Background: Evidence-based medicine (EbM) as a teaching subject is increasingly taken into account in the Master Plan 2020. To date, neither theoretical requirements nor practical applications of EbM have been consistently implemented in the clinical curriculum. To fill this gap, a digital and tutor-based EbM course has been developed. The aim is to identify the student characteristics (statistical competence, Need for Cognition (NFC), work and experience patterns (AVEM), diagnostic uncertainty) of the first cohort in order to ensure successful course implementation and to prepare future doctors for their role as mediators of health literacy using EbM methods.
Methods: The long-term study started in the summer term 2019 with 10 medical students during their clinical training. The measurements were conducted before (t0) and after course attendance (t1). Socio-demographic variables were taken at t0, the Quick Risk Test, PRU questionnaire, the NFC scale and the AVEM were collected at t0 and t1.
Results: Half of the students started their doctoral thesis before attending the course. The first test results of the Quick Risk Test (t0) were between 50 % and 90 % and at t1 between 60 % and 100 %. The students showed high scores on the NFC scale (X¯=4.6, SD=0.52, Δ X¯ t0 - t1=0.1) and medium scores on the Perfectionism scale (X¯=3.8, SD=0.51, Δ X¯ t0 - t1=0.1), Resignation Tendency (X¯=3.8, SD=1.17, Δ X¯ t0 - t1=0.1) and on the scale Aggressive Problem Solving (X¯=3.9, SD=1.06, Δ X¯ t0 - t1=0.2). They achieved high levels of Anxiety Due to Diagnostic Uncertainty (X¯=4.8, SD=0.69, Δ X¯ t0 - t1=0.4) and on the scale Concern about Poor Outcomes (X¯=3.9, SD=1.54, Δ X¯ t0 - t1=0.6). The scale Restraint in Disclosing Uncertainty to Patients was more pronounced than the scale Restraint in Disclosing Errors to Physicians (X¯=3.5, SD=0.93, Δ X¯ t0 - t1=-0.3 compared to X¯=2.3, SD=1.20, Δ X¯ t0 - t1=0.1).
Discussion: Statistical competence improved with course attendance, with only one student being able to correctly answer all items at t1. NFC and AVEM were strongly expressed and were not very sensitive to change in the sample. The greatest changes were observed on the scales of concern about poor results and fear of diagnostic uncertainty, both of which decreased with course participation.
Conclusion: In the long term, the development of a new measuring instrument to assess EbM competencies instead of the Quick Risk Test is conceivable. The longitudinal design will also enable us to make causal interpretations and to track changes in students' competence feelings, behaviour and attitudes.
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http://dx.doi.org/10.1016/j.zefq.2021.02.010 | DOI Listing |
Pain Rep
February 2025
Department Psychosomatic Medicine and Psychotherapy, Technical University Munich, Munich, Germany.
Introduction: The debate addressing the classification of chronic widespread pain as a physical disorder (fibromyalgia syndrome) [FMS] or a somatoform disorder according to psychiatric classification systems has continued for decades.
Objectives: The review aims to line out the new perspectives introduced by the 11th version of the International Classification of Diseases (ICD 11) of the World Health Organization (WHO).
Methods: Critical review of the classification criteria of fibromyalgia syndrome and bodily distress disorder in ICD 11.
BMC Womens Health
January 2025
Institute of Applied Nursing Science, School of Health, Eastern Switzerland University of Applied Sciences, Neumarkt 3, Vadianstrasse 29, St. Gallen, 9000, Switzerland.
Purpose: Women with breast cancer face a high degree of uncertainty. Trust between health providers and patients has been shown to improve patient quality of life and may enhance clinical outcomes. This study aimed to explore the meaning of trust along the treatment pathway.
View Article and Find Full Text PDFCreat Nurs
January 2025
Nursing, Rumah Sakit Umum Daerah Manokwari, Manokwari, West Papua, Indonesia.
Mothers living with human immunodeficiency virus (HIV) may experience adjustment issues due to their illness progression and the risk of intergenerational transmission of the disease. Existing research on women living with HIV has focused on how psychological transitions such as child care and breastfeeding influence maternal life, and how socioeconomic status, stigma, and social support impact psychological transitions. Little is known about the experiences of mothers living with HIV in Indonesia.
View Article and Find Full Text PDFBMJ
January 2025
Centre of General Practice, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Objective: To report on complications of conisation and its effects on fertility and stenosis.
Design: Register based nationwide cohort study on routinely collected data using several linked databases.
Setting: Primary and secondary care in Denmark, 2006-18.
Arch Osteoporos
January 2025
Department of Rheumatology and ULR 4490 (MabLab), University-Hospital of Lille, Lille, France.
Unlabelled: The management of osteoporosis even after a fracture is declining. Our pilot study in patients with osteoporosis confirms a large ignorance of the disease and major fears and uncertainties about the treatments. Complete and sustained medical information seems essential to counteract the contradictory information, which are exclusively negative.
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