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

Andy

Andy

Retired committee member
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
 
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:
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.
Participants were requested to (voluntarily) fill out several surveys, yet not all of them filled out all of the surveys. A large difference can be observed between the number of participants, who filled out the survey at the start of the course (N = 801), and the number of participants, who filled out the survey at the end of the course (N = 359).
Click to expand...
 
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.
 
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.

https://nalk.info/portfolio_page/scholing/

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.
 
You must log in or register to reply here.
Back
Top Bottom