Abstract:Hintergrund: Inhalte aus den Bereichen der klassischen Naturheilverfahren und Komplementärmedizin sind im Rahmen der ärztlichen Approbationsordnung curricular verankert. Im Gegensatz dazu werden in den Weiterbildungsordnungen zum Facharzt für Allgemeinmedizin keine komplementärmedizinischen Inhalte abgebildet. Bisher ist nicht bekannt, ob Ärzte in Weiterbildung (ÄiW) zum Facharzt für Allgemeinmedizin innerhalb ihrer Weiterbildung mit komplementärmedizinischen Verfahren in Kontakt kommen und ob sie solche erler… Show more
“…As GP trainees may not be familiar with all the conditions and the general framework of the German healthare system at the beginning of their professional career, they may have ranked the importance of these competencies higher. Similar uncertainties were congruently reported in a former needs assessment of GP trainees on CIM which was conducted by our study group [ 27 ]. As we focused on the ratings of GP trainees and GP specialists in order to cover the different levels of work experience, we did not distinguish gender differences during all stages of the multi-step, peer-based procedure.…”
Section: Discussionsupporting
confidence: 92%
“…The vast majority of GP trainees would support the implementation of CIM training in the GP postgraduate training program. The results of this survey have been published previously by our study group in 2018 [ 20 ]. Fig.…”
Background
Complementary and integrative medical procedures (CIM) play an important role in general practice (GP). Consequently, in some countries (e.g. USA, Australia) specific curricula for the integration of CIM competencies in GP postgraduate education exist. Although Germany is one of the countries where CIM is strongly integrated in general practice, no such catalogue exists up to date. The aim of this study was to define a set of CIM competencies that are seen as relevant and feasible for postgraduate education in the German general practice setting.
Methods
We used a multi-step, peer-based approach combining four different steps. Firstly, a survey among GP trainees (n = 138) was performed in order to assess needs and attitudes towards CIM. Then, existing competency-based CIM curricula were identified in international literature, translated into German and compared with the needs assessment from the survey. In a next step, we performed a survey among the CIM working group of the German Society for General Medicine and Family Medicine (DEGAM). As a last step, in a peer-based survey, GP trainers, GP trainees, and members of professional CIM associations (n = 131) evaluated a list of CIM competencies according to relevance and feasibility for general practice.
Results
Within this multistage process, a final catalogue of 16 competencies was defined, covering the following areas: Medical knowledge, patient care and communication, practice-based learning, professionalism, and competencies based on the German healthcare system.
Conclusion
The final catalogue of CIM competencies is intended to serve for GP training complementing the German competency-based curriculum for general practice. These competencies cover basic skills and are not intended to replace existing additional qualifications awarded by the medical associations in specific CIM methods, such as acupuncture or manual medicine. Therefore, a list of relevant competencies on CIM is available in order to serve as add-on for postgraduate education in general practice in Germany.
“…As GP trainees may not be familiar with all the conditions and the general framework of the German healthare system at the beginning of their professional career, they may have ranked the importance of these competencies higher. Similar uncertainties were congruently reported in a former needs assessment of GP trainees on CIM which was conducted by our study group [ 27 ]. As we focused on the ratings of GP trainees and GP specialists in order to cover the different levels of work experience, we did not distinguish gender differences during all stages of the multi-step, peer-based procedure.…”
Section: Discussionsupporting
confidence: 92%
“…The vast majority of GP trainees would support the implementation of CIM training in the GP postgraduate training program. The results of this survey have been published previously by our study group in 2018 [ 20 ]. Fig.…”
Background
Complementary and integrative medical procedures (CIM) play an important role in general practice (GP). Consequently, in some countries (e.g. USA, Australia) specific curricula for the integration of CIM competencies in GP postgraduate education exist. Although Germany is one of the countries where CIM is strongly integrated in general practice, no such catalogue exists up to date. The aim of this study was to define a set of CIM competencies that are seen as relevant and feasible for postgraduate education in the German general practice setting.
Methods
We used a multi-step, peer-based approach combining four different steps. Firstly, a survey among GP trainees (n = 138) was performed in order to assess needs and attitudes towards CIM. Then, existing competency-based CIM curricula were identified in international literature, translated into German and compared with the needs assessment from the survey. In a next step, we performed a survey among the CIM working group of the German Society for General Medicine and Family Medicine (DEGAM). As a last step, in a peer-based survey, GP trainers, GP trainees, and members of professional CIM associations (n = 131) evaluated a list of CIM competencies according to relevance and feasibility for general practice.
Results
Within this multistage process, a final catalogue of 16 competencies was defined, covering the following areas: Medical knowledge, patient care and communication, practice-based learning, professionalism, and competencies based on the German healthcare system.
Conclusion
The final catalogue of CIM competencies is intended to serve for GP training complementing the German competency-based curriculum for general practice. These competencies cover basic skills and are not intended to replace existing additional qualifications awarded by the medical associations in specific CIM methods, such as acupuncture or manual medicine. Therefore, a list of relevant competencies on CIM is available in order to serve as add-on for postgraduate education in general practice in Germany.
“…Im Speziellen waren dies: Akupunktur 38 %, Naturheilverfahren 26 %, Manuelle Medizin 17 %, Homöopathie 10 % [32]. Ähnliche Häufigkeiten zeigen sich bei den allgemeinmedizinischen Weiterbildungsassistenten [33]. Die in der vorliegenden Arbeit am häufigsten gefundene Qualifikation Akupunktur wurde vor allem in den Abteilungen für Gynäkologie und Geburtshilfe aufgeführt.…”
Zusammenfassung
Hintergrund In Deutschland werden komplementärmedizinische
Verfahren von bis zu 62% der Patienten genutzt, Art und Ausmaß
dieser Versorgungsangebote im stationären Sektor sind jedoch nicht
bekannt. Die Zielsetzung der Studie war es, eine Statuserhebung zu
komplementärmedizinischen Verfahren mittels Screening der
Internetauftritte aller bayerischen Akutkrankenhäuser jeglicher
Versorgungsstufe durchzuführen, um das Spektrum der angewendeten
komplementärmedizinischen Verfahren zu erfassen.
Methoden Im Jahr 2020 wurde nach dem Vier-Augen-Prinzip ein
unabhängiges und vollständiges Website-Screening aller
bayerischen Akutkrankenhäuser durchgeführt. Angebotene Verfahren
aus der Komplementärmedizin wurden in der Gesamtheit sowie getrennt nach
Fachgebieten analysiert.
Ergebnisse Von 389 bayerischen Krankenhäusern aus der
Akutversorgung boten 82% auf ihrer Website mindestens ein und
66% mindestens drei unterschiedliche komplementärmedizinische
Verfahren an. Am häufigsten wurden Entspannungstechniken (52%),
Akupunktur (44%), Massagen (41%), Bewegungs-, Kunst- und
Musiktherapie (33%, 30% bzw. 28%), meditative
Bewegungsverfahren wie Yoga (30%) und Aromatherapie (29%)
angeboten. Nach Fachgebieten getrennt fanden sich
komplementärmedizinische Verfahren mit 87% am häufigsten
in der Psychiatrie/Psychosomatik (primär Entspannungsverfahren
69%, Bewegungs- und Kunsttherapie jeweils 60%), sowie mit
72% in der Gynäkologie/Geburtshilfe (primär
Akupunktur 64%, Homöopathie 60% und Aromatherapie
41%).
Schlussfolgerungen Die große Mehrheit der bayerischen
Akutkrankenhäuser scheint laut ihrer Internetauftritte auch
komplementärmedizinische Verfahren in der Therapie einzusetzen,
insbesondere bei psychischen Indikationen sowie in der Geburtshilfe und
Gynäkologie. Wie häufig diese im Klinikalltag
tatsächlich zur Anwendung kommen und ob dies sich auch an der aktuellen
Evidenz orientiert, sollte in weiteren Studien untersucht werden.
Contexte : Le recours aux pratiques de soins non conventionnelles concerne une large proportion de la population en France, en particulier les patients ayant des maladies chroniques. Certaines sont utilisées par des professionnels de santé et sont intégrées aux soins conventionnels, par exemple dans des services hospitaliers de médecine intégrative. Sensibiliser les étudiants en médecine à ces approches est important pour mieux accueillir les choix thérapeutiques des patients et savoir les conseiller. La question de l’implication de l’université dans une formation à la médecine intégrative et certaines pratiques non conventionnelles est cependant débattue en France et ne fait pas consensus. Objectif : Après une clarification des concepts principaux mobilisés, cet article dresse un état des lieux de l’enseignement universitaire des pratiques de soins non conventionnelles et de la médecine intégrative en France. Il propose une analyse succincte de la structuration de la médecine intégrative et de son enseignement en Suisse et en Allemagne. Résultats : Notre analyse permet d’identifier certaines insuffisances dans l’offre de formation en France. Nous argumentons qu’un des aspects de la stratégie de réduction des risques appliquée à ces pratiques passe par une implication de l’université dans l’enseignement de la médecine intégrative. Le projet d’une formation spécialisée transversale en médecine intégrative est proposé comme une réponse possible. Conclusion : La structuration de la médecine intégrative et de son enseignement en France permettrait d’offrir aux patients un accès sécurisé à certaines pratiques pertinentes et la France de rejoindre les nombreux pays qui la devancent dans ce domaine.
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