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How to become a "Great Health Professional"?
1. How to become a
“Great Health Professional”?
Olaf Kraus de Camargo
@DevPeds
Ronen, G. M., Kraus de Camargo, O., & Rosenbaum, P. L. (2020). How Can We Create Osler’s “Great Physician”?
Fundamentals for Physicians’ Competency in the Twenty-first Century. Medical Science Educator, 30(3), 1279-1284.
https://doi.org/10.1007/s40670-020-01003-1
8. Please rank by importance!
What characteristics of a med school do you think help to make
great physicians?
https://www.mentimeter.com/app/presentation/alveazr6baorv5rbu2
r255zoehxida3d/9xmus64wn4e7/edit
9. Medical School Ratings
1. Research Activity 0.40 (Dollar$)
2. Quality Assessment 0.30 (rated by peers and residency directors)
3. Student Selectivity 0.20 (MCAT, GPA)
4. Faculty Resources 0.10 (ratio faculty/students)
https://www.usnews.com/education/best-graduate-schools/articles/medical-schools-methodology
25. Health Condition
(disorder/disease)
Body functions &
structures
(Impairment)
Activities
(Limitation)
Participation
(Restriction)
Environmental
Factors
Personal
Factors
ICF – Biopsychosocial Model
Pain
Fever
Dysfunction
Structural lesion
Health professionals
Health system
Suffering
Fear
Activity limitation
Participation restriction
Family Work
26. Health Condition
(disorder/disease)
Body functions &
structures
(Impairment)
Activities
(Limitation)
Participation
(Restriction)
Environmental
Factors
Personal
Factors
ICF – Biopsychosocial Model
Pain
Fever
Dysfunction
Structural lesion
Health professionals
Health system
Suffering
Fear
Activity limitation
Participation restriction
Family Work
28. Narrative Medicine
§ ”Narrative knowledge is what one uses to understand the meaning
and significance of stories through cognitive, symbolic, and affective
means.”
Charon R. Narrative Medicine A Model for Empathy, Reflection, Profession, andTrust.
JAMA - J Am Med Assoc. 2001;286(15):1897-1902.
29. Narrative Medicine
§ ”Narrative knowledge is what one uses to understand the meaning
and significance of stories through cognitive, symbolic, and affective
means.”
§ “Unlike its complement, logicoscientific knowledge, through which a
detached and replaceable observer generates or comprehends
replicable and generalizable notices, narrative knowledge leads to
local and particular understandings about one situation by one
participant or observer.”
Charon R. Narrative Medicine A Model for Empathy, Reflection, Profession, andTrust.
JAMA - J Am Med Assoc. 2001;286(15):1897-1902.
30. Narrative Medicine
§ ”Narrative knowledge is what one uses to understand the meaning
and significance of stories through cognitive, symbolic, and affective
means.”
§ “Unlike its complement, logicoscientific knowledge, through which a
detached and replaceable observer generates or comprehends
replicable and generalizable notices, narrative knowledge leads to
local and particular understandings about one situation by one
participant or observer.”
§ ”Medicine can, as a result, better understand the experiences of sick
people”
Charon R. Narrative Medicine A Model for Empathy, Reflection, Profession, andTrust.
JAMA - J Am Med Assoc. 2001;286(15):1897-1902.
https://jamanetwork.com/journals/jama/fullarticle/194300
31. PROs
§ PROs embrace any aspect of a personal report of the individual’s
health that comes directly, unfiltered, from that person
Valderas JM,Alonso J. Patient reported outcome measures: a model-based classification
system for research and clinical practice. Qual Life Res. 2008;17(9):1125-1135.
32. PROs
§ PROs embrace any aspect of a personal report of the individual’s
health that comes directly, unfiltered, from that person
§ Help healthcare providers to focus on a person’s individual health
goals and guide diagnostic and management decisions
Valderas JM,Alonso J. Patient reported outcome measures: a model-based classification
system for research and clinical practice. Qual Life Res. 2008;17(9):1125-1135.
33. PROs
§ PROs embrace any aspect of a personal report of the individual’s
health that comes directly, unfiltered, from that person
§ Help healthcare providers to focus on a person’s individual health
goals and guide diagnostic and management decisions
§ PROMs can teach us whether, in their own eyes, our patients are truly
better after interventions, by following the ethical principle of doing
more good than harm within the context of their own lives.
Valderas JM,Alonso J. Patient reported outcome measures: a model-based classification
system for research and clinical practice. Qual Life Res. 2008;17(9):1125-1135.
34. Ethics
§ consider beneficence (doing good), non-maleficence (not doing harm),
autonomy (independence of the person), and justice (fairness)
§ moral issues that often arise in clinical practice: decisions about
investigations, therapies, intensity of treatment, and whether and how
to incorporate patients’ voices.
§ knowing the narrative, understanding the biopsychosocial connections
helps to engage in ethical shared decision-making
35. A Brighter Future
PBL
Barrows, H.S., Mitchell,
D.L.M., 1975.
1887 1975 2001
Oxman,A.D.,Sackett,D.L.,
Guyatt, G.H., 1993
1993
EBM ICF
World Health Organization, 2001
Mac
2010
#Chronic Diseases
Ed. Reform
Frenk, J., et al. 2010.
Allotey, P., et al., 2010
36. A Brighter Future
Frenk J, Chen L, Bhutta ZA, et al. Health professionals for a new century: transforming education to strengthen health
systems in an interdependent world. Lancet. 2010;376(9756):1923-1958. doi:10.1016/s0140-6736(10)61854-5
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61854-5/fulltext?_eventId=login
37. A Brighter Future
PBL
Barrows, H.S., Mitchell,
D.L.M., 1975.
1887 1975 2020
2001
Oxman,A.D.,Sackett,D.L.,
Guyatt, G.H., 1993
1993
EBM ICF
World Health Organization, 2001
Mac “InMEd”
(Integrated Medical Education)
2010
#Chronic Diseases
Ed. Reform
Frenk, J., et al. 2010.
Allotey, P., et al., 2010 Ronen, G.M et al., 2020
38. Science:
Biomedical
Research &
Evidence-based
Medicine
The Patient’sVoice:
Narrative Medicine &
Patient-reported outcomes
Clinician’s
Tools:
ICF Framework &
Ethics principles
Integrated Model
§ICF as the foundation to organize
the narrative provided by patients
§Ethical reflection on investigation
and therapy options within a
shared decision-making process
§Exploring and choosing patient-
relevant outcomes understanding
that enabling participation is the
main goal of health care (ICF!)
ØLearning in interprofessional teams
39. “Great Health Professional”
“The good clinician treats the
impairment; the great clinician treats
the patient who has the impairment.”
after William Osler (1849 – 1919)
40. Acknowledgements
§ Gabriel M. Ronen
§ Peter Rosenbaum
§ Karen McAssey
§ Bernard Dan
https://link.springer.com/article/10.1007/s40670-020-01003-1
41. Q & A Session
Q A
&
ThankYou!
Contact: krausdc@mcmaster.ca