Swiss students and young physicians want a flexible goal-oriented GP training curriculum.

A growing shortage of general practitioners (GPs), in Switzerland and around the world, has forced countries to find new ways to attract young physicians to the specialty. In 2017, Switzerland began to fund hundreds of new study places for medical students. This wave of young physicians will soon finish University and be ready for postgraduate training. We hypothesized that an attractive postgraduate training program would encourage interested young physicians to pursue a GP career. This is a cross-sectional survey of young physicians from the Swiss Young General Practitioners Association (JHaS), members of Cursus Romand de médecine de famille (CRMF), and all current medical students (5 <sup>th</sup> or 6 <sup>th</sup> years) (n = 554) in Switzerland, excluding students indicating definitely not to become GPs. We asked all if they were likely to become a GP (Likert: 1-10), and then asked them to score general features of a GP training curriculum, and likely effects of the curriculum on their career choice (Likert scale). They then rated our model curriculum (GO-GP) for attractiveness and effect (Likert Scales, open questions). Most participants thought they would become GPs (Likert: 8 of 10). Over 90% identified the same features as an important part of a curriculum ("yes" or "likely yes"): Our respondents thought the GO-GP curriculum was attractive (7.3 of 10). It was most attractive to those highly motivated to become GPs. After reviewing the curriculum, most respondents (58%) felt GO-GP would make them more likely to become a GP. Almost 80% of respondents thought an attractive postgraduate training program like GO-GP could motivate more young physicians to become GPs. Overall, medical students and young physicians found similar features attractive in the general and GO-GP curriculum, regardless of region or gender, and thought an attractive curriculum would attract more young doctors to the GP specialty. Key points An attractive postgraduate training program in general practice can attract more young physicians to become GPs. In this study cross-sectional survey including medical students (n = 242) and young physicians (n = 312) we presented general features for a curriculum and a model curriculum for general practice training, for evaluation of attractiveness to our study population. General practice training curriculum provides flexibility in choice of rotations, access to short rotations in a wide variety of medical specialties, training in specialty practices as well, mentoring and career guidance by GPs and guidance in choosing courses/certificate programs necessary for general practice. These findings help building attractive postgraduate training programs in general practice and fight GP shortage

SYNDROME DE NEPHROPATHIE TUBULO-INTERSTITIELLE AVEC OU SANS UVEITE CHEZ L'ADULTE

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Un champ d'application : les ressources humaines et l'insertion professionnelle

International audienceCet ouvrage présente plusieurs champs de recherche issus de la psychologie sociale actuelle, choisis pour les applications existantes ou pour leur potentiel d’application : leur applicabilité. Il propose de réelles pistes pour l’action susceptibles de servir aussi bien le psychologue en apprentissage que le psychologue expérimenté et déjà en activité mais en recherche de dispositifs à développer pour répondre aux problématiques auxquelles il est confronté dans son quotidien professionnel

Cobalt-Iron-Manganese Catalysts for the Conversion of End-of-Life-Tire-Derived Syngas into Light Terminal Olefins

Co-Fe-Mn/γ-Al2 O3 Fischer-Tropsch synthesis (FTS) catalysts were synthesized, characterized and tested for CO hydrogenation, mimicking end-of-life-tire (ELT)-derived syngas. It was found that an increase of C2 -C4 olefin selectivities to 49 % could be reached for 5 wt % Co, 5 wt % Fe, 2.5 wt % Mn/γ-Al2 O3 with Na at ambient pressure. Furthermore, by using a 5 wt % Co, 5 wt % Fe, 2.5 wt % Mn, 1.2 wt % Na, 0.03 wt % S/γ-Al2 O3 catalyst the selectivity towards the fractions of C5+ and CH4 could be reduced, whereas the selectivity towards the fraction of C4 olefins could be improved to 12.6 % at 10 bar. Moreover, the Na/S ratio influences the ratio of terminal to internal olefins observed as products, that is, a high Na loading prevents the isomerization of primary olefins, which is unwanted if 1,3-butadiene is the target product. Thus, by fine-tuning the addition of promoter elements the volume of waste streams that need to be recycled, treated or upgraded during ELT syngas processing could be reduced. The most promising catalyst (5 wt % Co, 5 wt % Fe, 2.5 wt % Mn, 1.2 wt % Na, 0.03 wt % S/γ-Al2 O3 ) has been investigated using operando transmission X-ray microscopy (TXM) and X-ray diffraction (XRD). It was found that a cobalt-iron alloy was formed, whereas manganese remained in its oxidic phase

Development of complex pedagogical competencies and reflexivity in clinical teachers via distance learning: a mixed methods study

ABSTRACTClinical reasoning is the cornerstone to healthcare practice and teaching it appropriately is of utmost importance. Yet there is little formal training for clinical supervisors in supervising this reasoning process. Distance education provides interesting opportunities for continuous professional development of healthcare professionals. This mixed methods study aimed at gaining in-depth understanding about whether and how clinical teachers can develop complex pedagogical competencies through participation in a Massive Open Online Course on the supervision of clinical reasoning (MOOC SCR). Participants self-assed their clinical supervision skills before and after partaking in the MOOC SCR through the Maastricht Clinical Teachers Questionnaire. Item scores and the distribution of response proportions before and after participation were compared using paired t-tests and McNemar’s tests respectively. In parallel, the evolution of a subset of MOOC participants’ pedagogical practice and posture was explored via semi-structured interviews throughout and beyond their MOOC participation using simulated and personal situational recalls. The verbatim were analysed with standard thematic analysis. Quantitative and qualitative findings converged and their integration demonstrated that partaking in the MOOC SCR promoted the development of complex pedagogical competencies and reflexivity with the participants. This was quantitatively evidenced by significantly higher self-assessed supervision skills and corresponding attitudes after completing the MOOC. The qualitative data provided rich descriptions of how this progression in pedagogical practice and posture occurred in the field and how it was shaped by participants’ interaction with the MOOC’s content and their motivations to progress. Our findings provide evidence for the development of pedagogical skills and corresponding attitudes for the supervision of clinical reasoning through participation in the MOOC SCR and contribute to the literature body on the opportunities that distance learning provides for the development of pedagogical competencies. The extent to which the pedagogical underpinnings of the MOOC contributed to these developments remains to be determined

Understanding and Promoting Clinical Reasoning in Chronic and Multimorbid Conditions: A Call for GPs and Healthcare Professionals

Multimorbidity, defined as 2 or more chronic diseases, is of increasing importance for health professionals. Many factors are at play when it comes to multimorbidity, but we still know very little about how clinicians actually weigh up the different factors—medical, social, and psychological—to reach a particular course of action. Further research is therefore required to explore the ways in which clinical reasoning processes are involved in the follow up of patients suffering from multimorbidities, to highlight their potential risks of errors. A better understanding of these clinical processes will also enrich supervision of trainees and collaboration between healthcare professionals involved in primary care

Profils des usagers du programme « Au labo sans ordo », dépistage du VIH sans ordonnance et sans frais en laboratoire de biologie médicale

International audienceIntroduction – Since July 1st, 2019, the “Au labo sans ordo” (ALSO) program offers a free HIV testing solution, without prescription, in any walk-in medical laboratory in Paris and the Alpes-Maritimes. This article describes the ALSO program users’ profile and compares their characteristics to those of the persons who get tested for HIV in labs with a prescription or in public STI clinics.Methods – A cross-sectional survey was conducted on the week of November 18-23, 2019 in 240 medicallaboratories and 11 public STI clinics in both regions. An anonymous self-administered questionnaire wasproposed to every adult who got tested for HIV. Two logistic regression models were used to compare ALSO users to (1) prescription test users and (2) STI clinics clients.Results – 3,144 questionnaires were analyzed (295 ALSO users, 2,138 prescriptions test users and 711 STI clinics clients). Compared to people with a prescribed test, ALSO attracted more heterosexual men (42% vs 28%), better established socially but quite far from care (32% vs 21% see a doctor ≤ once a year), with multiple sexual partners (60% vs 49%). Public STI clinics attracted a younger population (42% vs 21% <25 years old), more exposed to HIV: 24% were MSM (vs 15%), 79% had multiple partners and 53% (vs 19%) had more than one exposure indicator.Conclusion – The ALSO program, described by its users as practical and accessible, attracts a population that differs from other testing offers, notably more heterosexual men who are often less reached by screening programs.Introduction – Depuis le 1er juillet 2019, le programme « Au labo sans ordo » (ALSO) offre, à Paris et dans les Alpes-Maritimes, un dépistage du VIH sans ordonnance et sans frais dans tous les laboratoires de biologie médicale de ville. Cet article décrit les usagers du programme ALSO et compare leurs caractéristiques à celles des personnes qui ont recours au dépistage du VIH en laboratoire sur prescription médicale ou en CeGIDD.Méthodes – Une étude transversale a été menée la semaine du 18 au 23 novembre 2019 dans 240 laboratoires et 11 CeGIDD, dans les deux départements. Un autoquestionnaire anonyme était proposé par le personnel d’accueil aux personnes majeures qui réalisaient un test VIH. Deux modèles de régression logistique ont permis de comparer les usagers ALSO aux personnes avec (1) un test prescrit ; (2) un dépistage en CeGIDD.Résultats – L’analyse portait sur 3 144 questionnaires (295 usagers ALSO, 2 138 personnes avec un testprescrit et 711 usagers des CeGIDD). Comparativement aux personnes avec un test prescrit, ALSO attiraitdavantage d’hommes hétérosexuels (42% vs 28%), bien insérés socialement mais assez éloignés du soin(32% vs 21% consultaient ≤1 fois/an), multipartenaires (60% vs 49%). Les CeGIDD touchaient une population plus jeune (42% vs 21% <25 ans) et plus exposée au VIH : 24% étaient HSH (vs 15%), 79% multipartenaires et 53% (vs 19%) présentaient ≥1 indicateur d’exposition.Conclusion – Le programme ALSO, décrit par les usagers comme pratique et accessible, attire une population distincte des autres offres, notamment davantage d’hommes hétérosexuels souvent moins atteints par les actions de dépistage