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Strukturiertes fallorientiertes Lernen : Eine Win-win-Situation fur Forschung, Lehre und Behandlung Structured Case-Oriented LearningA Win-Win Situation for Research, Teaching and Treatment

ABSTRACT: Ein modernes „case-based“ E‑Learning ist ein exzellentes Hilfsmittel, um Skills und Kommunikation zu trainieren, da „diagnostic reasoning“ als schematisches Problemlösen gesehen wird. Wir präsentieren einen Patientenfall zum Thema Gerinnungsstörung bei chronischem Substanzmissbrauch, bei dem nur durch interdisziplinäres Vorgehen ein adäquater Erfolg erzielt werden kann. Diesbezüglich ist zu erwähnen, dass zu diesem Thema noch wenig Evidenz vorhanden ist und es noch weiterer Forschung bedarf.

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In der Online-Version dieses Artikels (10.1007/s00739-020-00655-3) finden Sie weiterführende Literatur zum Thema.

SUBMITTER: Ertl S

PROVIDER: S-EPMC7330881 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND:In spite of increasing research into intersections of public policy and health, little evidence shows how policy processes impact the implementation of Health in All Policies (HiAP) initiatives. Our research sought to understand how and why strategies for engaging partners from diverse policy sectors in the implementation of HiAP succeed or fail in order to uncover the underlying social mechanisms contributing to sustainable implementation of HiAP. METHODS:In this explanatory multiple case study, we analyzed grey and peer-review literature and key informant interviews to identify mechanisms leading to implementation successes and failures in relation to different strategies for engagement across three case studies (Sweden, Quebec and South Australia), after accounting for the role of different contextual conditions. FINDINGS:Our results yielded no support for the use of awareness-raising or directive strategies as standalone approaches for engaging partners to implement HiAP. However, we found strong evidence that mechanisms related to "win-win" strategies facilitated implementation by increasing perceived acceptability (or buy-in) and feasibility of HiAP implementation across sectors. Win-win strategies were facilitated by mechanisms related to several activities, including: the development of a shared language to facilitate communication between actors from different sectors; integrating health into other policy agendas (eg., sustainability) and use of dual outcomes to appeal to the interests of diverse policy sectors; use of scientific evidence to demonstrate the effectiveness of HiAP; and using health impact assessment to make policy coordination for public health outcomes more feasible and to give credibility to policies being developed by diverse policy sectors. CONCLUSION:Our findings enrich theoretical understanding in an under-unexplored area of intersectoral action. They also provide policy makers with examples of HiAP across wealthy welfare regimes, and improve understanding of successful HiAP implementation practices, including the win-win approach.

Project description:In recent years, shared decision making (SDM) has been promoted as a model to guide interactions between persons with MS and their neurologists to reach mutually satisfying decisions about disease management - generally about deciding treatment courses of prevailing disease modifying therapies. In 2009, Dr. Paolo Zamboni introduced the world to his hypothesis of Chronic Cerebrospinal Venous Insufficiency (CCSVI) as a cause of MS and proposed venous angioplasty ('liberation therapy') as a potential therapy. This study explores the discussions that took place between persons with MS (PwMS) and their neurologists about CCSVI against the backdrop of the recent calls for the use of SDM to guide clinical conversations.In 2012, study researchers conducted focus groups with PwMS (n = 69) in Winnipeg, Canada. Interviews with key informants were also carried out with 15 participants across Canada who were stakeholders in the MS community: advocacy organizations, MS clinicians (i.e. neurologists, nurses), clinical researchers, and government health policy makers.PwMS reported a variety of experiences when attempting to discuss CCSVI with their neurologist. Some found that there was little effort to engage in desired discussions or were dissatisfied with critical or cautious stances of their neurologist. This led to communication breakdowns, broken relationships, and decisions to autonomously access alternative opinions or liberation therapy. Other participants were appreciative when clinicians engaged them in discussions and were more receptive to more critical appraisals of the evidence. Key informants reported that they too had heard of neurologists who refused to discuss CCSVI with patients and that neurology as a whole had been particularly vilified for their response to the hypothesis. Clinicians indicated that they had shared information as best they could but recommended against seeking liberation therapy. They noted that being respectful of patient emotions, values, and hope were also key to maintaining good relationships.While CCSVI proved a challenging context to carry out patient-physician discussions and brought numerous tensions to the surface, following the approach of SDM can minimize the potential for unfortunate outcomes as much as possible because it is based on principles of respect and more two-way communication.

Dataset Information

Strukturiertes fallorientiertes Lernen : Eine Win-win-Situation fur Forschung, Lehre und Behandlung Structured Case-Oriented LearningA Win-Win Situation for Research, Teaching and Treatment

Zusatzmaterial online

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