What you "see" is how you communicate: Medical students' meaning making of a patient's vignette.

Objectives: To examine how medical students notice issues in a vignette and construct their meaning, and how this construction influences their plan to communicate with the patient.

Methods: Following a breaking bad news course for 112 senior medical students, we qualitatively analyzed the participants' written descriptions of the issues they noticed as requiring special attention, using an Immersion/Crystallization iterative consensus process.

Results: Different students noticed different issues, but no-one noticed all 19 planted issues (Mean of issues noticed by students = 6.

[Psychological and familial aspects of the familial breast and ovarian cancer genetic counseling process].

Breast cancer is the most prevalent malignancy among women, whilst ovarian cancer is less common but carries a graver prognosis. Carriers of the BRCA mutations have a few-fold higher risk for those diseases. Genetic counseling for the families at risk has been available for almost two decades, since the definition of the mutation.

Current knowledge and future directions about the disclosure of dementia: a systematic review of the first decade of the 21st century.

Background: The disclosure of Alzheimer's disease presents a great challenge because it entails emotionally charged communication about a life-threatening, incurable, and stigmatized disease. Although a broad consensus has evolved regarding the potential benefits of early disclosure of the diagnosis, little is known about how these recommendations are actually implemented, and there is limited published research about the process issues of the disclosure.

Purpose: (1) To systematically obtain and evaluate the relevant literature on disclosing a diagnosis of dementia, with special attention to process issues, and (2) to summarize current research findings and draw conclusions for future research and clinical care in this area.

Are you talking to me?! An exploration of the triadic physician-patient-companion communication within memory clinics encounters.

Objective: To explore and gain further insight into the nature of the triadic interaction among patients, companions and physicians in first-time diagnostic disclosure encounters of Alzheimer's disease in memory-clinic visits.

Methods: Twenty-five real-time observations of actual triadic encounters by six different physicians were analyzed. The analysis was accomplished through an innovative combination of grounded theory text analysis and graphics to illustrate the communicational exchanges.

Expectations, experiences, and tensions in the memory clinic: the process of diagnosis disclosure of dementia within a triad.

Background: Health communication studies emphasize the importance of addressing the needs and expectations of patients and families with the disclosure of grave medical conditions. However, little attention has focused on their expectations and experiences of the clinical encounters in diagnosis disclosure of dementia.

Methods: In-depth post-encounter interviews with ten patients and 17 companions from two memory clinics in Israel were analyzed using grounded theory.

The impact of senior medical students' personal difficulties on their communication patterns in breaking bad news.

Purpose: To evaluate the possible influence of personal difficulties and barriers that are within the news bearer and his or her self-awareness (SA) of them, on the patterns of communication during encounters involving breaking bad news (BBN).

Method: Following an intensive BBN course in 2004, 103 senior medical students at the Sackler School of Medicine, Tel Aviv University, were evaluated for BBN competencies by the analysis of their written descriptions of how they visualized their manner of delivering bad news to a patient described in a challenging vignette. The students were further asked to reflect on their own difficulties and barriers that surfaced in response to reading the narrative presented in the vignette and in delivering the bad news.

Written notification of test results: meanings, comprehension and implication on patients' health behavior.

Objective: Mailing test results are frequently used to provide patients with information about their medical condition and enhancing their participation in subsequent management. This study explores patients' experiences of the written notification process and its implications.

Methods: Telephone interviews were conducted with 128 patients who had undergone endoscopic examinations in two gastroenterology clinics after the received of their mailed biopsies results.

Dilemmas in the (un)veiling of the diagnosis of Alzheimer's disease: walking an ethical and professional tight rope.

Objective: To enhance the understanding and effect of physician's difficulties, attitudes and communication styles on the disclosure of the diagnosis of AD in practice.

Methods: Qualitative, phenomenological study, combining pre-encounter interviews with physicians, observations of actual encounters of diagnosis disclosure of AD, and post-encounter interviews.

Results: There were various ways or tactics to (un)veil the bad news that may be perceived as different ways of dulling the impact and avoiding full and therefore problematic statements.

Factors in the doctor-patient relationship that accentuate physicians' hurt feelings when patients terminate the relationship with them.

Objective: The present study explores the emotional effect of the injury experienced by physician's, as a consequence of a patient's termination of their relationship.

Methods: A vignette study using different scenarios describing a patient who switched to another doctor was distributed to 119 family physicians. A three-way ANCOVA analysis was employed.

Comparisons of American, Israeli, Italian and Mexican physicians and nurses on the total and factor scores of the Jefferson scale of attitudes toward physician-nurse collaborative relationships.

This cross-cultural study was designed to compare the attitudes of physicians and nurses toward physician-nurse collaboration in the United States, Israel, Italy and Mexico. Total participants were 2522 physicians and nurses who completed the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration (15 Likert-type items, (Hojat et al., Evaluation and the Health Professions 22 (1999a) 208; Nursing Research 50 (2001) 123).

Maternal mosaicism for a second mutational event--a novel deletion--in a familial adenomatous polyposis family harboring a new germ-line mutation in the alternatively spliced-exon 9 region of APC.

Familial Adenomatous Polyposis (FAP) is an autosomal dominant heritable disorder caused by germ-line mutations in the APC gene. To date, more than 300 germ-line mutations within this gene have been described. Using PCR, SSCP and DNA sequencing, we have identified a new mutation in the alternatively spliced region of exon 9 (1042C-->T), which results in a stop signal.

The education and training of gastroenterologists for the 21st century: a paradigm for the education of medical specialists in technology-intensive fields - an international and Israeli perspective.

Gastroenterology in the developed world as a paradigm for technologically intensive medical specialties has undergone dramatic changes during the last half-century with expansion, proliferation and affluence followed by serious reactions on the part of cost-conscious and demanding governments, insurers and consumers. A review of events in several regions within the developed world reveals tremendous technological progress but inadequate attention to professional, economic and ethical issues, which are crucial for the education of a model gastroenterologist who will embody the qualities that will enable him/her to function well clinically, technologically, scientifically, professionally and ethically and thus enable him/her to cope with the increasingly complex challenges that are likely to arise during the next decades. The possibility and need for defining a specific ethic for technology-intensive medical specialists is discussed.