Challenged by patients: a qualitative study of clinical supervisions of endocrinologists conducted by psychiatric liaison clinicians.

Background: Clinical supervision by psychiatric liaison clinicians is frequently provided in medical settings such as oncology and palliative care, but rarely in endocrinology. Consequently, the specific psychosocial issues faced by endocrinologists in their daily clinical practice and how they deal with them remain largely unknown. We aimed to explore individual supervisions of endocrinologists to gain insight into what kind of clinical situations they present, how they react to them and how this is worked through in supervision.

Focus on the blind spots of clinician-patient interactions: A critical narrative review of collusion in medical setting.

Collusions, interpersonal phenomena with an impact on patients, significant others, clinicians, and care, are mainly described in the psychotherapeutic literature but also occur in the medical setting. Comprehended as an unconscious bond between two or more persons from a psychotherapeutic perspective, definitions and collusive situations described in the medical setting vary. The question arises whether medical collusions, compared to collusions occurring in the psychiatric setting emerge in different clinical situations or are not identified as transference-countertransference experiences, since there is less sensitivity for the unconscious dimensions of care.

Core stories of physicians on a Swiss internal medicine ward during the first COVID-19 wave: a qualitative exploration.

Introduction: The first COVID-19 wave (2020), W1, will remain extraordinary due to its novelty and the uncertainty on how to handle the pandemic. To understand what physicians went through, we collected narratives of frontline physicians working in a Swiss university hospital during W1.

Methods: Physicians in the Division of Internal Medicine of Lausanne University Hospital (CHUV) were invited to send anonymous narratives to an online platform, between 28 April and 30 June 2020.

Oncology clinicians' feelings towards patients presented in supervision: A pre-post assessment using the feeling word checklist.

Objective: Clinical supervision of oncology clinicians by psycho-oncologists is an important means of psychosocial competence transfer and support. Research on this essential liaison activity remains scarce. The aim of this study was to assess the impact of supervision on oncology clinicians' feelings towards patients presented in supervision.

Substance use and its association with mental health among Swiss medical students: A cross-sectional study.

Background: Studies on mental health and substance use among medical students indicated worrying prevalence but have been mainly descriptive.

Aim: To evaluate the prevalence of substance use in a sample of medical students and investigate whether mental health variables have an influence on substance use.

Methods: The data were collected as part of the first wave of the ETMED-L, an ongoing longitudinal open cohort study surveying medical students at the University of Lausanne (Switzerland).

Experiences of the medical profession: A qualitative study using narrative facilitators.

Background: Physicians' narratives are means to approach and comprehend the practice of medicine, and physicians' embedment in their work and the healthcare context.

Objective: This study aimed to explore physicians' professional experiences and to examine how they are affected by factors related to their inner (psychological) and outer (institutional and social) worlds.

Methods: The study was designed as an exploratory qualitative study based on "narrative facilitators" (NF).

[Towards a multilevel psychiatric liaison].

The first of this pair of articles ends with the observation that -psychiatric liaison activity remains underdeveloped. Moreover, -psychiatric liaison is not based on sound empirical foundations and is not taught, which has had the consequence of putting it out of step with the transformations of medicine and the medical profession. In this second article, we discuss possible evolutions of psychiatric liaison and the role that social sciences can play in them.

[Psychiatric liaison: From yesterday to tomorrow].

This article reviews the genesis and development of liaison psychiatry, whose mission is (i) taking care for patients with psychiatric comorbidities (psychiatric consultation) and (ii) transferring knowledge and skills to somatic medicine and supporting clinicians in their practice (psychiatric liaison). We argue for a strengthening of psychiatric liaison and a consistent focus on the clinician as an object-subject of research, of training and of support. The following article will discuss the contribution of social sciences and quali-tative research to medicine and psychiatric liaison and outline the contours of a clinician-centered liaison model.

"You'll need to settle your affairs": How the subject of death is approached by oncologists and advanced cancer patients in follow-up consultations.

Objectives: This qualitative study aimed to investigate communication about death in consultations with patients undergoing chemotherapy with no curative intent. Specifically, we examined (i) how the topic of death was approached, who raised it, in what way, and which responses were elicited, (ii) how the topic unfolded during consultations, and (iii) whether interaction patterns or distinguishing ways of communicating can be identified.

Methods: The data consisted of 134 audio-recorded follow-up consultations.

Identifying complex patients in family medicine for potential benefit from a case manager: a short questionnaire derived from the INTERMED Self-Assessment (IMSA) questionnaire.

Purpose: To investigate how useful the Intermed-Self Assessment (IMSA) questionnaire and its components were for identifying which patient candidates would benefit most from case management (CM) in general practice.

Methods: The study was carried out in a group family medicine practice in Lausanne comprising seven GPs and four medical assistants, from February to April 2019. All the patients attending the practice between February and April 2019 were invited to complete the IMSA questionnaire.

Running against the clock: a qualitative study of internal medicine residents' work experience.

Aim Of The Study: While hospitals are adopting strategies designed to increase the overall efficiency of the healthcare system, physicians are facing expanding requirements. Such changes in work environment add new psychosocial and physical stressors. Building on a previous quantitative time-motion study, we conducted a qualitative study to better understand the work experience of internal medicine residents.

The relationship between medical students' empathy, mental health, and burnout: A cross-sectional study.

Objective: To investigate how medical students' empathy is related to their mental health and burnout.

Methods: This cross-sectional study included 886 medical students from curriculum years 1-6. The cognitive, affective, and behavioural dimensions of empathy were measured with self-report questionnaires and an emotion recognition test.

The fragility of trust between patients and oncologists: A multiple case study.

Objectives: This study aimed to explore in a naturalistic, real-life setting the dynamics of trust in oncological consultations.

Methods: Cases to study were purposively selected from a data set of audio-recorded and transcribed consultations between oncology physicians and patients with advanced cancer, and analyzed qualitatively. The analytical approach was deductive, relying on a thematic framework of dimensions of trust, and inductive, not restricted by this framework.

Calling: Never seen before or heard of - A survey among Swiss physicians.

Background: Research is needed to gain a deeper understanding of what motivates physicians to do their work and what keeps them in the profession.

Objectives: To explore calling as an approach to work in a sample of physicians.

Methods: We designed an online survey addressing career choice and career calling among physicians in French-speaking Switzerland, and measured associations between calling and categorical variables (participant characteristics, motivations for choosing medicine, career choice(s) and consistency, and definition of calling).

[Bio-Psycho-Social Needs Assessment in Family Medicine: Acceptability of the Intermed Self-Assessment].

Bio-Psycho-Social Needs Assessment in Family Medicine: Acceptability of the Intermed Self-Assessment In view of the increasing number of patients with somato-psychic comorbidities, a tool for identifying complex patients such as the INTERMED self-assessment (IMSA) would prove useful in family medicine. An observational study was conducted in a practice with seven general practitioners to evaluate the acceptability of patients to fill in this questionnaire in the waiting room. The IMSA was quickly completed and well accepted by patients, who found the questions easy to understand and relevant to their health.

[Psychiatric liaison III: Research].

Liaison psychiatry consists of an activity of consultation for patients affected by somatic diseases and of an activity of liaison for clinicians. The liaison work can take different forms, such as teaching of patient-physician relationship, supervision or support. To illustrate psychiatric liaison research, we present four studies conducted in our service, which explore (a) the relations between medical students' mental health and their interpersonal competence, (b) the dreams of medical students and what they reveal of their subjectivities, (c) the stakes for primary care practitioners when asking for a specialist's consult, and (d) the situated clinical practice.

[Psychiatric liaison I : Clinical activities].

This series of three articles presents the evolutions of (1) the clinical activities of psychiatric liaison, illustrated by the PENbank project, (2) the training provided by psychiatric liaison clinicians, described by a recently developed clinician-centered supervision, and (3) research in psychiatric liaison, exemplified by four studies. Because it goes beyond traditional types of liaison interventions for clinicians, the PENbank may be considered a meta-liaison project. Indeed, the PENbank is an infrastructure (a data bank), which allows to collect, store on a long-term basis, and use physicians' narratives of experiences.

[Physicians, their practice, and the institution : to adapt or to situate oneself ?].

The context of the clinical encounter, and more generally of the practice of medicine, has effects on physicians. For example, it shapes their opinions, discourses, and ultimately their behaviors. The context may also directly impact physicians, sometimes affecting their physical and mental health.