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Development and User Experiences of a Biopsychosocial Interprofessional Online Course on Persistent Somatic Symptoms, 2021, Rosmalen et al

Discussion in 'Psychosomatic research - ME/CFS and Long Covid' started by Andy, Nov 26, 2021.

  1. Andy

    Andy Committee Member

    Hampshire, UK
    Background: Communication between healthcare providers and patients with persistent somatic symptoms (PSS) is frequently hampered by mutual misunderstanding and dissatisfaction.

    Methods: We developed an online, interprofessional course to teach healthcare providers the knowledge, skills, and attitude they need to diagnose and treat PSS in a patient-centered manner based on the biopsychosocial model. The course consisted of six modules of 45–60 min. Each module contained different types of assignments, based on six cases: videos, discussion boards, reading assignments, polls, and quizzes. For this study, we included (1) medical residents, following the course as part of their residency training, and (2) healthcare providers (general practitioners, medical specialists, physiotherapists, nurses, and psychologists), following the course as continuing vocational training. Throughout the course, participants were asked to fill out online surveys, enquiring about their learning gains and satisfaction with the course.

    Results: The biopsychosocial approach was integrated across the modules and teached health care workers about recent insights on biological, psychological and social aspects of PSS. In total, 801 participants with a wide variety in clinical experience started the course; the largest groups of professionals were general practitioners (N = 400), physiotherapists (N = 124) and mental healthcare workers (N = 53). At the start of the course, 22% of the participants rated their level of knowledge on PSS as adequate. At the end of the course, 359 participants completed the evaluation questionnaires. Of this group, 81% rated their level of knowledge on PSS as adequate and 86% felt that following the course increased their competencies in communicating with patients with PSS (N = 359). On a scale from 1 to 10, participants gave the course a mean grade of 7.8 points. Accordingly, 85% stated that they would recommend the course to a colleague.

    Conclusion: Our course developed in a co-design process involving multiple stakeholders can be implemented, is being used, and is positively evaluated by professionals across a variety of health care settings.

    Open access, https://www.frontiersin.org/articles/10.3389/fpsyt.2021.725546/full
  2. Peter Trewhitt

    Peter Trewhitt Senior Member (Voting Rights)

    What does this tell us?

    I imagine if you did an analogous study looking at training people in spiritual healing or mediumship you would get very similar results.

    Doesn’t this miss out one important component? If you are looking at communication between professionals and patients, don’t you also need the patients’ view too?

    [added - I wonder how the results of a course teaching medical professionals how to support patients whose conditions are poorly understood, have unexplained symptoms, have no available treatment or who have been failed by the medical profession would compare?]
    Last edited: Nov 26, 2021
    ola_cohn, Argos, EzzieD and 11 others like this.
  3. NelliePledge

    NelliePledge Moderator Staff Member

    UK West Midlands
    This tells us what a big job it is to overcome all the impact of this type of ‘training’
    Lilas, hibiscuswahine, Hutan and 5 others like this.
  4. Amw66

    Amw66 Senior Member (Voting Rights)

    Has anyone done this course ?
  5. Hutan

    Hutan Moderator Staff Member

    Aotearoa New Zealand
    The certainty of the authors that patients don't have anything physically wrong,
    the idea that a convincingly performed physical examination will provide sufficient reassurance to the patient,
    the packaging up of it all as an online course so medical professionals can have their prejudices confirmed in the comfort and convenience of their own home,
    and the labelling of it all as patient-centred...
    it's despair-inducing.

    The only good thing I can find in this study is that well less than half of the participants who started the course filled out the survey at the end of the course. So, my hope is that some didn't actually do much of the course.
    ola_cohn, Argos, Lilas and 12 others like this.
  6. NelliePledge

    NelliePledge Moderator Staff Member

    UK West Midlands
    Yet not all of them filled out all surveys - did they not stop to ask why their participation rate was poor, clearly not rocket scientists
  7. hibiscuswahine

    hibiscuswahine Senior Member (Voting Rights)

    Aotearoa/New Zealand
    The had only one patient representative on their team amongst many “experts” and “stakeholders” (health care providers). They measured their satisfaction (in money and time saved) but not the patient’s satisfaction though they say they will test that….

    They mention briefly iatrogenic harm (medically induced) but glossed over that.

    I read through the vignettes and know what they would be diagnosed with, what platitudes would be given and no further investigation.
    ola_cohn, Argos, Lilas and 5 others like this.
  8. Grigor

    Grigor Senior Member (Voting Rights)

    Judith Rosmalen is the chair of the Network Persistent Physical Symptoms (Netwerk Aanhoudende Lichamelijke Klachten). The website still mentions a course of CGT for CFS which is the type of CBT NICE distanced itself from.


    This was for a project of hers (my subtitles):

    So I'm very very curious and worried what has been taught to these health care providers.

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