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Master Thesis

Place et abord de la problématique tabac dans l’autoformation des internes de médecine générale : analyse de 192 portfolios validés en septembre 2015

Abstract : Introduction: GPs are at the forefront of tobacco management. At the faculty of Medicine of Bordeaux, the validation of the DES of General Medicine is sanctioned by the writing of a memoir in the form of a Portfolio (PF), true support and reflection of their self-study. Each PF contains 22 clinical situations (12 complex and 10 simpler) experienced by the intern in general medecine (IGM), and for which are developed problematic (s) and argument (s). The PF also gives access to the gender of the IMG and its training course. Main objective: it is proposed to study the approach of the tobacco problem through the analysis of the PF of the interns of general medicine who validated their DES in 2015. Secondary objectives: To study the influence of the training course, of the kind of the IMG on the approach of the tobacco problem. To study the documentary sources mobilized to deal with the tobacco problem. Methods and results: Retrospective descriptive study of the traces of learning of the IMG of the University of Bordeaux. 192 PFs were analyzed (for 134 IGM women and 58 IGM men), thanks to the isolation of keywords and truncations related to the tobacco problem, making it possible to count the citations and arguments about the tobacco problem and thus to Calculating a rate of exposure / receptivity to the tobacco problem and a propensity to acquire skills around the tobacco problem. For all PFs, the exposure / receptivity rate is 27%, and the propensity to acquire competence is 3.2%. In complex situations, the screening rate is 24% and the reactivity rate is 63%. The rate of exposure / receptivity and propensity to acquire competence is heterogeneous across all PFs, ranging from 10% to 38% and from 0% to 9%, respectively, between the first and last decile. Internships at the highest rates are: Ambulatory General Medicine and Pneumology. There is no significant difference between male and female IMGs. Smoking cessation is the most discussed topic. IMGs rely mainly on French-speaking sources (80 %) with a first confidence in the HAS. However, the sources are quite diverse, as 91% of the sources (corresponding to 62% of the occurrences) are cited only one to three times. Conclusion: overall, IGMs exhibit sensitivity to the tobacco problem in their self-training. She shows more favorably during the course in General Medicine. However, this level of sensitivity is heterogeneous across all IMGs, and therefore needs to be improved so that each IMG can face the enormous challenges of the tobacco problem. The experimental method of portfolios analysis used here is reproducible for other problems.
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Master Thesis
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Submitted on : Tuesday, September 26, 2017 - 2:54:06 PM
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Toavina Andriamahefa. Place et abord de la problématique tabac dans l’autoformation des internes de médecine générale : analyse de 192 portfolios validés en septembre 2015. Médecine humaine et pathologie. 2017. ⟨dumas-01593606⟩



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