Promoting a biopsychosocial orientation in family practice: effect of two teaching programs on the knowledge and attitudes of practising primary care physicians.
The bio-psychosocial (BPS) approach to patient care has gained acceptance in medical education. However, reported teaching programs rarely describe the efficacy of alternative approaches to continuing medical education aimed at promoting a BPS approach. The objective was to describe and evaluate the effect of two teaching programs on learners' BPS knowledge, management intentions, patient-centered attitudes, professional self-esteem, burnout, work related strain and mental workload. The learners were Israeli general practitioners. The first ("didactic") program consisted of problem-based reading assignments, lectures and discussions. The second ("interactive") program consisted of reading assignments, lectures and discussions, in addition to role-playing exercises, Balint groups and one-to-one counseling by a facilitator. One month before and six months after the teaching interventions, we used structured questionnaires to test for knowledge, management intentions (responses to questions, such as "what would you tell a patient with ...") and attitudes. Both programs led to measurable improvement in knowledge, intentions, patient-centered attitudes and self-esteem. The interactive teaching approach improved significantly more the learners' professional self-esteem and intentions than the didactic approach. Self-reported burnout significantly increased after the program. It is concluded that teaching intervention enhanced a BPS orientation and led to changes in knowledge, intentions, self-esteem and attitudes. An interactive method of instruction was more effective in achieving some of these objectives than a didactic one. The observed increase in burnout was unexpected and requires further study and confirmation.
Margalit
Alon P A
AP
Moshe Prywes Center for Medical Education, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Glick
Shimon M
SM
Benbassat
Jochanan
J
Cohen
Ayala
A
Katz
Michael
M
D002055:Burnout, Professional / Q000523:psychology; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000379:methods*; D005194:Family Practice / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007557:Israel; D005791:Patient Care / Q000379:methods*; D010817:Physician-Patient Relations; D010821:Physicians, Family; D018794:Problem-Based Learning / Q000379:methods; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic; D013315:Stress, Psychological / Q000523:psychology