The Use of online material in teaching general practice

I kurset på almen medicin ved Københavns Universitet optager de studerende video af deres konsultationer i almen praksis. Video konsultationer med skuespillere og praktiserende læger blev produceret for at understøtte undervisningen. Målet med dette studie var at evaluere effekten af at indføre konsultations-videos i den eksisterende undervisning. Sidste semester studerende (N=587) blev af universitet inddelt i seks grupper og en stigende mængde online materiale blev trinvis indført. Et spørgeskema og en test video målte ændringen i de studerendes evne til at identificere patient-centerede elementer i en test video før og efter kurset. Indførslen af videoklip øgede ikke de studerendes evne til dette. Derimod blev de studerende bedre til at evaluere det kliniske indhold i test video. At se konsultations videoklip før undervisningen med henblik på diskussion øger de studerendes forståelse af sygdomsbillede i almen praksis.In the general practice course at Copenhagen University, students record videos of their consultations in general practice. At university, the videos are discussed with a teacher and peers. Simulated video consultations were produced to support learning. The aim of this study was to evaluate the effect of adding simulated consultation videos to standard teaching. Final semester students (N=587) were assigned by the university to six groups and received more online teaching material one step at a time. A questionnaire and a test video consultation measured the change in students’ ability to identify patient-centered elements in a consultation pre-and post-course. Effect sizes were calculated as the difference between the pre-and post-course measures divided by the mean-variance before the course. The overall teaching effect size (ES) was positive (0,67). A high average ES of 0.94 was found for the communication questions, which included most of the patient-centered elements. Introducing simulated video consultations did not increase awareness of patient-centered elements. However, an increase in clinical skills was demonstrated. Showing simulated video consultations from general practice increase the students awareness of clinical cases in general practice and can be supplement to the clinical teaching

Psychosocial consequences of screening-detected abdominal aortic aneurisms:a cross-sectional study

OBJECTIVE: In Sweden, an abdominal aortic aneurysm (AAA) screening programme was gradually implemented from 2009 to reduce the incidence of rupture and thereby mortality. AAA screening introduces a variety of unintended, but generally unavoidable, harms, e.g. stress and worry. Such psychosocial consequences have previously only been investigated with generic measures. Therefore, the aim of this study was to describe and compare the psychosocial consequences in men with a screening detected AAA to men with a normal screening result after they participated in the Swedish national AAA-screening programme using a validated psychometric instrument. MATERIAL AND METHODS: This study was a cross-sectional survey. Data were originally collected to validate the COS-AAA and has previously been published in details. The Consequences of Screening in Abdominal Aortic Aneurysm (COS-AAA) questionnaire was sent to 250 men with a screening detected AAA and 500 with a normal screening result who were randomly selected from a Swedish population-based screening register. RESULTS: In total, 158 (63%) men with a screening detected AAA and 275 (55%) men with a normal screening result completed the COS-AAA. We found that men with a screening detected AAA reported negative psychosocial consequences to a greater extent in 10 of 13 COS-AAA Part 1 scales, all statistically significant except three (behaviour, sleep and negative experiences from examination). For COS-AAA Part 2, there was a statistically significant difference between groups in four of five scales. CONCLUSIONS: Men diagnosed with a screening detected AAA, reported more negative psychosocial consequences compared to men with a normal result. Screening for abdominal aorta aneurism (AAA) introduces intended benefits and unintended harms. Adequate measures are necessary to determine the balance between them. KEY POINTS: This study applied a condition-specific questionnaire with high content validity and adequate psychometric properties to measure psychosocial consequences in men participating in AAA screening. We found that men with a screening detected AAA reported more negative psychosocial consequences than men with a normal aorta size. The risk of negative psychosocial consequences is important to include in the decision making on whether to participate in screening or not

Psychosocial consequences of invitation to colorectal cancer screening:A matched cohort study

BACKGROUND: Psychosocial consequences of colorectal cancer (CRC) screening can arise anywhere in the screening cascade. Previous studies have investigated the consequences of participating in CRC screening; however, we have not identified any studies investigating the psychosocial consequences of receiving the invitation. Therefore, the objective of this study was to investigate psychosocial consequences of invitation to CRC screening. METHODS: The study was a longitudinal study performed in Region Zealand, Denmark. Participants included in this study were a random sample of 1000 CRC screening invitees and 1000 control persons, not invited to screening, matched in a 1:1 design on sex, age and municipality. We assessed psychosocial consequences before and after invitation in both study groups concurrently. The primary outcomes were psychosocial consequences measured with the condition-specific questionnaire Consequences of Screening in ColoRectal Cancer. RESULTS: Preinvitation response rates were 575 (57.5%) and 610 (61.0%) for the invitation group and control group, respectively. Postinvitation response rates were 442 (44.2%) for the invitation group and 561 (56.1%) for the control group. No differences in mean change in scale score were seen except for the scale ‘Change in body perception’. The invitation group had a 0.39 lower change (99% CI (−0.78 to −0.004), p=0.009) in mean score than the control group in the direction of a less negative body perception after invitation. CONCLUSIONS: This study did not identify an association between invitation to CRC screening and negative psychosocial consequences