Family physicians\u27 professional identity formation: a study protocol to explore impression management processes in institutional academic contexts.

BACKGROUND: Despite significant differences in terms of medical training and health care context, the phenomenon of medical students\u27 declining interest in family medicine has been well documented in North America and in many other developed countries as well. As part of a research program on family physicians\u27 professional identity formation initiated in 2007, the purpose of the present investigation is to examine in-depth how family physicians construct their professional image in academic contexts; in other words, this study will allow us to identify and understand the processes whereby family physicians with an academic appointment seek to control the ideas others form about them as a professional group, i.e. impression management. METHODS/DESIGN: The methodology consists of a multiple case study embedded in the perspective of institutional theory. Four international cases from Canada, France, Ireland and Spain will be conducted; the \u22case\u22 is the medical school. Four levels of analysis will be considered: individual family physicians, interpersonal relationships, family physician professional group, and organization (medical school). Individual interviews and focus groups with academic family physicians will constitute the main technique for data generation, which will be complemented with a variety of documentary sources. Discourse techniques, more particularly rhetorical analysis, will be used to analyze the data gathered. Within- and cross-case analysis will then be performed. DISCUSSION: This empirical study is strongly grounded in theory and will contribute to the scant body of literature on family physicians\u27 professional identity formation processes in medical schools. Findings will potentially have important implications for the practice of family medicine, medical education and health and educational policies

Quels sont les facteurs prioritaires à mettre en œuvre pour développer une démarche éducative en médecine générale ?

National audienceLe médecin généraliste (MG) occupe une place privilégiée pour mener une démarche éducative auprès de ses patients atteints de maladies chroniques. Malgré le souhait d’implication des MG, cette démarche reste en pratique peu réalisée.Objectif  : Faire déterminer par des MG les facteurs nécessaires au développement d’une démarche éducative en médecine générale.Méthode  : Étude qualitative par la technique du groupe nominal modifié, réalisée auprès de 21 MG investigateurs d’une étude interventionnelle qui testait une démarche éducative structurée à partir d’outils conçus pour une utilisation en soins primaires. Il s’agissait de MG libéraux non spécifiquement formés à l’éducation thérapeutique, ayant mené lors de leurs consultations habituelles une démarche éducative individuelle par micro-objectifs personnalisés auprès de 31 patients atteints de BPCO durant un suivi de 9 mois.Résultats  : À la lumière de l’expérience vécue par les MG, le groupe a produit 23 facteurs, regroupés après l’étape de clarification-reformulation en six facteurs nécessaires au développement de la démarche éducative en médecine générale. Le consensus hiérarchisé a indiqué que le renforcement d’une formation médicale initiale et continue était le facteur le plus cité et le plus prioritaire. Le développement de coopérations inter et intra-professionnelles était le second facteur à privilégier.Conclusion  : Renforcer la formation et les coopérations des MG avec d’autres professionnels peut permettre aux MG de développer lors de leurs consultations une démarche éducative structurée. Ces résultats peuvent éclairer les orientations de la politique régionale de santé publique concernant le déploiement de l’éducation thérapeutique en soins primaires

The Influence of Academic Discourses on Medical Students' Identification with the Discipline of Family Medicine

International audienc

Family physicians’ professional identity formation: a study protocol to explore impression management processes in institutional academic contexts

International audienceBackground: Despite significant differences in terms of medical training and health care context, the phenomenon of medical students’ declining interest in family medicine has been well documented in North America and in many other developed countries as well. As part of a research program on family physicians’ professional identity formation initiated in 2007, the purpose of the present investigation is to examine in-depth how family physicians construct their professional image in academic contexts; in other words, this study will allow us to identify and understand the processes whereby family physicians with an academic appointment seek to control the ideas others form about them as a professional group, i.e. impression management.Methods/Design: The methodology consists of a multiple case study embedded in the perspective of institutional theory. Four international cases from Canada, France, Ireland and Spain will be conducted; the "case" is the medical school. Four levels of analysis will be considered: individual family physicians, interpersonal relationships, family physician professional group, and organization (medical school). Individual interviews and focus groups with academic family physicians will constitute the main technique for data generation, which will be complemented with a variety of documentary sources. Discourse techniques, more particularly rhetorical analysis, will be used to analyze the data gathered. Within- and cross-case analysis will then be performed.Discussion: This empirical study is strongly grounded in theory and will contribute to the scant body of literature on family physicians’ professional identity formation processes in medical schools. Findings will potentially have important implications for the practice of family medicine, medical education and health and educational policies

Local perceptions on the state of the pelagic fisheries and fisheries management in Uvira, Lake Tanganyika, DR Congo

The fisheries of Lake Tanganyika play an important role in food security in Central and Eastern Africa. Conservation of these valuable fish stocks will benefit from documenting the ideas, opinions and observations of stakeholders. Knowledge of the perceptions and an understanding of the concerns and struggles of stakeholders of these fisheries can provide policy-makers with recommendations for more suitable fisheries management. We did 1018 interviews with stakeholders, in one close-ended and three semi-open ended surveys. Factor analysis revealed seven clusters of opinions. Linear-mixed effects models identified common grounds and differences in opinions between groups of stakeholders about strategies in fisheries management. Stakeholders of the fisheries indicated challenges due to weather or climate variability, a noticeable decrease in fish abundance and size, and an increase in the price of fish. Fishermen experienced a lack of safety on the lake, including aggression and dangerous weather conditions, and hardly had access to safety gear and infrastructure. Landing site officials, state employees who monitor the beaches, mentioned capture of juveniles and declining catch-rates as the biggest threats to the fisheries. None of the groups of stakeholders attributed the problems in the fisheries to overfishing or overpopulation. We found similarities in opinions over a wide range of stakeholder groups, with many stakeholders asking for better and fair enforcement of existing legislation. State employees were more positive than the other groups towards creating more strict regulation of the fisheries. The results presented offer focuspoints for policy-makers to improve the management of the Lake Tanganyika pelagic fisheries