Himmel, Wolfgang

[["dc.bibliographiccitation.firstpage","810"],["dc.bibliographiccitation.issue","6"],["dc.bibliographiccitation.journal","Medical Decision Making"],["dc.bibliographiccitation.lastpage","818"],["dc.bibliographiccitation.volume","28"],["dc.contributor.author","Fischer, Thomas"],["dc.contributor.author","Fischer, Susanne"],["dc.contributor.author","Himmel, Wolfgang"],["dc.contributor.author","Kochen, Michael M."],["dc.contributor.author","Hummers-Pradier, Eva"],["dc.date.accessioned","2018-11-07T11:09:39Z"],["dc.date.available","2018-11-07T11:09:39Z"],["dc.date.issued","2008"],["dc.description.abstract","Background. The influence of patient characteristics on family practitioners' (FPs') diagnostic decision making has mainly been investigated using indirect methods such as vignettes or questionnaires. Direct observation-borrowed from social and cultural anthropology-may be an alternative method for describing FPs' real-life behavior and may help in gaining insight into how FPs diagnose respiratory tract infections, which are frequent in primary care. Objective. To clarify FPs' diagnostic processes when treating patients suffering from symptoms of respiratory tract infection. Methods. This direct observation study was performed in 30 family practices using a checklist for patient complaints, history taking, physical examination, and diagnoses. The influence of patients' symptoms and complaints on the FPs' physical examination and diagnosis was calculated by logistic regression analyses. Dummy variables based on combinations of symptoms and complaints were constructed and tested against saturated (full) and backward regression models. Results. In total, 273 patients (median age 37 years, 51% women) were included. The median number of symptoms described was 4 per patient, and most information was provided at the patients' own initiative. Multiple logistic regression analysis showed a strong association between patients' complaints and the physical examination. Frequent diagnoses were upper respiratory tract infection (URTI)/common cold (43%), bronchitis (26%), sinusitis (12%), and tonsillitis (11%). There were no significant statistical differences between \"simple heuristic'' models and saturated regression models in the diagnoses of bronchitis, sinusitis, and tonsillitis, indicating that simple heuristics are probably used by the FPs, whereas \"URTI/common cold'' was better explained by the full model. Conclusion. FPs tended to make their diagnosis based on a few patient symptoms and a limited physical examination. Simple heuristic models were almost as powerful in explaining most diagnoses as saturated models. Direct observation allowed for the study of decision making under real conditions, yielding both quantitative data and \"qualitative'' information about the FPs' performance. It is important for investigators to be aware of the specific disadvantages of the method (e. g., a possible observer effect)."],["dc.identifier.doi","10.1177/0272989X08315254"],["dc.identifier.isi","000261037800003"],["dc.identifier.pmid","18448702"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/13099"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/53054"],["dc.notes.intern","Merged from goescholar"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Sage Publications Inc"],["dc.publisher.place","Thousand oaks"],["dc.relation.conference","25th Annual Meeting of the Society-for-Medical-Decision-Making"],["dc.relation.eventlocation","Chicago, IL"],["dc.relation.issn","0272-989X"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights","Goescholar"],["dc.rights.uri","https://goescholar.uni-goettingen.de/licenses"],["dc.title","Family Practitioners' Diagnostic Decision-Making Processes Regarding Patients with Respiratory Tract Infections: An Observational Study"],["dc.type","conference_paper"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","486"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","BMC Research Notes"],["dc.bibliographiccitation.volume","5"],["dc.contributor.author","Simmenroth-Nayda, Anne"],["dc.contributor.author","Weiss, Cora"],["dc.contributor.author","Fischer, Thomas"],["dc.contributor.author","Himmel, Wolfgang"],["dc.date.accessioned","2019-07-09T11:53:57Z"],["dc.date.available","2019-07-09T11:53:57Z"],["dc.date.issued","2012"],["dc.description.abstract","Background Although it is taken for granted that history-taking and communication skills are learnable, this learning process should be confirmed by rigorous studies, such as randomized pre- and post-comparisons. The purpose of this paper is to analyse whether a communication course measurably improves the communicative competence of third-year medical students at a German medical school and whether technical or emotional aspects of communication changed differently. Method A sample of 32 randomly selected students performed an interview with a simulated patient before the communication course (pre-intervention) and a second interview after the course (post-intervention), using the Calgary-Cambridge Observation Guide (CCOG) to assess history taking ability. Results On average, the students improved in all of the 28 items of the CCOG. The 6 more technically-orientated communication items improved on average from 3.4 for the first interview to 2.6 in the second interview (p < 0.0001), the 6 emotional items from 2.7 to 2.3 (p = 0.023). The overall score for women improved from 3.2 to 2.5 (p = 0.0019); male students improved from 3.0 to 2.7 (n.s.). The mean interview time significantly increased from the first to the second interview, but the increase in the interview duration and the change of the overall score for the students’ communication skills were not correlated (Pearson’s r = 0.03; n.s.). Conclusions Our communication course measurably improved communication skills, especially for female students. These improvements did not depend predominantly on an extension of the interview time. Obviously, “technical” aspects of communication can be taught better than “emotional” communication skills."],["dc.identifier.doi","10.1186/1756-0500-5-486"],["dc.identifier.fs","592278"],["dc.identifier.pmid","22947372"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/8276"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/60535"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights","CC BY 2.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/2.0"],["dc.title","Do communication training programs improve students' communication skills? - a follow-up study"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","212"],["dc.bibliographiccitation.journal","International Journal of Medical Education"],["dc.bibliographiccitation.lastpage","218"],["dc.bibliographiccitation.volume","5"],["dc.contributor.author","Simmenroth-Nayda, Anne"],["dc.contributor.author","Heinemann, Stephanie"],["dc.contributor.author","Nolte, Catharina"],["dc.contributor.author","Fischer, Thomas"],["dc.contributor.author","Himmel, Wolfgang"],["dc.date.accessioned","2019-07-09T11:41:30Z"],["dc.date.available","2019-07-09T11:41:30Z"],["dc.date.issued","2014"],["dc.description.abstract","OBJECTIVE: The aim of this study was to analyse the psychometric properties of the short version of the Calgary Cambridge Guides and to decide whether it can be recommended for use in the assessment of communications skills in young undergraduate medical students. METHODS: Using a translated version of the Guide, 30 members from the Department of General Practice rated 5 videotaped encounters between students and simulated patients twice. Item analysis should detect possible floor and/or ceiling effects. The construct validity was investigated using exploratory factor analysis. Intra-rater reliability was measured in an interval of 3 months, inter-rater reliability was assessed by the intraclass correlation coefficient. RESULTS: The score distribution of the items showed no ceiling or floor effects. Four of the five factors extracted from the factor analysis represented important constructs of doctor-patient communication The ratings for the first and second round of assessing the videos correlated at 0.75 (p<0.0001). Intraclass correlation coefficients for each item ranged were moderate and ranged from 0.05 to 0.57. CONCLUSIONS: Reasonable score distributions of most items without ceiling or floor effects as well as a good test-retest reliability and construct validity recommend the C-CG as an instrument for assessing communication skills in undergraduate medical students. Some deficiencies in inter-rater reliability are a clear indication that raters need a thorough instruction before using the C-CG."],["dc.identifier.doi","10.5116/ijme.5454.c665"],["dc.identifier.fs","608012"],["dc.identifier.pmid","25480988"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/12155"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/58447"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.relation.issn","2042-6372"],["dc.relation.orgunit","Institut für Allgemeinmedizin"],["dc.rights","CC BY 3.0"],["dc.rights.uri","https://creativecommons.org/licenses/by/3.0"],["dc.subject.mesh","Clinical Competence"],["dc.subject.mesh","Communication"],["dc.subject.mesh","Education, Medical, Undergraduate"],["dc.subject.mesh","Educational Measurement"],["dc.subject.mesh","Factor Analysis, Statistical"],["dc.subject.mesh","Female"],["dc.subject.mesh","Humans"],["dc.subject.mesh","Male"],["dc.subject.mesh","Observer Variation"],["dc.subject.mesh","Psychometrics"],["dc.subject.mesh","Reproducibility of Results"],["dc.subject.mesh","Students, Medical"],["dc.title","Psychometric properties of the Calgary Cambridge guides to assess communication skills of undergraduate medical students."],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]