Francesc Borrell-Carrió

University of Barcelona | UB · Department of Clinical Sciences

E l término "competencia" siempre se refiere a "saber ha-cer" algo. Cuando hablamos de competencia emocional del médico, nos referimos a saber reconocer y gestionar las emociones que surgen en su trabajo cotidiano con otras per-sonas (ya sean pacientes o compañeros de trabajo). El pre-sente artículo tiene dos partes. En la primera analizaremos el s...

Los clínicos estamos permanentemente negociando con la ignorancia. En realidad nuestras creencias son probabilísticas, y nos conformamos con que nuestras apreciaciones sobre la salud de nuestros pacientes sean plausibles. Vivimos siempre en un equilibrio entre esfuerzo por diagnosticar, pronóstico e información a dar al paciente. A través de alguno...

n our eagerness to control our health we can embrace metaphysical models that explain the vicissitudes of our lives and prescribe preventive behaviors. The model we call "of natural life" proposes that a strict life regime is capable of preventing chronic diseases and even reversing its course. It is a very widespread model and sometimes justifies...

o The emotional climate of a whole day's work is set in the first interviews. o Learn how to identify your own emotions "listening" to your own tone, pitch and manner of speech.

The conversations of clinicians about the existence or non-existence of diseases therefore offer data of great interest for social epidemiology. It reveals on the one hand that the concept that the clinicians handle is partly indebted to pragmatism and partly indebted to essentialism. Also that once defined a group of patients based on a pragmatic...

Resumen: El propósito de este artículo es profundizar en cómo tomamos decisiones clínicas satisfactorias ante escenarios de incertidumbre. En la práctica clínica aplicamos reglas de decisión para estimar grados de certeza y adecuar nuestra conducta. La certeza es un " saber qué hacer " frente a la perplejidad o la duda, con un componente epistémico...

o The emotional climate of a whole day's work is set in the first interviews. o Learn how to identify your own emotions "listening" to your own tone, pitch and manner of speech.o Establishing rapport o Asking and listening o Communication problems

Resumen: Kahneman entiende que el ser humano dispone de dos sistemas de decisión, un sistema rápido, S1, y un sistema lento S2. El primero se encarga de procesos automáticos, el segundo los supervisa y analiza la realidad para encontrar nuevas ventanas de oportunidad. Mientras que uno de los papeles que asignamos al S2 es la de ser auto-crítico con...

The portfolio has gathered pace in recent years, being a useful tool for teaching and assessment. The main goal is to improve learning through student reflection and continuous feedback of evaluations. The implantation of information technology has facilitated the introduction of the electronic portfolio (e-portfolio). Based on previous experience...

Pragmatism, as a philosophical option, is concerned with end results and argues that “all our thought-distinctions, however subtle, demand a possible difference of practice.”1 Physicians calculate daily the best plan of action for each patient, following some pragmatic rules: only taking into account different strategies when they lead to different...

The Institut Català de la Salut (ICS) has designed and integrated in electronic clinical station of primary care a new software tool to support the prescription of drugs, which can detect on-line certain medication errors. The software called PREFASEG (stands for Secure drug prescriptions) aims to prevent adverse events related to medication use in...

The purpose of this article is to analyze some models of expert decision and their impact on the clinical practice. We have analyzed decision-making considering the cognitive aspects (explanatory models, perceptual skills, analysis of the variability of a phenomenon, creating habits and inertia of reasoning and declarative models based on criteria)...

The purpose of this article is to analyze some models of expert decision and their impact on the clinical practice. We have analyzed decision-making considering the cognitive aspects (explanatory models, perceptual skills, analysis of the variability of a phenomenon, creating habits and inertia of reasoning and declarative models based on criteria)...

Objective To identify organizational processes, violations of rules, or professional performances that pose clinical levels of insecurity. Design Descriptive cross-sectional survey with customized externally-behavioral verification and comparison of sources, conducted from June 2008 to February 2010. Setting Thirteen of the 53 primary care teams...

OBJECTIVE To identify organizational processes, violations of rules, or professional performances that pose clinical levels of insecurity. DESIGN Descriptive cross-sectional survey with customized externally-behavioral verification and comparison of sources, conducted from June 2008 to February 2010. SETTING Thirteen of the 53 primary care teams...

La comunicación forma parte de la actividad clínica y en ocasiones determina el éxito o fracaso del proceso asistencial. Sin embargo, no ha sido reconocida en los planes de estudio del Estado español hasta muy recientemente, sobre todo con el impulso del llamado 'Plan Bolonia'. En el año 2009 se aprobó en la Facultad de Medicina de la Universitat d...

This collaborative work is consists of two articles. In the first we will analyse Clinical Safety from a systemic perspective. In the second, we will focus on specific medical errors, with particular attention to the diagnostic error. Epidemiological studies are based on clinical document audits, adverse event reports, standardised patients–who in...

Usually in medicine was considered that the technical evaluation and the ethical are different, and that the first has nothing to do with the second. However, it is a mistake to say that science and technology, are completely neutral. Both assessments are based on values and epistemological orientation they have in each historical moment is based o...

El autor plantea todos los aspectos prácticos y teóricos que intervienen en la atención clínica de los pacientes: de tipo emocional, cultural, social y moral, sin los cuales toda práctica clínica resulta insuficiente, (un mero ejercicio técnico de aspectos biológicos de la persona). El autor empieza su libro con un capítulo dedicado a “El paciente...

The first article of this series on Clinical Safety was dedicated to the epidemiology and systemic preventive policies. In the present review we focus on medical errors with special emphasis on diagnostic type errors. These errors sometimes arise from the elusive characteristics of the disease itself, the way in which the patients present their sym...

This collaborative work is consists of two articles. In the first we will analyse Clinical Safety from a systemic perspective. In the second, we will focus on specific medical errors, with particular attention to the diagnostic error. Epidemiological studies are based on clinical document audits, adverse event reports, standardised patients-who in...

Little is known about the quality of the physical examination and its effectiveness in daily practice. To determine if family physicians (FPs) were able to detect an important physical sign (hepatomegaly) and to relate this result with other measures of quality. 57 of 104 invited FPs from the National Health Service of the Southern Barcelona Area a...

This paper provides an overview of the implementation of using unannounced standardized patients (USPs) to conduct health communication research in clinical settings. Certain types of health communication situations are difficult to capture because of their rarity or unpredictable nature. In primary care the real reasons for a visit are frequently...

Muchas personas intentan hacer cambios saludables en sus vidas (dejar de fumar, de beber alcohol, hacer más ejercicio, etc), con más o menos éxito. Siempre ocurre que los primeros días, las primeras semanas, son las más difíciles de afrontar. Aquellos que lo intentan honestamente suelen encontrarse en una situación bastante complicada. Han abandona...

To evaluate how primary care physicians perceive and face clinical errors (CE) and/or adverse events (AE). Cross-sectional study (personal mail survey). SETTING. Primary care physicians from "Ambit Costa de Ponent." All doctors with tenure from this area (717). Standardized questionnaire with error and adverse event frequencies. We compared answers...

Objective To evaluate how primary care physicians perceive and face clinical errors (CE) and/or adverse events (AE). Design Cross-sectional study (personal mail survey). Setting Primary care physicians from “Ambit Costa de Ponent”. Participants All doctors with tenure from this area (717). Main measurements Standardized questionnaire with error...

In our view, the biopsychosocial model is a vision and an approach to practice rather than an empirically verifiable theory, a coherent philosophy, or a clinical method. In some cases, when that vision is confused with ideologic dogmatism, it can invite abandonment of the vision entirely or in selected situations. The authors suggest that habits of...

Francesc Borrell es médico, profesor de la Universidad de Barcelona y especialista en medicina de familia. A finales de los años ochenta publicó su Manual de Entrevista Clínica, que supuso una importante renovación en este campo. La entrevista semiestructurada que proponía en aquellas páginas es hoy una estrategia de referencia. Desde entonces ha t...

The biopsychosocial model is both a philosophy of clinical care and a practical clinical guide. Philosophically, it is a way of understanding how suffering, disease, and illness are affected by multiple levels of organization, from the societal to the molecular. At the practical level, it is a way of understanding the patient's subjective experienc...

While ascribing medical errors primarily to systems factors can free clinicians from individual blame, there are elements of medical errors that can and should be attributed to individual factors. These factors are related less commonly to lack of knowledge and skill than to the inability to apply the clinician's abilities to situations under certa...

Background: ignorance of the value of the phy- sical cervical exploration. Objective: to establish the predictivity and utility of several cervical maneuvres in relation to cervi-

Background. Ignorance of the value of the physical cervical exploration. Objective: To establish the predictivity and utility of several cervical maneuvres in relation to cervicoarthrosis. Design: descriptive transversal study with systematic sampling. Patients and methods: A series of 100 patients whom were realized a cervical radiological explora...

Nada más importante para la calidad de vida de un médico de familia que la gestión adecuada de la agenda de trabajo. Estamos en el paleolítico de una tecnología que va a aportarnos mucho. Desde el «cojan número, que el doctor ya les visitará», a nuestras agendas con cita previa hay un pequeño avance. Pero un avance que verdaderamente no ha contribu...

The expression of emotion and the sharing of information are determined by cultural factors, consultation time, and the structure of the health care system. Two emblematic situations in Spain - the expression of aggression in the patient-physician encounter, and the withholding of diagnostic information from the patient - have not been well-describ...