Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen
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Z Evid Fortbild Qual Gesundhwes · Jan 2008
[Methods paper on the development of a practice guideline for the avoidance of physical restraints in nursing homes].
Physical restraints are routinely used in nursing home residents in Germany. Bedrails are applied to at least one of four residents. Belts, fixed tables and other measures are less frequent but are still used as routine measures. ⋯ The "German Network for Quality Development in Nursing (DNQP)" deliberately distinguishes their so-called "national expert standards" from "medical" practice guidelines. Funded by the German Ministry of Education and Science, a project aiming to develop an evidence-based practice guideline on the avoidance of physical restraints in nursing homes, for the first time applies internationally discussed methods to a nursing guideline in Germany. This article describes the methodological framework, instruments and processes of the guideline's development.
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Z Evid Fortbild Qual Gesundhwes · Jan 2008
[Concept, implementation and evaluation of an interfaculty Master of Medical Education Programme].
The implementation of new medical licensing regulations (AAppO 2003) was the starting point for radical curricular changes in all German medical schools. In 2004, the postgraduate and interfaculty Master of Medical Education (MME) degree programme was established at the University of Heidelberg under the auspices of the Medical Faculty Association (Medizinischer Fakultätentag, MFT) and supported by the Association for the Promotion of Science and Humanities in Germany (Stifterverband für die Deutsche Wissenschaft). This new degree programme is intended to train multipliers and leaders in medical education, to build a German-speaking network and to strengthen educational research. ⋯ In 2006, an external evaluation conducted by international experts positively highlighted the MME Programme structure as a leading example emphasizing all aspects of modern medical education, including relevant managerial skills. The MME Programme as a contribution to the professionalization of medical education in the German-speaking area has become firmly established. The impact of the MME Programme on the career development of its participants and the institutional development of the medical faculties still remains to be evaluated.
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Z Evid Fortbild Qual Gesundhwes · Jan 2008
[Ethical problems surrounding decision making by means of patient participation and public health oriented overall risk approaches].
Strengthening citizen participation, patient rights and patient autonomy places more and more responsibility for achieving certain health care goals on the health care consumer ('customer'). Public health based governance using tools and concepts of health economics consider this a responsibility of physicians and hospitals. ⋯ Holding health care providers responsible for goals which, in part, are beyond their control is unfair from an ethical point of view. Politics should accept that physicians are responsible for the quality of their services, and not for the health of the individual.
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Z Evid Fortbild Qual Gesundhwes · Jan 2008
[Role playing as an essential element of simulation procedures in medicine].
Role playing is an important element of virtually all simulation-based procedures. An improved understanding for methodological aspects facilitates its goal-oriented use in education and training, research and examinations. ⋯ We describe a plausibility study from skills labs demonstrating that the introduction of role-playing can increase perceived realism. Finally we derive practical suggestions for the conduction of role plays in medical simulation.
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Z Evid Fortbild Qual Gesundhwes · Jan 2008
[A satisfied patient--a good doc? To what extent is patient satisfaction an indicator of quality in general practice? A systematic review].
"How can I find a good doctor?" is one of the most frequent requests patients' help desks receive. The aim of the present study is to appraise whether current available patient satisfaction surveys reflect the quality of ambulatory care from the patients' perspective, and whether this information can be used to choose an adequate care facility. ⋯ Patient satisfaction is an aspect of ambulatory care. However, quality of ambulatory care is not reflected by patient satisfaction alone. Evidence-based information is decisive for the patient's judgement of the quality of medical care. The instruments analysed cannot be used to answer the question: "Is this a good doctor?", unless they consider the availability of adequate patient information.