Browsing by Author "Moore, Philippa"
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- ItemA study of hospital complaints and the role of the doctor-patient communication(SOC MEDICA SANTIAGO, 2011) Moore, Philippa; Vargas, Alex; Nunez, Salomon; Macchiavello, StefanoBackground: Medical practice in Chile has changed dramatically over the last few years. Patients have raised their expectations and there is a growing number of complaints, and malpractice lawsuits. The doctor-patient relationship plays a fundamental role in patient satisfaction and has also been identified as an issue in most medical lawsuits. Aim: To analyze the importance of doctor-patient communication in the complaints received in a university hospital in Chile. Material and Methods: Review of all complaints received at the office for quality of care at a university hospital. Complaints classified in delay, manners and information categories were selected for further analysis. Results: Of a total of 8931 complaints registered between 2001 and 2008, 635 (19%) involved a doctor. Fifty one per cent of the latter, were related to the doctor-patient relationship. Of these, 146 cases (45%) were further classified as "Dysfunctional delivery of Information", 74 cases (23%) as "Not understanding the patient/family's perspective': 54 cases (17%) as "Discrediting the patient or family's views" and 49 cases (15%) as "Lack of communication': Conclusions: The percentage of complaints related to communication with the doctor is high, though lower than cited in other studies. The most common complaint is the dysfunctional delivery of information. (Rev Med Chile 2011; 139: 880-885).
- ItemBarriers for faculty development in medical education: a qualitative study(SOC MEDICA SANTIAGO, 2012) Montero, Luz; Trivino, Ximena; Sirhan, Marisol; Moore, Philippa; Leiva, LoretoBackground: Since 2000, the medical school of the Catholic University of Chile (EMUC) has offered courses for its faculty as part of a Diploma in Medical Education (DEM). However by 2009, 41% of faculty had never taken any courses. Aim: To explore the reasons why faculty choose not to participate in these courses. Material and Methods: Semi-structured interviews to seven faculty members, all of whom have an active role in teaching but who had not taken any DEM courses. The sampling was intentional and guided by theory. Based on Grounded theory, the data was analyzed using open, axial and selective coding. Results: Three categories emerged from the analysis. First, the characteristics of a "good teacher" and what it means to be a good teacher. Second, the current status of teaching. Third, the barriers to participate in courses of DEM. Non-attendance is multifactorial; teaching is seen as a natural skill that is difficult to be trained, teaching has a lower priority than other activities, and there are many barriers perceived for attendance. Conclusions: With these results we developed a model to explain the reasons why faculty choose not to participate in these courses. The lower value of teaching and the multiple roles that teachers have, are highlighted. (Rev Med Chile 2012; 140: 695-702).
- ItemClinical and serological profile of asymptomatic and non- severe symptomatic COVID-19 cases: Lessons from a longitudinal study in primary care in Latin America(2021) Puschel, Klaus; Ferreccio, Catterina; Penaloza, Blanca; Abarca, Katia; Rojas, Maria-Paulina; Tellez, Alvaro; Moore, Philippa; Maria Cea, Ana; Wilson, Carlos; Cid, Vicente; Montero, JoaquinBackground: Chile has one of the highest incidences of COVID-19 infection in the world. Primary care can play a key role in early detection and containment of the disease. There is a lack of information on the clinical profile of patients with suspected COVID-19 in primary care, and controversy on the effectiveness of rapid serologic tests in the diagnosis and surveillance of the disease. Aim: To assess the effectiveness of rapid serologic testing in detection and surveillance of COVID-19 cases in primary care. Design & setting: A longitudinal study was undertaken, which was based on a non-random sample of 522 participants, including 304 symptomatic patients and 218 high -risk asymptomatic individuals. They were receiving care at four primary health clinics in an underserved area in Santiago, Chile. Method: The participants were systematically assessed and tested for COVID-19 with transcriptase- polymerase chain reaction (RT-PCR) and serology at baseline, and were followed clinically and serologically for 3 weeks. Results: The prevalence rate of RT-PCR confirmed COVID-19 cases were 3.5 times higher in symptomatic patients (27.5%; 95% confidence interval [CI] = 22.1 to 32.8) compared with asymptomatic participants (7.9%; 95% CI = 4.3 to 11.6). Similarly, the immune response was significantly different between groups. Sensitivity of serologic testing was 57.8% (95% CI = 44.8 to 70.1) during the third week follow- up and specificity was 98.4% (95% CI = 95.5 to 99.7). Conclusion: Rapid serologic testing is ineffective for detecting asymptomatic or non- severe cases COVID-19 at early stages of the disease, but can be of value for surveillance of immunity response in primary care. The clinical profile and immune response of patients with COVID-19 in primary differs from those in hospital- based populations.
- ItemDoctor-patient communication: one of the basic competencies, but different(EDICIONES DOYMA S A, 2012) Moore, Philippa; Gomez, Gricelda; Kurtz, SuzanneEffective communication skills form part of being a good doctor. Today there is solid evidence to support the teaching of effective communication skills in all medical schools.
- ItemEvidence based medicine: a view after a decade.(2003) Letelier Saavedra, Luz María; Moore, PhilippaEvidence based medicine (EBM) appeared early in the 1990s and since then it has been developed and expanded worldwide. A decade later we summarize the history of EBM, the initial debates and the evolution to the current concept of evidence based health care (EBHC) as a tool for clinical decision making. We also describe the process of EBHC, some insights to current dilemmas and the situation of EBM in Chile.
- ItemLearning doctor-patient communication: does co-teaching help?(SOC MEDICA SANTIAGO, 2012) Gomez, Gricelda; Moore, Philippa; Araos Baeriswyl, EstebanBackground: The first part of the medical interview is perhaps one of the most significant components of the doctor's role. How to collect relevant information and how to build a therapeutic relationship with the patient must be taught during the undergraduate curriculum. Clinical teachers have little experience in the teaching skills required to help students learn about doctor-patient communication. Aim: To measure outcomes and perceptions of using a co-teaching model in a course on interviewing during the third year of medical school in the Pontificia Universidad Catolica de Chile. Material and Methods: A mixed methods controlled study in which the intervention group participated in a co-teaching workshop with a clinical teacher and a specialist in doctor-patient communication skills (SDPC). The control group participated in a workshop with one clinical teacher. All students completed a questionnaire measuring perception of their learning in communication skills. Semi-structured interviews were used to collect the clinical teachers' perception. At the end of the course, the clinical and communication skills of all the students were measured in an objective structured clinical examination. Results: Students and teachers agreed that co-teaching allows greater emphasis and practice in communication skills. The results of the objective structured clinical examination show that despite this greater emphasis, no deleterious effect on the clinical skills was demonstrated during the exam. Conclusions: The use of co-teaching in a course on interviewing allows students to perceive a higher level of learning in communication skills, and possibly enhances their skills. The clinical teachers felt that the co-teacher was an important support. (Rev Med Chile 2012; 140: 396-403).