Marie-Claude Audétat

• M.Ps., Ma (Ed)., Ph.D in biomedical sciences, Faculty of medicine, Université de Montréal, Canada
• Professor (Associate) at University of Geneva

Contexte : Les scripts cliniques sont des réseaux de connaissances organisées pour l’action clinique que les cliniciens mobilisent afin d’accomplir leurs tâches de diagnostic et de prise en charge. Fondés sur les connaissances biomédicales que les étudiants apprennent lors de leurs premières années de formation, ces scripts cliniques se développent...

400 pages I 9782807360723 I 25,90 € Comment mieux superviser les étudiants en sciences de la santé dans leurs stages et dans leurs activités de recherche ? Vous supervisez des étudiants à l'hôpital ou en cabinet ? Vous dirigez des travaux de recherche? Ce livre est fait pour vous ! Il répond de façon résolument pratique aux préoccupations des ensei...

Introduction Despite the development of national recommendations and training programs for effective leadership, junior and senior medical leaders often find themselves ill-prepared to take on these new responsibilities. This study aimed to explore physicians’ perceptions, feelings, and beliefs regarding leadership and to provide recommendations re...

Contexte et problématique : Les stages en cabinet privé de médecine de famille offrent l’opportunité aux étudiants de développer les compétences nécessaires à la prise en charge ambulatoire. Les cliniciens enseignants qui accueillent les étudiants au sein de leur cabinet (CEC) doivent développer des outils pédagogiques spécifiques pour faire face a...

Background: Clinical teachers often struggle to record trainee underperformance due to lacking evidence-based remediation options. Objectives: To provide updated evidence-based recommendations for addressing academic difficulties among undergraduate and postgraduate medical learners. Methods: A systematic review searched databases including ME...

Background Because of COVID-19, the 2020 written medical examinations were replaced by mandatory formative online assessments. This study aimed to determine students’ performance, self-assessment of performance, and perception about the switch from a summative to a formative approach. Methods Medical students from year 2 to 5 (n=648) were included....

Introduction Effective leadership and management (L&M) are essential to the success of health care organizations. Young medical leaders often find themselves ill-prepared to take on these new responsibilities, but rarely attend training in L&M skills. The aims of this study were to evaluate physician’s self-perceived competencies and training needs...

Clinical reasoning is the cornerstone to healthcare practice and teaching it appropriately is of utmost importance. Yet there is little formal training for clinical supervisors in supervising this reasoning process. Distance education provides interesting opportunities for continuous professional development of healthcare professionals. This mixed...

La "bible" des formateurs et des enseignants en santé Comment construire un cas clinique ? Comment débriefer une séance de simulation ? Comment enseigner un geste ? Comment animer un cours magistral ? Comment former et évaluer à distance ? Comment motiver les étudiants ? Comment favoriser leur réflexivité ? Comment les aider à développer leur rai...

Background : Because of COVID-19, the 2020 written medical examinations were replaced by mandatory formative online assessments. This study aimed to determine students’ performance, self-assessment of performance, and perception about the switch from a summative to a formative approach. Methods : Medical students from year 2 to 5 (n=648) were inclu...

Contexte : L’apprentissage en milieu clinique est à la fois le plus riche pour les apprenants (résidents ou externes) et le plus stressant pour le superviseur (médecin), en particulier dans un contexte de salle d’attente surchargée, de situations critiques multiples, etc. Pourtant, il existe diverses stratégies que le clinicien-enseignant peut appl...

Background Physicians suffering from burnout are more likely to develop depression, substance dependence, and cardiovascular diseases, which can affect their practices. Stigmatization is a barrier to seeking treatment. This study aimed to understand the complex links between burnout among medical doctors and the perceived stigma. Methods and findi...

Background : Because of COVID-19, the 2020 written medical examinations were replaced by mandatory formative online assessments. This study aimed to determine students’ performance, self-assessment of performance, and perception about the switch from a summative to a formative approach. Methods : Medical students from year 2 to 5 (n=648) were inclu...

Background: Undergraduate Entrustable Professional Activities (EPAs) are intended to entrust future physicians with a number of clinical tasks from their first day of residency, in accordance with the competency-based medical education (CBME) reform. While the development and implementation of EPAs has been widely published in postgraduate, little...

Contexte et problématique : La littérature scientifique récente nous force à constater que les étudiants en médecine rencontrent des difficultés pour développer leurs raisonnement clinique. De plus, il semblerait qu’ils gagnent à être stimulés afin de raisonner. Or, ils manquent d’opportunités et de ressources pédagogiques à cet effet. Comment enco...

Introduction Effective leadership and management (L&M) are essential to the success of health care organizations. Young medical leaders often find themselves ill-prepared to take on these new responsibilities, but rarely attend training in L&M skills. The aims of this study were to evaluate physician’s self-perceived competencies and training needs...

Le raisonnement clinique est un processus cognitif qui correspond à un ensemble de pensées et prises de décisions permettant de résoudre les problèmes de santé posés aux professionnels de santé par leurs patients. Depuis une trentaine d’année, le raisonnement clinique fait l’objet de nombreuses recherches qui permettent de mieux en comprendre les p...

Clinical teachers use both clinical and teaching scripts when supervising students. The aims of the study were 1) to explore how teaching scripts are operationalized during supervision of clinical reasoning, and 2) to evaluate whether teaching scripts and their activation vary according to clinical teachers’ level of teaching experience. The resul...

Introduction GP’s clinical reasoning processes in the context of patients suffering from multimorbidity are often a process which remains implicit. Therefore, the goal of this case study analysis is to gain a better understanding of the processes at play in the management of patients suffering from multimorbidity. Methods A case study analysis, us...

Les universités suisses ont mis en place la réforme de l’éducation médicale par compétences en 2019. L’intégration des activités professionnelles confiables (entrustable professional activities - EPA ) pendant les stages est le changement le plus visible pour les étudiants et les superviseurs cliniques. Les EPA sont des activités ou des tâches médi...

In this conference, we have disseminated the findings of our latest research in regard to the clinical reasonning processes at play during the follow up and care of patients suffering from multimorbidity. We have highlighted the barriers and facilitators related to collaborative reasoning with healthcare professionals and patients.

Background: Clinical reasoning is a complex process that is central to medical practice. GPs who follow patients with multimorbidities have to combine several roles in their care. Metaphors are a language tool that potentially provides access to the clinical reasoning behind this management. Aim: To analyse the metaphors expressed by GPs to better...

The COVID-19 pandemics has deeply impacted academic teaching and forced a complete shift to distance learning formats during the first and second waves. Medical education, among other professional training programs, relies also on practical and clinical immersion, while some of these clinical activities had to be postponed. This article analyzes ho...

Cognitive biases are systematic cognitive distortions, which can affect clinical reasoning. The aim of this study was to unravel the most common cognitive biases encountered in in the peculiar context of the COVID-19 pandemic. Case study research design. Primary care. Single centre (Division of General Internal Medicine, University Hospitals of Gen...

Background The unfolding of the COVID-19 pandemic during spring 2020 has disrupted medical education worldwide. The University of Geneva decided to shift on-site classwork to online learning; many exams were transformed from summative to formative evaluations and most clinical activities were suspended. We aimed to investigate the perceived impact...

Objectives Despite the high prevalence of patients suffering from multimorbidity, the clinical reasoning processes involved during the longitudinal management are still sparse. This study aimed to investigate what are the different characteristics of the clinical reasoning process clinicians use with patients suffering from multimorbidity, and to w...

Aims of the study Residents in difficulty are a major cause for concern in medical education, with a prevalence of 7–15%. They are often detected late in their training and cannot make use of remediation plans. Nowadays, most training hospitals in Switzerland do not have a specific program to identify and manage residents in difficulty. The aim of...

Supervisors in clinical practice need to engage in continuous education so as to acquire the appropriate pedagogical tools to continue improving their teaching abilities. A new monthly « Pedagogical Quality Cercle » (PQC) has recently been developed to provide a virtual and innovative exchange of practices focused on supervisors' difficulties durin...

The COVID-19 pandemic has brought challenges that sparked a multitude of research questions at the Institutes of Family Medicine in Geneva and Lausanne. This article presents a synthesis of these questions, and the research projects that have resulted from them.

Due to the increasing complexity of medical education and practice, the training of healthcare professionals for leadership and management roles and responsibilities has become increasingly important. But gaps in physician leadership and management skills have been identified across a broad range of organizational and geographic settings. Many clin...

Background Most consultations in primary care involve patients suffering from multimorbidity. Nevertheless, few studies exist on the clinical reasoning processes of general practitioners (GPs) during the follow‐up of these patients. The aim of this systematic review is to summarize published evidence on how GPs reason and make decisions when managi...

Background Primary care physicians are at the very heart of managing patients suffering from multimorbidity. However, several studies have highlighted that some physicians feel ill-equipped to manage these kinds of complex clinical situations. Few studies are available on the clinical reasoning processes at play during the long-term management and...

Purpose As the COVID-19 pandemic outbreak occurred, most structured clinical communication training were transformed from in-person to remote seminars. The aim of our study was to evaluate the usefulness and feasibility of online synchronous clinical communication training from both students’ and tutors’ perspectives. Patients and Methods We condu...

The proposed viewpoint seems important at this time of the COVID-19 pandemic. Indeed, the COVID-19 prevention strategies implemented in the population are based on medical paradigms that generate extremely deleterious social and environmental impacts. Using the occupational health and safety perspective – taking care of myself with recyclables PPE...

Résumé Le raisonnement clinique étant central à la plus grande part des décisions prises en clinique, il est indispensable de l'enseigner avec la plus grande pertinence. Sachant qu'environ 10 % des apprenants rencontrent des difficultés majeures de raisonnement clinique au cours de leur cursus, la formation des superviseurs à des interventions péda...

Background: Junior clinical faculty require institutional support in the acquisition of feedback and clinical supervision skills of trainees. We tested the effectiveness of a personalized coaching versus guided self-reflection format of a faculty development program at improving faculty skills and self-efficacy. Methods: Participants were evaluated...

Nous présentons ici une vignette clinique d’une jeune patiente suivie en consultation de médecine interne générale afin d’illustrer les différents rôles du médecin généraliste superviseur dans son cabinet avec sa « double casquette » de clinicien et de superviseur. Pour superviser un apprenant lors du suivi d’une affection digestive chronique dont...

Background: Little is known about simulated students’ ability in assessing feedback received in Objective Structured Teaching Encounters (OSTEs). We aimed to assess to which extent students’ perceptions matched objective analysis regarding quality of received feedback, to explore what elements of feedback they emphasized and what they learned about...

Ambulatory medicine is faced with the challenge of continuing to offer high quality and efficient healthcare in the context of a rapidly increasing and aging population that typically suffers from chronic diseases.To better understand the challenges faced by clinical teachers in primary care, we set up a studies to explore the issues and difficulti...

Primary care clerkships are a valuable place for trainees to develop skills and clinical reasoning habilities. It is therefore crucial that clinical teachers involved in supervision be able to master supervision skills. However, what evidence do we have that our clinical teachers are competent to fulfill this responsibility? If we embrace the conce...

Facing uncertainty: humility, curiosity and sharing

Study objective: Clinical reasoning is considered a core competency of physicians. Yet there is a paucity of research on clinical reasoning specifically in emergency medicine, as highlighted in the literature. Methods: We conducted a scoping review to examine the state of research on clinical reasoning in this specialty. Our team, composed of conte...

Background: Clinical teachers often struggle to report unsatisfactory trainee performance, partly because of a lack of evidence-based remediation options. Objectives: To identify interventions for undergraduate (UG) and postgraduate (PG) medical learners experiencing academic difficulties, link them to a theory-based framework and provide literatur...

Background: Although clinical teachers can often identify struggling learners readily and reliably, they can be reluctant to act upon their impressions, resulting in failure to fail. In the absence of a clear process for identifying and remediating struggling learners, clinical teachers can be put off by the prospect of navigating the politically...

Faculty development is essential for renewing and assisting faculty to maintain teaching effectiveness and adapt to innovations in Health Professions educational institutions. The evaluation of faculty development programs appears to be a significant step in maintaining its relevance and efficiency. Yet, little has been published on the specific ca...

In this conference in French, we explored clinical reasoning processes used by nurses and presented efficient supervision strategies. Multimorbidity and its related challenges were used to to put forward the necessity of collaborative clinical reasoning between healthcare professionnals.

Multimorbidity, defined as 2 or more chronic diseases, is of increasing importance for health professionals. Many factors are at play when it comes to multimorbidity, but we still know very little about how clinicians actually weigh up the different factors—medical, social, and psychological—to reach a particular course of action. Further research...

Ce guide est le premier ouvrage en langue française destiné à aider les enseignants, formateurs et professionnels de la santé dans leurs missions de supervision des étudiants en stage et dans leurs activités de recherche. • À quoi doit servir le stage dans la formation des étudiants en sciences de la santé ? • Comment aider vos étudiants à dével...

MOOCs are Massive Open Online Courses aimed at providing online courses for free to an infinite number of participants. They promote access to education and are particularly interesting for professional training. A team of researchers from the faculty of medicine of the Université de Montréal (U de M) developed a comprehensive model of the clinical...

Background: Although clinical teachers can identify struggling learners readily and reliably, they are often reluctant to act upon their impressions, in the absence of clear or familiar subsequent steps. There is a specific need to help clinical teachers address clinical reasoning difficulties, which have significant implications for patient care....

Introduction: Medical students develop professional identity through structured activities and impromptu interactions in various settings. We explored if contributing to an Objective Structured Teaching Exercise (OSTE) influenced students’ professional identity development. Methods: University clinical faculty members participated in a faculty deve...

Background: Moving from postgraduate training into independent practice represents a major transition in physicians' professional life. Little is known about how Swiss primary care graduates experience such a transition. The aim of this study was to explore the extent to which primary care physicians who recently set up private practice felt prepa...

There are many obstacles to the timely identification of clinical reasoning difficulties in health professions education. This Guide aims to provide readers with a framework for supervising clinical reasoning and identifying the potential difficulties as they may occur at each step of the reasoning process. This Guide consists of two sections. Part...

This paper proposes a framework in order to evaluate students during their clerkship in outpatient clinics.

Purpose The predicted shortage of primary care physicians emphasizes the need to increase the family medicine workforce. Therefore, Swiss universities develop clerkships in primary care physicians’ private practices. The objective of this research was to explore the challenges, the stakes, and the difficulties of clinical teachers who supervised fi...

Objectives: Professional identity can be defined as a developmental process. Literature suggests that residents aiming to practice in a teaching institution should receive support for the development of teaching competencies as much as they do for medical competencies, but there is limited data on how to recognize teacher identity development in re...

Part II of this AMEE Guide provides a detailed overview of the main difficulties in clinical reasoning, including the cues to look out for in clinical supervision, the root causes of each difficulty and targeted remediation strategies. Specific challenges and issues related to the management of clinical reasoning difficulties will also be discussed...

There are many obstacles to the timely identification of clinical reasoning difficulties in health professions education. This guide aims to provide readers with a framework for supervising clinical reasoning and identifying the potential difficulties as they may occur at each step of the reasoning process.

When supervising a medical student or a doctor in training, it is useful to know the different stages of clinical reasoning in order to identify at what stage the learner encounters a difficulty in making the right decision. Is he having trouble characterizing the clinical problem ? Is he generating the right hypotheses that are adapted to the data...

In many countries, the number of graduating medical students pursuing a primary care career does not meet demand. These countries face primary care physician shortages. Students' career choices have been widely studied, yet many aspects of this process remain unclear. Conceptual models are useful to plan research and educational interventions in su...

Objectives: Supervision of communication competency in clinical settings in medicine is an important component of professional training. The purpose of this study was to describe the content and rationale of psychology and social work preceptor feedback to family medicine residents who express educational needs during case-based written vignettes....

Struggling medical trainees pose a challenge to clinical teachers, since these learners warrant closer supervision that is time-consuming and competes with time spent on patient care. Clinical teachers’ perception that they are ill equipped to address learners’ difficulties efficiently may lead to delays or even lack of remediation for these learne...

Teaching clinical reasoning is more like detective work than you might imagine ! When supervising a medical student or a doctor in training, it is useful to know the different stages of clinical reasoning in order to identify at what stage the learner encounters a difficulty in making the right decision. Is he having trouble characterizing the clin...

Problématique : La carte conceptuelle (CC) est une stratégie d’apprentissage populaire en éducation des sciences de la santé. Elle est notamment utilisée pour soutenir l’organisation des connaissances, dans l’apprentissage par problème (APP) en formation médicale pré-clinique. On dispose cependant de peu de données sur la meilleure façon de l’utili...

This conference present the results of a research conducted by the author and a colleague (Valérie Dory) to explore supervisors’ beliefs regarding the management of clinical reasoning difficulties (their role, norms and self-efficacy). Metaphors differed in the intensity of the relationship with residents. Changing the educational culture requires...

Introduction While clinical teachers generally identify problem learners readily, they often find themselves ill-equipped for the following steps, from diagnosis to remediation. Although various tools have been developed to guide them when dealing with problem learners whose difficulties are based in their clinical reasoning, theses tools might be...