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Nature of the clinical difficulties of first-year family medicine residents under direct observation.

https://arctichealth.org/en/permalink/ahliterature224328
Source
CMAJ. 1992 Feb 15;146(4):489-97
Publication Type
Article
Date
Feb-15-1992
Author
A. Beaumier
G. Bordage
D. Saucier
J. Turgeon
Author Affiliation
Unité de médecine familiale, Hôpital Laval, Sainte-Foy, Que.
Source
CMAJ. 1992 Feb 15;146(4):489-97
Date
Feb-15-1992
Language
English
Publication Type
Article
Keywords
Clinical Competence - statistics & numerical data
Family Practice - education
Hospitals, Teaching
Humans
Internship and Residency - statistics & numerical data
Interviews as Topic
Medical History Taking
Physician-Patient Relations
Quebec
Abstract
To determine and classify the difficulties of first-year family medicine residents observed during clinical interviews.
Retrospective, descriptive study.
Family practice unit at a teaching hospital.
Forty-seven of the 56 first-year family medicine residents during their 2-month compulsory rotation in ambulatory family medicine, between July 1983 and December 1988, and 4 physicians who supervised the residents.
The residents' difficulties noted on the observation forms.
A total of 1500 difficulties were observed during 194 interviews, an average of 7.7 (standard deviation 5.2) per interview. There were 167 different difficulties, which were classified into seven categories (introduction, initial contract, body of the interview, techniques and organization, interpersonal aspects, final contract and miscellaneous) and 20 subcategories. The 17 most frequently noted difficulties accounted for 40% of the total.
The results constitute a useful starting point for developing a classification of residents' difficulties during clinical interviews. We believe that the list of difficulties is applicable to residents at all levels and in other specialties, especially in ambulatory settings. The list can be used to develop learning materials for supervisors and residents.
Notes
Cites: Med Educ. 1984 Jan;18(1):46-516690897
Cites: Med Educ. 1983 Jan;17(1):24-76823216
Cites: J Med Educ. 1982 Feb;57(2):105-127057429
Cites: Med Educ. 1977 Nov;11(6):390-3593178
Cites: JAMA. 1976 Aug 16;236(7):852-5947266
Cites: J Med Educ. 1976 Jan;51(1):62-31246068
Cites: Fam Pract. 1986 Jun;3(2):75-93721098
Cites: J Med Educ. 1966 Feb;41(2):150-615902330
Cites: Med Educ. 1988 Jul;22(4):287-933173155
Cites: Acad Med. 1989 May;64(5):277-92713013
Cites: Med Teach. 1986;8(3):261-93807738
Cites: Fam Pract. 1986 Sep;3(3):164-73770336
Cites: JAMA. 1970 Jun 15;212(11):1843-65467679
PubMed ID
1737313 View in PubMed
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Taxonomy of difficulties in general practice.

https://arctichealth.org/en/permalink/ahliterature221000
Source
Can Fam Physician. 1993 Jun;39:1369-75
Publication Type
Article
Date
Jun-1993
Author
M D Beaulieu
H. Leclère
G. Bordage
Author Affiliation
Clinique de Médecine Familiale, Hôpital Notre-Dame, Québec.
Source
Can Fam Physician. 1993 Jun;39:1369-75
Date
Jun-1993
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Clinical Competence
Diagnosis
Education, Medical
Education, Medical, Continuing
Family Practice - classification - education
Humans
Interprofessional Relations
Observer Variation
Physician-Patient Relations
Preventive Medicine
Professional Practice - classification
Professional-Family Relations
Psychophysiologic Disorders
Quebec
Reproducibility of Results
Therapeutics
Abstract
A questionnaire combining qualitative and quantitative methods was used to compile a taxonomy of the difficulties experienced by general practitioners in their practices. Difficulties are grouped in 11 categories, ranging from clinical diagnosis to physicians' personal feelings. The taxonomy can be used as a guide for planning medical education or as a starting point for further research in general practice.
Notes
Cites: Biometrics. 1977 Mar;33(1):159-74843571
Cites: J Med Educ. 1984 Jun;59(6):487-936726768
Cites: Med Care. 1983 Jan;21(1):105-226403780
PubMed ID
8324406 View in PubMed
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Why are clinical problems difficult? General practitioners' opinions concerning 24 clinical problems.

https://arctichealth.org/en/permalink/ahliterature227814
Source
CMAJ. 1990 Dec 15;143(12):1305-15
Publication Type
Article
Date
Dec-15-1990
Author
H. Leclère
M D Beaulieu
G. Bordage
A. Sindon
M. Couillard
Author Affiliation
Bureau de pédagogie des sciences de la santé, Faculté de médecine, Université Laval, Ste-Foy, PQ.
Source
CMAJ. 1990 Dec 15;143(12):1305-15
Date
Dec-15-1990
Language
English
Publication Type
Article
Keywords
Adult
Aged
Attitude of Health Personnel
Clinical Competence - standards
Education, Medical, Continuing - standards
Family Practice - education
Female
Humans
Male
Physician's Practice Patterns - statistics & numerical data
Physician-Patient Relations
Physicians, Family
Pilot Projects
Quebec
Questionnaires
Sampling Studies
Abstract
This study was conducted to describe the difficulties perceived by general practitioners concerning 24 common clinical problems and to compare their perceptions with those of faculty members in family medicine. A random sample of 467 general practitioners and all 182 faculty members in family medicine in Quebec were sent one of four open-ended questionnaires, each of which dealt with six clinical problems; 214 general practitioners and 114 faculty members participated. A total of 5111 difficulties were reported; the number reported by each subject varied from 0 to 13 (mean 2.6 [standard deviation 2.09]) per problem. The problems that generated the most difficulties were depression, confusion in the elderly, chronic back pain, loss of autonomy in the elderly and sexually transmitted disease. The most frequent difficulties were with the patient's noncompliance with treatment, clinical diagnosis, failure of a specific treatment, inadequate health care resources and the physician's own emotional reactions. The difficulties for each problem were the same in the two groups 70% of the time. Physician's perceptions of their difficulties can be useful in the planning of initial training and continuing medical education.
Notes
Cites: Biometrics. 1977 Mar;33(1):159-74843571
Cites: N Z Med J. 1983 May 25;96(732):395-76573610
Cites: Med Care. 1983 Jan;21(1):105-226403780
Cites: N Engl J Med. 1982 Mar 4;306(9):511-57057858
Cites: Can Med Assoc J. 1981 Mar 1;124(5):563-67471001
PubMed ID
2253138 View in PubMed
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