Marie-Claude Audétat

Marie-Claude Audétat
University of Geneva | UNIGE · Faculty of Medicine UDREM -UIGP

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

About

124
Publications
52,205
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Introduction
My experience in medical education spans the continuum of education from undergraduate to continuing professional development, and my research interests focus on clinical reasoning, and on the factors linked to clinical reasoning difficulties. I am also interested in how healthcare profesionnals think when following patients patients suffering from multimorbidity.
Additional affiliations
May 2014 - March 2020
University of Geneva
Position
  • Managing Director
January 2010 - April 2014
Université de Montréal
Position
  • Managing Director
July 2008 - April 2014
Université de Montréal
Position
  • Clinical Professor (Assistant) and clinical teacher

Publications

Publications (124)
Conference Paper
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...
Article
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...
Conference Paper
Full-text available
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.
Article
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...
Article
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...
Article
Full-text available
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...
Article
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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...
Article
Full-text available
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...
Article
Full-text available
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 o...
Article
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...
Article
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.
Article
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...
Article
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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...
Article
Full-text available
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...
Article
Full-text available
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 c...
Article
Full-text available
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...
Article
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...
Article
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...
Article
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...
Article
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...
Article
Full-text available
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...
Conference Paper
Full-text available
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...
Article
Full-text available
Facing uncertainty: humility, curiosity and sharing
Article
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...
Article
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...
Article
Full-text available
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...
Article
Full-text available
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...
Conference Paper
Full-text available
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.
Article
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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...
Book
Full-text available
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...
Article
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...
Conference Paper
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....
Article
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...
Article
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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...
Book
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...
Article
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This paper proposes a framework in order to evaluate students during their clerkship in outpatient clinics.
Article
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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...
Article
Full-text available
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...
Article
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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...
Article
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.
Article
Full-text available
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...
Article
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...
Article
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....
Article
Full-text available
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...
Article
Full-text available
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...
Article
Full-text available
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...
Conference Paper
Full-text available
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...
Conference Paper
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...
Book
Full-text available
Comment (mieux) former et évaluer les étudiants en médecine et en sciences de la santé ? En librairie et sur www.deboecksuperieur.com 9782804194239 • septembre 2016 • 480 pages • 16 x 24 cm • 27,00 € Voici LE guide de référence destiné à tous les enseignants et les soignants impliqués dans la formation des étudiants et des professionnels de san...
Article
Full-text available
Background: Switzerland is facing an impending primary care workforce crisis since almost half of all primary care physicians are expected to retire in the next decade. Only a minority of medical students choose a primary care specialty, further deepening the workforce shortage. It is therefore essential to identify ways to promote the choice of a...
Poster
Our aim was to identify potential difficulties met by clinical teachers who supervised voluntary final year medical students in private practice during a one-month pilot rotation in Geneva, Switzerland
Article
Full-text available
Background: Helping trainees develop appropriate clinical reasoning abilities is a challenging goal in an environment where clinical situations are marked by high levels of complexity and unpredictability. The benefit of simulation-based education to assess clinical reasoning skills has rarely been reported. More specifically, it is unclear if cli...
Article
Full-text available
Lorsque vient le temps d'enseigner la réalisation de gestes techniques, les cliniciens enseignants, soucieux à la fois de soutenir l'acquisition d'habiletés par leurs stagiaires et d'assurer la sécurité des patients, peuvent faire mieux que simplement appliquer l'ancienne méthode combinant observation, imitation et répétition 1 ou le vieil adage «...
Article
Objective: The aim of this study was to develop a descriptive tool for peer review of clinical teaching skills. Two analogies framed our research: (1) between the patient-centered and the learner-centered approach; (2) between the structures of clinical encounters (Calgary-Cambridge communication model) and teaching sessions. Method: During the...
Article
Full-text available
Objective To assess use of the remediation instrument that has been implemented in training sites at the University of Montreal in Quebec to support faculty in diagnosing and remediating resident academic difficulties, to examine whether and how this particular remediation instrument improves the remediation process, and