RESUMEN
BACKGROUND: Postgraduate education, training and clinical governance in occupational medicine (OM) require easily accessible yet rigorous, research and evidence-based tools based on actual clinical practice. AIMS: To develop and evaluate an online resource helping physicians develop their OM skills using their own cases of work-related ill-health (WRIH). METHODS: WRIH data reported by general practitioners (GPs) to The Health and Occupation Research (THOR) network were used to identify common OM clinical problems, their reported causes and management. Searches were undertaken for corresponding evidence-based and audit guidelines. A web portal entitled Electronic, Experiential, Learning, Audit and Benchmarking (EELAB) was designed to enable access to interactive resources preferably by entering data about actual cases. EELAB offered disease-specific online learning and self-assessment, self-audit of clinical management against external standards and benchmarking against their peers' practices as recorded in the research database. The resource was made available to 250 GPs and 224 occupational physicians in UK as well as postgraduate OM students for evaluation. RESULTS: Feedback was generally very favourable with physicians reporting their EELAB use for case-based assignments. Comments such as those suggesting a wider range of clinical conditions have guided further improvement. External peer-reviewed evaluation resulted in accreditation by the Royal College of GPs and by the Faculties of OM (FOM) of London and of Ireland. CONCLUSIONS: This innovative resource has been shown to achieve education, self-audit and benchmarking objectives, based on the participants' clinical practice and an extensive research database.
Asunto(s)
Educación a Distancia , Educación Médica Continua/métodos , Medicina del Trabajo/educación , Benchmarking , Guías como Asunto , Humanos , Internet , Médicos , Reino UnidoRESUMEN
Relocation effects may be positive when residents are prepared for the move. The degree to which they exercise control over their environment and participate in the decision-making process influences the outcome of relocation. Planned interventions may offset adverse effects of stress. Prerelocation involvement of the residents we observed in visiting the new facility, and in selecting their bedrooms and roommates, reduced their anxiety to an acceptable, even positive level. These choices had a direct impact on their quality of life. The greater the number of choices the residents had, the more predictable the new environment became. Any stress generated became a positive, rather than a negative, force.