About 5% of the European population report symptoms for which the doctor cannot find a medical cause that sufficiently explains their symptoms, even after adequate medical examinations. These Medically Unexplained Symptoms (MUS) are f.e. chronic fatigue, dizziness, abdominal discomfort, chronic lower back pain or non-cardiac chest pain. MUS represent 30-40% of the caseload of doctors and are one of the most expensive diagnostic categories in Europe. MUS consultations are perceived by many doctors in Europe as very difficult, especially when patients are from different ethnic minorities, have invalidating symptoms without underlying pathology and face substantial functional impairment. In practice most doctors feel incompetent to define with their patients a problem definition and are easily triggered to perform more additional medical investigations. There is a strong need for MUS education, that MUS-trained doctors better communicate and that doctors no longer perceive MUS care as too complex to address. The crucial challenges in MUS intercultural doctor-patient communication are differences in perspectives, values and beliefs about illness. MUS as well as intercultural doctor-patient communication (IC) gets not enough emphasis in undergraduate and postgraduate medical teaching in European countries despite the weight of the problem in healthcare. MUSIC aims to search for existing effective as well as new, promising patient-centered communication interventions focused on MUS and IC, and to transfer this information into competencies, assessments and education programmes to better prepare European doctors for their daily clinical encounters with ethnic minority MUS patients. The 5 concrete objectives of the MUSIC project are to develop a competency profile on patient-centered communication on MUS and IC, to synthesize and share expertise, methods and materials on MUS and IC into accessible information for medical students, residents and faculties, to develop and pilot blended training for teachers on MUS and IC, to develop and pilot blended training for medical students aimed at patient-centered communication focused on MUS and IC, to develop and pilot a blended Small Private Online Course (SPOC) for residents aimed at patient-centered communication on MUS and IC. These objectives are realised in 5 different IO’s and 3 multiplier events. The expected results of the project are a competency profile on patient-centered communication focused on MUS and intercultural communication, an online platform with validated and qualified information, resources and practical tools on MUS and intercultural doctor-patient communication for medical students, residents and teachers, a blended Teacher Programme on MUS and Intercultural doctor-patient communication to be accredited for Continuing Medical Education (50 teachers), a training programme on MUS and Intercultural Communication in the Bachelor phase (450 students), a blended Training programme on MUS and Intercultural Communication in the Master (232 students), a SPOC on MUS and Intercultural Communication for 75 residents, a narrative review on tools for communication with ethnic minority MUS patients to be published in open access journal, an open access article about the development and content of the several training programmes. Implementation and dissemination of the new training programmes will be accomplished by the staff of the Medical Schools of the partners and assisted by associated partners and other stakeholders. During the project execution TSPM will be used. TSPM is a methodology giving the partners a core set of processes to follow the projects objectives and results. Using this methodology the partners will be able to create a project roadmap, monitor time, cost and quality (project triple constraint), control change and scope, minimise risks and issues and manage their staff. In order to guarantee a high-quality and impact/cost effective project, the partners will use a monitoring and evaluation model which builds on the Partnership Effectiveness Model. MUSIC’s impact is students will acquire knowledge and skills that helps them to treat MUS patients from minority groups to the satisfaction of their patients and of themselves. The (associated) partners will be able to improve their training programmes for teachers and students thus contributing to an improved health care and health situation of patients from minority groups. The longer term benefits of MUSIC focus are an improved healthcare for ethnic MUS patients, less costs due to more effective consultations with ethnic minority MUS patients and less unnecessary referrals, an improved reinforcement of efficient healthcare networks focused on patients with MUS and a better cooperation between primary and secondary care as well as between mental health care and somatic care concerning ethnic minority MUS patients.
Context/background: About 5% of the European population report symptoms for which the doctor cannot find a medical cause that sufficiently explains their symptoms, even after adequate medical examinations. These Medically Unexplained Symptoms (MUS) are f.e. chronic fatigue, dizziness, abdominal discomfort, chronic lower back pain or non-cardiac chest pain. MUS represent 30-40% of the caseload of doctors and are one of the most expensive diagnostic categories in Europe. MUS consultations are perceived by many doctors as very difficult, especially when patients are from different ethnic minorities, have invalidating symptoms without underlying pathology and face substantial functional impairment. MUS and intercultural doctor-patient communication (IC) don't get enough attention in undergraduate and postgraduate medical teaching in European countries despite the weight of the problem in healthcare. Hence most doctors feel incompetent to define with their patients a shared problem definition and are easily triggered to perform more additional medical investigations than guidelines suggest, while patients often feel misunderstood. Crucial challenges in MUS intercultural doctor-patient communication are dealing with differences in perspectives, values and beliefs about illness. Objectives: To better prepare European doctors for their daily clinical encounters with ethnic minority MUS patients the MUSIC project had 5 objectives: - developing a competency profile on patient-centered communication on MUS and IC, - synthesizing expertise on MUS and IC into accessible information for medical students, residents and faculties, - developing blended training for teachers on MUS and IC, - developing blended training for medical students on MUS and IC, - developing a blended Small Private Online Course (SPOC) for residents aimed at patient-centered communication on MUS and IC. Number and type of participants: - Teachers: 55 medical teachers have been trained through an online course and in person on patient-centered communication on MUS & IC. - Medical students:460 Bachelor students and 782 Master students in Medicine have received education on MUS & IC. - Residents: 106 residents were trained by the renewed Blended Learning on MUS & IC. Description of undertaken activities: 5 Intellectual Outputs were realized and 3 Multiplier Events were organized. Monthly online meetings were held by the partnership to monitor the progress of activities. Additionally 8 Transnational Project Meetings were held to facilitate the interaction with stakeholders and deepen the cooperation as partners. Results attained: - a competency profile focused on MUS and intercultural communication on four levels (Ba, Ma students, residents and teacher). - an online platform with validated and qualified information, resources and practical tools on MUS and intercultural communication for medical students, residents and teachers, - a blended Teacher Programme on MUS and Intercultural doctor-patient communication accredited for Continuing Medical Education - a training programme on MUS and Intercultural Communication for Bachelor students - a blended Training programme on MUS and Intercultural Communication for Master students - a SPOC on MUS and Intercultural Communication for residents, - a narrative review in Journal Medical & Clinical Research, titled 'Perceptions and attitudes of health care givers and patients on MUS: a narrative review with focus on cultural diversity and migrants'. - Manuscript titled 'Education on MUS: a systematic review with a focus on cultural diversity and migrants' is submitted in 2021 to Journal Medical Education Online, under review. - implementation and dissemination of the developed training programmes has been accomplished by the staff of the MUSIC partnership in the curricula of the medical faculties. In some of the modules migrant training actors or patients take part in the education. - the article 'Epidemiology and organisation of care in MUS: a systematic review with a focus on cultural diversity and migrants' has been published in the International Journal of Clinical Practice, 2021. Impact attained: Students (Ba/Ma), teachers and residents have gained more know how, skills and a better understanding and attitude how to deal with complex consultations on migrant patients with MUS. The participating organisations improved their education for students, residents and teachers, and contributed to better health care for MUS patients from minority groups. Longer term benefits: An improved healthcare for MUS patients from minority groups, less costs due to more effective consultations with ethnic minority MUS patients and less unnecessary referrals, reinforcement of efficient healthcare networks focused on migrant patients with MUS and a better cooperation between primary and secondary care in the region as well as between mental health care and somatic care concerning ethnic minority MUS patients.