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Simulation in healthcare in an way to train professionals but it is not yet use commonly to train patient or their caregivers. Recently, it has been suggested to extend simulations to patients with chronic conditions. Simulations could help patients and caregivers to acquire psychosocial and self-management skills. This approach proved to be effective for the training of healthcare professionals, but its transferability to patients needs to be evaluated. Already, several questions arise. However, by considering simulations as pretexts for debriefing, they enable patients and professionals to assess a concrete situation, implying voluntary and reflexive learning processes. Thus, video recording should be assessed for its role in patient metacognition, defined as knowing about knowing. A taxonomy for simulations dedicated to patients, like that already developed for healthcare professionals, should be considered. Although practical constraints must be identified and addressed, they should not be the primary issue guiding research. The transferability of simulation as an educational technique from professionals to patients and caregivers should be investigated essentially in order to provide a significant benefit to patients.

The article presents a study which explored speech therapists' experience with and interest in medical improvisation training for communication skills. Topics discussed include definition of medical improvisation, skills that were used to train speech therapist students with inspired-by-real-life experience clinical situations, and benefits of medical improvisation to speech therapist students.

Copyright of Pédagogie Médicale is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pédagogie Médicale is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pédagogie Médicale is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Simulation is rarely used to help individuals with chronic diseases develop skills. The aim of the study was to provide recommendations for the use of simulation in therapeutic patient education (S-TPE)., Methods: Expert consensus was achieved with the participation of the following 3 groups of experts: (a) expert patients and caregivers; (b) health professionals specialized in therapeutic patient education (TPE); and (c) simulation experts. Each expert received a list of questions by e-mail in 3 iterations. The synthesis of the 2 first questionnaires resulted in 34 first recommendations voted during the consensus conference meeting. Each recommendation was subject to an extensive literature review. The quality of the evidence and the strength of the recommendations were assessed through the evaluation, development, and evaluation criteria categories (GRADE criteria). The third questionnaire selected and illustrated recommendations more specific to the use of S-TPE., Results: At the end of the process, the experts identified 26 recommendations specific to the use of S-TPE. They proposed examples of skills in different diseases and stressed the importance of adapting the conditions of use (location, equipment, time of the care) to the circumstances of the patient learner and skills to be developed. Experts should exercise great caution as this technique presents ethical considerations related to patient care., Conclusions: These recommendations underline the fact that simulation could bring added value to TPE. They provide a framework and examples for the experimental use of simulation in TPE. Research into feasibility and acceptability is needed.

Introduction: The main objective of this study was to estimate prevalence on the liberal general practitioners. The secondary objectives are to identify the possible brakes with the declaration in the monitoring observatory for security of the doctors as well as to determine if the feminization of the profession was associated with the situations violence., Methods: A questionnaire in 5 parts was submitted by telephone to 146 drawn lots liberal general practitioners. It approached the undergone physical and verbal attacks, the infringements on the properties arisen during their career, and the proven feeling of insecurity., Results: The rate of participation was 63% (93/146). In all 171 incidents were reported among which 96 physical and verbal attacks (56%), and 75 infringements on the properties (44%) without difference according to the sex. The main motive for the attacks was the refusal of prescription (44%). Practically, no concerned doctor made declaration for the monitoring observatory for the security of the doctors, for lack of interest for 5 of them or the ignorance of its existence for 10 on 32 practitioners having undergone an aggression after the creation of the monitoring observatory., Conclusion: We observed an under-reporting of the attacks or of the infringements on the properties by the doctors victims. Our study did not highlight difference between men and women., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Alcohol consumption in itself is not forbidden in France. Two situations are reprehended by the law: public drunkenness - where only the behavior is sanctioned and not the alcohol level - and driving with a level of alcohol superior to 0.5g per liter. The management of a severe state of drunkenness - even though frequent - is on the one hand poorly managed and on the other hands badly mastered by doctors. The management of drunken patients lies essentially in a strong monitoring of the possible complications. The inherent question of the returning-back-home for a drunken patient should be approached according to the state of consciousness rather than the alcohol rate in the blood. No matter what the rate is, the authorization to release a patient depends on the preservation of his judgmental capacities. If those are altered, the doctor can then decide to keep - even against his will - the patient temporarily and until he has recovered his discernment. Patients still keep their right to refuse any medical treatment. Indeed, the law does not provide any answer concerning the particular issue of the refusal of medical care by the patient, especially in case of a severe alcoholic intoxicated state that let the patient incapable to express his will and to understand the range of the given information. There is no legal measure that can able a doctor to firmly forbid a drunk patient to be released and to take the wheel. Doctors have to try to dissuade them by proposing other alternatives but they cannot physically oppose themselves to the patient decision. However, proofs that the doctor tried his best to convince the patient not to drive while under the influence of alcohol can be demanded. Doctors have the duty to inform patients on every risk that alcohol can bring while driving but do not have any measure of pressure., (Copyright © 2015 Elsevier Masson SAS. All rights reserved.)

Introduction: The general practitioner’s (GP) waiting room is an ideal place to conduct health education actions. The use of tools in GP waiting rooms would appear to be a useful approach, but the available tools are not very efficient. The objective of this study was to study the efficacy of a game compared with two other health education strategies., Methods: A comparative study was conducted in two general practices. 212 patients were divided into three groups using a paper-game or a booklet or nothing in the waiting room, before a discussion about immunization with the practitioner. The capacity of the tool to encourage questions about immunization was estimated by the GP at the end of the consultation by a questionnaire., Results: The use of a tool in the waiting room facilitated the discussion between patients and practitioners (34% vs 12%, p<0.01). The game induced longer discussions than the booklet (1 minute 32 seconds vs 1 minute 14 seconds, p<0.05) without more themes. The game and the booklet had a comparable acceptability., Conclusions: Using a multistep education strategy facilitated discussion between the patient and the practitioner. However, the GP is required to trigger the conversation.