Teaching and learning about self care in family medicine

1. Teaching and learning about self care in family medicine Group 3 Bled course 2008

2. The drops 31 group • Yonah Yaphe (Israel) • ZigaHladnik (SLO) • KatjaPesjak (SLO) • Dragana BalanovicTrifunovic (Serbia) • MirjamZemljak (SLO) • TadejaCerin (SLO) • SnezanaJankovic (Seriba) • Alberto Carvalho (PT) • ZlataFrasto (BiH) • Matilda Vojnovic (Serbia) • MarijaGlavinic (Serbia) • Janko Kersnik (SLO) • NenaKopcavarGucek (SLO) • KsenijaTusekBunc (SLO)

3. BACKGROUND • Information, promotion, limitation about self care • type of participants: CME, 40 GPs • venue: Department of Family Medicine, University Medical School

4. OBJECTIVES (information, promotion, limitation of self care) • A) knowledge • know how to find sources of information • know how to educate patients over limitations of self-care • know how to promote self care

5. OBJECTIVES (information, promotion, limitation) • B) skills • able to: communicate effectively with patients • negotiate effective compliance and concordance considering self care

6. OBJECTIVES (information, promotion, limitation of self care) • C) attitude • consider self care as an important part of treatment • be aware of advantages and disadvantages of self care • respect religious, cultural etc. differences

7. METHODS ABOUT INFORMATION • pre-prepared homework (literature search, 5 pcs.) with keywords: self-treatment, self-care, self-medication, physician • discussion on reliability of sources in small groups (15-20 min) • reports from small groups (15-20 min) • plenary by a distinguish faculty member on the quality of information on self care (20 min) • discussion – if any – 5 min

8. METHODS ABOUT LIMITATION • work in small groups – evaluation of different sources of self-health information (leaflets, TV clips, web sites, manuals, blogs…) with Likert scale 1-5 as follows: reliability, validity, comprehension, accessibility (20 min) • presentation from small groups on the quality of resources (20-25 min) • plenary comparison between sources and ranging them on the blackboard

9. Objectives - knowledge At the end of this unit doctors will know the different types of patient needs • List of patient needs: • Medical needs (injection, prescription, etc.) • Psychological needs (support, etc.) • Administrative needs (sick leave, etc.) • Social needs (loneliness, living alone, etc.)

10. Objectives - skills • At the end of this unit the participants will be able to use proper communication skills about patient needs • At the end of this unit the participants will be able to understand patient needs

11. Methods Workshop (15 participants) • literature review read before the course • 15 min introductory lecture: Available epidemiology data on self medication/self care Data of most often used self medication/self care in our population

12. METHODS The attitude of GP’s towards self medication/self care • 5 min video presentation (patient visiting a healer) • 15 min discussion in small groups with case reports (case reports prepared before the course with experiences of self medication/self care in GP’s surgery) • 15 min report to the group • Evaluation list • BREAK

13. Objectives At the end of this unit doctors will be able how to establish partnership with pt: • Types of partnerships : • Paternalistic • Shared decision

14. Objectives - skills • At the end of this unit the participants will be able to use proper communication skills • At the end of this unit the participants will be able to create doctor-patient partnership

15. Methods Workshop (with 15 participants) • Warming-up session (shark game)………….10’ • Role play Scenario: Joke-bad communication between doctor and patient: doctor speaks slovene, patient speaks serbian; patient seeks information about using magnets)……….10’

16. Methods • Discussion in three groups about role play (doctors, patients, observers)….........…....15’ • Group’s representative report ……………….15’ • Evaluation list • Break

17. Understanding patient needs for self care and relationship with healers in the local community Unit 4

18. Objectives At the end of the session participants will: • Know how to accept / understand patients and their need for self-care and alternative medicine • Know how to establish the relationship with a healer in the community

19. Methods • Brainstorm • Small groups • Reading articles on alternative medicine previously selected by organizers • Presentations by the groups • Role-play • Discussion and reflection

20. Methods • Audience : family doctors in CPD • Location : University department • Time frame : two hours

21. Time table • 15 min brainstorm “relationship between family doctor and the healers in the local community” • 15 min group work ( four groups of five people) on the given literature ( articles about different alternative medicine) • 5 min presentation for each group about articles

22. Time table • 30 min discussion and reflections about articles • 30 min role-plays: one doctor- patient, another doctor- acupuncturist, with discussions and reflections ( 5 min the play and ten min discussion per play) • Questionnaire • The break

23. Examples of articles • Acupuncture • Homeopathy • Herbal drugs • Bioenergy

24. Questions about the article • How much is this method used • Why is this method used • Patients satisfaction • Effectiveness • Cost • Side effects and safety • Objectivity of the authors

25. Role play Scenario 1 • Patient with a long history of back pain coming to his family doctor satisfied with his new acupuncturist treatment • Doctor accepts patients needs, but wants to understand the reasons of patients satisfaction in non judgemental way

26. Role play Scenario 2 • Family doctor has many patients going to the acupuncturist. He invites the acupunturist to the health center to discuss the subject.The doctor is very suspicious of acupuncture and believes in EBM • The acupuncturist is very knowledgable in acupuncture and is critical about narrow-minded doctors. He knows that he had helped lots of patients with acupuncture

27. Assessment • Questionnaire • Direct observation • Essay