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Background and Objective: More than 600 trainees in family medicine (FM trainees) have participated in the Verbundweiterbildung(plus) (VWB(plus)) since this rotation network programme has been implemented in 2009. Mentoring as need-based support and counselling is an essential element of this programme. The aim of this study was to identify FM trainees' most frequent reasons for counselling in order to explore the qualifications and requirements to be a mentor., Methods: 141 e-mails written between December 2009 and July 2014 were analysed according to Mayring. This procedure generated thematic categories of common reasons for seeking counselling., Results: 32 % of all VWB(plus) participants asked mentors of the programme for advice. The most frequent questions (38 %) related to job vacancies, the application process and employment contracts. The second most common inquiries (30 %) referred to participation in the VWB(plus) as well as contents of education meetings within the VWB(plus). Other questions pertained to general aspects of postgraduate training in family medicine (16 %), individual conflict consulting (10 %) and funding applications (6 %)., Conclusion: The results of the needs assessment survey reveal that a mentoring programme needs competent advisors with experience in family medicine. While FAQ lists are helpful in answering general questions, specific requests such as, for example, a personal crisis require individual counselling provided by a mentor., (Copyright © 2016. Published by Elsevier GmbH.)

Introduction: Implementation research deals with the question of how to ensure that evidence-based knowledge is put into practice. One approach is the development of "tailored interventions (TI)". These are designed to address previously identified barriers and enablers. A common definition or methodological concept for TI has not yet been established. In this paper, a concept for TI is introduced. We describe the stepwise development of an implementation intervention for GP settings where recommendations based on current evidence are provided for the treatment of multimorbid patients receiving polypharmacy. Each step will be explained and illustrated by original data., Methods/results: A stepwise approach was used to develop a TI: problem analysis, identification and prioritisation of determinants, identification and prioritisation of strategies and the design of a complex intervention and its underlying logic model., Discussion: The stepwise exemplary description of this tailoring strategy may support other researchers in this field when designing a TI., (Copyright © 2013. Published by Elsevier GmbH.)

Background: Manual medicine (MM) has high importance in the ambulant treatment of complaints of the musculoskeletal system. Although there are several randomized controlled trials and meta-analyses, evidence about its efficacy is limited due to different organizations offering MM courses teaching different techniques. The aim of this study was to gain an understanding of the motivation and experiences of physicians using MM in daily practice., Methods: In a qualitative study, 21 semi-structured phone call interviews were performed with physicians who have an additional qualification in MM. Recruitment was done by sending an e-mail to every physician listed on the homepage of the German Society for Manual Medicine or known to be interested in MM research from a previous study. Interviews were performed, recorded, transcribed and evaluated content-analytically using the software program Atlas.ti., Results: One of the main motivations for using MM therapy was a better doctor-patient relationship because of improved patient access, with often rapid treatment success. Further advantages were the relative simplicity of the method, the independence from spatial or apparatus conditions and the associated low costs. Positive factors discussed as directly influencing the satisfaction with MM are the possibility to use own skills, the gratitude of the patient, and the possibility to influence the patient towards a healthy lifestyle. Factors negatively influencing the satisfaction were named as follows: the low gratification for the therapy, heterogeneous evidence, the indication in often self-limiting diseases, the risk of serious adverse effects and the risk of iatrogenic fixation., Conclusions: The results of this study show a wide range of mostly positive views and experiences of physicians when applying MM. The immediate curative action seems to be a welcome change for physicians who perceive the practice of their profession seen as distant from the patient., (Copyright © 2012 S. Karger AG, Basel.)

Background and Purpose: Due to the increasing lack of physicians, an ageing and thus multi-morbid society and a misdistribution of physicians in Germany primary care provided by general practitioners is at risk. Therefore, approaches to recruit more physicians for general practice are being sought. The aim of the present study was to explore individual motivations for choosing a career in general practice, vocational trainees' perspectives on the current situation of vocational training and to identify possible approaches to improve the situation with suggestions from vocational trainees in Germany., Methods: A qualitative study was conducted by interviewing 13 trainees. The interviews that were based on a predefined interview guideline were recorded and transcribed. The analysis was performed according to Mayring supported by the software Atlas.ti., Results: In general, the reasons given for choosing general practice include the holistic view towards patients, the opportunity to see the direct impact of therapies and self-employment. Furthermore, general practice was perceived as a job with a positive work-life balance. Barriers to vocational training are the lack of structure of individual rotations and the low salaries during the rotation in practice. Furthermore, the basic conditions for working as a self-employed general practitioner in Germany were described as being a disincentive. A general suggestion for improvement was to promote professional recognition of general practice at universities. A qualification of vocational trainers was requested. Specific suggestions were: better payment, better-structured rotations and a specific preparation for the self-employed general practitioner., Conclusion: The results of this study reveal that a single measure is insufficient for recruiting more young doctors for general practice. In fact, a package of measures is necessary to improve aspects of the vocational training but also general conditions for the profession., (Copyright © 2010. Published by Elsevier GmbH.)

Background: In Germany content-related vocational training mostly is the responsibility of the trainees themselves. The aim of this needs assessment is to explore the requirements of a longitudinal training course in vocational training., Methods: A combined quantitative-qualitative needs assessment was chosen. We used data of a continuous record keeping system in primary care to assess the occupational field, and the needs of vocational trainees were explored in a qualitative survey., Results: Data of more than 120,000 consulting problems in primary care were attributed to different medical expertises by frequency (orthopaedics 22.1%; internal medicine 17.2%; dermatology 12.2%; ear, nose, and throat medicine 11.9%). They revealed a high concordance between the needs derived from the consulting problems and the vocational trainees' needs identified in the qualitative survey (421 text units in the categories: medical expertise, competencies and skills and reflection on one's own performance)., Conclusion: The results of this needs assessment demonstrate the importance of vocational trainees' needs and the findings of health services research for improvement of content-related vocational training. Furthermore, the results form the basis for longitudinal training courses in vocational training, as shown in the approach of the training course within the training programme Verbundweiterbildung(plus)., (Copyright © 2010. Published by Elsevier GmbH.)

Background: The increasing shortage of (primary care) physicians in Germany is currently being discussed within and outside the profession. A national survey among general practice trainees aimed to explore their perspectives of vocational training (VT)., Methods: After translation, cultural adaptation and web implementation of the questionnaire of the "Vasco da Gama Movement," the survey was conducted during 2009. Descriptive analyses were performed., Results: Among 436 participants (mean age 36 years, 64% female, 49 months of VT) discipline-specific ("medically diverse discipline", "one-to-one care", and "holistic approach"), but also gender-related (females: "compatibility with family life", males: "autonomy and independence", and "opportunities to start their own practice") aspects were important to their choice of career. Despite the heavy workload job satisfaction, but not salary satisfaction, was generally high. Participants rated the following general conditions and content of VT as important: "structured rotations", "rotations in hospitals", "management skills", "working in a local care setting and in a multidisciplinary team" (all>88%)., Conclusions: These results provide clues to improving VT in General Practice with respect to organisation and content including the consideration of gender-related living conditions. Furthermore, improvement and further development of VT programmes should ideally be part of an area-wide, interdisciplinary and intersectoral approach., (Copyright © 2010. Published by Elsevier GmbH.)

Tinnitus is one of the 20 most common reasons why patients aged 45-64 years consult a general practitioner in Germany. In the literature a correlation is claimed between disease patterns of the cervical spinal column and nuclei of cerebral nerves. In the case report presented here, a 30-year-old female patient with acute tinnitus after acute hearing loss was cured from her tinnitus after a single manual medical treatment at C0/C1, which supports the correlation claimed. If cervical spine diseases should therefore regularly be included in the differential diagnoses of acute tinnitus is a matter of further research., (2010 S. Karger AG, Basel.)