[Development and implementation of the dementia guideline of the German Society of General Practice and Family Medicine].

The evidence-based guidelines of the German Society of General Practice and Family Medicine (DEGAM) are developed according to an established ten-stage plan. The twelfth guideline addresses the health care problem of dementia. The main focus is the sensitive handling of patients and their relatives, e.

Job requirements compared to medical school education: differences between graduates from problem-based learning and conventional curricula.

Background: Problem-based Learning (PBL) has been suggested as a key educational method of knowledge acquisition to improve medical education. We sought to evaluate the differences in medical school education between graduates from PBL-based and conventional curricula and to what extent these curricula fit job requirements.

Methods: Graduates from all German medical schools who graduated between 1996 and 2002 were eligible for this study.

Knowledge transfer for the management of dementia: a cluster randomised trial of blended learning in general practice.

Background: The implementation of new medical knowledge into general practice is a complex process. Blended learning may offer an effective and efficient educational intervention to reduce the knowledge-to-practice gap. The aim of this study was to compare knowledge acquisition about dementia management between a blended learning approach using online modules in addition to quality circles (QCs) and QCs alone.

German ambulatory care physicians' perspectives on continuing medical education - a national survey.

Introduction: This survey aimed to investigate German ambulatory physicians' opinions about mandatory continuing medical education (CME) and CME resources shortly before the introduction of mandatory CME in 2004.

Methods: A structured national telephone survey of general practitioners and specialists was conducted. Main outcome measures were opinions about mandatory CME, preferred CME media, and financial aspects of CME.

Dementia care initiative in primary practice: study protocol of a cluster randomized trial on dementia management in a general practice setting.

Background: Current guidelines for dementia care recommend the combination of drug therapy with non-pharmaceutical measures like counselling and social support. However, the scientific evidence concerning non-pharmaceutical interventions for dementia patients and their informal caregivers remains inconclusive. Targets of modern comprehensive dementia care are to enable patients to live at home as long and as independent as possible and to reduce the burden of caregivers.

General Practitioners' preferences and use of educational media: a German perspective.

Background: Several studies suggest that General Practitioners (GPs) prefer "traditional" media such as journals or quality circles when they are seeking out different options to meet their continuing medical education (CME) requirements. A survey was designed in order to gain a better understanding of German General Practitioners' preferences for different forms of educational media that will meet their CME needs.

Methods: Four hundred and forty nine (N = 449) German physicians were contacted to take part in this study on the occasion of one of their quality circle meetings.

[Primary care physicians, internet and educational media. Preferences, usages and appraisal in a 6-year comparison].

Background And Purpose: Several studies suggest that primary care physicians prefer "traditional" media like journals or quality circles for their postgraduate medical education. This survey was designed to gain a better understanding of primary care physicians' learning media preferences. The actual results were compared with data from a survey with the same physicians conducted in 2001 to identify a change in their preferred learning media.

Knowledge translation on dementia: a cluster randomized trial to compare a blended learning approach with a "classical" advanced training in GP quality circles.

Background: Thus far important findings regarding the dementia syndrome have been implemented into patients' medical care only inadequately. A professional training accounting for both, general practitioners' (GP) needs and learning preferences as well as care-relevant aspects could be a major step towards improving medical care. In the WIDA-study, entitled "Knowledge translation on dementia in general practice" two different training concepts are developed, implemented and evaluated.

[Multimodal training of general practitioners--evaluation and knowledge increase within the framework of the dementia management initiative in general medicine (IDA)].

Background And Objective: In many industrialized countries diagnostic and therapeutic deficits in the management of patients with dementia are well documented. Due to demographic trends the next years will see a further rise in the number of affected patients. Accordingly, the knowledge and competence of the physicians taking care of these patients need to be keep up-to-date.

[How to change physicians' practice--health services research with the knowledge-performance gap on focus].

How can the knowledge-performance gap be bridged? The discrepancy between our scientific knowledge on the one hand and its inadequate application in everyday practice on the other remains a major challenge for implementation research. Looking back on ten years of Health Services Research and acknowledging the achievements of educational research we have gained access to a variety of research findings and tools describing how physicians'--and other health professionals'--behavior and performance in medical care may be influenced. The time has come for testing and evaluating them.

[EbM and patient perspective--a 5-step approach].

Objectives: Shared decision making describes a way of involving patients in the planning and management of their individual healing process. Doing this effectively seems to be quite a challenge for both physicians and patients. The mutual transfer of information appears to be one of the main steps of this process.

[The future is chronic: German primary care and the Chronic Care Model--The comprehensive principles in the proactive treatment of the chronically ill].

Background: In Germany, primary healthcare for patients with chronic diseases needs to be improved. Taking the example of depression, congestive heart failure, diabetes and diseases of the musculoskeletal system we analyzed to which extent the 'Chronic Care Model' allows for improvements.

Methods: Diagnosis-specific health assessment; adaptation of the 'Chronic Care Model' to the German healthcare system; peer reviewed discussions of the potentials for improving primary care of the chronically ill.

German ambulatory care physicians' perspectives on clinical guidelines - a national survey.

Background: There has been little systematic research about the extent to which German physicians accept or reject the concept and practice of a) clinical practice guidelines (CPG) and b) evidence based medicine (EBM)The aim of this study was to investigate German office-based physicians' perspective on CPGs and EBM and their application in medical practice.

Methods: Structured national telephone survey of ambulatory care physicians, four thematic blocks with 21 questions (5 point Likert scale). 511 office-based general practitioners and specialists.

[Shared decision making. The perspective of practicing physicians].

Background And Purpose: More and more, patients want to participate in medical decision making. They expect a patient-centered communication as well as adequate information. However, little is known about the physicians' perspective and skills regarding shared decision making (SDM).

Looking back on back pain: trial and error of diagnoses in the 20th century.

Context: The societal costs of low back pain and associated disability are immense. However, very little is known about the etiology of low back pain. Lumbar disc disease was discovered in the last century and became the predominant etiology for back pain.

[Evidence-based medicine in professional training and education in practice? The integrated evidence-based medicine curriculum at the Medical School at the University of Witten/Herdecke]].

Applying the principles of evidence-based medicine in clinical practice is becoming more and more important for healthcare professionals in Germany. In this context Witten/Herdecke University has implemented an EbM Curriculum for medical students that is closely related to problem-based learning and clinical rotations within the scope of the six-year medical reform curriculum. Starting with the first semester, students will be able to acquire the necessary skills to search medical databases, to critically review the information retrieved according to EbM standards, to gather evidence for answering diagnostic or therapeutic questions during their clinical education and to ultimately participate in the development of clinical guidelines during their last year.

[Family physicians, the internet and new knowledge. Utilization and judgment of efficiency of continuing education media by general physicians and internists in family practice].

Background And Objective: The application of new information technologies has a lasting impact on the physicians' working environment. Not only practice administration is undergoing substantial change, increasingly, individual learning preferences and continuing medical education are influenced by new media. This survey is designed to demonstrate current methods of and demand for continuing medical education by primary care physicians.

[www.evidence.de--assessment and utilization of clinical guidelines by primary care physicians and internists].

Background And Objective: Compared to the generation of new scientific results, implementation and utilization of evidence based knowledge is lacking far behind. Strengths and weaknesses of evidence- and HTML-based guidelines were evaluated in an academic network of primary care physicians to better understand the expectations and information needs of GPs.

Methods: Standardized survey of 72 primary care physicians (21% female, 79% male) regarding three network based issues: "frequency of guideline use", "reasons to use/not to use guidelines", "evaluation and overall judgement of guidelines".