Medical Care as Flea Market Bargaining? An International Interdisciplinary Study of Varieties of Shared Decision Making in Physician-Patient Interactions.

Shared decision making (SDM) is a core ideal in the interaction between healthcare providers and patients, but the implementation of the SDM ideal in clinical routines has been a relatively slow process. In a sociological study, 71 interactions between physicians and simulated patients enacting chronic heart failure were video-recorded in China, Germany, the Netherlands, and Turkey as part of a quasi-experimental research design. Participating physicians varied in specialty and level of experience.

Hearts in their hands-Physicians' gestures embodying shared professional knowledge around the world.

The biomedical approach to medical knowledge is widely accepted around the world. This article considers whether the incorporated aspects of physician-patient interaction have become similarly common across the globe by comparing the gestures that physicians use in their interactions with patients. Up to this point, there has been little research on physicians' use of gestures in health-care settings.

Developing communication curricula in healthcare education: An evidence-based guide.

Objective: To present a guide for communication curriculum development in healthcare professions for educators and curriculum planners.

Methods: We collated a selection of theories, frameworks and approaches to communication curriculum development to provide a roadmap of the main factors to consider when developing or enhancing communication skills curricula.

Results: We present an evidence-based guide for developing and enhancing communication curriculum that can be applied to undergraduate and postgraduate healthcare education.

The learning effects of different presentations of worked examples on medical students' breaking-bad-news skills: A randomized and blinded field trial.

Objectives: Effective instructional approaches are needed to enable undergraduates to optimally prepare for the limited training time they receive with simulated patients (SPs). This study examines the learning effects of different presentation formats of a worked example on student SP communication.

Methods: Sixty-seven fourth-year medical students attending a mandatory communication course participated in this randomized field trial.

Medical students' communication skills in clinical education: Results from a cohort study.

Objective: To assess students' communication skills during clinical medical education and at graduation.

Methods: We conducted an observational cohort study from 2007 to 2011 with 26 voluntary undergraduate medical students at Hamburg University based on video-taped consultations in year four and at graduation. 176 consultations were analyzed quantitatively with validated and non-validated context-independent communication observation instruments (interrater reliability ≥0.

Communication in Health Professions: A European consensus on inter- and multi-professional learning objectives in German.

Background And Aim: Communication is object of increasing attention in the health professions. Teaching communication competencies should already begin in undergraduate education or pre-registration training. The aim of this project was to translate the Health Professions Core Communication Curriculum (HPCCC), an English catalogue of learning objectives, into German to make its content widely accessible in the German-speaking countries.

Desire and reality--teaching and assessing communicative competencies in undergraduate medical education in German-speaking Europe--a survey.

Objectives: Increasingly, communicative competencies are becoming a permanent feature of training and assessment in German-speaking medical schools (n=43; Germany, Austria, Switzerland - "D-A-CH"). In support of further curricular development of communicative competencies, the survey by the "Communicative and Social Competencies" (KusK) committee of the German Society for Medical Education (GMA) systematically appraises the scope of and form in which teaching and assessment take place.

Methods: The iterative online questionnaire, developed in cooperation with KusK, comprises 70 questions regarding instruction (n=14), assessment (n=48), local conditions (n=5), with three fields for further remarks.

The costs of dementia from the societal perspective: is care provided in the community really cheaper than nursing home care?

Objective: To compare the costs of care for community-dwelling dementia patients with the costs of care for dementia patients living in nursing homes from the societal perspective.

Design: Cross-sectional bottom-up cost of illness study nested within the multicenter German AgeCoDe-cohort.

Setting: Community and nursing homes.

Predictors of costs in dementia in a longitudinal perspective.

Objective: To analyse predictors of costs in dementia from a societal perspective in a longitudinal setting.

Method: Healthcare resource use and costs were assessed retrospectively using a questionnaire in four waves at 6-month intervals in a sample of dementia patients (N = 175). Sociodemographic data, dementia severity and comorbidity at baseline, cognitive impairment and impairment in basic and instrumental activities of daily living were also recorded.

Can a brief two-hour interdisciplinary communication skills training be successful in undergraduate medical education?

Objective: To pilot-test feasibility, acceptance and learning-outcomes of a brief interdisciplinary communication skills training program in undergraduate medical education.

Methods: A two-hour interdisciplinary communication skills program with simulated patients was developed and pilot-tested with clinical students at Hamburg University. Five psychosocial specialties facilitated the training.

The CERAD neuropsychological assessment battery total score detects and predicts Alzheimer disease dementia with high diagnostic accuracy.

Objectives: To establish the diagnostic accuracy of the Total Score of the Consortium to Establish a Registry for Alzheimer's Disease neuropsychological assessment battery (CERAD-NP) both for cross-sectional discrimination of Alzheimer disease (AD) dementia and short-term prediction of incident AD dementia.

Design: Longitudinal cohort study with two assessments at a 1.5-year interval.

Depression, non-fatal stroke and all-cause mortality in old age: a prospective cohort study of primary care patients.

Background: Depression is a risk factor for stroke and mortality but whether this also holds into old age is uncertain. We therefore studied the association of depression with the risk for non-fatal stroke and all-cause mortality in very old age.

Methods: A representative sample of 3085 primary care patients aged ≥ 75 years were serially assessed during a 6-year follow-up.

Incidence and predictors of depression in non-demented primary care attenders aged 75 years and older: results from a 3-year follow-up study.

Objective: to determine incidence and predictors of late-life depression.

Methods: this is a 3-year observational cohort study of 3,214 non-demented patients aged 75 and over completing three waves of assessment. The patients were recruited in 138 primary care practices in six urban areas in Germany.

A European consensus on learning objectives for a core communication curriculum in health care professions.

Objective: To develop learning objectives for a core communication curriculum for all health care professions and to survey the acceptability and suitability of the curriculum for undergraduate European health care education.

Methods: Learning objectives for a Health Professions Core Communication Curriculum (HPCCC) in undergraduate education were developed based on international literature and expert knowledge by an international group of communication experts representing different health care professions. A Delphi process technique was used to gather feedback and to provide a consensus from various health care disciplines within Europe.

Effect of cardiovascular and metabolic disease on cognitive test performance and cognitive change in older adults.

Objectives: To examine the effect of cardiovascular and metabolic diseases on initial cognitive test performance and rate of change in three cognitive measures.

Design: Prospective cohort study.

Setting: General practices in six towns throughout Germany.

Association of the Alzheimer's disease clusterin risk allele with plasma clusterin concentration.

A variant within the clusterin gene has been recently associated with increased risk for Alzheimer's disease (AD) in genome wide association studies. Here we tested the association of the respective single nucleotide polymorphisms (rs11136000) with plasma concentration of clusterin in 67 AD subjects and 191 cognitively unimpaired elderly individuals. We observed an association of the rs11136000 AD-risk variant with low clusterin plasma levels in an allele-dose dependent manner in the healthy individuals (p = 0.

Prediction of dementia by subjective memory impairment: effects of severity and temporal association with cognitive impairment.

Context: Subjective memory impairment (SMI) is receiving increasing attention as a pre-mild cognitive impairment (MCI) condition in the course of the clinical manifestation of Alzheimer disease (AD).

Objectives: To determine the risk for conversion to any dementia, dementia in AD, or vascular dementia by SMI, graded by the level of SMI-related worry and by the temporal association of SMI and subsequent MCI.

Design: Longitudinal cohort study with follow-up examinations at 1(1/2) and 3 years after baseline.

Apart from nihilism and stigma: what influences general practitioners' accuracy in identifying incident dementia?

Objectives: To assess the accuracy of the General Practitioner's (GP) judgment in the recognition of incident dementia cases and to explore factors associated with recognition.

Design: Prospective observational cohort study, two follow-up assessments (FU 1 and FU 2) within 3 years after baseline.

Setting: One hundred thirty-eight general practice surgeries in the six study centers of a prospective German study.

Recommendations for reviewing a manuscript for the GMS Zeitschrift für Medizinische Ausbildung.

The aim of this paper, written by the committee of educational research methodology of the "Society for Medical Education" of the German-speaking countries, will give recommendations for the review process of scientific papers in medical education. The recommendations are based on the results of a workshop in 2007 and on a survey among reviewers of the journal GMS Z Med Ausbild. It reflects on international standards and research in medical education in Germany.

Is the clock drawing test appropriate for screening for mild cognitive impairment?--Results of the German study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe).

Background: Individuals with mild cognitive impairment (MCI) are at high risk of developing dementia and are a target group for preventive interventions. Therefore, research aims at diagnosing MCI at an early stage with short, simple and easily administrable screening tests. Due to the fact that the Clock Drawing Test (CDT) is widely used to screen for dementia, it is questionable whether it is suited to screen for MCI.

Prevalence and risk factors for depression in non-demented primary care attenders aged 75 years and older.

Background: Depression among the elderly is an important public health issue. The aims of this study were to report the prevalence of depression and to determine the impact of socio-demographic variables, functional impairment and medical diagnoses, lifestyle factors, and mild cognitive impairment on depression as part of the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe Study).

Methods: Included in the cross-sectional survey were 3327 non-demented subjects aged 75 and over attending general practitioners (GPs) (n=138) in an urban area of Germany.

Telling "the truth" in dementia--do attitude and approach of general practitioners and specialists differ?

Objective: The prevailing opinion in the literature that disclosing the diagnosis of dementia to patients is important is not always put into practice. The purpose of this study was to investigate differences between GPs and specialists (neurologists and psychiatrists) in the German ambulatory care system concerning the disclosure of the diagnosis of dementia.

Methods: Thirty in depth interviews with randomly selected GPs were conducted.