the objectivity and reliability of both these tests. The generation Y (births between 1980 and 1992) has grown up in the digital age with widespread access to technology and as such expect new and innovative teaching aids. Serious games, developed in the health education field, could be used as a student assessment tool. This requires the convergence between medical s...
Current normative or formative assessments of medical students tend to focus more on skills rathe... more Current normative or formative assessments of medical students tend to focus more on skills rather than knowledge. The script concordance test has good psychometric qualities to assess reasoning skills required to resolve complex problems in situations of uncertainty. Objective structured clinical examinations assess clinical competence in realistic situations (clinical situation, standardized and simulated patients, neutral observers, observation check lists) however their organization is complex and costly. The introduction of human factors (panel of experts, simulated and standardized patients and observers) reduces the objectivity and reliability of both these tests. The generation Y (births between 1980 and 1992) has grown up in the digital age with widespread access to technology and as such expect new and innovative teaching aids. Serious games, developed in the health education field, could be used as a student assessment tool. This requires the convergence between medical s...
Introduction : Chaque annee en France, cent mille personnes presentent un infarctus du myocarde. ... more Introduction : Chaque annee en France, cent mille personnes presentent un infarctus du myocarde. D'apres le registre FACT en 2003 : dans 1/3 des cas, le medecin generaliste est le premier intervenant face a une situation evoquant un syndrome coronarien aigue (SCA). L'objectif de cette etude etait de determiner la demarche diagnostique des medecins generalistes de l'Herault face a un syndrome coronarien se presentant sous une forme digestive. Ce travail permet ainsi d'isoler les limites rencontrees face a ce diagnostic et de trouver des moyens possibles d’amelioration. Materiel et Methode : Etude qualitative par focus groupe aupres de medecins generalistes liberaux de l’Herault. L'analyse s'est faite de maniere thematique a partir des verbatims. Resultats : Devant une presentation atypique, le diagnostic de syndrome coronarien aigu passe par un examen clinique approfondi en s'appuyant sur le contexte, les antecedents, les facteurs de risques cardiovasculai...
Syndrome coronarien aigu de présentation épigastrique
En France, l’infarctus du myocarde touche 100 000 personnes par an. Le registre FACT de 2003 a mo... more En France, l’infarctus du myocarde touche 100 000 personnes par an. Le registre FACT de 2003 a montre que dans 36 % des syndromes coronariens, les medecins generalistes intervenaient en premier. 30 % des syndromes coronariens aigus presentaient des manifestations cliniques atypiques comme des epigastralgies. Si les medecins generalistes pensent a une origine coronarienne lors d’une douleur epigastrique, quelles sont les limites a leur demarche diagnostique et quelles pistes d’amelioration proposent-ils ?Dans cette etude, les medecins generalistes se basaient sur la presentation clinique, le contexte et l’electrocardiogramme pour s’orienter vers un syndrome coronarien aigu lors de manifestations cliniques atypiques et en cas de suspicion de syndrome coronarien aigu ils sollicitaient le centre 15. Mais le syndrome coronarien aigu de presentation atypique etait un diagnostic complexe pour les medecins generalistes interroges en raison des diagnostics differentiels existant et de la pri...
General practitioners must acquire skills to communicate with child with Autism Spectrum Disorder to regain their values and role in the follow-up – phenomenological study
Scandinavian Journal of Primary Health Care, 2021
Objective To understand the perceptions and attitudes of general practitioners (GPs) regarding ch... more Objective To understand the perceptions and attitudes of general practitioners (GPs) regarding children with an Autism Spectrum Disorder (ASD). Design Phenomenological qualitative study. Setting Three focus groups, clinical settings. Subjects French GPs. Main outcome measures 22 GPs took part in the study divided among three focus groups. They were volunteers to participate. Data were transcribed verbatim and analysed using a grounded theory data analysis, completed with a semiopragmatic analysis. Results Representing autism as a strange disorder in the doctor–patient relationship, GPs perceive a loss of sensory contact with the child with ASD that prevents the usual professional relationship between doctor and patient. They disengage themselves from monitoring the subject, concentrating on supporting the family. According to them, their role was to refer the patient to a specialist in the case of clinical intuition, but they have several reasons to give themselves time, all the mor...
Background In 2020, the number of new cancer cases was estimated at 20 490 862 worldwide up from ... more Background In 2020, the number of new cancer cases was estimated at 20 490 862 worldwide up from 18.1 million in 2018 and 14.1 million in 2012. Since the 2000s, cancer treatments have significantly improved, allowing either a cure or control of the disease. Patients share their experience of the disease and use supportive care solutions through involvement in patient associations and online forums. All the associations were built on the principle of “peer support,” which is based on mutual aid between people who suffer or have suffered from the same somatic or psychological illness or had the same life experience.This experiential knowledge can be explored to understand the role of peers and associations in the appropriation of their cancer Methods: A qualitative phenomenological study was undertaken through semi-structured interviews with 12 participants. Interviews were audio-recorded, transcribed verbatim, then analyzed by means of triangulation up to the point of theoretical sat...
BACKGROUND: Colorectal cancer (CRC) is the third most common cancer in men and the second in wome... more BACKGROUND: Colorectal cancer (CRC) is the third most common cancer in men and the second in women worldwide. During the period 2017-2018, in France, 32.1% of the eligible population completed screening, which is under the acceptable uptake rate. The FORCEPS study aimed to test whether a training program focused on improving general practitioners’ (GPs’) communication skills could increase their patients’ CRC screening rate. Our study reports on the construction of, participation in and evaluation of the e-learning training program tested in the FORCEPS study.METHODS: An interdisciplinary team designed an e-learning program for French GPs on the Moodle® platform. Learning activities related to the stated learning objectives and interactive approaches were specified. Two sessions took place, in May and November 2018. The training lasted 6 weeks. RESULTS: In all, 116 GPs registered for the training program. Seventy per cent of the GPs who registered for the first session opted to foll...
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