Abstract:
BACKGROUND:The transition from undergraduate to postgraduate training is a crucial career step for physicians. Several international studies have shown that graduates feel insufficiently prepared to perform various aspects of clinical practice. The publication of a national framework for undergraduate medical education triggered major curricular reforms at our institution. Through this study, we explored the perceptions of preparedness for practice of junior residents who graduated from the new curriculum. METHODS:This was a cross-sectional, triangulation mixed-methods quantitative and qualitative study among junior residents and senior physicians of 13 hospitals in western Switzerland. We administered two online questionnaires aimed at exploring perceptions in five areas of clinical competence (knowledge, clinical skills, clinical reasoning, communication and collaboration), as well in self-confidence and coping with the daily work. The qualitative part consisted of six semi-structured focus groups with junior residents, aimed at further clarifying the perceptions and circumstances of their preparedness. Verbatim transcriptions were analysed through thematic analysis. RESULTS:Fifty-nine (43.3%) junior residents and 68 (26.5%) senior physicians completed the questionnaire. Among residents, 54.2% considered the curriculum to have adequately prepared them for practice. However, residents felt they were underperforming particularly in developing therapeutic strategies, in communicating with patients’ relatives, and in writing discharge letters. 50.8% (95% confidence interval 37.5-64.1) of them felt overwhelmed by the workload and 39% felt unfulfilled at work. Perceptions of senior physicians about residents’ clinical competences most often agreed with those of their young colleagues. Nineteen residents volunteered to participate in six focus groups. Thematic analysis allowed us to highlight six areas associated with perceptions of underpreparedness: (1) the adequacy of undergraduate instruction; (2) the ability to work efficiently within an interprofessional team; (3) the ability to communicate with patients and colleagues; (4) the effect of the curriculum on the development of critical inquiry and their approach to learning; (5) difficulties in managing their daily clinical work; (6) the negative emotions experienced at the beginning of postgraduate training. CONCLUSIONS:Several important aspects of daily clinical practice appear to be insufficiently mastered in the first few months of residency. The resulting stress and anxiety negatively affect job satisfaction. This study provides concrete examples and guidance for program directors and educators on how to better prepare students for postgraduate training.
journal_name
Swiss Med Wklyjournal_title
Swiss medical weeklyauthors
Monti M,Brunet L,Michaud PAdoi
10.4414/smw.2020.20370subject
Has Abstractpub_date
2020-11-24 00:00:00pages
w20370eissn
1424-7860issn
1424-3997pii
Swiss Med Wkly. 2020;150:w20370journal_volume
150pub_type
杂志文章abstract:QUESTIONS UNDER STUDY:This study aims at estimating the costs of disorders of the brain in Switzerland based on the published epidemiological and economic evidence. METHODS:the data presented for Switzerland are derived from the "cost of disorders of the brain in Europe" study of the European Brain Counsil (EBC). Avai...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2008/01/smw-11910
更新日期:2008-01-12 00:00:00
abstract:OBJECTIVES:To investigate the subjective treatment goals of insulin-treated diabetic patients. METHODS:297 type 1 and 205 type 2 diabetic patients, representative of the North-western Swiss population, filled out a self report questionnaire focusing on their own treatment goals using standardized measures wherever ava...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2006/35/smw-11502
更新日期:2006-09-02 00:00:00
abstract:AIM:The levels of teamwork and clinician burnout in healthcare differ depending on demographic and unit characteristics. However, the impact of these characteristics varies between clinical settings. In addition, the impact of objectively measured workload in such settings is largely unknown. The aim of this study was ...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2019.20033
更新日期:2019-03-24 00:00:00
abstract:QUESTIONS UNDER STUDY:To improve the response of deteriorating patients during their hospital stay, the University Hospital Bern has introduced a Medical Emergency Team (MET). Aim of this retrospective cohort study is to review the preceding factors, patient characteristics, process parameters and their correlation to ...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2014.14027
更新日期:2014-10-08 00:00:00
abstract::Understanding how best to manage the complex healthcare needs of hospitalised, mostly multimorbid medical patients is an international priority. Healthcare should be effective, safe and provide high quality at a reasonable cost. However, basic logistic and organisational issues of medical ward-based care have received...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2017.14515
更新日期:2017-10-22 00:00:00
abstract:BACKGROUND:Extracorporeal photopheresis (ECP) has been reported to be safe and the ultimate treatment option in lung transplant recipients with chronic lung allograft dysfunction (CLAD), the main overall cause of mortality in lung transplant recipients. However, ECP is not reimbursed in selected health jurisdictions, a...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2017.14429
更新日期:2017-03-13 00:00:00
abstract::With regard to HCV elimination in opioid agonist therapy patients by 2030, case finding and regular screening for new and re-infections remain a challenge, especially for non-cohort patients in a decentralised setting. Documentation of the HCV sero- and RNA status of each opioid agonist therapy patient by the ca...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2020.20317
更新日期:2020-08-06 00:00:00
abstract::Minimal residual disease (MRD) refers to the small number of malignant cells that remain after therapy when the patient is in remission and shows no symptoms or overt signs of disease. Current treatment protocols for haematological malignancies allow most patients to obtain some form of MRD state, but cure seldom foll...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:10.4414/smw.2014.13907
更新日期:2014-01-22 00:00:00
abstract:BACKGROUND:The European Consensus Statement of Neonatal Hearing recommended universal newborn hearing screening (UNHS) in 1998. UNHS was introduced in Switzerland in 1999 under the auspices of a "Swiss Working Group Hearing Screening in Newborns". The aim of this study was to evaluate the number of newborns being scree...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2013.13905
更新日期:2013-12-13 00:00:00
abstract::Of the two million people estimated to be newly infected with human immunodeficiency virus (HIV) every year, 95% live in poorer regions of the world where effective HIV treatment is not universally available. Strategies to reduce the spread of HIV infection, which predominantly occurs via sexual contact, are urgently ...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2018.14580
更新日期:2018-01-26 00:00:00
abstract:BACKGROUND:Neuroendocrine neoplasms (NENs) are difficult to diagnose. We used SwissNET data to characterise NEN patients followed in the two academic centres of western Switzerland (WS), and to compare them with patients followed in eastern Switzerland (ES) as well as with international guidelines. METHOD:SwissNET is ...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2014.13924
更新日期:2014-02-19 00:00:00
abstract::In this review article, we aim at analysing the role of stress in addiction and relapse. In order to do so, we first offer a summary of the findings from affective neuroscience trying to understand compulsive reward-seeking behaviours. These behaviours are characterised by an imbalance between the considerable amount ...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:10.4414/smw.2019.20151
更新日期:2019-11-29 00:00:00
abstract:AIMS OF THE STUDY:The purpose of this study was to establish a new computed tomography (CT) sign for pulmonary congestion (Kerley B lines in the lung apex in patients with cardiac or renal insufficiency) and to find the best signs to differentiate between pulmonary congestion and interstitial lung disease (ILD). METHO...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2019.20119
更新日期:2019-09-02 00:00:00
abstract::Metallothioneins (MTs) are a family of small proteins containing 61-68 amino acids with an unusually high concentration of cysteine. MT-1, the most functional and active MT in humans, has the ability to react with and enhance the detoxification of a number of metals including zinc, mercury, copper and cadmium. MT dysf...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:
更新日期:2008-02-09 00:00:00
abstract:PRINCIPLES:Cardiac myxoma is the most commonly diagnosed cardiac tumour. Infection of herpes simplex virus 1 (HSV1) has been postulated to be a factor for this pathologic entity. The aim of the current study was to evaluate the association between HSV 1 and myxoma occurrence. METHODS:Between 1965 and 2005, 70 patients...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2011.13223
更新日期:2011-08-26 00:00:00
abstract:PURPOSE:To study the association between maternal smoking during pregnancy and low birth weight (LBW), small-for-gestational-age birth weight (SGA) and preterm birth, and to quantify the population-attributable fractions for these outcomes in Switzerland. METHODS:Data were gathered for all births in the Canton of Vaud...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2005/35/smw-11122
更新日期:2005-09-03 00:00:00
abstract::Dementia with Lewy bodies (DLB) accounts for 15-20% of all autopsy confirmed dementias in old age. Characteristic histopathological changes are intracellular Lewy bodies and Lewy neurites, with abundant senile plaques but sparse neurofibrillary tangles. Core clinical features are fluctuating cognitive impairment, pers...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:2003/09/smw-10028
更新日期:2003-03-08 00:00:00
abstract:BACKGROUND:The Swiss Monitoring of Potential Organ Donors (SwissPOD) was initiated to investigate the causes of the overall low organ donation rate in Switzerland. The objective of our study was an assessment of the donation after brain death (DBD) process in Swiss adult intensive care units (ICUs), and to provide an o...
journal_title:Swiss medical weekly
pub_type: 杂志文章,多中心研究
doi:10.4414/smw.2014.14045
更新日期:2014-10-23 00:00:00
abstract::We report on two toddlers suffering from Mycobacterium bohemicum lymphadenitis. Acid-fast bacilli were cultured from submandibular lymph nodes and identified by molecular methods as Mycobacterium bohemicum. Surgical treatment was successful and complemented by oral treatment with clarithromycin and rifampicin. ...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2004/15/smw-10558
更新日期:2004-04-17 00:00:00
abstract::In his 1966 monograph "Charcot joints", Sidney N. Eichenholtz (1909-2000) described "three well defined stages … in the course and development of a Charcot joint", based on plain X-rays of 68 patients. Since then, medical imaging has advanced very much: computed tomography and magnetic resonance imaging (MRI) scans ex...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:10.4414/smw.2014.13948
更新日期:2014-04-24 00:00:00
abstract:BACKGROUND:Thyroid hemiagenesis (TH) is a rare congenital abnormality of the thyroid gland, characterised by the absence of one lobe. The true prevalence of this congenital abnormality is not known because the absence of one thyroid lobe usually does not cause clinical symptoms by itself. This study aims to identify th...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:smw-12956
更新日期:2010-02-20 00:00:00
abstract:BACKGROUND:Based on a reduction in morbidity and mortality, cardiac resynchronisation therapy (CRT) has evolved as a standard therapy for patients with advanced heart failure. OBJECTIVE:To provide insight into patient demographics, safety, echocardiographic remodelling and long-term follow-up of patients treated with ...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2017.14425
更新日期:2017-04-18 00:00:00
abstract:OBJECTIVES:The sero-prevalence of co-infection with the hepatitis B virus (HBV) and the hepatitis D virus (HDV) is well known in many European countries, starting from 6.8% in Germany to more than 27% in some Turkish areas. To gain a better description of this infection in Switzerland, and to characterise those affecte...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2011.13176
更新日期:2011-03-18 00:00:00
abstract::A nationwide survey was conducted in Switzerland to assess the quality level of osteoporosis management in patients aged 50 years or older presenting with a fragility fracture to the emergency ward of the participating hospitals. Eight centres recruited 4966 consecutive patients who presented with one or more fracture...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:/aop/smw-aop12294
更新日期:2008-11-15 00:00:00
abstract::Increased survival rates after orthotopic liver transplantation (OLT) in patients with end-stage liver disease have become possible due to an advanced understanding of the pathophysiology of liver disease, the establishment of multiorgan procurement and preservation techniques, and the development of safer and more po...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:2007/13/smw-11681
更新日期:2007-04-07 00:00:00
abstract:AIMS:In comparison with other central European countries, Switzerland has a high prevalence of gun ownership and a high rate of suicide by shooting. After the Army XXI reform in 2003, which reduced personnel from about 400,000 to approximately 200,000, a decline in suicides by firearms and a decline in the total number...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2018.14646
更新日期:2018-09-23 00:00:00
abstract:OBJECTIVE:An increasing number of patients with asthma are attracted by complementary and alternative medicine (CAM). Therefore, it is of importance that scientific evidence about the efficacy of this type of therapy is regarded. METHOD:We searched the electronic databases Medline, Embase and the Cochrane Library for ...
journal_title:Swiss medical weekly
pub_type: 杂志文章,评审
doi:2002/25/smw-09972
更新日期:2002-06-29 00:00:00
abstract:OBJECTIVES:To determine 1) rates of needlestick and sharps injuries (NSSIs) not reported to occupational health services, 2) reasons for underreporting and 3) awareness of reporting procedures in a Swiss university hospital. MATERIALS AND METHODS:We surveyed 6,367 employees having close clinical contact with patients ...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:10.4414/smw.2012.13523
更新日期:2012-02-10 00:00:00
abstract:BACKGROUND:Epidemiological studies focusing on first-ever seizures have been carried out mainly on community based populations. However, since hospital populations may display varying clinical features, we prospectively analysed patients with first-ever seizure in a hospital based community to evaluate prognosis and th...
journal_title:Swiss medical weekly
pub_type: 杂志文章
doi:2004/39/smw-10738
更新日期:2004-10-02 00:00:00
abstract:BACKGROUND:Evaluating the effects of a commercially available synbiotic preparation (contains both prebiotic and probiotic elements) on functional constipation in males. METHODS:In a randomised controlled trial, a total of 66 adult men with functional constipation were equally allocated to receive a synbiotic mixture ...
journal_title:Swiss medical weekly
pub_type: 杂志文章,随机对照试验
doi:10.4414/smw.2011.13239
更新日期:2011-07-30 00:00:00