Mireille Schaufelberger

General practitioner teachers' job satisfaction and their medical students' wish to join the field - a correlational study.

BackgroundThere will be increasing competition for young physicians worldwide as more and more physicians retire. While enthusiasm towards GP work is important for GP teachers as role models, satisfaction within the profession has declined. This study aims to determine if medical students’ desire to become GPs is related to the job satisfaction of their teaching GPs and explore the factors tied to this job satisfaction.MethodsIn this cross-sectional, correlational study, teaching GPs of the University of Bern and the fourth year medical students completing internships with them filled in separate questionnaires.ResultsWhether or not the GP teacher is perceived by a student to be satisfied with her/his job is correlated to that student’s satisfaction with the internship, which in turn, is correlated with student’s wish to be a GP after the internship. Results show which factors are most related to GP job satisfaction and the effect of working hours and their composition.ConclusionsMedical students’ perception of their GP teachers’ job satisfaction positively affect their wish to become GPs, and their satisfaction with their internships adds to this. Enhancing the positive aspects of GP work, such as recognition, and improving negative ones, such as administrative duties, are necessary to attract medical students into the GP field.

Emergency telephone consultations: a new course for medical students

Background:  Using the telephone for consultations is now common practice. Although there is a clear need for specific training for telephone consultations, it is uncommon for it to be taught in medical school.

Benefits of communication skills training after real patient exposure

Background:  The established communication skills training (CST) curriculum consists of continuous education, frequent practice with real patients, supervision and feedback from medical teachers. The limitation of this curriculum is that students have to directly apply the theoretical basis they are provided with to real patients. To improve the existing CST curriculum a CST module involving simulated patients was introduced in order to develop more complex communication skills.

Primary care at Swiss universities - current state and perspective

BackgroundThere is increasing evidence that a strong primary care is a cornerstone of an efficient health care system. But Switzerland is facing a shortage of primary care physicians (PCPs). This pushed the Federal Council of Switzerland to introduce a multifaceted political programme to strengthen the position of primary care, including its academic role. The aim of this paper is to provide a comprehensive overview of the situation of academic primary care at the five Swiss universities by the end of year 2012.ResultsAlthough primary care teaching activities have a long tradition at the five Swiss universities with activities starting in the beginning of the 1980ies; the academic institutes of primary care were only established in recent years (2005 – 2009). Only one of them has an established chair. Human and financial resources vary substantially. At all universities a broad variety of courses and lectures are offered, including teaching in private primary care practices with 1331 PCPs involved. Regarding research, differences among the institutes are tremendous, mainly caused by entirely different human resources and skills.ConclusionSo far, the activities of the existing institutes at the Swiss Universities are mainly focused on teaching. However, for a complete academic institutionalization as well as an increased acceptance and attractiveness, more research activities are needed. In addition to an adequate basic funding of research positions, competitive research grants have to be created to establish a specialty-specific research culture.

Reply to the letter to the editor of K. Walsh

We very much appreciate the comments of Kieran Walsh [1] on the relationship between reduced performance and the insecurity of medical students in simulated emergency telephone consultations (ETCs). In our study [2], the second most frequent reason cited by students for feeling insecure was a low level of knowledge about the necessary questions to ask, suggesting that insecurity and poor performance were associated with this lack of knowledge. It was this finding that led us to recommend better education on emergency telephone consultations, as well as training on what questions to ask. There is indeed, as Walsh points out, the possibility that a feeling of insecurity about the ETC itself may have prevented the students from using their knowledge to perform well. Interestingly, little is known about the factors that improve or hinder the transition from knowledge into performance as exemplified by Miller’s pyramid of competence [3]. It is unclear whether insecurity is one of the factors that hinder such a transition. In our study, the reason most frequently cited by medical students for their insecurity was lack of clinical knowledge and experience. This insecurity could indeed have led to difficulties in applying existing knowledge. Training on strategies to deal with this was our second recommendation. We agree with Walsh that training in emergency telephone consultations should be accompanied by reflective activity including how to deal with insecurity. In our practical course, reflection is done at the end of each simulated consultation, when students discuss their emergency telephone call with the simulated patient and are asked to state how they felt during it [5]. This reflective component could have a stronger focus on any feelings of insecurity, as well as feedback from clinicians or communication experts about phases with unclear communication. Recorded consultations could also be used by students to help them reflect on any feeling of insecurity during the ETC [5]: a “think aloud” approach, or asking students to note and comment on times that they felt insecure. Reflection during the consultation itself could be taught by immediate interruption of the consultation by either student or tutor as soon as any insecurity is perceived, allowing them to discuss it. We agree that, to produce an improvement in ETCs, training needs to address both knowledge and how to handle feelings of insecurity. Further investigation to disentangle the relationship between these two components would be worthwhile.

Blended Learning "Polypharmazie im Alter" im 4. Studienjahr Humanmedizin

Einführung In der Schweiz nehmen mehr als 41 % der über 65-jährigen, zu Hause lebenden Menschen ≥5 verschiedene Medikamente ein1. Die Überprüfung komplexer Medikationen gehört zu den ärztlichen Kernkompetenzen. Entsprechende Lernziele sind im Schweizerischen Lernzielkatalog SCLO (http://sclo.smifk.ch) formuliert (P 233, C PT 8, C PT 15). Unser Ziel war, die Medizinstudierenden der Universität Bern im Hinblick auf ihre klinische Tätigkeit auf den Umgang mit Polypharmazie im Alter vorzubereiten.