Abstract
Background: Communication between healthcare providers and patients with persistent somatic symptoms (PSS) is frequently hampered by mutual misunderstanding and dissatisfaction.Methods: We developed an online, interprofessional course to teach healthcare providers the knowledge, skills, and attitude they need to diagnose and treat PSS in a patient-centered manner based on the biopsychosocial model. The course consisted of six modules of 45–60 min. Each module contained different types of assignments, based on six cases: videos, discussion boards, reading assignments, polls, and quizzes. For this study, we included (1) medical residents, following the course as part of their residency training, and (2) healthcare providers (general practitioners, medical specialists, physiotherapists, nurses, and psychologists), following the course as continuing vocational training. Throughout the course, participants were asked to fill out online surveys, enquiring about their learning gains and satisfaction with the course.Results: The biopsychosocial approach was integrated across the modules and teached health care workers about recent insights on biological, psychological and social aspects of PSS. In total, 801 participants with a wide variety in clinical experience started the course; the largest groups of professionals were general practitioners (N = 400), physiotherapists (N = 124) and mental healthcare workers (N = 53). At the start of the course, 22% of the participants rated their level of knowledge on PSS as adequate. At the end of the course, 359 participants completed the evaluation questionnaires. Of this group, 81% rated their level of knowledge on PSS as adequate and 86% felt that following the course increased their competencies in communicating with patients with PSS (N = 359). On a scale from 1 to 10, participants gave the course a mean grade of 7.8 points. Accordingly, 85% stated that they would recommend the course to a colleague.Conclusion: Our course developed in a co-design process involving multiple stakeholders can be implemented, is being used, and is positively evaluated by professionals across a variety of health care settings.
Highlights
A substantial proportion of physical symptoms cannot be explained by a medical disease
We developed an online, interprofessional course to teach healthcare providers the knowledge, skills, and attitude they need to diagnose and treat persisting somatic symptoms (PSS) in a patient-centered manner based on the biopsychosocial model
The biopsychosocial approach was integrated across the modules and teached health care workers about recent insights on biological, psychological and social aspects of PSS
Summary
A substantial proportion of physical symptoms cannot be (fully) explained by a medical disease. Even though most physical symptoms are self-limiting, 10–30% of symptoms persist after a year, causing considerable suffering and disability [5] Those persisting somatic symptoms (PSS) are associated with increased use of healthcare resources and their medical costs rank among the highest of all patient groups [6]. This is partly due to repeated referrals and investigations, which are often unhelpful and sometimes even cause iatrogenic damage [7]. PSS result from the complex interplay of biomedical, psychological and/or social (biopsychosocial) factors This multifactorial etiology complicates the deduction of a clear diagnostic and treatment rationale used by all different types of health care providers [8]. Communication between healthcare providers and patients with persistent somatic symptoms (PSS) is frequently hampered by mutual misunderstanding and dissatisfaction
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