M-C Audétat1,2,3, S Cairo Notari4,5, J Sader6, C Ritz4, T Fassier6,7, J M Sommer4, M Nendaz6, N Caire-Fon8. 1. Primary Care Institut (iuMFE), Faculty of Medicine, University of Geneva, CMU 5-6, Rue Michel-Servet 1, 1211, Geneva, Switzerland. marie-claude.audetat@unige.ch. 2. Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, Geneva, Switzerland. marie-claude.audetat@unige.ch. 3. Department of Family and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montreal, Canada. marie-claude.audetat@unige.ch. 4. Primary Care Institut (iuMFE), Faculty of Medicine, University of Geneva, CMU 5-6, Rue Michel-Servet 1, 1211, Geneva, Switzerland. 5. Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland. 6. Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, Geneva, Switzerland. 7. Division of Internal Medicine for the elderly, University Hospitals of Geneva, Geneva, Switzerland. 8. Department of Family and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montreal, Canada.
Abstract
BACKGROUND: Primary care physicians are at the very heart of managing patients suffering from multimorbidity. However, several studies have highlighted that some physicians feel ill-equipped to manage these kinds of complex clinical situations. Few studies are available on the clinical reasoning processes at play during the long-term management and follow-up of patients suffering from multimorbidity. This study aims to contribute to a better understanding on how the clinical reasoning of primary care physicians is affected during follow-up consultations with these patients. METHODS: A qualitative research project based on semi-structured interviews with primary care physicians in an ambulatory setting will be carried out, using the video stimulated recall interview method. Participants will be filmed in their work environment during a standard consultation with a patient suffering from multimorbidity using a "button camera" (small camera) which will be pinned to their white coat. The recording will be used in a following semi-structured interview with physicians and the research team to instigate a stimulated recall. Stimulated recall is a research method that allows the investigation of cognitive processes by inviting participants to recall their concurrent thinking during an event when prompted by a video sequence recall. During this interview, participants will be prompted by different video sequence and asked to discuss them; the aim will be to encourage them to make their clinical reasoning processes explicit. Fifteen to twenty interviews are planned to reach data saturation. The interviews will be transcribed verbatim and data will be analysed according to a standard content analysis, using deductive and inductive approaches. CONCLUSION: Study results will contribute to the scientific community's overall understanding of clinical reasoning. This will subsequently allow future generation of primary care physicians to have access to more adequate trainings to manage patients suffering from multimorbidity in their practice. As a result, this will improve the quality of the patient's care and treatments.
BACKGROUND: Primary care physicians are at the very heart of managing patients suffering from multimorbidity. However, several studies have highlighted that some physicians feel ill-equipped to manage these kinds of complex clinical situations. Few studies are available on the clinical reasoning processes at play during the long-term management and follow-up of patients suffering from multimorbidity. This study aims to contribute to a better understanding on how the clinical reasoning of primary care physicians is affected during follow-up consultations with these patients. METHODS: A qualitative research project based on semi-structured interviews with primary care physicians in an ambulatory setting will be carried out, using the video stimulated recall interview method. Participants will be filmed in their work environment during a standard consultation with a patient suffering from multimorbidity using a "button camera" (small camera) which will be pinned to their white coat. The recording will be used in a following semi-structured interview with physicians and the research team to instigate a stimulated recall. Stimulated recall is a research method that allows the investigation of cognitive processes by inviting participants to recall their concurrent thinking during an event when prompted by a video sequence recall. During this interview, participants will be prompted by different video sequence and asked to discuss them; the aim will be to encourage them to make their clinical reasoning processes explicit. Fifteen to twenty interviews are planned to reach data saturation. The interviews will be transcribed verbatim and data will be analysed according to a standard content analysis, using deductive and inductive approaches. CONCLUSION: Study results will contribute to the scientific community's overall understanding of clinical reasoning. This will subsequently allow future generation of primary care physicians to have access to more adequate trainings to manage patients suffering from multimorbidity in their practice. As a result, this will improve the quality of the patient's care and treatments.
Authors: Jason R Frank; Linda S Snell; Olle Ten Cate; Eric S Holmboe; Carol Carraccio; Susan R Swing; Peter Harris; Nicholas J Glasgow; Craig Campbell; Deepak Dath; Ronald M Harden; William Iobst; Donlin M Long; Rani Mungroo; Denyse L Richardson; Jonathan Sherbino; Ivan Silver; Sarah Taber; Martin Talbot; Kenneth A Harris Journal: Med Teach Date: 2010 Impact factor: 3.650
Authors: Katherine S Blondon; K C Gary Chan; Virginie Muller-Juge; Stéphane Cullati; Patricia Hudelson; Fabienne Maître; Nu V Vu; Georges L Savoldelli; Mathieu R Nendaz Journal: PLoS One Date: 2017-08-08 Impact factor: 3.240
Authors: Claire Ritz; Julia Sader; Sarah Cairo Notari; Cedric Lanier; Nathalie Caire Fon; Mathieu Nendaz; Marie-Claude Audétat Journal: Fam Med Community Health Date: 2021-09