Student-centred GP ambassadors: Perceptions of experienced clinical tutors in general practice undergraduate training

Objective. To explore experienced general practitioner (GP) tutor perceptions of a skilled GP tutor of medical students. Design. Interview study based on focus groups. Setting. Twenty GPs experienced in tutoring medical students at primary health care centres in two Swedish regions were interviewed. Method. Four focus-group interviews were analysed using qualitative content analysis. Subjects. Twenty GP tutors, median age 50, specifically selected according to age, gender, and location participated in two focus groups in Gothenburg and Malmo, respectively. Main outcome measures. Meaning units in the texts were extracted, coded and condensed into categories and themes. Results. Three main themes emerged: "Professional as GP and ambassador to general practice", "Committed and student-centred educator", and "Coordinator of the learning environment". Conclusion. Experienced GP tutors describe their skills as a clinical tutor as complex and diversified. A strong professional identity within general practice is vital and GP tutors describe themselves as ambassadors to general practice, essential to the process of recruiting a new generation of general practitioners. Leaders of clinical education and health care planners must understand the complexity in a clinical tutor's assignment and provide adequate support, time, and resources in order to facilitate a sustainable tutorship and a good learning environment, which could also improve the necessary recruitment of future GPs

"I couldn't do this with opposition from my colleagues": A qualitative study of physicians' experiences as clinical tutors

<p>Abstract</p> <p>Background</p> <p>Clinical contact in the early curriculum and workplace learning with active tutorship are important parts of modern medical education. In a previously published study, we found that medical students' tutors experienced a heavier workload, less reasonable demands and less encouragement, than students. The aim of this interview study was to further illuminate physicians' experiences as clinical tutors.</p> <p>Methods</p> <p>Twelve tutors in the Early Professional Contact course were interviewed. In the explorative interviews, they were asked to reflect upon their experiences of working as tutors in this course. Systematic text condensation was used as the analysis method.</p> <p>Results</p> <p>In the analysis, five main themes of physicians' experiences as clinical tutors in the medical education emerged: <it>(a) Pleasure and stimulation</it>. Informants appreciated tutorship and meeting both students and fellow tutors, <it>(b) Disappointment and stagnation</it>. Occasionally, tutors were frustrated and expressed negative feelings, <it>(c) Demands and duty</it>. Informants articulated an ambition to give students their best; a desire to provide better medical education but also a duty to meet demands of the course management, <it>(d) Impact of workplace relations</it>. Tutoring was made easier when the clinic's management provided active support and colleagues accepted students at the clinic, and <it>(e) Multitasking difficulties</it>. Combining several duties with those of a tutorship was often reported as difficult.</p> <p>Conclusions</p> <p>It is important that tutors' tasks are given adequate time, support and preparation. Accordingly, it appears highly important to avoid multitasking and too heavy a workload among tutors in order to facilitate tutoring. A crucial factor is acceptance and active organizational support from the clinic's management. This implies that tutoring by workplace learning in medical education should play an integrated and accepted role in the healthcare system.</p

Medical students' and facilitators' experiences of an Early Professional Contact course: Active and motivated students, strained facilitators

Background: Today, medical students are introduced to patient contact, communication skills, and clinical examination in the preclinical years of the curriculum with the purpose of gaining clinical experience. These courses are often evaluated from the student perspective. Reports with an additional emphasis on the facilitator perspective are scarce. According to constructive alignment, an influential concept from research in higher education, the learning climate between students and teachers is also of great importance. In this paper, we approach the learning climate by studying both students' and facilitators' course experiences.\ud \ud In 2001, a new "Early Professional Contact" longitudinal strand through term 1–4, was introduced at the Sahlgrenska Academy, University of Gothenburg, Sweden. General practitioners and hospital specialists were facilitators.\ud \ud The aim of this study was to assess and analyse students' and clinical facilitators' experiences of the Early Professional Contact course and to illuminate facilitators' working conditions.\ud \ud Methods: Inspired by a Swedish adaptation of the Course Experience Questionnaire, an Early Professional Contact Questionnaire was constructed. In 2003, on the completion of the first longitudinal strand, a student and facilitator version was distributed to 86 students and 21 facilitators. In the analysis, both Chi-square and the Mann-Whitney tests were used.\ud \ud Results: Sixty students (70%) and 15 facilitators (71%) completed the questionnaire. Both students and facilitators were satisfied with the course. Students reported gaining [inspiration] for their future work as doctors along with increased confidence in meeting patients. They also reported increased motivation for biomedical studies. Differences in attitudes between facilitators and students were found. Facilitators experienced a greater workload, less reasonable demands and less support, than students.\ud \ud Conclusion: In this project, a new Early Professional Contact course was analysed from both student and facilitator perspectives. The students experienced the course as providing them with a valuable introduction to the physician's professional role in clinical practice. In contrast, course facilitators often experienced a heavy workload and lack of support, despite thorough preparatory education. A possible conflict between the clinical facilitator's task as educator and member of the workplace is suggested. More research is needed on how doctors combine their professional tasks with work as facilitators

Traditionell modernism eller modern traditionalism?

Denna uppsats fokuserar på King Hus actionestetik och den montagekonstruerade rörelsen, enligt en konkret syftesformulering som lyder: Att öka förståelsen för King Hus estetiska val genom att belysa vissa rytmiska rörelsetendenser, såsom en konstruktion av filmens montage, och dess relation till två vitt skilda konstyttringar, med dessa avses Pekingoperan och cinéma pur. Ledande tes genom uppsatsen är att Hus visuella stil visserligen är starkt präglad av ett personligt intresse och en djup förståelse för estetiska normer i Pekingoperan, men att han samtidigt genom ett skickligt utnyttjande av cinematiska tekniker skapar en alldeles unik version av kinesisk estetik, som måste förstås som specifik för filmmediet. Sammantaget är förhoppningen att resultatet skall bidra till avmarginaliseringen av Hu som förvaltare till en förment essens av traditionell kinesisk kultur. Metoden består i en jämförande analys av rörligt bildmaterial i två steg, som illustrativ modell och teoretisk ingång till rörelsebegreppet tillämpas Heinrich von Kleists marionett och i dess förlängning även Sergei Eisensteins biomekaniska rakurs. Min analys leder mig till slutsatsen att den rytmiska rörelsen i Hus actionscener har starka likheter med såväl Pekingoperan som cinéma pur, och jag vill på grundval av detta föreslå att Hu snarare bör förstås som en nyskapare av kinesisk estetik, då han positionerar sig någonstans mellan traditionalism och modernism genom att skapa en estetisk jämvikt mellan teater och film där ingenderas legat går förlorad

Patient-centred attitudes among medical students: gender and work experience in health care make a difference

Background: Previous studies of medical students' patient-centred attitudes show a decline across undergraduate education and overall higher scores for female students. Aim: To assess undergraduate students' patient-centred attitudes at various stages of education and to explore possible associations between attitudes and age, gender and work experience in health care. Methods: In autumn 2005, medical students in Gothenburg (n = 797) were asked to answer Patient-Practitioner Orientation Scale (PPOS), a validated instrument exploring attitudes towards the doctor-patient relationship. Data including gender, age, current term and students' work experience in health care were collected. Results: Of 797 students 600 (75%) answered the questionnaire. No decrease of students' PPOS score across the curriculum was observed. PPOS scores from female students were higher compared to males (p < 0.0001) and female scores were significantly higher in the later terms compared with earlier (p = 0.0011). Female students had more experience from working in health care (p = 0.0023). Extended work experience was associated with higher PPOS only among females (p = 0.0031). Conclusion: No decline of students' patient-centred attitudes may indicate an ongoing shift. Gender differences in patient-centred attitudes were reproduced. Work experience in health care presents a new gender difference. These gender differences should be considered when training patient-centred attitudes and skills

A conceptual study of OFDM-based multiple access schemes : Part 1: Air interface requirements

The multimedia era has started. The migration of computer (packet oriented) and telephony (circuit switched) networks in combination with an explosive development of new services, creates a mass market for public broadband communication. There are no reasons foreseen why these kinds of services should not go mobile. Future customers will not treat a mobile access differently than a fixed access to the network. The different types of services together with the demand of broadband mobile communication requires a new air interface. Limitations in the existing systems (flexibility and bit-rate) gives that they are not serious competitirs.Godkänd; 1996; Bibliografisk uppgift: ETSI STC SMG2 meeting no 18, Helsinki, Finland, May 1996.; 20080221 (ysko

Medical students' learning of the consultation and the patient-doctor relationship

Background: In medical education, learning about the consultation and the patient-doctor relationship is nowadays highly recommended. However, research from educational practice from students’ perspective is needed to facilitate a better understanding of students’ learning. The thesis is based on four studies. Aims: The overall aims were to study and analyse medical students’ learning of the consultation and patient-doctor relationship. Specific aims were to analyse students’ descriptive evaluations of a Consultation skills course and course development over five years (I), to explore final-year students’ abilities to communicate with patients (II), to analyse final-year students’ written reflective accounts of a memorable consultation (III), to assess students’ patient-centred attitudes at various stages of undergraduate medical education and to explore the association between patient-centred attitudes and gender, age and work experience in health care (IV). Method: A qualitative content analysis method was used in studies I-III, covering term 5 and term 10 (T5, T10). T5 students’ descriptive evaluations and teachers’ documentation were analysed 1995-1999. Experienced supervisors assessed T10 students’ communication abilities in video consultations with patients and supervisors’ focus group meetings were analysed. T10 students’ written reflective accounts of a memorable consultation were analysed. A cross-sectional study of students’ patient-centred attitudes was performed across the curriculum by an internationally validated instrument (Patient-Practitioner Orientation Scale, PPOS). Students’ gender, age and earlier work experience in health care were also collected and analysed statistically. Results: Learning of the consultation was facilitated when the T5 student was active in practice and could have a choice, by a link between explicit learning goals, learning activities and an examination in practice including feedback. Students’ descriptions of awareness and confidence corresponded to a strengthened relation with the facilitator and reflection. In exploring T10 students’ video consultations, an instrumental strategy was suggested as a stage in students’ consultation training. However, analysis of T10 students’ written reflective accounts of a memorable consultation displayed a view of the patient as a person beyond symptoms, an insight into the complexity of medical work and students’ search for a professional role. In contrast to previous reports, no decline of students’ patient-centred attitudes at the end of education was found. Independent of age or work experience in health care, female students had higher PPOS scores compared to men. Female students also had significantly more work experience in health care. Conclusions: Students’ learning of the skills and attitudes needed for the consultation and the patient-doctor relationship is complex. Senior students display patient-centeredness in writing but might have difficulties in integrating their know-how with the performance of physician’s clinical tasks. Learning the consultation and the patient –doctor relationship is suggested to benefit from integrating a patient-centred perspective in a student-centred learning relationship through clinical education; and by adopting a process-oriented and experience-based model including feedback and reflection

The geographic distribution of mosquito species in Sweden

Surveillance of the actual distribution of mosquito species in Northern Europe is fundamental for evaluating risk for emerging pathogens, and for research on potential vectors. The Swedish mosquito fauna composition and geographic distribution, originally described by Professor Christine Dahl in the 1970´s, included 43 species. We have compiled the information published from 1978 to 2012, and our own surveillance data from 2001 to 2013, and compared this with the species list and geographic distribution provided in “Taxonomy and geographic distribution of Swedish Culicidae” by Dahl (1977). New species detected during these 36 years were Culiseta (Culicella) ochroptera (Peus, 1935) published 1984, Aedes (Aedes) rossicus Dolbeskin, Goritzkaja &amp; Mitrofanova, 1930 published 1986, Anopheles (Anopheles) beklemishevi published 1986, Aedes (Ochlerotatus) euedes (Howard, Dyar &amp; Knab, 1912) published 2001, Aedes (Ochlerotatus) nigrinus (Eckstein, 1918) first recorded in 2012, and Anopheles (Anopheles) algeriensis Theobald, 1903, first recorded in 2013. We provide maps with the distribution by province for each species, including historic information up until 1977, and new records from 1978 to 2013, showing the similarities and differences between the old and the new records. Important findings in recent years include the wide distribution of the Sindbis virus enzootic vector Culex (Culex) torrentium Martinii, 1925, and the more limited distribution of the potential West Nile virus vector Culex (Culex) pipiens Linnaeus, 1758. The updated list of mosquito species in Sweden now includes 49 species