Welcome to the 26th WONCA Europe Virtual Conference Programme Scheduling

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Background and purpose: Learning and assessing skilled communication requires considering contextual factors in clinical encounters. Purpose is to develop narrative profiles describing behavioural patterns of consultation performance of trainees in Family Medicine (FM) and identify challenges for future learning.

Methods: A qualitative study was conducted in FM residency training consisting of three phases: 1. From year 1 (N=6) and year 3 (N=7) trainees, in total 81 videotaped consultations were observed and overall trainee consultation performance classified in one of four-pre-existing typologies, 2. During an individual interview, FM supervisors (N=20) observed four selected consultations mirroring each of these typologies and reflected on trainee behaviours, 3. Development of four narrative profiles based on template analysis of the interviews and a content comparison with the typologies. (1)

Results: Four narrative profiles describing trainee attitude, patterns of consultation behaviours and challenges for future learning, align with the pre-existing typologies. There is a shared frame of reference between supervisors when identifying behavioural patterns mirroring proficiency in doctor patient interaction. Learning challenges focus on balancing patient-centeredness with effectively working on clinical tasks, while outlining the developmental route for contextual adaptation.

Discussion: Narrative profiles support meaningful and tailored feedback on consultation performance and stimulate monitoring of individual competence development integrating learning and assessment during workplace based learning. The value of using the narrative profiles in workplace-based learning needs further exploration in future studies.

1. Oerlemans M, et al. Should we assess clinical performance in single patient encounters or consistent behaviors of clinical performance over a series of encounters? A qualitative exploration of narrative trainee profiles. Medical Teacher. 2017;39(3):300-7.

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Background and purpose:
As demands on collaboration is progressively increasing in the primary care setting, effective interprofessional teamwork between GPs and allied health professionals is crucial. The need for more training in interprofessional collaboration competencies is widely recognised. However, existing competency frameworks are not specific enough to guide learning in medical specialty training for GPs. Purpose of this study is a consensus among GPs and allied health professionals on competencies to be learned by GP trainees to fulfil their role in interprofessional collaborative practice.

Methods:
Three nominal group sessions were held with experts of primary care and interprofessional collaboration, each resulting in its own group consensus on interprofessional collaboration competencies. The researchers conducted a content analysis to merge and thematise the three consensuses of prioritised competencies into one list. The merged list was presented to the participants for the final ranking of the competencies. The final ranking was regarded as consensus on core GP competencies regarding interprofessional practice.

Results:
The content analysis resulted in 31 competencies of which fourteen competencies were prioritised by the experts in the final ranking into three main themes: 1. Professional identity and role definition of the GP. (3 competencies); 2. Developing and executing shared care plans for individual patients (6); 3. Setting up and maintaining interprofessional collaborative partnerships (5).

Conclusions:
An interprofessional group of experts reached consensus on 14 competencies within 3 themes. This framework provides a steppingstone for future GPs to focus their interprofessional development.

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Background and purpose: The spread of the disease during the pandemic damaged the economic resources of countries as well as deteriorating the health of communities. Many sectors played a role in the management of the pandemic, but the most significant was played by the health sector, by providing preparedness and appropriate response. Since the outbreak of the COVID-19 pandemic, meeting the health needs of the affected individuals, families, and communities was the top priority. After the increased number of COVID-19 positive patients, a plateau-phase and a decrease in the numbers are expected, followed by a second-phase which could lead to an increased health system workload. The importance of training well-educated and qualified healthcare professionals (HPs) was reconsidered again. The rapid spread of the epidemic revealed the limitations of traditional method education. Massive online courses (MOOCs) were offered as a solution to keep the information up-to-date and accessible. The aim of our study is to evaluate the perceptions and experiences of healthcare professionals on strengthening the health system during the COVID-19 pandemic.

Methods: In this descriptive cross-sectional study, an online survey is applying to HPs between February-May 2021. A sample size of at least 30 HPs from each country (it is aimed to be done in 7 countries) is envisaged, reaching our goal of 210 HPs. Due to international participation, the survey will be conducted in English. Ethical approval has been obtained from the Ethics Committee of IUE. Participation is based on volunteerism.

Results: This is an ongoing study. Results will be presented at the congress.

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Background: In supporting better healthcare for person centred care, it is expected that physicians increasingly take the role of Health Advocacy (HA). Despite the evident value and need of HA in primary care, incorporating this remains challenging. That is why it is also difficult to educate future General Practitioners as Healthcare Advocates at the workplace. Central to this workshop is the struggle professionals within primary healthcare teams have with learning and practicing HA.

Aim: to identify practical situations in order to make the education of the HA role more explicit. HA is a mindset but also a set of knowledge and skills. (Boroumand 2020) A competent HA professional in a primary healthcare team understands factors as health inequities and influences of health policy on the patient population, but also mobilizes resources for personal centred care. (Hubinette 2014, 2017)

The resuts are 1) to express the developments of HA competence and the importance of HA for primary healthcare, 2) to reflect on opportunities and threats of developing HA within practice and training, and 3) to share best-practice and formulate suggestions for individual and (interprofessional) team activities to develop HA activities and education.

Method and timetable: We start the workshop with sharing images of the HA in 2025 in breakout rooms (20’). After that we present the evidence and discuss our research of HA (20’). We share and collect best practices with HA in participant’s experience (20’) and formulate individual and plenary conclusions to stimulate (education in) HA in primary healthcare teams (30’).

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Background and purpose

Language barriers between physicians and citizens with limited German proficiency are challenging. Oftentimes, bilingual staff members help out by interpreting. However, these language brokers do not necessarily comply with professional standards of interpreting, which can affect quality of care. In Germany, there is no systematic approach to train bilingual staff members in ambulatory settings.

Methods

We evaluated a course for medical assistants (MAs) co-taught by bilingual communication experts and medical experts following a structured curriculum: initial oral language assessment, weekend courses with practical training of culture-sensitive interpreting skills, coaching, and final assessment. The intervention involved eight bilingual Turkish-German MAs. Using a pre-post design, participants self-assessed their interpreting skills from 1 (very good) to 5 (poor) as well as other perceived changes and attitudes towards the training (agree / disagree). Protocols of the coaching sessions and final interviews were summarized and evaluated.

Results

MAs reported an increase in general interpreting skills (∆Mpre-Mpost=.63; 95%-CI: 0.19-1.06). A majority felt more confident in patient contact (n=5) and would recommend the training (n=7). In the coaching and interviews, MAs reported that they now prefer the strategy of interpreting literally, take more time to interpret accurately, pay more attention to their spatial positioning and separate their interpreter role from their role as an MA.

Conclusions

A systematic approach to training interpreting skills of bilingual staff in ambulatory settings was perceived as valuable by the MAs. It might be an important contribution to the improvement of quality in healthcare for a potentially vulnerable group.

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Background

Lifestyle medicine (LM) has become an integral component of Family Medicine. However, most physicians report insufficient confidence, clinical knowledge, and skills as major barriers to counseling patients about lifestyle. A free online LM course was created using the NextGenU.org platform to bridge the gap. This research evaluates its implementation.

Methods

We developed a 30-hour, competency-based course, 10 modules consisting of readings, videos, quizzes, and peer/mentored activities. All course components (like all NextGenU.org courses/training) are free, including registration, learning, testing, and a certificate of completion. The course has been offered online since 2017 (updated in 2020) for independent use and as part of a freely-available Master’s in Public Health.

Results.

Among students, 636 began and 114 completed the course; 100 took the final exam (15.7%), 94 passed. Positive feedback was received from students, including easy accessibility, high quality of educational resources, and the importance of issues. Heavy reading requirements were reported as a challenge (particularly by non-native-English-speakers), which led to a revision of the course in 2020 to include more concise readings and presentation recordings of the lessons.

Conclusion

This online LM course shows great promise to provide affordable, quality LM education to a global audience, particularly now during current pandemic challenges. Continued research is needed to assess knowledge and skill gains, and long-term impact on LM counseling among family physicians and other health professionals.