Erikoislääkärikouluttajien valmennuksen ABC - yleislääketieteen malli

Vertaisarvioitu.Yleislääketieteen erikoislääkärikouluttajien koulutusta tai valmennusta on järjestetty 1980-luvulta lähtien. Toiminta on ollut koko Suomessa samankaltaista ja järjestelmällistä 2010-luvun alusta. Kurssimuotoisen valmennuksen ytimessä ovat vaikuttaviksi havaitut elementit: teorian ja käytännön ohjaustyön jatkuva vuoropuhelu, monipuoliset harjoitukset, keskustelut, käytännönläheiset ennakko- ja välitehtävät sekä reflektio. Palaute on olennaista harjoituksissa ja välitehtävissä. Valmennusta kehitetään ja muokataan vastaamaan erikoistujien, tulevien kouluttajien ja palvelujärjestelmän tarpeita. Erikoislääkärikouluttajat ovat merkittävä voimavara perusterveydenhuollon palvelutuotannon laadun varmistamisessa, sillä noin puolet terveyskeskusten lääkäreistä suorittaa jotain koulutusvaihetta

Erikoislääkärikouluttajien valmennuksen ABC - yleislääketieteen malli

publishedVersio

Erikoislääkärikouluttajien valmennuksen ABC - yleislääketieteen malli

Yleislääketieteen erikoislääkärikouluttajien koulutusta tai valmennusta on järjestetty 1980-luvulta lähtien. Toiminta on ollut koko Suomessa samankaltaista ja järjestelmällistä 2010-luvun alusta. Kurssimuotoisen valmennuksen ytimessä ovat vaikuttaviksi havaitut elementit: teorian ja käytännön ohjaustyön jatkuva vuoropuhelu, monipuoliset harjoitukset, keskustelut, käytännönläheiset ennakko- ja välitehtävät sekä reflektio. Palaute on olennaista harjoituksissa ja välitehtävissä. Valmennusta kehitetään ja muokataan vastaamaan erikoistujien, tulevien kouluttajien ja palvelujärjestelmän tarpeita. Erikoislääkärikouluttajat ovat merkittävä voimavara perusterveydenhuollon palvelutuotannon laadun varmistamisessa, sillä noin puolet terveyskeskusten lääkäreistä suorittaa jotain koulutusvaihetta

The profiles of health care utilization among a non-depressed population and patients with depressive symptoms with and without clinical depression

Objective: To examine health service (HS) utilization profiles among a non-depressive population and patients with depressive symptoms (DS) with and without clinical depression. Design, subjects and setting: The study population was based on primary care patients with DS scoring >= 10 in the 21-item Beck Depression Inventory (BDI) and who were at least 35 years old and had been referred to depression nurse case managers (n = 705). Their psychiatric diagnosis was confirmed with the Mini-International Neuropsychiatric Interview (M.I.N.I.). Of these patients, 447 had clinical depression. The number of patients with DS without clinical depression was 258. The control group consisted of a random sample of 414 residents with a BDI score <10. Use of HS (visits and phone calls to a doctor and a nurse) was based on patient records. Main outcome measures: Number of visits and calls to physicians and nurses. Results: Patients with DS regardless of their depression diagnosis used primary health care (PHC) services three times more than the controls (p <0.001). In the secondary care, the differences were smaller but significant. Of the controls, 70% had 0-4 HS contacts per year whereas a majority of the patients having DS had more than 5 contacts per year. The number of contacts correlated with the BDI from a score of 0 to 10 but not as clearly in the higher scores. Conclusion: Depressive symptoms, both with or without clinical depression, are associated with increased HS use, especially in PHC. This study suggests that even mild depressive symptoms are associated with an increased use of HS.Peer reviewe

Depressive symptoms decrease health-related quality of life of patients with coronary artery disease and diabetes: a 12-month follow up study in primary care

AbstractObjective Health-related quality of life (HRQoL) is a multidimensional patient-related outcome. Less is known about the role of depressive symptoms on HRQoL in chronic diseases. This follow-up study analyzed depressive symptoms’ association with HRQoL change measured with 15D in patients with chronic diseases.Design and setting A total of 587 patients from the Siilinjärvi Health Center, Finland were followed up due to the treatment of hypertension (HA), coronary artery disease (CAD) or diabetes (DM). Depressive symptoms were based on Beck Depression Inventory (BDI) (BDI ≥10 =depressive symptoms). HRQoL was assessed at the baseline and after 12 months.Results There were 244 patients with HA (mean age 70 years, 59% women); 103 patients (72 years, 38%) with CAD and 240 with DM (67 years, 52%). The change from baseline to the 12-month follow-up in 15D was significantly different between patients without and with depressive symptoms in CAD (p < 0.001) and DM (p = 0.024). In CAD with depressive symptoms, the change was −0.064 (95% CI: −0.094 to −0.035) and in DM −0.018 (95% CI: −0.037 to 0.001). In the 15 HRQoL dimensions of 15D, a depressive symptoms-related decrease was found in three dimensions with HA, in 9 with CAD and in 7 with DM. As a function of the BDI at baseline, the 15D score decreased significantly among patients with CAD and DM.Conclusions Depressive symptoms impact negatively on future HRQoL among primary care patients with coronary artery disease and diabetes emphasizing that mood should be acknowledged in their care and follow-up.Trial registration Clinical Trials registration number: NCT02992431, registered December 14th 201

Medical certificate education:controlled study between lectures and flipped classroom

Abstract Background: Finnish permanent residents are covered by social security insurance administered by the Social Insurance Institution of Finland. The procedure of insurance is initiated with medical certificate written by the treating doctor. Thus, the doctor must have certificate writing skills accompanied with the knowledge of the content and goals for insurance. Quality certificates are important part of doctors’ professional skills worldwide and most effective teaching methods for learning these should be investigated. Methods: Medical certificate data were collected from two independent courses of fourth-year student taught in autumn 2015 (N = 141) and 2016 (N = 142) in the medical faculty of the University of Eastern Finland. A random sample of 40 students per course was drawn for the analysis. All certificates were analyzed as one sample. This was done to obtain reliable results with internal control group on the differences between two teaching methods, the traditional approach and the flipped classroom (FC) approach, in 2015 and 2016, respectively. The medical certificates were evaluated and scored with a rubric (range: − 4.00–14.25) by two independent experienced specialists. Results: Compared to students in the traditional classroom, students involved in the FC received significantly higher scores in all relevant sections of the assessed certificates. The mean of the total scores was 8.87 (SD = 1.70) for the traditional group and 10.97 (SD = 1.25) for the FC group. Based on the common language effect size, a randomly selected student from the FC group had an 85% probability of receiving a higher total score than a student from the traditional group. Conclusions: In this study, the FC approach resulted in a statistical significant improvement in the content and technical quality of the certificates. The results suggest that the FC approach can be applied in the teaching of medical certificate writing